Ferritin, Serum Iron and Hemoglobin as Acute Phase Reactants in Laparoscopic and Open Surgery of Cholecystectomy: An Observational Prospective Study

Acute changes in serum iron concentrations in anesthetized healthy horses

OBJECTIVE

To determine if serum iron concentrations decrease acutely during and after general anesthesia in healthy horses.

STUDY DESIGN

Prospective experimental study.

ANIMALS

A convenience sample of 24 healthy adult horses (eight females, 16 geldings), weighing 545 ± 33 kg (mean ± standard deviation).

METHODS

Horses were anesthetized for 120 minutes with isoflurane, after premedication with intravenous (IV) xylazine (0.8 mg kg-1) and induction with IV midazolam (0.1 mg kg-1) and ketamine (2.2 mg kg-1). Blood samples for serum iron analysis were obtained just before premedication (baseline), after 60 minutes of anesthesia (T60), after 120 minutes of anesthesia (T120), immediately after recovery (TREC) and 24 hours after induction (T24). Serum iron values are reported as mean ± standard deviation.

RESULTS

Serum iron concentration was 152 ± 29 μg dL-1 at baseline, with reductions at other time points: 136 ± 25 μg dL-1 at T60, 133 ± 26 μg dL-1 at T120, 136 ± 26 μg dL-1 at TREC and 63 ± 19 μg dL-1 at T24.

CONCLUSIONS AND CLINICAL RELEVANCE

Serum iron concentrations acutely decrease in healthy horses during and after general anesthesia for at least 24 hours. General anesthesia may interfere with the use of serum iron for detecting and monitoring systemic disease and inflammation in horses.

Threshold Ferritin Concentrations Reflecting Early Iron Deficiency Based on Hepcidin and Soluble Transferrin Receptor Serum Levels in Patients with Absolute Iron Deficiency

(1) Background: The serum ferritin cut-off to define absolute iron deficiency is not well-established. The aim of the present study was to determine a clinically relevant ferritin threshold by using early serum biomarkers of iron deficiency such as hepcidin and the soluble transferrin receptor; (2) Methods: Two hundred and twenty-eight asymptomatic subjects attending a hospital as outpatients between 1st April 2020 and 27th February 2022 were selected. Iron metabolism parameters as part of the blood analysis were requested by their doctor and included in the study. Then, they were classified into groups according to their ferritin levels and iron-related biomarkers in serum were determined, quantified, and compared between ferritin score groups and anemic subjects. (3) Results: Serum ferritin levels below 50 ng/mL establish the point from which the serum biomarker, the soluble transferrin receptor to hepcidin ratio (sTfR/Hep ratio), begins to correlate significantly with ferritin levels. (4) Conclusion: Ferritin levels ≤ 50 ng/mL are indicative of early iron deficiency; hence, this should be considered as a clinically relevant cut-off for iron deficiency.