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Mitochondrial engagement, including binding to voltage-dependent anion channels, can heighten oxidative stress in nonlesional tissues and contribute to organ dysfunction independent of lesion-directed ferroptosis (94, 95)

Routine blood studies CBC: typically normal Liver chemistries: AST, ALT, and GGT Renal function: may be abnormal Iron studies: serum ferritin Hepatitis B screening, hepatitis C screening, and HIV testing (if the patient has susceptibility factors) Confirmatory diagnostic studies First-line testing Spot urine sample test: uroporphyrins Blood test: serum porphyrins Second-line testing: UROD activity analysis and gene mutation detection Management [2] [3] The goal of therapy is to resolve the patient's symptoms by reducing porphyrin levels

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Models were initially controlled for age, sex, education, marital status, and income level, and then for the presence of obesity, diabetes, hypertension, and dyslipidemia