title: Serum Iron Level Is Associated with Time to Antibiotics in Cystic Fibrosis.
abstract: BACKGROUND
  Serum levels of hepcidin-25, a peptide hormone that reduces blood iron content, are elevated when patients with cystic fibrosis (CF) develop pulmonary exacerbation (PEx). Because hepcidin-25 is unavailable as a clinical laboratory test, we questioned whether a one-time serum iron level was associated with the subsequent number of days until PEx, as defined by the need to receive systemic antibiotics (ABX) for health deterioration.
  
  
  METHODS
  Clinical, biochemical, and microbiological parameters were simultaneously checked in 54 adults with CF. Charts were reviewed to determine when they first experienced a PEx after these parameters were assessed. Time to ABX was compared in subgroups with and without specific attributes. Multivariate linear regression was used to identify parameters that significantly explained variation in time to ABX.
  
  
  RESULTS
  In univariate analyses, time to ABX was significantly shorter in subjects with Aspergillus-positive sputum cultures and CF-related diabetes. Multivariate linear regression models demonstrated that shorter time to ABX was associated with younger age, lower serum iron level, and Aspergillus sputum culture positivity.
  
  
  CONCLUSIONS
  Serum iron, age, and Aspergillus sputum culture positivity are factors associated with shorter time to subsequent PEx in CF adults.
authors.affiliation: Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: Alex H
authors.initials: AH
authors.lastname: Gifford
authors.affiliation: Translational Research Core, Dartmouth Lung Biology Center, Lebanon, New Hampshire, USA.
authors.forename: Dana B
authors.initials: DB
authors.lastname: Dorman
authors.affiliation: Translational Research Core, Dartmouth Lung Biology Center, Lebanon, New Hampshire, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Moulton
authors.affiliation: Translational Research Core, Dartmouth Lung Biology Center, Lebanon, New Hampshire, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Helm
authors.affiliation: Translational Research Core, Dartmouth Lung Biology Center, Lebanon, New Hampshire, USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Griffin
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
authors.forename: Todd A
authors.initials: TA
authors.lastname: MacKenzie
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001230:Aspergillus; D015992:Body Mass Index; D002648:Child; D003550:Cystic Fibrosis / Q000097:blood* / Q000188:drug therapy* / Q000382:microbiology; D057286:Electronic Health Records; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006454:Hemoglobins / Q000032:analysis; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007501:Iron / Q000097:blood*; D016014:Linear Models; D008171:Lung Diseases / Q000097:blood / Q000188:drug therapy; D008297:Male; D015999:Multivariate Analysis; D013147:Spirometry; D013183:Sputum / Q000382:microbiology; D061665:Time-to-Treatment; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D006454:Hemoglobins; D064451:Hepcidins; C545475:hepcidin 25, human; D007501:Iron
keywords: Aspergillus; age; cystic fibrosis; exacerbation; iron