Lower hemoglobin with lower ferritin - results from the HUNT 2 Study

Area of Science:

• Hematology
• Clinical Biochemistry
• Public Health

Background:

• Iron deficiency is a common cause of anemia.
• Serum ferritin (s-ferritin) is a key indicator of iron stores.
• Understanding hemoglobin (b-hemoglobin) and s-ferritin relationships is crucial for population health.

Purpose of the Study:

• To investigate the association between blood hemoglobin and serum ferritin in healthy females.
• To compare these findings with a prior study on female patients.
• To assess the prevalence of low hemoglobin across different s-ferritin levels.

Main Methods:

• Quantile regression analysis of b-hemoglobin percentiles against s-ferritin levels.
• Comparison of median b-hemoglobin and anemia fractions across s-ferritin ranges (10-100 μg/L).
• Inclusion of 2122 healthy women (aged 20-55) from the HUNT 2 survey with self-reported good health and normal creatinine.

Main Results:

• A downward shift in the entire b-hemoglobin distribution was observed for s-ferritin < 20 μg/L.
• Significantly lower median b-hemoglobin levels were found in women with s-ferritin < 20 μg/L.
• The fraction of women with anemia (b-hemoglobin < 12 g/dL) was 0.15 in the s-ferritin < 20 μg/L group.

Conclusions:

• Low serum ferritin is associated with reduced blood hemoglobin in a substantial portion of the healthy female population.
• The link between low iron stores and lower hemoglobin extends beyond conventionally defined anemia.
• These findings highlight the importance of considering s-ferritin levels for a broader assessment of iron status in women.