C-reactive protein and serum iron: Exploring the link between inflammation and iron metabolism

Aim: This study aimed to examine the link between C-reactive protein (CRP), serum iron, and hematological indices in a cohort from a Saudi hospital, with a focus on inflammation-induced hypoferremia. Methods: A retrospective cross sectional study was carried out involving 2478 patients attending a tertiary care hospital in Saudi Arabia during the period January 2023 through December 2024. C-reaction are protein serum, iron and hematological indices were measured by immunoturbidimetric and colorimetric methods. Results: There was a marked negative correlation between CRP and serum iron concentration. As CRP levels increased, serum iron concentration decreased significantly, with a mean serum iron concentration of 14.2 μmol/L in the high CRP group, compared to 21.5 μmol/L in the low CRP group (p < 0.01). Notably, CRP emerged as an independent variable correlated with serum iron levels, emphasizing its role in inflammation-induced changes in iron metabolism. The other correlation with serum ferritin and red cell distribution width is also in accordance to the impact of inflammation on hematological indices. There were differences in serum iron between genders, but the correlation between CRP and serum iron level was consistent in both genders. Conclusion: This research highlights the role of chronic inflammation in hypoferremia and emphasizes the significance of CRP as a key marker of inflammation, which impacts iron metabolism. The findings have implications in explaining the aspects of anemia of chronic disease (ACD) and underline the need for integrating markers of inflammation in the assessment and management of Anemia. Further studies are needed to explore novel therapeutic approaches targeting hepcidin and cytokine pathways.