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Cited by 1Antifungal resistance and susceptibilityFungal Infections and StudiesIron Metabolism and Disorders

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Reduced serum iron levels predict poor prognosis in pulmonary mucormycosis patients: a prospective, case‒control study

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Luo, Qiongzhen, He, Xinwei, Xu, Jiao, Li, Li, Zhao, Lina, Mu, Xiangdong·2025·Scientific Reports
DOI 10.1038/s41598-025-15186-3PMC PMC12365034

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Abstract

Pulmonary mucormycosis (PM) and invasive pulmonary aspergillosis (IPA) are both invasive pulmonary fungal infections with similar clinical manifestations. Few studies have focused on the expression of serum iron in patients with PM and IPA. A prospective, case‒control study was conducted between January 2023 and December 2024. Patients diagnosed with PM or IPA were assigned to the PM group or the IPA group, respectively. Clinical data were recorded for all enrolled patients. Serum iron, serum ferritin, unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), and percentage transferrin saturation levels were determined via an automatic biochemical detector. A total of 58 patients with PM and 49 patients with IPA were enrolled. Nine patients in the PM group and one patient in the IPA group died during hospitalization. The serum iron, UIBC, and TIBC levels in the PM group were significantly lower than those in the IPA group (all p < 0.05). The serum ferritin level was significantly greater in the PM group than in the IPA group (p = 0.021). Binary logistic regression analysis revealed that only the TIBC level was an independent risk factor for PM [OR (95% CI) = 0.892 (0.839-0.947), p < 0.001]. Cox proportional hazards regression analysis revealed that the serum iron concentration [HR (95% CI) = 0.872 (0.784-0.969); p = 0.011] was an independent predictor of mortality risk in PM patients. Lower TIBC levels at admission were associated with a greater risk of PM, and reduced serum iron levels predict poor prognosis in patients with PM. Using IPA patients as controls, we preliminarily revealed aberrant iron metabolism in PM patients.Trial registration: ClinicalTrials.gov ID NCT06495905, Date of registration July 11, 2024 (retrospectively registered).

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Fig. 1 Comparison of comorbidities between patients with PM and IPA.
Fig. 1 Comparison of comorbidities between patients with PM and IPA.CC BY-NC-ND · PubMed Central
Fig. 2 Histograms comparing the levels of serum iron-related markers in the PM group and IPA group. (A) Serum iron levels in the PM and IPA groups, p = 0.039. (B) Levels of unsaturated iron-binding capacity in the PM and IPA groups, p = 0.023. (C) Total iron-binding capacity in the PM and IPA groups, p < 0.001. (D) Percent transferrin saturation in the PM and IPA groups, p = 0.584. (E) Serum ferritin levels in the PM and IPA groups, p = 0.021.
Fig. 2 Histograms comparing the levels of serum iron-related markers in the PM group and IPA group. (A) Serum iron levels in the PM and IPA groups, p = 0.039. (B) Levels of unsaturated iron-binding capacity in the PM and IPA groups, p = 0.023. (C) Total iron-binding capacity in the PM and IPA groups, p < 0.001. (D) Percent transferrin saturation in the PM and IPA groups, p = 0.584. (E) Serum ferritin levels in the PM and IPA groups, p = 0.021.CC BY-NC-ND · PubMed Central

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Citations

Cites

Research works printed but not linked: 26

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Metadata

Authors
Luo, Q., He, X., Xu, J., Li, L., Zhao, L., & Mu, X.
Affiliations
Beijing Tsinghua Chang Gung Hospital (CN)
Corresponding author
Mu, Xiangdong
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2025-08-19
Volume
15
Issue
1
Pages
30395-30395
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-025-15186-3
PMC
PMC12365034
OpenAlex
W4413329062
Cited by
1
References
3
Citations by year
2026: 1
FWCI
0.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by-nc-nd)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Beijing Hospitals Authority Clinical Medicine Development of special funding support (ZLRK202323)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
Keywords
pulmonary mucormycosis, invasive pulmonary aspergillosis, serum iron, total iron binding capacity, serum ferritin, iron metabolism, prognostic factors, mortality risk, invasive pulmonary fungal infection
MeSH terms
Adult, Aged, Female, Ferritins, Humans, Iron, Lung Diseases, Fungal, Male, Middle Aged, Mucormycosis, Prognosis, Prospective Studies, Risk Factors, Biomarkers, Case-Control Studies, Invasive Pulmonary Aspergillosis

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