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Sci Rep. 2019 Apr 15;9(1):6054. doi: 10.1038/s41598-019-42622-y.

Decreased Total Iron Binding Capacity May Correlate with Ruptured Intracranial Aneurysms.

Author information

1
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2
Research Information Systems and Computing, Partners Healthcare, Boston, MA, USA.
3
Center for Statistical Science, Tsinghua University, Beijing, China.
4
Department of Computer Science, Loyola University, Chicago, IL, USA.
5
Boston Children's Hospital Informatics Program, Boston, MA, USA.
6
Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA.
7
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
8
Biostatistics, Harvard School T. H. Chan of Public Health, Boston, MA, USA.
9
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
10
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rdu@bwh.harvard.edu.
11
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA. rdu@bwh.harvard.edu.

Abstract

Iron and its derivatives play a significant role in various physiological and biochemical pathways, and are influenced by a wide variety of inflammatory, infectious, and immunological disorders. We hypothesized that iron and its related factors play a role in intracranial aneurysm pathophysiology and investigated if serum iron values are associated with ruptured intracranial aneurysms. 4,701 patients with 6,411 intracranial aneurysms, including 1201 prospective patients, who were diagnosed at the Massachusetts General Hospital and Brigham and Women's Hospital between 1990 and 2016 were evaluated. A total of 366 patients with available serum iron, ferritin and total iron binding capacity (TIBC) values were ultimately included in the analysis. 89% of included patients had anemia. Patients were categorized into ruptured and non-ruptured groups. Univariable and multivariable logistic regression analyses were performed to determine the association between ruptured aneurysms and iron, ferritin, and TIBC. TIBC values (10-3 g/L) within 1 year of diagnosis (OR 0.41, 95% CI 0.28-0.59) and between 1 and 3 years from diagnosis (OR 0.52, 95% CI 0.29-0.93) were significantly and inversely associated with intracranial aneurysm rupture. In contrast, serum iron and ferritin were not significant. In this case-control study, low TIBC was significantly associated with ruptured aneurysms, both in the short- and long term. However, this association may not apply to the general population as there may be a selection bias as iron studies were done in a subset of patients only.

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