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Lower hemoglobin with lower ferritin – results from the HUNT 2 Study

Abstract Aim. We wanted to study the association between blood hemoglobin concentration (b-hemoglobin) and serum ferritin concentration (s-ferritin) in a healthy female population, and compare the findings to those in a previous study of ambulant female patients. Methods. We compared median b-hemoglobin and the fraction with anemia in groups of women with s-ferritin from less than 10 μg/L to 100 μg/L. These women, aged 20–55 years, were part of a health screening survey (HUNT 2) where they reported to have ‘good’ or ‘very good’ general health and were found to have normal s-creatinine. The s-ferritin values were adjusted to the level of the previous study. The 10, 50 and 90 percentiles of b-hemoglobin were modelled as functions of s-ferritin using quantile regression. Results. Among 2122 healthy females the entire b-hemoglobin distribution was shifted downwards in women with s-ferritin less than 20 μg/L. Accordingly, the median b-hemoglobin was statistically significantly lower. In women with s-ferritin less than 20 μg/L the fraction with anemia was 0.15. Conclusions. Lower s-ferritin is associated with lower b-hemoglobin in many more subjects than those labelled anemic.