Association of ferritin and transferrin saturation with all-cause mortality, and the effect of concurrent inflammation: a danish cohort study

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The association between ferritin and transferrin saturation (TS), respectively, and all-cause mortality is unclear. Furthermore, the influence of concurrent inflammation has not been sufficiently elucidated. We investigated these associations and the effect of concurrently elevated C-reactive protein (CRP), and accordingly report the levels associated with lowest all-cause mortality for females and males with and without inflammation. Blood test results from 161,921 individuals were included. Statistical analyses were performed in sex-stratified subpopulations, with ferritin or TS level as continuous exposure variables, and were adjusted for age, co-morbidity and inflammation status using CRP. An interaction was used to investigate whether the effect of ferritin or TS on all-cause mortality was modified by inflammation status (CRP >= 10 mg/L or CRP < 10 mg/L). Low and high ferritin and TS levels were respectively associated with increased all-cause mortality in females and in males. These associations persisted with concurrent CRP >= 10 mg/L. The ferritin level associated with lowest mortality was 60 mu g/L for females and 125 mu g/L for males with CRP < 10 mg/L. It was 52 mu g/L for females and 118 mu g/L for males with CRP >= 10 mg/L. The TS level associated with lowest mortality was 33.9% for females and 32.3% for males with CRP < 10 mg/L. It was 28.7% for females and 30.6% for males with CRP >= 10 mg/L. Our findings can nuance clinical interpretation and further aid in defining recommended ranges for ferritin and TS.

Original languageEnglish
Book seriesScandinavian Journal of Clinical and Laboratory Investigation. Supplement
Issue number7-8
Pages (from-to)525-532
Publication statusPublished - 2022

    Research areas

  • Ferritins, transferrin, iron, iron metabolism disorders, iron deficiencies, iron overload, C-reactive protein, acute-phase proteins, acute-phase reaction, inflammation, mortality, public health, primary health care, GENERAL-POPULATION, SERUM FERRITIN, IRON

ID: 322940321