title: [Study on abnormal iron metabolism and iron overload in patients with aplastic anemia].
abstract: OBJECTIVE
  To investigate the abnormalities of iron metabolism, the prevalence and risk factors of iron overload and clinical characteristics of patients with aplastic anemia (AA).
  
  
  METHODS
  A cross-sectional study was conducted on 520 newly diagnosed AA patients.
  
  
  RESULTS
  Iron overload was observed in 66(13%) of 520 AA patients,in which a higher prevalence of iron overload was seen not only in patients with infections(19/86, 22%)than those without infections (47/434, 11%, P<0.01), but also in patients with hepatitis associated AA(HAAA) (6/22, 19%) than the idiopathic cases (60/488, 12%, P>0.05). Excluded the patients with infections and/or HAAA, 43 of 405(11%)cases had iron overload, including 14 of 248(6%) cases without history of blood transfusion and 29 of 157 patients (18%, P<0.01) with transfusion. In univariate analysis, higher levels of serum ferritin (SF), serum iron (SI) and transferrin saturation (TS) were mainly observed in adult male patients with severe AA (SAA) and significantly upward with increasing blood transfusion (P<0.01). No differences of soluble transferrin receptor (sTfR) were observed between adults and children, males and females, hepatitis and idiopathic AA. However, patients with infections had significantly lower level of sTfR (0.50 mg/L) than cases without infections (0.79 mg/L, P<0.01). The level of sTfR in SAA patients (0.70 mg/L) was only half of that in non-SAA (NSAA) (1.36 mg/L, P<0.01). Patients with increasing blood transfusion had significantly downward levels of sTfR (P<0.01). In multivariate analysis, more than 8 U blood transfusion (OR=10.52, P<0.01), adults (OR=3.48, P<0.01), males (OR=3.32, P<0.01) and infections (OR=2.09, P<0.01) were independent risk factors.
  
  
  CONCLUSIONS
  AA patients had higher iron burden and were high-risk populations occurring iron overload. The iron overload occurred in 18% of patients with blood transfusion and in 6% of patients without transfusion.
authors.affiliation: Institute of Hematology and Blood Disease Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Jin
authors.forename: Jun
authors.initials: J
authors.lastname: Shi
authors.forename: Xing-xin
authors.initials: XX
authors.lastname: Li
authors.forename: Ying-qi
authors.initials: YQ
authors.lastname: Shao
authors.forename: Neng
authors.initials: N
authors.lastname: Nie
authors.forename: Mei-li
authors.initials: ML
authors.lastname: Ge
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhen-dong
authors.initials: ZD
authors.lastname: Huang
authors.forename: Jin-bo
authors.initials: JB
authors.lastname: Huang
authors.forename: Yi-zhou
authors.initials: YZ
authors.lastname: Zheng
mesh_terms: D000741:Anemia, Aplastic / Q000150:complications / Q000503:physiopathology*; D001803:Blood Transfusion; D005293:Ferritins / Q000097:blood; D006505:Hepatitis / Q000150:complications; D006801:Humans; D007501:Iron / Q000097:blood / Q000378:metabolism*; D019190:Iron Overload / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D005293:Ferritins; D007501:Iron