title: Elevated serum ferritin is associated with reduced survival in amyotrophic lateral sclerosis.
abstract: BACKGROUND
  Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder caused by the loss of motor neurons. Its etiology remains unknown, but several hypothesis have been raised to explain motor neuron death, including oxidative stress. Dysregulation of cellular iron metabolism can lead to increased oxidative stress, and existing data argue for a role of iron metabolism in ALS pathophysiology.
  
  
  METHODS
  We performed a retrospective analysis of iron metabolism (IM) variables (serum levels of iron, transferrin, ferritin, and TSC for Transferrin Saturation Coefficient) in a cohort of 694 ALS patients and 297 healthy controls.
  
  
  RESULTS
  Serum ferritin levels and TSC were higher, whereas serum transferrin levels were lower in ALS patients than controls. In addition, patients with a high level serum ferritin had a shorter survival time compared to those with low level serum ferritin (618 days versus 921 days for men subgroup; p = .007). Site of onset and ALS-FRS score were not associated with IM variables.
  
  
  CONCLUSIONS
  This study suggests that ALS patients may have increased iron storage, as measured by increased serum ferritin and TSC. Elevated serum ferritin may also have a deleterious impact on survival in ALS.
authors.affiliation: Fédération des Maladies du Système Nerveux, APHP, Centre de référence maladies rares SLA, Hôpital Pitié-salpêtrière, Paris, France. ynadjar@gmail.com
authors.forename: Yann
authors.initials: Y
authors.lastname: Nadjar
authors.forename: Paul
authors.initials: P
authors.lastname: Gordon
authors.forename: Philippe
authors.initials: P
authors.lastname: Corcia
authors.forename: Gilbert
authors.initials: G
authors.lastname: Bensimon
authors.forename: Laurence
authors.initials: L
authors.lastname: Pieroni
authors.forename: Vincent
authors.initials: V
authors.lastname: Meininger
authors.forename: François
authors.initials: F
authors.lastname: Salachas
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000097:blood* / Q000401:mortality*; D016022:Case-Control Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014168:Transferrin / Q000378:metabolism
chemical_list: D014168:Transferrin; D005293:Ferritins; D007501:Iron