Ceruloplasmin and Alpha-1-Acid Glycoprotein, but not C-Reactive Protein, Correlate With Serum Ferritin During Various Postpartum/Lactation Periods in Congolese Females

Background: Serum ferritin usually correlates positively with acute phase proteins (APPs), but limited information is available on this association during various postpartum/lactation periods. The objective of this study was to assess the association between serum ferritin and APPs in Congolese females during different postpartum/lactation periods. Methods: Serum ferritin, C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), ceruloplasmin (Cp), and transferrin saturation (TS) were measured during various postpartum/lactation periods (0.5 to 6, 6.1 to 12, 12.1 to 18, and 18.1 to 24 months) in 131 Congolese females aged 15 to 45 years. Results: Mean serum ferritin concentrations were lower in females in the 0.5- to 6-month postpartum/lactation subgroup than in the other 3 subgroups (P<0.05). Mean concentrations of hemoglobin, APPs, and TS were not different among the 4 subgroups. While serum ferritin concentrations correlated with Cp (r=0.514) and AGP (r=0.795) during the 0.5- to 6-month and the 6.1- to 12-month postpartum/lactation periods, respectively (P<0.05), they did not correlate with CRP. Multiple regression analysis suggested that Cp explained 25% of serum ferritin variance in the 0.5- to 6-month postpartum/lactation period (39.3% at 0.5 to 4 months) and AGP explained 60.5% of the variance in the 6.1- to 12-month period (3.7% at 0.5 to 4 months). CRP explained <5% of the serum ferritin variance at these postpartum/lactation periods. APPs explained ≤15.1% of serum ferritin variance at postpartum/lactation periods >12 months. Conclusion: Data suggest that the association between serum ferritin and inflammation is dependent on APP type and lactation time. This association may affect the diagnosis of iron deficiency in lactating females. The positive association between serum ferritin and Cp at 0.5 to 6 months postpartum may be necessary to increase liver iron release and erythropoiesis after childbirth.