# Heightened Serum Mitochondrial Biomarkers; FGF21 and NOS in Pediatric Anemia and a Negative Correlation between GDF15 and Serum Ferritin

## TL;DR

This study found that mitochondrial biomarkers FGF21 and eNOS are elevated in children with anemia, suggesting a link between anemia and mitochondrial dysfunction.

## Contribution

The study identifies specific cutoff levels for FGF21 and eNOS as predictors of pediatric anemia and reveals novel correlations between mitochondrial markers and anemia-related blood parameters.

## Key findings

- FGF21 levels ≥ 0.745 pg/mL and eNOS levels ≥ 1.265 µg/mL predicted anemia in children.
- Hemoglobin levels negatively correlated with FGF21 and eNOS levels.
- GDF-15 showed a significant negative correlation with serum ferritin.

## Abstract

Objective: Mitochondrial dysfunction is closely linked to chronic disorders. This study aims to explore the correlation between pediatric anemia and mitochondrial markers, specifically fibroblast growth factor 21 (FGF21), growth/differentiation factor 15 (GDF-15), and nitric oxide synthase (eNOS). Method: This study included 66 children, with 34 diagnosed with anemia and 32 in the healthy control group. Statistically significant biomarkers were determined through cutoff levels. Results: Among the participants, 34 children were classified as anemic, while 32 were categorized as healthy. The study revealed that FGF21 levels ≥ 0.745 pg/mL and eNOS levels ≥ 1.265 µg/mL predicted anemia. Hemoglobin levels exhibited a negative correlation with FGF21 (r = −0.381; p = 0.002) and eNOS levels (r = −0.462; p < 0.001). Furthermore, a significant negative correlation was observed between GDF-15 and ferritin (r = −0.311; p = 0.019), while eNOS levels correlated positively with folate (r = 0.313; p = 0.019). Conclusions: Anemia induced elevated mitochondrial biomarkers; FGF21 and eNOS levels. The findings suggest that the long-term ramifications of anemia in childhood may be associated with mitochondrial dysfunction.