BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disorder with systemic effects that can impact liver function, inflammatory parameters, and hematological parameters other than those relating to joints. AIMS OF THE STUDY: The present study was designed to assess the levels of liver function tests, inflammatory markers, and hematological parameters in RA patients and to explore their correlation with age and gender differences. MATERIALS AND METHODS: This case–control study comprised 50 RA patients and 30 apparently healthy age- and sex-matched controls. Standard laboratory procedures were used to measure biochemical, inflammatory, and hematological markers. Data analysis was carried out with parametric, principal component analysis, hierarchical clustering, and correlation mapping and a P < 0.05 level of significance was set. RESULTS: RA patients exhibited significantly elevated total bilirubin (0.91 ± 0.42 vs. 0.68 ± 0.09 mg/dL), alkaline phosphatase (ALP) (107.80 ± 18.95 vs. 89.03 ± 4.60 U/L), C-reactive protein (28.58 ± 33.04 vs. 1.97 ± 0.85 mg/L), erythrocyte sedimentation rate (31.28 ± 9.62 vs. 6.03 ± 1.25 mm/L), platelet count, and white blood cell count compared with controls (P < 0.05). This was seen to be significantly different across the age groups for the markers ALP, alanine aminotransferase, aspartate aminotransferase, lymphocyte percentage (%), neutrophil-to-lymphocyte ratio, and bilirubin. Male and female patients had a significant elevation of inflammatory indices and selected hepatic parameters as compared to their respective controls, whereas a few of the hematological indices were not statistically different. CONCLUSIONS: These changes suggest inflammatory activation in RA and mild changes in the liver; the latter seem to be mainly inflammatory in nature and not due to direct damage to the hepatocytes. Routine blood liver function testing and inflammatory marker levels could be useful for assessing disease activity and systemic complications in patients with RA.
BACKGROUND: Acute myeloid leukemia is a hematological malignancy, characterized by abnormal proliferation of immature myeloid cells and impaired hematopoiesis. AIMS OF THE STUDY: Investigating the association of Monocyte Chemoattractant Protein-1 (MCP-1), Interleukin-8 (IL-8), tissue angiogenesis markers, and pathogenesis of acute myeloid leukemia (AML), and their potential role in the progression and prognosis of AML. METHODOLOGY: A case–control study that was carried out in Al-Habboubi Teaching Hospital, Iraq, from January 2024 to June 2025 to evaluate 100 participants diagnosed AML patients with 50 matched healthy controls. Blood was also taken to carry out complete blood count and serum tests. Biomarkers, measured with enzyme-linked immunosorbent assay and automated analyses, were MCP-1, IL-8, vascular endothelial growth factor (VEGF), angiopoietin-2, CRP, tumor necrosis factor-alpha, IL-6, ferritin, and lactate dehydrogenase. All the procedures were ethical as participants gave informed consent. RESULTS: Levels of MCP-1, IL-8, VEGF, and CD34 were significantly higher in the AML patients than in healthy controls (P < 0.001). Serum levels of the MCP-1 and VEGF appeared to be significantly elevated in AML cases. There was also strong, positive correlation between MCP-1 and IL-8 and between VEGF and CD34, suggesting a possible interaction between inflammatory and angiogenic pathways in AML. Multivariable logistic regression analysis showed that MCP-1 was independently associated with AML when adjusted for potential confounding factors (adjusted OR = 1.465, P = 0.021). CONCLUSIONS: Significantly higher levels of MCP-1, IL-8, VEGF, and CD34 were found to be associated with inflammatory and angiogenic changes in AML patients. Higher MCP-1 levels also were independently associated with AML, possibly reflecting microenvironmental changes associated with leukemic cell survival and progression.
BACKGROUND: Iron deficiency (ID) is the most prevalent nutritional deficiency and mainly affects pregnant women and women of childbearing age. The thyroid gland is responsive to iron status. This relationship is being increasingly recognized, but the published evidence is inconsistent and restricted to particular population groups. OBJECTIVE: The objective of the study was to study the effect of ID on thyroid function in early pregnancy. MATERIALS AND METHODS: Two hundred seventy-four pregnant women in their first trimester were recruited and classified into three groups according to their serum ferritin and hemoglobin concentrations: ID group, an ID anemia (IDA) group, and a healthy control (normal control [NC]) group. They then compared and evaluated thyroid markers between these groups which included thyroid stimulating hormone (TSH), total thyroxin, free thyroxin (FT4), and thyroid peroxidase antibodies (TPOAb). They also assessed the prevalence of thyroid dysfunction in each group. RESULTS: Higher levels of TSH and lower levels of FT4 were found in ID and ID compared to the NC group (P < 0.01) and in IDA compared to the ID group (P < 0.05). The IDA group showed higher concentrations of TPOAb compared to both the ID and NC groups. The rates of hypothyroidism and subclinical hypothyroidism were significantly higher in women in the anemic group compared to the other groups (P < 0.05). Furthermore, the frequency of TPOAb positivity was significantly higher in the anemic group than in the ID and NC groups (P < 0.05). CONCLUSION: In early pregnancy, ID, especially in the stage of anemia, has been linked with a hypothyroid state.
BACKGROUND: Hypoxia causes lipid accumulation in human hepatocytes. The effect of erythropoietin (EPO) on lipid metabolism and hepatosteatosis is unclear. Most studies suggest that serum ferritin is a predictor of advanced hepatosteatosis. AIM: The aim of this study was to investigate the relationship between EPO and ferritin levels and fatty liver in patients diagnosed with polycythemia. Out of 5840 patients screened, 292 were included in the study. EPO was absent in 74 patients, and ferritin was absent in 189 patients. MATERIALS AND METHODS: Data from 292 polycythemic patients (hemoglobin >16 g/dl in women, hematocrit >48 and >16.5 g/dl in men, erythropoietin, ferritin and degree of hepatosteatosis on abdominal ultrasonography) were used in the study. The relationship between ferritin and erythropoietin levels and fatty liver disease in these patients was examined. RESULTS: As the severity of liver steatosis increased, a significant increase was observed in the mean and median age values (P < 0.001). While no significant change was found in EPO levels according to the degree of steatosis (P = 0.636), ferritin levels tended to increase in terms of mean, especially in advanced steatosis (P = 0.09). It was determined that there was no statistically significant difference in gender distribution in the degree of steatosis group (P = 0.208). Hepatosteatosis was related to age and may affect ferritin levels. CONCLUSION: Hepatosteatosis appears to be age-related and may affect ferritin levels. A direct link between EPO and steatosis has not been supported. The tendency for a nonsignificant increase in ferritin levels with the degree of steatosis is supported by the literature.
This study examines the impact of frailty on clinical outcomes among patients with myelodysplastic syndrome (MDS), a heterogeneous group of neoplasms arising from abnormalities in hematopoietic stem cell proliferation and differentiation in the bone marrow. Frailty reflects increased vulnerability to internal and external stressors. Patients with both MDS and frailty were identified using the 2021–2022 National Inpatient Sample (NIS) through International Classification of Diseases, Tenth Revision codes. Clinical outcomes of interest included risk of mortality, severity of illness, length of stay, and hospitalization costs. To estimate the association between these outcomes and frailty, ordered logistic regression was used for mortality risk and severity of illness (ordinal variables), while linear regression was applied for length of stay and hospitalization costs (continuous variables). To further reduce potential confounding, propensity score matching (PSM) was also employed as a robustness check. According to our PSM results, which provide a more balanced comparison between frail and nonfrail patients, frail MDS patients had higher odds of being in a higher mortality risk category (odds ratio [OR] = 1.227, 95% confidence interval [CI]: 1.133–1.330, P < 0.001) and in a higher severity of illness category (OR = 1.453, 95% CI: 1.339–1.577, P < 0.001). They also experienced longer hospital stays (β = 1.33, 95% CI: 0.93–1.72, P < 0.001) and higher hospitalization costs (β = 0.08, 95% CI: 0.04–0.12, P < 0.001). Frail patients also have greater rates of hemochromatosis (OR = 1.45, 95% CI: 1.003–2.096, P < 0.043). Our findings suggest that having both frailty and MDS may contribute to greater clinical and economic burden, efforts to address frailty in patients with MDS may help reduce disease severity, mortality risk, length of hospital stay, and hospitalization costs.
