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Is intervertebral disc degeneration associated with reduction in serum ferritin?

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Abstract

Objective

Ferritin autophagy is characterized by intracellular ferroptosis and selective ferritin degradation. However, the role of ferritin in the development of intervertebral disc degeneration (IDD) has not been elucidated. The study aimed to investigate the role of serum iron metabolism markers, especially serum ferritin (SF), in IDD.

Methods

217 patients who came to the spine surgery department of our hospital for low back pain were recruited, and blood samples were collected for routine examination after admission. The cumulative grade was also calculated by summing up the Pfirrmann grade of all lumbar discs.

Results

Correlation analysis showed that cumulative grade was correlated with SF (r = − 0.185, p = 0.006), not with serum iron (SI), transferrin saturation (TS), unsaturated iron-binding capacity (UIBC) and total iron-binding capacity (TIBC) (all p > 0.05). In addition, SF levels in the low severity IDD were significantly higher than high severity IDD in cumulative grade (p = 0.003) and single disc grade. No statistically significant difference was found in the other four indicators. A statistically significant difference was observed between the high (cumulative grade > 17) and low score (cumulative grade ≤ 17) groups in terms of age. According to the ROC curve, the cut-off value of SF levels was 170.5. Patients with SF < 170.5 ng/mL had severe disc degeneration. The sensitivity and specificity were 0.635 and 0.602, respectively.

Conclusion

This study preliminarily showed that SF was negatively correlated with the degree of IDD and can be used to predict IDD severity.

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Data availability

The datasets generated and/or analysed during the present study are available from the corresponding author upon reasonable request.

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Funding

We would like to thank all the participants in the studies. This study was supported by Shanghai East Hospital Xuri Young Excellent Talents Program 2019xrrcjh04 and Key Laboratory of Inorganic Coating Materials, Chinese Academy of Sciences.

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Author notes

  1. Youfeng Guo and Chao Li contributed equally to this article.

Authors and Affiliations

  1. Department of Spine Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China

    Youfeng Guo, Beiduo Shen, Tao Hu & Desheng Wu

  2. Department of Neurosurgery, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200092, China

    Chao Li & Xianzhen Chen

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  1. Youfeng Guo
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Contributions

All authors contributed to the conception and design of the study, or acquisition and analysis of data; drafting the article or revising it critically for important intellectual content; and the final approval of the version to be submitted. All authors are committed to being responsible for their work and consent to the publication of this paper.

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Correspondence to Xianzhen Chen, Tao Hu or Desheng Wu.

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This is an observational study. The Ethics Committee of Shanghai East Hospital has confirmed that no ethical approval is required.

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Guo, Y., Li, C., Shen, B. et al. Is intervertebral disc degeneration associated with reduction in serum ferritin?. Eur Spine J 31, 2950–2959 (2022). https://doi.org/10.1007/s00586-022-07361-1

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