title: Lower hemoglobin with lower ferritin: It is not just a question of anemia.
abstract: OBJECTIVE
  To study the association between blood hemoglobin concentration (b-hemoglobin) and serum ferritin concentration (s-ferritin) in an ambulant patient population without inflammation and with normal kidney function.
  
  
  METHODS
  In ambulant, adult patients with normal values of s-CRP and s-creatinine, median b-hemoglobin and the fraction with anemia was compared in groups with lower s-ferritin from a level of 100 μg/L. The 10, 50 and 90 percentiles of b-hemoglobin were modelled as functions of s-ferritin using quantile regression.
  
  
  RESULTS
  Among 3206 women the entire b-hemoglobin distribution was shifted downwards in patients with s-ferritin less than 20 μg/L. Accordingly, the median b-hemoglobin was statistically significantly lower and the fraction with anemia was higher. In 1246 men the findings were similar, except that the turning point toward lower b-hemoglobin was at a s-ferritin level of 30 μg/L.
  
  
  CONCLUSIONS
  Low s-ferritin is associated with decreased b-hemoglobin in many more subjects than those labelled anemic.
authors.affiliation: Department of Clinical Chemistry, Trondheim University Hospital , Trondheim , Norway.
authors.forename: Arne
authors.initials: A
authors.lastname: Asberg
authors.forename: Gustav
authors.initials: G
authors.lastname: Mikkelsen
authors.forename: Ketil
authors.initials: K
authors.lastname: Thorstensen
authors.forename: Ann E
authors.initials: AE
authors.lastname: Asberg
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D006454:Hemoglobins; D005293:Ferritins; C020622:hemoglobin B; D007501:Iron