Materiały źródłowe

• #1 British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults | Gut

  https://gut.bmj.com/content/70/11/2030

  Iron deficiency anaemia (IDA) is common, and a major cause of morbidity worldwide (evidence quality high, consensus 100%, statement strength strong). […] IDA can be caused by a range of GI pathologies including cancer, and so GI investigation on an urgent basis should be considered in adults with a new diagnosis of IDA without obvious explanation (evidence quality high, consensus 85%, statement strength strong). […] Hb levels normalise with iron replacement therapy (IRT) in most cases of IDA, but IDA recurs in a minority of these on long-term follow-up (evidence quality low, consensus 92%, statement strength strong). […] We recommend that long-term IRT may be an appropriate strategy when the cause of recurrent IDA is unknown or irreversible (evidence quality low, consensus 100%, statement strength strong). […] After the restoration of Hb and iron stores with IRT, we recommend that the blood count should be monitored periodically (perhaps every 6 months initially) to detect recurrent IDA (evidence quality very low, consensus 85%, statement strength strong).

• #2 Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6163749/

  Acute myocardial infarction remains a leading cause of morbidity and mortality. […] We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). […] Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p = 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI). […] This association remained significant (HR 1.73 (95% CI 1.07-2.81; p = 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). […] Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome. […] Iron deficiency is a wide-spread comorbidity in ACS, which is strongly associated with adverse outcome in the mid-term, independent of systolic heart function, the size of myocardial necrosis, and anemia.

• #3 Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30037035/

  Acute myocardial infarction remains a leading cause of morbidity and mortality. […] We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). […] Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p= 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI). […] This association remained significant (HR 1.73 (95% CI 1.07-2.81; p= 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). […] Survival analyses for cardiovascular mortality and MI provided further evidence for the prognostic relevance of iron deficiency (HR 1.50 (95% CI 1.02-2.20)). […] Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome.

• #4 Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome

  https://www.mdpi.com/2218-273X/8/3/60

  Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p = 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI) […] This association remained significant (HR 1.73 (95% CI 1.07–2.81; p = 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). […] Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome. […] Iron deficiency is a wide-spread comorbidity in ACS. It is strongly associated with adverse outcome in the mid-term, independent of systolic heart function, size of myocardial necrosis, and anemia.

• #5 Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30037035/

  Acute myocardial infarction remains a leading cause of morbidity and mortality. […] We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). […] Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p= 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI). […] This association remained significant (HR 1.73 (95% CI 1.07-2.81; p= 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). […] Survival analyses for cardiovascular mortality and MI provided further evidence for the prognostic relevance of iron deficiency (HR 1.50 (95% CI 1.02-2.20)). […] Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome.

• #6 Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6163749/

  Acute myocardial infarction remains a leading cause of morbidity and mortality. […] We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). […] Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p = 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI). […] This association remained significant (HR 1.73 (95% CI 1.07-2.81; p = 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). […] Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome. […] Iron deficiency is a wide-spread comorbidity in ACS, which is strongly associated with adverse outcome in the mid-term, independent of systolic heart function, the size of myocardial necrosis, and anemia.

• #7 Serum iron: a new predictor of adverse outcomes independently from serum hemoglobin levels in patients with acute decompensated heart failure | Scientific Reports

  https://www.nature.com/articles/s41598-021-82063-0

  Low serum iron was an independent predictor of poor prognosis in ADHF, irrespective of hemoglobin or ferritin level, providing a new concept that iron may play a role in the pathophysiology of ADHF via non-hematopoietic roles. […] The present study investigated the significance of serum iron levels in patients with ADHF and demonstrated that serum iron level is independently associated with poor prognosis in patients with ADHF. […] Our finding that CRP was associated with low iron levels supports this theory. […] Notably, low iron level was an independent predictor of adverse outcomes even in multivariate analysis including hemoglobin and MCV. […] These findings may imply that the significance of iron is shifting from the cause of anemia toward the more direct effects of iron itself on non-hematopoietic tissues such as cardiac muscle and skeletal muscles.

• #8 Serum iron: a new predictor of adverse outcomes independently from serum hemoglobin levels in patients with acute decompensated heart failure | Scientific Reports

  https://www.nature.com/articles/s41598-021-82063-0

  Therefore, serum iron may have important roles unrelated to anemia. […] In this study, the serum iron cutoff value was 64 g/dL based on ROC curve analysis. […] Our results suggest that intravenous iron administration may be useful even in the acute phase of HFrEF. […] Our findings suggest that iron administration may be a new therapeutic target in HFpEF. […] We demonstrated that low iron level was an independent poor prognostic factor in ADHF, irrespective of hemoglobin or ferritin level.

• #9 How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-022-00922-6

  Iron deficiency (ID) is associated with poor clinical outcome, including poor performance, reduced quality of life, as well as increased hospitalization and mortality. […] A low iron status and particularly a low TSAT value was associated with a poor outcome in all investigated indications, with the strongest evidence in HF patients. […] ID as a medical condition uncoupled from ID anemia was demonstrated in many trials with HF patients. It was shown that the presence of ID affects outcome, irrespective of anemia. […] Patients with HF and ID were associated with poor health status, higher morbidity and mortality. […] In some studies, negative outcomes were directly associated with low TSAT levels regardless of ferritin. […] A persistence of ID with TSAT20% in HF patients both at baseline and at 6 months was strongly associated with higher mortality compared with never having ID, superior to ID based on serum ferritin levels.

• #10 How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-022-00922-6

  Thus, TSAT may be used as a marker for prognosis in HF patients. […] In CKD, ID is often associated with a negative clinical impact. […] However, it should be noted that the diagnosis and treatment of ID without anemia is not well studied in CKD. […] Irrespective of the presence of ID with or without anemia, the study results provide a correlation between low iron status and clinical outcome in patients with non-dialysis (ND)/hemodialysis (HD)-CKD. […] In an analysis of approx. 2500 ND-CKD patients, a significantly lower physical health-related QoL was found for ID (measured by low TSAT level) after adjustment for Hb levels. […] The worse outcome of ID in CKD reflects the major importance of its diagnosis and treatment. […] In IBD, a routine monitoring of serum ferritin and TSAT is recommended to detect and treat ID, although most results about iron laboratory parameters derive from expert recommendations or reviews and clinical impact is not well studied.

• #11 How to diagnose iron deficiency in chronic disease: A review of current methods and potential marker for the outcome | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-022-00922-6

  Clinical data about ID without anemia in gastroenterology are still rare. […] However, one study found a relation between the treatment of ID and an improvement in the QoL of IBD patients. […] ID was more frequent in this trial than ID anemia with a prevalence of 33.0%. […] Overall, oncologic patients with anemia showed worse outcome as those without anemia, related to the progressive stadium of the disease and the fact that anemia can be a limiting factor for cancer treatment. […] Thus, anemic cancer patients had a higher risk of dose reductions and discontinuation in chemotherapy, poor prognosis and significantly shorter overall survival. […] Therefore, the iron status may provide information about medical outcome, making the monitoring and treatment of iron parameters essential. […] A higher hospitalization rate was observed in HF and CKD in correlation with ID. […] A higher risk of morbidity, mortality and reduced QoL within all indications was associated with reduced iron levels.

• #12 The prevalence of iron deficiency and anemia and their impact on survival in patients at a cardio-oncology clinic | Cardio-Oncology | Full Text

  https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-020-00086-4

  Iron deficiency (ID) and anemia are common in both heart failure (HF) and cancer patients and are associated with poor quality of life and survival. […] About half of cardio-oncology patients had anemia and iron deficiency, with the absolute type being twice as prevalent as the functional one. […] Both anemia and iron deficiency independently predicted all-cause mortality. […] The prognostic impact of different factors is presented in Table 4. Using univariate Cox regression model we found that male gender, cancer location except hematologic and other type of cancer, previous cancer history, elevated BNP (20ng/L), TSAT 20%, ferritin < 100g/L, serum iron concentration < 12 umol/L and anemia were significantly associated with increased risk of all-cause death. [...] The present study's critical findings are that ID is ubiquitous in cardio-oncology patients, AID is more prevalent than FID, and the iron deficit is a significant factor associated with prognosis and clinical outcomes in this population.

• #13 The prevalence of iron deficiency and anemia and their impact on survival in patients at a cardio-oncology clinic | Cardio-Oncology | Full Text

  https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-020-00086-4

  Iron deficiency (ID) and anemia are common in both heart failure (HF) and cancer patients and are associated with poor quality of life and survival. […] About half of cardio-oncology patients had anemia and iron deficiency, with the absolute type being twice as prevalent as the functional one. […] Both anemia and iron deficiency independently predicted all-cause mortality. […] The prognostic impact of different factors is presented in Table 4. Using univariate Cox regression model we found that male gender, cancer location except hematologic and other type of cancer, previous cancer history, elevated BNP (20ng/L), TSAT 20%, ferritin < 100g/L, serum iron concentration < 12 umol/L and anemia were significantly associated with increased risk of all-cause death. [...] The present study's critical findings are that ID is ubiquitous in cardio-oncology patients, AID is more prevalent than FID, and the iron deficit is a significant factor associated with prognosis and clinical outcomes in this population.

• #14 The prevalence of iron deficiency and anemia and their impact on survival in patients at a cardio-oncology clinic | Cardio-Oncology | Full Text

  https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-020-00086-4

  The high prevalence of ID in such cancer types as gastrointestinal, genitourinary, gynecological, lung may be explained by the increased risk of bleeding. […] ID, FID, and anemia were more reliable predictors of mortality than elevated BNP in our study. […] We determined that almost half of our patients with ID (41%) had anemia, and more than half (59%) died during the study period. The prevalence of anemia and mortality was higher among FID. […] Low transferrin saturation, ferritin < 100g/L, iron level < 12 mol/L, functional iron deficiency, and anemia independently predicted all-cause death.

• #15 Zinc protoporphyrin levels in COVID-19 are indicative of iron deficiency and potential predictor of disease severity | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0262487

  Iron deficiency anemia (IDA) and the anemia of chronic disease (ACD) are the two most common causes of anemia worldwide. Anemia can be observed in up to 95% of critically ill patients even if their admission levels were in the normal range. Anemia is of clinical importance in critically ill patients because it is associated with morbidity and mortality. […] In COVID-19 patients an association between iron status and the risk of adverse outcomes has been reported showing that patients with low serum iron status and other indicators of iron deficiency anemia are likely to suffer from severe conditions in COVID-19. Therefore it is of concern to manage the anemia in critically ill patients to improve morbidity and mortality. […] For the first time ZnPP in COVID-19 patients were reported in this study. Among all iron-related markers tested, ZnPP was the only one that was associated with anemia as based on hemoglobin. The increase in ZnPP might indicate that the underlying cause of anemia in COVID-19 patients is not only due to the inflammation but also of nutritional origin. Additionally, the ZnPP/L ratio might be a valid prognostic marker for the severity of COVID-19.

• #16 Zinc protoporphyrin levels in COVID-19 are indicative of iron deficiency and potential predictor of disease severity | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0262487

  Iron deficiency anemia (IDA) and the anemia of chronic disease (ACD) are the two most common causes of anemia worldwide. Anemia can be observed in up to 95% of critically ill patients even if their admission levels were in the normal range. Anemia is of clinical importance in critically ill patients because it is associated with morbidity and mortality. […] In COVID-19 patients an association between iron status and the risk of adverse outcomes has been reported showing that patients with low serum iron status and other indicators of iron deficiency anemia are likely to suffer from severe conditions in COVID-19. Therefore it is of concern to manage the anemia in critically ill patients to improve morbidity and mortality. […] For the first time ZnPP in COVID-19 patients were reported in this study. Among all iron-related markers tested, ZnPP was the only one that was associated with anemia as based on hemoglobin. The increase in ZnPP might indicate that the underlying cause of anemia in COVID-19 patients is not only due to the inflammation but also of nutritional origin. Additionally, the ZnPP/L ratio might be a valid prognostic marker for the severity of COVID-19.

• #17 Zinc protoporphyrin levels in COVID-19 are indicative of iron deficiency and potential predictor of disease severity | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0262487

  The only two markers were independently associated with the severity of COVID-19 in logistic regression analysis; D-dimer and ZnPP/L ratio. […] This study provides novel data reporting the ZnPP measurements in COVID-19 subjects. However, our study is limited in that ZnPP levels in males and females were not individually reported due to the restrictions in sample size. In conclusion, ZnPP can serve as a biomarker for the diagnosis of causes of anemia in hospital settings but might have the potential to be a predictor of COVID-19 severity when used in combination with lymphocyte count due to the stronger discrimination power than the N/L ratio.

• #18 MCHC Blood Test: What High and Low Results Mean

  https://www.health.com/mchc-blood-test-7092747

  Low levels of MCHC have been shown to be associated with poorer outcomes among people hospitalized with acute heart attack or acute pulmonary embolism. Low MCHC levels may help predict the outcome of certain cases of heart attack or pulmonary embolism. […] Anemia is usually what’s associated with abnormal MCHC levels. If anemia is the cause of your low or high MCHC levels, your healthcare provider will want to figure out what is causing your anemia and treat that cause.

• #19 British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults | Gut

  https://gut.bmj.com/content/70/11/2030

  Iron deficiency anaemia (IDA) is common, and a major cause of morbidity worldwide (evidence quality high, consensus 100%, statement strength strong). […] IDA can be caused by a range of GI pathologies including cancer, and so GI investigation on an urgent basis should be considered in adults with a new diagnosis of IDA without obvious explanation (evidence quality high, consensus 85%, statement strength strong). […] Hb levels normalise with iron replacement therapy (IRT) in most cases of IDA, but IDA recurs in a minority of these on long-term follow-up (evidence quality low, consensus 92%, statement strength strong). […] We recommend that long-term IRT may be an appropriate strategy when the cause of recurrent IDA is unknown or irreversible (evidence quality low, consensus 100%, statement strength strong). […] After the restoration of Hb and iron stores with IRT, we recommend that the blood count should be monitored periodically (perhaps every 6 months initially) to detect recurrent IDA (evidence quality very low, consensus 85%, statement strength strong).

• #20 British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults | Gut

  https://gut.bmj.com/content/70/11/2030

  Iron deficiency anaemia (IDA) is common, and a major cause of morbidity worldwide (evidence quality high, consensus 100%, statement strength strong). […] IDA can be caused by a range of GI pathologies including cancer, and so GI investigation on an urgent basis should be considered in adults with a new diagnosis of IDA without obvious explanation (evidence quality high, consensus 85%, statement strength strong). […] Hb levels normalise with iron replacement therapy (IRT) in most cases of IDA, but IDA recurs in a minority of these on long-term follow-up (evidence quality low, consensus 92%, statement strength strong). […] We recommend that long-term IRT may be an appropriate strategy when the cause of recurrent IDA is unknown or irreversible (evidence quality low, consensus 100%, statement strength strong). […] After the restoration of Hb and iron stores with IRT, we recommend that the blood count should be monitored periodically (perhaps every 6 months initially) to detect recurrent IDA (evidence quality very low, consensus 85%, statement strength strong).

• #21 Identification of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron deficiency anemia

  https://www.medsci.org/v08p0030.htm

  Iron deficiency anemia (IDA) is a frequent disorder. Also, it may be a sign of underlying serious diseases. Iron deficiency points to an occult or frank bleeding lesion when occurred in men or postmenopausal women. In this study, we aimed to evaluate the diagnostic yield of endoscopy in patients with IDA and to define predictive factors of gastrointestinal (GI) lesions causing IDA. […] The risk factors for finding GI lesions causing IDA were as follows: male gender (p= 0.004), advanced age ( 50 years) (p= 0.010), weight loss (over 20% of total body weight lost in last 6 month) (p= 0.020), chronic diarrhea (p= 0.006), change of bowel habits (p= 0.043), epigastric tenderness (p= 0.037), raised carcinoembryonic antigen (CEA) level (normal range: 0-7 ng/mL) (p= 0.039), 10 gr/dl hemoglobin (Hb) level (p=0.054).

• #22 Identification of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron deficiency anemia

  https://www.medsci.org/v08p0030.htm

  Iron deficiency anemia (IDA) is a frequent disorder. Also, it may be a sign of underlying serious diseases. Iron deficiency points to an occult or frank bleeding lesion when occurred in men or postmenopausal women. In this study, we aimed to evaluate the diagnostic yield of endoscopy in patients with IDA and to define predictive factors of gastrointestinal (GI) lesions causing IDA. […] The risk factors for finding GI lesions causing IDA were as follows: male gender (p= 0.004), advanced age ( 50 years) (p= 0.010), weight loss (over 20% of total body weight lost in last 6 month) (p= 0.020), chronic diarrhea (p= 0.006), change of bowel habits (p= 0.043), epigastric tenderness (p= 0.037), raised carcinoembryonic antigen (CEA) level (normal range: 0-7 ng/mL) (p= 0.039), 10 gr/dl hemoglobin (Hb) level (p=0.054).

• #23 Identification of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron deficiency anemia

  https://www.medsci.org/v08p0030.htm

  In multivariate analysis, advanced age (p=0.017), male gender (p 0.01) and weight lost (p=0.012) found that associated with GI lesions in all patients. It may be an appropriate clinical approach to consider these risk factors when deciding for gastrointestinal endoscopic evaluation in iron deficiency anemia. […] The presence of advanced age (50 years), male gender, diarrhea, lost weight, change of bowel habits, epigastric tenderness, positively serological sprue, hemoglobin levels less than 10 g/dl and high CEA level (5 pg/ml) were associated with an increased likelihood of significant gastrointestinal lesions (p0.05); […] In addition, we determine the yield of endoscopy evaluations in pre-menopausal and age 50 women with iron deficiency anemia but without any clinically significant sign-symptoms and laboratory findings.

• #24 Identification of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron deficiency anemia

  https://www.medsci.org/v08p0030.htm

  In multivariate analysis, advanced age (p=0.017), male gender (p 0.01) and weight lost (p=0.012) found that associated with GI lesions in all patients. It may be an appropriate clinical approach to consider these risk factors when deciding for gastrointestinal endoscopic evaluation in iron deficiency anemia. […] The presence of advanced age (50 years), male gender, diarrhea, lost weight, change of bowel habits, epigastric tenderness, positively serological sprue, hemoglobin levels less than 10 g/dl and high CEA level (5 pg/ml) were associated with an increased likelihood of significant gastrointestinal lesions (p0.05); […] In addition, we determine the yield of endoscopy evaluations in pre-menopausal and age 50 women with iron deficiency anemia but without any clinically significant sign-symptoms and laboratory findings.

• #25 Identification of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron deficiency anemia

  https://www.medsci.org/v08p0030.htm

  The standard diagnostic procedure for men and postmenopausal women with iron deficiency is to investigate gastrointestinal tract (upper and lower) pathology as well as rule out a nutritional cause. […] The ability to predict the site of GI lesions that cause IDA could optimize the endoscopic approach. […] The statistically limited association for the presence of GI tract lesions were following; constipation, melena and a family history of a first-degree relative with GI cancer. […] In our study, predictive risk factors for GI tract lesions to cause of IDA were older age (50 years) and positive FOBT. […] In conclusion, our study demonstrated that it may be an appropriate clinical approach to consider these risk factors when deciding for gastrointestinal endoscopic evaluation in iron deficiency anemia.

• #26 Development and validation of a prediction model for iron status in a large U.S. cohort of women | Scientific Reports

  https://www.nature.com/articles/s41598-023-42993-3

  Model performance was weak, with an R2 less than 0.10 for the maximum likelihood models for iron and transferrin saturation but stronger, with an R2 of 0.13 in the premenopausal group and 0.19 in the postmenopausal group for ferritin. […] The overall R2 for ferritin with both menopausal groups in the same model was 0.31. […] The weak model performance does not support the use of a large array of predictive variables to replace common serum measures. […] The predictive model for serum ferritin demonstrated the best performance, especially for the postmenopausal group of women, with an R2 close to 0.20. […] However, even that model leaves around 69% of the variance unexplained. […] The calibration slope from the internal validation was close to one, 0.98, for the ferritin outcome in the postmenopausal group, indicating that this model should provide predicted values in new samples from the same underlying population that are not systematically different from those observed. […] Creating predictive models for body iron status based on questionnaire data that could usefully replace the iron markers measured in serum samples remains a challenge.

• #27 Development and validation of a prediction model for iron status in a large U.S. cohort of women | Scientific Reports

  https://www.nature.com/articles/s41598-023-42993-3

  Model performance was weak, with an R2 less than 0.10 for the maximum likelihood models for iron and transferrin saturation but stronger, with an R2 of 0.13 in the premenopausal group and 0.19 in the postmenopausal group for ferritin. […] The overall R2 for ferritin with both menopausal groups in the same model was 0.31. […] The weak model performance does not support the use of a large array of predictive variables to replace common serum measures. […] The predictive model for serum ferritin demonstrated the best performance, especially for the postmenopausal group of women, with an R2 close to 0.20. […] However, even that model leaves around 69% of the variance unexplained. […] The calibration slope from the internal validation was close to one, 0.98, for the ferritin outcome in the postmenopausal group, indicating that this model should provide predicted values in new samples from the same underlying population that are not systematically different from those observed. […] Creating predictive models for body iron status based on questionnaire data that could usefully replace the iron markers measured in serum samples remains a challenge.

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