Iron Metabolism Disorders Associated With the Severity of Pyogenic Liver Abscess

Pyogenic liver abscess (PLA) is a serious intra-abdominal infection with high morbidity and mortality. Current diagnostic methods are time-consuming, inefficient and high-cost. Rapid identification/assessment of PLA and early recognition of bacterial liver abscess (BLA) improve prognosis. Iron metabolism disorders play a critical role in infections, but their role in PLA (especially ferritin) remains unclear. Notably, dietary nutrition, as a modulator of iron metabolism/immune function, may influence PLA progression, with limited research. In this study, we collected clinical data of 125 PLA patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database to identify rapid, low-cost severity biomarkers, and verified them by an independent clinical cohort of 36 patients from Peking University Third Hospital. We analyzed the correlation between iron metabolism and disease severity, explored independent risk factors, and evaluated diagnostic efficiency via receiver operating characteristic (ROC) curves. Iron metabolism disorders were observed in patients with PLA and correlated strongly with liver dysfunction and systemic inflammation. Ferritin was associated with disease severity and served as an independent prognostic marker, with optimal cut-offs of 390 ng/mL for predicting severe PLA and 748 ng/mL for identifying BLA. This study identifies ferritin as a promising multifaceted biomarker for PLA which not only reflects disease severity but also aids in the early identification of bacterial etiology. Additionally, the findings provide a basis for dietary nutritional interventions in PLA management.