The association of ferritin with cardiovascular and all-cause mortality in community-dwellers: The English longitudinal study of ageing

Background: Ferritin constitutes a sensitive iron-storage index and multi-functional protein. Evidence on its association with mortality in general population is scarce and conflicting. We investigated the sex-specific associations of ferritin levels with all-cause and cardiovascular mortality in a population-based cohort. Methods: Data came from the English Longitudinal Study of Ageing and the national mortality registry. The sample comprised 5,471 participants aged ≥52 years. Blood concentration of ferritin was measured at baseline in 2004–05. Sex-specific Cox proportional hazards models were estimated with adjustment for age, major chronic diseases, marital status, educational attainment, total net household wealth, anemia, inflammatory markers, body mass index, smoking, and physical activity. Stratified analyses by chronic disease status were also performed. Results: We categorized ferritin in sex-specific quartiles. In men, we used, the following categorization: lowest (2-69ng/ml), second lowest (70-118ng/ml), second highest (reference category) (119-193ng/ml) and highest (194-598ng/ml) ferritin quartiles. In women, ferritin was categorized as follows: lowest (2-44ng/ml), second lowest (45-73ng/ml), second highest (reference category) (74-115ng/ml) and highest (116-341ng/ml) ferritin quartiles. 841 deaths of which 262 cardiovascular disease-related were recorded over a mean follow-up time of 7.7 years. Risk for all-cause mortality was found increased in men with hyperferritinemia (194-598ng/ml) and no history of major chronic diseases compared with the reference group [fully-adjusted HR: 1.49 (95%CI 1.03–2.16)]. Among women, those in the lowest ferritin quartile (2-44ng/ml) had increased risk for all-cause mortality [fully-adjusted HR: 1.59 (95%CI 1.18–2.13)] compared with the reference group after adjustment for all covariates. Regarding cardiovascular mortality, we observed a positive association with ferritin levels in men, which was blunted after adjustment for inflammatory markers and lifestyle parameters. Men with no major chronic diseases who were in the highest ferritin quartile had a significantly increased risk of cardiovascular mortality. No association between ferritin levels and cardiovascular mortality was detected in women. Conclusion: Circulating ferritin levels showed sex-specific prognostic patterns. High ferritin levels in men with no major chronic disease and low ferritin levels in all women were associated with increased all-cause mortality after adjusting for covariates. High ferritin levels in men with no major chronic diseases were also independently associated with an increased risk of cardiovascular mortality. Future research is needed to clarify the prognostic role of ferritin

Numerous published biomarker prognostic models for heart failure exist, but none is officially recommended in clinical guidelines:a paradox or a research scandal/failure?

Trillmich F. Effects of low temperature and photoperiod on reproduction in the female wild guinea pig (Cavia aperea). JOURNAL OF MAMMALOGY. 2000;81(2):586-594.Small mammals in the tropics and subtropics usually rely opportunistically on favorable environmental conditions for breeding rather than base their breeding decision on prediction from photoperiodic cues as most high-latitude species do. Species producing precocial young may be more likely to reproduce aseasonally than species with altricial young. For female wild guinea pigs (Cavia aperea) from Argentina (35 degrees S) that produce extremely precocial young, these hypotheses would predict moderate responsiveness of female reproduction to photoperiod. These predictions were tested in a series of laboratory experiments. Guinea pigs reproduced aseasonally when kept under natural photoperiod and temperatures at Bielefeld (52 degrees 01'N, 8 degrees 32'E). When given short days (9L:15D) and long days (14L:10D) under indoor temperature conditions (20-23 degrees C), no effect of photoperiod on female reproduction was noted. A shift from long day length (14L:10D) to short day length (9L:15D) did not stop reproduction. Increasing energy expenditure for thermoregulation at low temperature (5 degrees C) under long-day (14L:10D) conditions also did not inhibit reproduction. Wild guinea pigs thus reproduce throughout the year without respect to photoperiod as long as food and temperature conditions allow reproduction