title: Evaluation of a model of latent pathologic factors in relation to serum ferritin elevation.
abstract: OBJECTIVE
  Serum ferritin increases in various disorders and clinical conditions. However, causal associations between the serum ferritin level and clinical factors that influence serum ferritin level are not well characterized. We report a model that quantitatively analyzes the causal relations between the serum ferritin level and clinical factors.
  
  
  METHODS
  We analyzed the ferritin level and other laboratory data in the sera of 274 patients. Structural equation modeling was used to verify causal relations and the adequacy of latent factors.
  
  
  RESULTS
  Three factors representing clinical status were identified: cell damage, hepatic function, and inflammation. Serum iron (SI) had the strongest effect on serum ferritin elevation. The effect of the cell damage factor on serum ferritin indicated cell destruction, and that of the hepatic function factor represented decreased serum ferritin clearance. The cell damage factor also indirectly increased the ferritin level via SI or the hepatic function factor. The total effect of the inflammatory status factor on ferritin level was very weak.
  
  
  CONCLUSIONS
  These causal relations may explain the mechanism of serum ferritin level elevation in various clinical conditions.
authors.affiliation: Laboratory for Clinical Investigation, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. yamaha@hp-lab.med.osaka-u.ac.jp
authors.forename: Hachiro
authors.initials: H
authors.lastname: Yamanishi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kimura
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Hata
authors.forename: Shigeru
authors.initials: S
authors.lastname: Iyama
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kanakura
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Iwatani
mesh_terms: D005293:Ferritins / Q000097:blood* / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology; D007501:Iron / Q000378:metabolism; D008099:Liver / Q000378:metabolism / Q000473:pathology; D015233:Models, Statistical; D015203:Reproducibility of Results
chemical_list: D005293:Ferritins; D007501:Iron