51
|
Trends in biomedical analysis of red blood cells – Raman spectroscopy against other spectroscopic, microscopic and classical techniques. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2021.116481] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
52
|
Rahman MA, Shanjana Y, Ahmed MS, Dhama K, Hasan Fahim M, Mahmud T, Shuvo AA, Milan ZH, Rahman MS, Roy A, Bhuiyan MA, Islam MR. Hematological Abnormalities and Comorbidities Are Associated With the Severity of Kidney Disease: A Hospital-Based Cross-Sectional Study in Bangladesh. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2022; 15:2632010X221114807. [PMID: 35898700 PMCID: PMC9310280 DOI: 10.1177/2632010x221114807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022]
Abstract
Background Abnormalities in hematology and comorbidities might have a role in chronic kidney disease (CKD) patients. However, the exact relationships between hematological parameters and the severity of CKD are not well understood. Also, the underlying mechanisms remain under investigation. The present study aimed to evaluate the association of different blood parameters and comorbidities among hospitalized CKD patients in Bangladesh. Methods The present study enrolled admitted CKD patients at Evercare Hospital Ltd, Dhaka, Bangladesh, from January 1, 2021, to August 1, 2021. For this study, the demographic and clinical information of the patients were collected. Then some routine blood tests for the hematological profile of CKD patients were performed. Finally, several statistical methods were performed and data interpretations were done to evaluate the role of hematological changes on CKD patients. Results Among 300 patients, early-stage CKD patients (ESCKDP) and advanced-stage CKD patients (ASCKDP) were 153 and 147, respectively. The decreased levels of hemoglobin (Hb) and red blood cell (RBC) in ASCKDP were observed. However, the present study found increased levels of corpuscular Hb in ASCKDP than ESCKDP. Also, the present study noticed correlations between these changes and the severity of CKD. Also, we observed a significant difference in age and body mass index between ESCKDP and ASCKDP. Conclusions Based on our results, lower Hb and RBC levels may use in assessing the severity and the treatment decisions of CKD patients in the hospital setting. Therefore, our findings may assist with developing a treatment protocol for hospitalized CKD patients.
Collapse
Affiliation(s)
- Md Ashrafur Rahman
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Yeasna Shanjana
- Department of Environmental Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Md Shakil Ahmed
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Mahadi Hasan Fahim
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Tarif Mahmud
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Arif Anzum Shuvo
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | | | | | - Arpita Roy
- Department of Biotechnology, Sharda University, Greater Noida, Uttar Pradesh, India
| | | | - Md Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Farmgate, Dhaka, Bangladesh
| |
Collapse
|
53
|
Gomez HM, Pillar AL, Brown AC, Kim RY, Ali MK, Essilfie AT, Vanders RL, Frazer DM, Anderson GJ, Hansbro PM, Collison AM, Jensen ME, Murphy VE, Johnstone DM, Reid D, Milward EA, Donovan C, Horvat JC. Investigating the Links between Lower Iron Status in Pregnancy and Respiratory Disease in Offspring Using Murine Models. Nutrients 2021; 13:nu13124461. [PMID: 34960012 PMCID: PMC8708709 DOI: 10.3390/nu13124461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
Maternal iron deficiency occurs in 40-50% of all pregnancies and is associated with an increased risk of respiratory disease and asthma in children. We used murine models to examine the effects of lower iron status during pregnancy on lung function, inflammation and structure, as well as its contribution to increased severity of asthma in the offspring. A low iron diet during pregnancy impairs lung function, increases airway inflammation, and alters lung structure in the absence and presence of experimental asthma. A low iron diet during pregnancy further increases these major disease features in offspring with experimental asthma. Importantly, a low iron diet increases neutrophilic inflammation, which is indicative of more severe disease, in asthma. Together, our data demonstrate that lower dietary iron and systemic deficiency during pregnancy can lead to physiological, immunological and anatomical changes in the lungs and airways of offspring that predispose to greater susceptibility to respiratory disease. These findings suggest that correcting iron deficiency in pregnancy using iron supplements may play an important role in preventing or reducing the severity of respiratory disease in offspring. They also highlight the utility of experimental models for understanding how iron status in pregnancy affects disease outcomes in offspring and provide a means for testing the efficacy of different iron supplements for preventing disease.
Collapse
Affiliation(s)
- Henry M. Gomez
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Amber L. Pillar
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Alexandra C. Brown
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Richard Y. Kim
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Md Khadem Ali
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Ama-Tawiah Essilfie
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
| | - Rebecca L. Vanders
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - David M. Frazer
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Gregory J. Anderson
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
- School of Chemistry and Molecular Bioscience, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Philip M. Hansbro
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Centre for Inflammation, School of Life Sciences, Faculty of Science, Centenary Institute and University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Adam M. Collison
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
| | - Megan E. Jensen
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
| | - Vanessa E. Murphy
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
| | - Daniel M. Johnstone
- School of Medical Sciences, University of Sydney, Camperdown, NSW 2050, Australia;
| | - David Reid
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
| | - Elizabeth A. Milward
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Chantal Donovan
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Jay C. Horvat
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Correspondence: ; Tel.: +612-4042-0220
| |
Collapse
|
54
|
Body Composition, Anemia, and Kidney Function among Guatemalan Sugarcane Workers. Nutrients 2021; 13:nu13113928. [PMID: 34836182 PMCID: PMC8621317 DOI: 10.3390/nu13113928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 01/01/2023] Open
Abstract
Rates of anemia among agricultural workers, who are also at risk for kidney injury and chronic kidney disease of unknown cause (CKDu), are unknown. We evaluated body composition through the sum of three skinfolds among 203 male sugarcane cutters and assessed the relationship of variables related to nutrition, anemia (hemoglobin < 13 g/dL), and elevated hemoglobin A1c (HbA1c ≥ 5.7%) with estimated glomerular filtration rate (eGFR) using linear regression. Eleven percent of workers were at the level of essential body fat (2-5%). Anemia was present among 13% of workers, 70% of which were normochromic normocytic, a type of anemia suggesting potential underlying chronic disease. Anemia was more common among those with lower BMI and fat free mass. The prevalence of elevated HbA1c was 21%. A moderate negative correlation was found between hemoglobin and HbA1c (Pearson's r = -0.32, p <0.01) which suggests that HbA1c values should be interpreted with caution in populations that have high rates of anemia. Twelve percent of workers had reduced kidney function with an eGFR < 90 mL/min/1.73 m2. On average, the eGFR was 18 mL/min per 1.73 m2 lower [(95% CI:-24, -12), p <0.01)] for those with anemia than those without, and 8 mL/min per 1.73 m2 lower among those with elevated HbA1c [(95% CI: -13, -2), p < 0.01]. Results will inform future studies examining the role of anemia in the evaluation of CKDu and interventions to improve nutrition for workers in low-resource settings.
Collapse
|
55
|
Amjad W, Qureshi W, Singh RR, Richter S. Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis. Ann Gastroenterol 2021; 34:788-795. [PMID: 34815644 PMCID: PMC8596206 DOI: 10.20524/aog.2021.0660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/16/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Gastroparesis is a debilitating condition that may impact morbidity and mortality, but there is a lack of long-term studies examining this relation. The aim of this study was to determine the predictors of mortality in gastroparesis and to determine the nutritional deficiencies. METHODS Between September 30, 2009 and January 31, 2020, we identified 320 patients (mean age 47.5±5.3 years, 70% female, 71.3% Whites, 39.7% diabetic and 60.3% nondiabetic) with gastroparesis. 99mTc sulfur-labeled food was used to diagnose gastroparesis. Cox proportional-hazard regression was used to compute the association of mortality predictors. RESULTS Of the 320 patients, 46 (14.4%) died during the study period. Among diabetics, advanced age (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.03-1.10; P<0.001), chronic kidney disease (CKD) (HR 4.69, 95%CI 1.62-13.59; P=0.004), and malnutrition (HR 10.95, 95%CI 3.23-37.17; P<0.001) were associated with higher mortality, whereas in nondiabetics older age (HR 1.05, 95%CI 1.01-1.09; P=0.04), CKD (HR 10.2, 95%CI 2.48-41.99; P=0.001), chronic obstructive pulmonary disease (COPD) (HR 7.5, 95%CI 2.11-26.82; P=0.002), coronary artery disease (CAD) (HR 9.7, 95%CI 1.8-52.21; P=0.008), and malnutrition (HR 3.83, 95%CI 1.14-29.07; P=0.03) were associated with increased mortality. Overall, 48.8% had vitamin D, 18.2% had vitamin B12, and 50.8% had iron deficiencies. Only 19.4% of the whole cohort was evaluated by a nutritionist. CONCLUSIONS Advanced age, CAD, CKD, COPD and malnutrition were associated with higher mortality in gastroparesis. Despite the high prevalence of nutritional deficiencies, consultation of a specialist nutritionist was uncommon.
Collapse
Affiliation(s)
- Waseem Amjad
- Department of Internal Medicine, Albany Medical Center, Albany, NY (Waseem Amjad)
| | - Waqas Qureshi
- Department of Cardiovascular Medicine, University of Massachusetts, Worchester, MA (Waqas Qureshi)
| | - Ritu R. Singh
- Department of Medicine, Indiana University School of Medicine, Fort Wayne, Indiana, USA (Ritu R. Singh)
- Johns Hopkins Bloomberg School of Public Health (Ritu R. Singh)
| | - Seth Richter
- Department of Gastroenterology, Albany Medical Center, Albany NY (Seth Richter), USA
| |
Collapse
|
56
|
Sylla MM, Gruffi L, Roth ES, Rosato FE, Wong CHJ, Razi AE. How Does Iron Deficiency Anemia Impact Outcomes following Revision Total Hip Arthroplasty? Hip Pelvis 2021; 33:140-146. [PMID: 34552891 PMCID: PMC8440132 DOI: 10.5371/hp.2021.33.3.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/10/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose Studies have shown the prevalence of iron deficiency anemia (IDA) increasing worldwide, and currently the literature is limited on the impact of IDA on outcomes following revision total hip arthroplasty (RTHA). Therefore, the purpose of this study was to determine whether IDA patients undergoing RTHA have longer: 1) in-hospital lengths of stay (LOS); 2) medical complications; and 3) costs of care. Materials and Methods A retrospective query of a nationwide administrative claims database was performed. Using Boolean command operations, the study group consisted of all patients in the database undergoing RTHA with IDA; whereas, patients without IDA served as controls. To reduce the effects of confounding, study group patients were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities yielding 92,948 patients with (n=15,508) and without (n=77,440) IDA undergoing revision THA. A P-value less than 0.001 was considered statistically significant. Results IDA patients were found to have significantly longer in-hospital LOS (5 days vs. 4 days, P<0.0001). Additionally, the study showed IDA patients were found to higher incidence and odds of (73.84% vs. 11.77%, OR 5.04, P<0.0001) 90-day medical complications. IDA patients also incurred high 90-day episode of care costs ($25,597.51 vs. $20,085.70, P<0.0001). Conclusion After adjusting for age, sex, and medical comorbidities this study of over 92,000 patients demonstrated IDA is associated with longer in-hospital LOS, complications, and costs of care. Future studies should compare the duration and severity of IDA on outcomes.
Collapse
Affiliation(s)
- Mohamed M Sylla
- State University of New York (SUNY) Downstate College of Medicine, Brooklyn, NY, USA.,Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Lauren Gruffi
- State University of New York (SUNY) Downstate College of Medicine, Brooklyn, NY, USA.,Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Eric S Roth
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Francis E Rosato
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Che Hang Jason Wong
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Afshin E Razi
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| |
Collapse
|
57
|
B LS, Rathnavelu V, Sabesan M, Ganesh A, Anandan S. A Study to Assess the Levels of Salivary Ferritin in Iron Deficiency Anemia Subjects and Healthy Subjects. Cureus 2021; 13:e17241. [PMID: 34540467 PMCID: PMC8444485 DOI: 10.7759/cureus.17241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Iron deficiency anemia is one of the most widespread disorders in humans. Early diagnosis of iron deficiency anemia is challenged by assessing serum ferritin levels. However, studies across the globe have concluded that ferritin is present in quantifiable amounts in saliva. Thus, in the study, the scope of using salivary ferritin as a diagnostic biomarker in detecting iron deficiency anemia is studied. Methods: Levels of salivary ferritin in patients with iron deficiency anemia (test group, n=15) and non-anemic subjects (control group, n=15) were assessed by an automated chemilumesent method with a total sample size of 30 volunteers. Results: The mean level of salivary ferritin in subjects with iron deficiency anemia was 139.37±47.90 µg/dl, which was significantly higher when compared to the level in non-anemic subjects, 94.18±62.90 µg/dl, which was contradictory when compared to the levels of serum ferritin. Conclusion: The raise in the levels of salivary ferritin in subjects with iron deficiency anemia can be attributed to the iron-dependent enzymatic function of saliva. Thus, salivary ferritin can become a biomarker that helps in the diagnosis of iron deficiency anemia; however, more research is needed for devising a more standard cutoff value for diagnosing iron deficiency anemia.
Collapse
Affiliation(s)
- Lokesh Sundaram B
- Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Vidhya Rathnavelu
- Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Mythili Sabesan
- Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Akila Ganesh
- Public Health Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Soumya Anandan
- Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| |
Collapse
|
58
|
Basha A, Ibrahim MIM, Hamad A, Chandra P, Omar NE, Abdullah MAJ, Aldapt MB, Hussein RM, Mahfouz A, Adel AA, Shwaylia HM, Ekeibed Y, AbuMousa R, Yassin MA. Efficacy and cost effectiveness of intravenous ferric carboxymaltose versus iron sucrose in adult patients with iron deficiency anaemia. PLoS One 2021; 16:e0255104. [PMID: 34375369 PMCID: PMC8354439 DOI: 10.1371/journal.pone.0255104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 07/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background Iron deficiency anaemia (IDA) is a major health issues and common type of nutritional deficiency worldwide. For IDA treatment, intravenous (IV) iron is a useful therapy. Objective To determine the efficacy and cost-effectiveness (CE) of intravenous (IV) Ferric Carboxymaltose (FCM) versus IV Iron Sucrose (IS) in treating IDA. Data sources Electronic medical record i.e. Cerner® system. Target population Adults patients with iron deficiency anaemia. Time horizon A 12-month period (01/01/2018–31/12/2018). Perspective Hamad Medical Corporation (HMC, a public hospital). Intervention IV Ferric Carboxymaltose versus IV Iron Sucrose. Outcome measures With regard to responses to treatment i.e., efficacy of treatment with FCM & IS in IDA patients, hemoglobin (Hgb), ferritin, and transferrin saturation (TSAT) levels were the primary outcomes. Additionally, the researchers also collected levels of iron, platelet, white blood cell (WBC), red blood cell (RBC), mean corpuscular hemoglobin (MCH), and mean corpuscular volume (MCV). The costs i.e. resources consumed (obtained from NCCCR-HMC) and the CE of FCM versus IS were the secondary outcomes. Results of base-case analysis There was a significant improvement in Hgb, RBC and MCH levels in the IS group than the FCM group. The overall cost of IS therapy was significantly higher than FCM. The medication cost for FCM was approximately 6.5 times higher than IS, nonetheless, it is cheaper in terms of bed cost and nursing cost. The cost effectiveness (CE) ratio illustrated that FCM and IS were significantly different in terms of Hgb, ferritin and MCH levels. Further, Incremental Cost Effectiveness Ratio (ICER) indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes. Results of sensitivity analysis Not applicable. Limitations The study did not consider the clinical or humanistic outcome. Conclusions The higher cost of FCM versus IS can be offset by savings in healthcare personnel time and bed space. ICER indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes.
Collapse
Affiliation(s)
- Ahmad Basha
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
- * E-mail:
| | | | - Anas Hamad
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Prem Chandra
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Nabil E. Omar
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | | | - Mahmood B. Aldapt
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| | - Radwa M. Hussein
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Ahmed Mahfouz
- Heart Hospital (HH), Pharmacy Department, HMC, Doha, Qatar
| | - Ahmad A. Adel
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Hawraa M. Shwaylia
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| | - Yaslem Ekeibed
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| | - Rami AbuMousa
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Mohamed A. Yassin
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| |
Collapse
|
59
|
Martino FG, Vitillo M, Pieri M, Marrone G, Gangeri F, Ansali F, Dessì M, Bernardini S, Di Daniele N, Noce A. Biomarkers of Glyco-Metabolic Control in Hemodialysis Patients: Glycated Hemoglobin vs. Glycated Albumin. ACTA ACUST UNITED AC 2021; 57:medicina57070712. [PMID: 34356993 PMCID: PMC8307856 DOI: 10.3390/medicina57070712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 12/18/2022]
Abstract
Background and Objectives: Glycated hemoglobin (HbA1c) dosage is considered the gold standard in glycol-metabolic monitoring, but it presents limits, which can underestimate the glycemia trend. In this regard, it was introduced the glycated albumin (GA). The aim of the study is to verify the predictivity of the GA compared to HbA1c in identifying glyco-metabolic alterations in non-diabetic and diabetic hemodialysis (HD) patients. Materials and Methods: For this purpose, we conducted a multicenter study involving one analysis laboratory and six dialysis centers in the Lazio region (Rome, Italy). Both diabetic and non-diabetic HD patients represent the study population, and the protocol included five time points. Results: The analyzed data highlighted the ability of GA to predict changes in glycemic metabolism in HD patients, and GA values are not significantly influenced, like HbA1c, by dialysis therapy itself and by comorbidities of the uremic state, such as normochromic and normocytic anemia. Thus, GA seems to reflect early glyco-metabolic alterations, both in patients with a previous diagnosis of diabetes and in subjects without diabetes mellitus. As part of this study, we analyzed two HD patients (one diabetic and one non-diabetic) in which GA was more predictive of glycol-metabolic alterations compared to HbA1c. Our study confirms the need to compare classical biomarkers used for the monitoring of glyco-metabolic alterations with new ones, likely more reliable and effective in specific subgroups of patients in which the classic biomarkers can be influenced by the preexisting pathological conditions. Conclusions: In conclusion, our evidence highlights that in uremic patients, GA shows a better ability to predict glyco-metabolic alterations allowing both an earlier diagnosis of DM and a prompt modulation of the hypoglycemic therapy, thus improving the clinical management of these patients.
Collapse
Affiliation(s)
- Francesca Gabriela Martino
- UOC Clinical Pathology, Hospital San Filippo Neri Laboratory HUB, ASL Roma 1, 00135 Rome, Italy; (F.G.M.); (M.V.)
| | - Marina Vitillo
- UOC Clinical Pathology, Hospital San Filippo Neri Laboratory HUB, ASL Roma 1, 00135 Rome, Italy; (F.G.M.); (M.V.)
| | - Massimo Pieri
- Department of Experimental Medicine, Clinical Biochemistry, University of Rome Tor Vergata, 00133 Rome, Italy; (M.P.); (M.D.); (S.B.)
| | - Giulia Marrone
- UOC of Internal Medicine—Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata Via Montpellier, 00133 Rome, Italy; (G.M.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Fabio Gangeri
- UOC Nephrology and Dialysis, Santo Spirito Hospital, ASL Roma 1, 00193 Rome, Italy;
| | - Ferruccio Ansali
- UOC Nephrology and Dialysis, San Paolo Hospital, ASL Roma 4, 00053 Civitavecchia, Italy;
- UDD Nephrology and Dialysis, Padre Pio Hospital, ASL Roma 4, 00062 Bracciano, Italy
| | - Mariarita Dessì
- Department of Experimental Medicine, Clinical Biochemistry, University of Rome Tor Vergata, 00133 Rome, Italy; (M.P.); (M.D.); (S.B.)
| | - Sergio Bernardini
- Department of Experimental Medicine, Clinical Biochemistry, University of Rome Tor Vergata, 00133 Rome, Italy; (M.P.); (M.D.); (S.B.)
| | - Nicola Di Daniele
- UOC of Internal Medicine—Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata Via Montpellier, 00133 Rome, Italy; (G.M.); (N.D.D.)
| | - Annalisa Noce
- UOC of Internal Medicine—Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata Via Montpellier, 00133 Rome, Italy; (G.M.); (N.D.D.)
- Correspondence: ; Tel./Fax: +39-06-20902188
| |
Collapse
|
60
|
Anemia and PET imaging. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00442-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
61
|
Challenges in Patient Blood Management for Cardiac Surgery: A Narrative Review. J Clin Med 2021; 10:jcm10112454. [PMID: 34205971 PMCID: PMC8198483 DOI: 10.3390/jcm10112454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
About 15 years ago, Patient Blood Management (PBM) emerged as a new paradigm in perioperative medicine and rapidly found support of all major medical societies and government bodies. Blood products are precious, scarce and expensive and their use is frequently associated with adverse short- and long-term outcomes. Recommendations and guidelines on the topic are published in an increasing rate. The concept aims at using an evidence-based approach to rationalize transfusion practices by optimizing the patient's red blood cell mass in the pre-, intra- and postoperative periods. However, elegant as a concept, the implementation of a PBM program on an institutional level or even in a single surgical discipline like cardiac surgery, can be easier said than done. Many barriers, such as dogmatic ideas, logistics and lack of support from the medical and administrative departments need to be overcome and each center must find solutions to their specific problems. In this paper we present a narrative overview of the challenges and updated recommendations for the implementation of a PBM program in cardiac surgery.
Collapse
|
62
|
Boonkaew S, Teengam P, Jampasa S, Rengpipat S, Siangproh W, Chailapakul O. Cost-effective paper-based electrochemical immunosensor using a label-free assay for sensitive detection of ferritin. Analyst 2021; 145:5019-5026. [PMID: 32520014 DOI: 10.1039/d0an00564a] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ferritin, a blood cell protein containing iron, is a crucial biomarker that is used to estimate the risk assessment of iron deficiency anemia. For point-of-care analysis, a reliable, cost-effective, selective, sensitive, and portable tool is extremely necessary. In this study, a label-free electrochemical immunosensor for detecting ferritin using a paper-based analytical device (ePAD) was created. The device pattern was custom designed onto filter paper to successfully fabricate a deliverable immunosensor. Graphene oxide was first modified onto the working electrode using an inkjet printing technique. An activation step of the electrode surface was then performed using standard 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC)/N-hydroxysulfosuccinimide (sulfo-NHS) chemistry. Anti-ferritin antibodies were covalently immobilized onto the amine-reactive ester surface. The amount of ferritin was monitored by observing the electrochemical signal of the selected redox couple by differential pulse voltammetry (DPV). In the presence of ferritin, the sensor showed a considerable decrease in electrochemical response in a concentration-dependent manner. In contrast, there was no observable change in current response detected in the absence of ferritin. The current response provided a good correlation with ferritin concentrations in the range of 1 to 1000 ng mL-1, and the limit of detection (3SD/slope) was found to be 0.19 ng mL-1. This fabricated immunosensor offered good selectivity, reproducibility, and long-term storage stability. In addition, this proposed immunosensor was successfully applied to detect ferritin in human serum with satisfactory results. The promising results suggested that this handmade paper-based immunosensor may be an alternative device for the diagnosis of iron deficiency anemia.
Collapse
Affiliation(s)
- Suchanat Boonkaew
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Chulalongkorn University, Bangkok, Pathumwan 10330, Thailand
| | - Prinjaporn Teengam
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Chulalongkorn University, Bangkok, Pathumwan 10330, Thailand
| | - Sakda Jampasa
- Institute of Biotechnology and Genetic Engineering, Chulalongkorn University, Bangkok 10330, Pathumwan, Thailand
| | - Sirirat Rengpipat
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Pathumwan 10330, Thailand
| | - Weena Siangproh
- Department of Chemistry, Faculty of Science, Srinakharinwirot University, Bangkok, Wattana 10110, Thailand
| | - Orawon Chailapakul
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Chulalongkorn University, Bangkok, Pathumwan 10330, Thailand and Center of Excellence on Petrochemical and Materials Technology, Chulalongkorn University, Bangkok, Pathumwan 10330, Thailand.
| |
Collapse
|
63
|
On Iron Metabolism and Its Regulation. Int J Mol Sci 2021; 22:ijms22094591. [PMID: 33925597 PMCID: PMC8123811 DOI: 10.3390/ijms22094591] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/14/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023] Open
Abstract
Iron is a critical metal for several vital biological processes. Most of the body’s iron is bound to hemoglobin in erythrocytes. Iron from senescent red blood cells is recycled by macrophages in the spleen, liver and bone marrow. Dietary iron is taken up by the divalent metal transporter 1 (DMT1) in enterocytes and transported to portal blood via ferroportin (FPN), where it is bound to transferrin and taken up by hepatocytes, macrophages and bone marrow cells via transferrin receptor 1 (TfR1). While most of the physiologically active iron is bound hemoglobin, the major storage of most iron occurs in the liver in a ferritin-bound fashion. In response to an increased iron load, hepatocytes secrete the peptide hormone hepcidin, which binds to and induces internalization and degradation of the iron transporter FPN, thus controlling the amount of iron released from the cells into the blood. This review summarizes the key mechanisms and players involved in cellular and systemic iron regulation.
Collapse
|
64
|
Effect of hepcidin antagonists on anemia during inflammatory disorders. Pharmacol Ther 2021; 226:107877. [PMID: 33895185 DOI: 10.1016/j.pharmthera.2021.107877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/20/2021] [Indexed: 12/11/2022]
Abstract
Iron is an essential element for the mammalian body however, its homeostasis must be regulated accurately for appropriate physiological functioning. Alterations in physiological iron levels can lead to moderate to severe iron disorders like chronic and acute iron deficiency (anemia) or iron overload. Hepcidin plays an important role in regulating homeostasis between circulating iron and stored iron in the cells as well as the absorption of dietary iron in the intestine. Inflammatory disorders restrict iron absorption from food due to increased circulating levels of hepcidin. Increased production of hepcidin causes ubiquitination of ferroportin (FPN) leading to its degradation, thereby retaining iron in the spleen, duodenal enterocytes, macrophages, and hepatocytes. Hepcidin inhibitors and antagonists play a consequential role to ameliorate inflammation-associated anemia. Many natural and synthesized compounds, able to reduce hepcidin expression during inflammation have been identified in recent years. Few of which are currently at various phases of clinical trial. This article comprises a comprehensive review of therapeutic approaches for the efficient treatment of anemia associated with inflammation. Many strategies have been developed targeting the hepcidin-FPN axis to rectify iron disorders. Hepcidin modulation with siRNAs, antibodies, chemical compounds, and plant extracts provides new insights for developing advanced therapeutics for iron-related disorders. Hepcidin antagonist's treatment has a high potential to improve iron status in patients with iron disorders, but their clinical success needs further recognition along with the identification and application of new therapeutic approaches.
Collapse
|
65
|
Ilardi L, Proto A, Ceroni F, Morniroli D, Martinelli S, Mosca F, Giannì ML. Overview of Important Micronutrients Supplementation in Preterm Infants after Discharge: A Call for Consensus. Life (Basel) 2021; 11:331. [PMID: 33920163 PMCID: PMC8069002 DOI: 10.3390/life11040331] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 01/10/2023] Open
Abstract
Preterm infants have a lower level of nutrient body stores and immature body systems, resulting in a higher risk of malnutrition. Imbalanced complementary feeding could lead to further risk of nutritional deficits and excesses. However, evidence on their nutritional requirements following hospital discharge is limited. When planning complementary feeding, appropriate micronutrient intake should be considered for their critical role in supporting various body functions. This narrative review summarizes the need for iron, zinc, vitamin D, calcium, phosphate and long-chain polyunsaturated fatty acids (LCPUFAs) supplementation in preterm infants during complementary feeding. Regarding iron and vitamin D, the scientific community is reaching an agreement on supplementation in some categories of prematures. On the contrary, there is still not enough evidence to detail possible recommendations for LCPUFAs, zinc, calcium and phosphorus supplementation. However, these micronutrients are paramount for preterms' health: LCPUFAs can promote retinal and brain development while calcium and phosphorus supplementation is essential to prevent preterms' metabolic bone disease (MBD). Waiting for a consensus on these micronutrients, it is clear how the knowledge of the heterogeneity of the prematures population can help adjust the nutritional planning regarding the growth rate, comorbidities and comprehensive clinical history of the preterm infant.
Collapse
Affiliation(s)
- Laura Ilardi
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (L.I.); (A.P.); (S.M.)
| | - Alice Proto
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (L.I.); (A.P.); (S.M.)
| | - Federica Ceroni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (F.C.); (F.M.)
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy;
| | - Stefano Martinelli
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (L.I.); (A.P.); (S.M.)
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (F.C.); (F.M.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy;
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (F.C.); (F.M.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy;
| |
Collapse
|
66
|
Gajbhiye S, Koli PG, Harit M, Chitrakar M, Bavane V, Chawda M. An Evaluation of the Efficacy, Safety, and Tolerability of Abhraloha Compared With Oral Ferrous Ascorbate on Iron Deficiency Anemia in Women: A Randomized Controlled, Parallel-Group, Assessor-Blind Clinical Trial. Cureus 2021; 13:e14348. [PMID: 33972905 PMCID: PMC8104902 DOI: 10.7759/cureus.14348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/05/2022] Open
Abstract
Background and objective Iron deficiency anemia (IDA) is a common condition in women for which ferrous ascorbate (FA) is often prescribed, which can lead to multiple side effects. Abhraloha is an Ayurvedic medicine that has been used for decades in India to treat IDA. In this study, we aimed to evaluate the efficacy and safety of Abhraloha with regard to change in hemoglobin (Hb) levels as compared to the standard treatment using FA in participants with IDA. Materials and methods We conducted a single-center, pragmatic, prospective, randomized, active-controlled, two-arm, parallel-group, assessor-blind study to evaluate the efficacy and safety of Abhraloha with regard to change in Hb levels as compared to the standard treatment using FA in participants suffering from IDA. The eligible participants were randomized and were advised to take either Abhraloha (two tablets twice a day) or FA (one tablet twice a day) for eight weeks; they were asked to follow up after 14 days for re-evaluation. On visit 1 and during the study period, the physician assessed the participants on the Pandurog scale and subjective variables. Descriptive statistics were used with unpaired T-test/Mann-Whitney U test for comparison between the groups. The Wilcoxon signed-rank test was used for within-group analysis, and the chi-square test/Fisher's exact test was employed for categorical data. Results Based on our findings, Abhraloha tablets significantly increased all the variables including the Pandurog scale after eight weeks of treatment. Abhraloha reduced total iron-binding capacity (TIBC) and peripheral smear lymphocyte (PSL), which is consistent with an improvement in IDA. There was a statistically significant increase in Hb, red blood cell (RBC) count, packed cell volume (PCV), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in the Abhraloha group as compared with the FA group at eight weeks. The Abhraloha group also exhibited a statistically significant improvement in all the subjective variables. Abhraloha was found to be safe and well-tolerated among the participants. Conclusions Abhraloha possesses hematinic activity and it improves all the blood indices. It is associated with significantly fewer adverse effects compared to oral iron therapy, which proves that it can be safely used for the treatment of IDA.
Collapse
Affiliation(s)
- Snehalata Gajbhiye
- Pharmacology and Therapeutics, Seth Gordhandas Sunderdas Medical College - King Edward Memorial Hospital, Mumbai, IND
| | - Paresh G Koli
- Pharmacology, Seth Gordhandas Sunderdas Medical College - King Edward Memorial Hospital, Mumbai, IND
- Pharmacology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Mumbai, IND
| | - Maheshkumar Harit
- Department of Swasthavritta and Yoga, DY Patil Deemed To Be University School of Ayurveda, Mumbai, IND
| | - Mrudul Chitrakar
- Department of Swasthavritta and Yoga, DY Patil Deemed To Be University School of Ayurveda, Mumbai, IND
| | - Vishnu Bavane
- Department of Swasthavritta and Yoga, DY Patil Deemed To Be University School of Ayurveda, Mumbai, IND
| | - Mukesh Chawda
- Medical Services, Shree Dhootapapeshwar Limited, Mumbai, IND
| |
Collapse
|
67
|
Berger MM, Herter-Aeberli I, Zimmermann MB, Spieldenner J, Eggersdorfer M. Strengthening the immunity of the Swiss population with micronutrients: A narrative review and call for action. Clin Nutr ESPEN 2021; 43:39-48. [PMID: 34024545 PMCID: PMC7987506 DOI: 10.1016/j.clnesp.2021.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The enormous health impact of the COVID-19 pandemic has refocused attention on measures to optimize immune function and vaccine response. Dietary deficiencies of micronutrients can weaken adaptive immunity. The aim of this review was to examine links between micronutrients, immune function and COVID-19 infection, with a focus on nutritional risks in subgroups of the Swiss population. METHODS Scoping review on the associations between selected micronutrients (vitamins D and C, iron, selenium, zinc, and n-3 PUFAs) and immunity, with particular reference to the Swiss population. These nutrients were chosen because previous EFSA reviews have concluded they play a key role in immunity. RESULTS The review discusses the available knowledge on links between sufficient nutrient status, optimal immune function, and prevention of respiratory tract infections. Because of the rapid spread of the COVID-19 pandemic, controlled intervention studies of micronutrients in the context of COVID-19 infection are now underway, but evidence is not yet available to draw conclusions. The anti-inflammatory properties of n-3 PUFAs are well established. In Switzerland, several subgroups of the population are at clear risk of nutrient deficiencies; e.g., older adults, multiple comorbidities, obesity, pregnancy, and institutionalized. Low intakes of n-3 PUFA are present in a large proportion of the population. CONCLUSION There are clear and strong relationships between micronutrient and n-3 PUFA status and immune function, and subgroups of the Swiss population are at risk for deficient intakes. Therefore, during the COVID-19 pandemic, as a complement to a healthy and balanced diet, it may be prudent to consider supplementation with a combination of moderate doses of Vitamins C and D, as well as of Se, Zn and n-3 PUFA, in risk groups.
Collapse
Affiliation(s)
- Mette M Berger
- Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland.
| | | | | | - Manfred Eggersdorfer
- Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
| |
Collapse
|
68
|
Madhushani C. Haputhanthri, Hasini R. Perera. A Novel Potentiometric Ion Selective Electrode Based on Piperine for the Determination of Fe(III) Ions. JOURNAL OF ANALYTICAL CHEMISTRY 2021. [DOI: 10.1134/s1061934821010032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
69
|
Kulkarni A, Khade M, Arun S, Badami P, Kumar GRK, Dattaroy T, Soni B, Dasgupta S. An overview on mechanism, cause, prevention and multi-nation policy level interventions of dietary iron deficiency. Crit Rev Food Sci Nutr 2021; 62:4893-4907. [PMID: 33543636 DOI: 10.1080/10408398.2021.1879005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Iron deficiency anemia (IDA) is probably the most ignored situation in the world of malnutrition-largely due to its slow progression. Multiple reasons can be attributed as the cause of IDA, which is not limited to any specific region or population; therefore, making it a matter of global concern. Despite the human body's ability to absorb and conserve iron stores, the gradual loss due to various physiological conditions leads to net deficiency of iron. Countless commercial iron supplements are available, but at given physiological conditions, almost all of these "Bio-not-available" iron forms quite often become ineffective. World Health Organization and other government bodies have jointly developed health advisories and tried to developed nutrition supplements several times in the last two decades. IDA, when combined with other disease conditions, becomes a life-threatening situation. At the same time, an overdose of iron could also be very harmful to the body. Therefore, it is important to deal with this situation with caution. This article covers iron metabolism, available options for iron supplementation, regulatory aspects and strategies to prevent IDA.
Collapse
Affiliation(s)
- Abhishek Kulkarni
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - Monika Khade
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - Sharadha Arun
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - Pranesh Badami
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - G Raja Krishna Kumar
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - Tomal Dattaroy
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - Badrish Soni
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| | - Santanu Dasgupta
- Synthetic Biology Group, Reliance Corporate Park, Reliance Industries Limited, Ghansoli, Navi Mumbai, India
| |
Collapse
|
70
|
Sim PY, Taribagil P, Woollacott IOC, Rashid S, Kidd DP. Idiopathic intracranial hypertension presenting as iron deficiency anemia: a case report. J Med Case Rep 2021; 15:45. [PMID: 33526092 PMCID: PMC7852283 DOI: 10.1186/s13256-020-02631-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The presentation of idiopathic intracranial hypertension (IIH) in association with iron deficiency anemia (IDA) is rare. CASE PRESENTATION This case report depicts the unusual case of a 31-year-old woman of mixed Jamaican and English heritage with IIH who presented initially as IDA in the context of menorrhagia. Subsequent ophthalmic review, lumbar puncture, cerebrospinal fluid analysis and neuroimaging studies revealed severe bilateral optic disc swelling and raised intracranial pressure in keeping with IIH. Prompt treatment of IDA with blood transfusion and orally administered iron supplements, in addition to medical treatment for IIH, contributed to significant improvement of symptoms and prevented long-term visual deficits. CONCLUSION The possibility of IDA, albeit rare, should always be considered and investigated appropriately in all patients with IIH, as the treatment of the anemia alone may be sight-saving.
Collapse
Affiliation(s)
- Peng Yong Sim
- Department of Ophthalmology, Royal Free Hospital, London, UK.
| | | | | | - Safina Rashid
- Department of Ophthalmology, Royal Free Hospital, London, UK
| | - Desmond P Kidd
- Department of Ophthalmology, Royal Free Hospital, London, UK.,Department of Neurology, Royal Free Hospital, London, UK
| |
Collapse
|
71
|
Majoni SW, Lawton PD, Rathnayake G, Barzi F, Hughes JT, Cass A. Narrative Review of Hyperferritinemia, Iron Deficiency, and the Challenges of Managing Anemia in Aboriginal and Torres Strait Islander Australians With CKD. Kidney Int Rep 2021; 6:501-512. [PMID: 33615076 PMCID: PMC7879094 DOI: 10.1016/j.ekir.2020.10.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Abstract
Aboriginal and Torres Strait Islander Australians (Indigenous Australians) suffer some of the highest rates of chronic kidney disease (CKD) in the world. Among Indigenous Australians in remote areas of the Northern Territory, prevalence rates for renal replacement therapy (RRT) are up to 30 times higher than national prevalence. Anemia among patients with CKD is a common complication. Iron deficiency is one of the major causes. Iron deficiency is also one of the key causes of poor response to the mainstay of anemia therapy with erythropoiesis-stimulating agents (ESAs). Therefore, the effective management of anemia in people with CKD is largely dependent on effective identification and correction of iron deficiency. The current identification of iron deficiency in routine clinical practice is dependent on 2 surrogate markers of iron status: serum ferritin concentration and transferrin saturation (TSAT). However, questions exist regarding the use of serum ferritin concentration in people with CKD because it is an acute-phase reactant that can be raised in the context of acute and chronic inflammation. Serum ferritin concentration among Indigenous Australians receiving RRT is often markedly elevated and falls outside reference ranges within most national and international guidelines for iron therapy for people with CKD. This review explores published data on the challenges of managing anemia in Indigenous people with CKD and the need for future research on the efficacy and safety of treatment of anemia of CKD in patients with high ferritin and evidence iron deficiency.
Collapse
Affiliation(s)
- Sandawana William Majoni
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Flinders University and Northern Territory Medical Program, Royal Darwin Hospital Campus, Darwin, Northern Territory, Australia
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Paul D. Lawton
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Geetha Rathnayake
- Flinders University and Northern Territory Medical Program, Royal Darwin Hospital Campus, Darwin, Northern Territory, Australia
- Chemical Pathology–Territory Pathology, Department of Health, Northern Territory Government, Northern Territory, Australia
| | - Federica Barzi
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Jaquelyne T. Hughes
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Alan Cass
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| |
Collapse
|
72
|
Almehmadi M, Salih M, Elmissbah TE, Alsharif A, Alsiwiehri N, Alzahrani K, Shafie A, Dahlawi H. Prevalence of anemia among Saudi patients with solid cancers at diagnosis in King Faisal Hospital, Taif Province, Kingdom of Saudi Arabia. PLoS One 2021; 16:e0246202. [PMID: 33507998 PMCID: PMC7842985 DOI: 10.1371/journal.pone.0246202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/14/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence of anemia among patients newly diagnosed with solid malignancies at King Faisal Hospital in Taif Province, Kingdom of Saudi Arabia. METHODS A descriptive, cross-sectional, hospital-based study was conducted from December 2017 to March 2020. A total of 320 patients newly diagnosed with solid malignancy were examined to assess anemia prevalence. RESULTS Of 320 patients with solid cancers, 245 (76.6%) were female and 75 (23.4%) were male. The median (interquartile range) age of 57 (45 ─ 66) years, range between 16 and 108 years. The types of cancer included were breast (29.1%), female genital tract (20.0%), colorectal (25.3%), head and neck (10.3%), urinary bladder (4.7%), prostate (5.0%), lung (2.5%), liver (2.2%) and lymphoma (0.9%). The prevalence of anemia at diagnosis of cancer was 44.1% across all cancer types. A higher anemia prevalence was noted in colorectal (n = 46/81, 56.8%) (p = 0.047). CONCLUSION Patients with colorectal or female genital tract cancers had a higher anemia prevalence (56.8% and 43.8%, respectively) than did patients with other cancers.
Collapse
Affiliation(s)
- Mazen Almehmadi
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| | - Magdi Salih
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
- * E-mail:
| | - Tariq E. Elmissbah
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| | - Abdulaziz Alsharif
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| | - Naif Alsiwiehri
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| | - Khalid Alzahrani
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| | - Alaa Shafie
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| | - Haytham Dahlawi
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif Province, Kingdom of Saudi Arabia
| |
Collapse
|
73
|
Sheikh AB, Javed N, Ijaz Z, Barlas V, Shekhar R, Rukov B. Iron deficiency anemia in males: a dosing dilemma? J Community Hosp Intern Med Perspect 2021; 11:46-52. [PMID: 33552414 PMCID: PMC7850434 DOI: 10.1080/20009666.2020.1831743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Iron deficiency anemia is a major problem worldwide treated by replenishment of iron stores. The treatment is complicated by differing pharmacodynamics of administrative routes, equations with design effects, ongoing losses, additional daily requirement, plateauing of markers required for iron absorption, food–drug interactions, gender, and age. Accounting for these factors in one dosing regimen becomes difficult, specifically in males. This review aimed at analyzing multiple dosages of iron supplements in different studies and determining if there are factors that could individualize treatment in male patients. Methods: A scoping review was performed using PubMed, Google Scholar, and ClinicalTrials.gov. We reviewed literature from 1980 to 2020. The keywords used in the review were ‘iron deficiency’, ‘dosage’, ‘males’, and ‘standardized’. Results and conclusions: The review included 1507 male participants from 9 major studies (4 clinical trials, 1 systematic review, 2 prospective and 2 descriptive studies). In the case of males, differences in lean body weight, and factors affecting absorption of iron also need to be considered. In order to thoroughly explore the issues in treatment of iron deficiency anemia, randomized controlled trials are required to investigate the frequency of dosing, impact of vitamin C and proper counselling, and weight changes in male participants.
Collapse
Affiliation(s)
- Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Nismat Javed
- Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Zainab Ijaz
- Department of Internal Medicine , Windsor University School of Medicine, Canyon St. Kitts, Jamaica
| | - Venus Barlas
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Rahul Shekhar
- Department of Internal Medicine, Division of Hospital Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Blavir Rukov
- Department of Internal Medicine, Raymond G. Murphy VA Medical Center, University of New Mexico School of Medicine, Albuquerque, NM, USA
| |
Collapse
|
74
|
Verna G, Sila A, Liso M, Mastronardi M, Chieppa M, Cena H, Campiglia P. Iron-Enriched Nutritional Supplements for the 2030 Pharmacy Shelves. Nutrients 2021; 13:378. [PMID: 33530485 PMCID: PMC7912282 DOI: 10.3390/nu13020378] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 12/18/2022] Open
Abstract
Iron deficiency (ID) affects people of all ages in many countries. Due to intestinal blood loss and reduced iron absorption, ID is a threat to IBD patients, women, and children the most. Current therapies can efficiently recover normal serum transferrin saturation and hemoglobin concentration but may cause several side effects, including intestinal inflammation. ID patients may benefit from innovative nutritional supplements that may satisfy iron needs without side effects. There is a growing interest in new iron-rich superfoods, like algae and mushrooms, which combine antioxidant and anti-inflammatory properties with iron richness.
Collapse
Affiliation(s)
- Giulio Verna
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy
| | - Annamaria Sila
- National Institute of Gastroenterology “S. de Bellis”, Institute of Research, 70013 Castellana Grotte, Italy; (A.S.); (M.L.); (M.M.); (M.C.)
| | - Marina Liso
- National Institute of Gastroenterology “S. de Bellis”, Institute of Research, 70013 Castellana Grotte, Italy; (A.S.); (M.L.); (M.M.); (M.C.)
| | - Mauro Mastronardi
- National Institute of Gastroenterology “S. de Bellis”, Institute of Research, 70013 Castellana Grotte, Italy; (A.S.); (M.L.); (M.M.); (M.C.)
| | - Marcello Chieppa
- National Institute of Gastroenterology “S. de Bellis”, Institute of Research, 70013 Castellana Grotte, Italy; (A.S.); (M.L.); (M.M.); (M.C.)
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, 27100 Pavia, Italy
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy
| |
Collapse
|
75
|
Mishra A, Marwah S, Divedi P, Dewan R, Ahluwalia H. A Cross-Sectional Study of Barriers in Prevention of Anemia in Pregnancy. Cureus 2021; 13:e12802. [PMID: 33628671 PMCID: PMC7894214 DOI: 10.7759/cureus.12802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Anemia in pregnancy is a significant health challenge in India and other developing countries. Various health programs aiming anemia prevention are existing in India for many decades. Despite that, anemia affects more than half of pregnant women. Our objective for performing this study was to evaluate the barriers in the prevention of anemia and to evaluate the perceptions and practices of anemic women towards their condition. Methods A cross-sectional questionnaire-based study, including 210 anemic women, was conducted in a tertiary care center in Delhi, India. In-depth interviews were conducted with 50 participants. Results Our important observations were that anemia was more prevalent in multigravida, and 43.80% of anemic patients were not taking iron supplements at the time of diagnosis. Chronic diseases were associated with 28.2% (n=59) of anemic women. Only 19% (n=40) of women sought antenatal care in the first and second trimester; the rest all booked themselves in the third trimester only. Twenty-two percent (n=48) of women reached our hospital after 36 weeks. Ignorance to anemia symptoms and the importance of consistent intake of the oral iron supplements was seen in 35.2% (n=74). One hundred and sixty-five (74.8%) women accepted that healthcare provider had informed them about iron-rich and high protein diet, but only 47.1% (n=98) actually made dietary modifications. Only 9.5% (n=20) of women were consistent in iron intake. Side effects of iron were reported by 30% (n=64) of women, and 15% (n=32) were intolerant to oral iron. Non-availability, change of residence, and forgetfulness were the main reasons behind non-compliance to oral iron. Conclusion We emphasize motivation for early registration, regular antenatal care, adequate iron supplement supply, and persistent counseling to ensure compliance to iron supplements by the antenatal care provider. Behavior-changing communication is needed at a societal level for antenatal mothers and their families aiming to prevent anemia in pregnancy instead of focussing on treatment.
Collapse
Affiliation(s)
- Archana Mishra
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Sheeba Marwah
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Pragati Divedi
- Department of Obstetrics and Gynecology, Rama Medical College and Hospital, Hapur, IND
| | - Rupali Dewan
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Himani Ahluwalia
- Department of Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| |
Collapse
|
76
|
TEKİN M, UZUN ND, UZUN F. Evaluation of ferric carboxymaltose treatment efficacy in women with postpartum iron deficiency anemia. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.800829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
77
|
Nazarenko A, Zaiko O, Korotkevich O, Konovalova T, Osintseva L. Correlation of the iron level in the bristles of Kemerovo pigs with macro- and essential microelements. BIO WEB OF CONFERENCES 2021. [DOI: 10.1051/bioconf/20213606032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Correlation data analysis of the iron content with macro- and essential microelements, as well as on the group of chemical elements interrelated with the Fe level in pig bristles are presented. The studies were carried out of the Kemerovo region on six-month-old pigs of the Kemerovo breed. Chemical analysis of swine bristle samples was carried out using atomic absorption spectrometry. The data were processed using of the program R. Only positive relationships were established between the iron content and the chemical elements of the bristle, as well as the group of chemical elements associated with the Fe level in the bristle. Most of the connections are explained by comparing the data obtained with the research of other scientists on the topic.
Collapse
|
78
|
ABUALHASAN M, DWAIKAT S, ATAYA R, ALI A, AL-ATRASH M. Quality evaluation of iron-containing food supplements in the Palestinian market. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1590/fst.01621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
79
|
Lone NM, Shah SHS, Farooq M, Arif M, Younis S, Riaz S. Role of TMPRSS6 rs855791 (T > C) polymorphism in reproductive age women with iron deficiency anemia from Lahore, Pakistan. Saudi J Biol Sci 2021; 28:748-753. [PMID: 33424363 PMCID: PMC7785418 DOI: 10.1016/j.sjbs.2020.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is the highest nutritional deficiency worldwide. It is a multifactorial disease, with a higher morbidity rate. TMPRSS6 polymorphisms importantly rs855791 is found to play an essential role in iron homeostasis in the human body. The rs855791 (T > C) polymorphism is highly associated with iron levels, and multiple blood parameters, leading to IDA. The role of TMPRSS6 rs855791 polymorphism and the significance of complete blood count (CBC) parameters in the pathogenesis of IDA is not yet studied in the Pakistani population. METHODS We enrolled 113 cases and 136 controls to conduct a case control study. Complete blood count (CBC) and iron parameters were analyzed for association studies. PCR-RFLP based genotyping was performed. RESULTS The TMPRSS6 rs855791 (T > C) polymorphism is significantly associated with IDA pathogenesis as observed in the codominant model and recessive models (P < 0.05, OR: 1.5 and 95% CI: 0.9, 2.6, P < 0.05, OR: 0.5 and 95% CI: 0.2, 0.9 respectively). Elderly women among cases (30-49 years) were found to be more susceptible to IDA (P < 0.05, AOR: 2.1 and 95% CI: 1.0, 4.2). The most significant parameters associated with IDA were red blood cell count (RBC) and hematocrit (Hct%) (P < 0.05, AOR: 16.5, 95% CI: 7.6, 35.9 and P < 0.05, AOR: 10.1, 95% CI: 2.5, 41.6, respectively). CONCLUSION TMPRSS6 polymorphism at rs855791 (T > C) is significantly associated with IDA susceptibility in reproductive age women in Pakistan. Age, RBC count and Hct% are found to play an important role in IDA pathogenesis in our study population.
Collapse
Key Words
- CBC, Complete blood count
- Fe, Iron
- Ferritin
- GWAS, gGenome wide association studies
- Hb, Hemoglobin
- Hct%, Hematocrit%
- Hemoglobin
- ID, Iron deficiency
- IDA
- IDA, Iron deficiency anemia
- IRIDA, Iron refractory iron deficiency anemia
- MCH, Mean corpuscular hemoglobin
- MCHC, Mean corpuscular hemoglobin concentration
- MCV, Mean corpuscular volume
- PCR-RFLP, Polymerase chain reaction- restriction length polymorphism
- Rs855791 (T>C)
- SNP, Single nucleotide polymorphisms
- TIBC, Total iron binding capacity
- TMPRSS6
- WHO, World health organization
Collapse
Affiliation(s)
- Nasira Munawar Lone
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | | | - Mariya Farooq
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Mizna Arif
- Citi Lab and Research Center Lahore, Pakistan
- Department of Pathology, Ameer ud din Medical College, General Hospital, Lahore, Pakistan
| | - Sidra Younis
- Department of Biological Sciences, National University of Medical Sciences, Abid Majeed Road, Rawalpindi, Pakistan
| | - Saba Riaz
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
- Citi Lab and Research Center Lahore, Pakistan
| |
Collapse
|
80
|
Cotter J, Baldaia C, Ferreira M, Macedo G, Pedroto I. Diagnosis and treatment of iron-deficiency anemia in gastrointestinal bleeding: A systematic review. World J Gastroenterol 2020; 26:7242-7257. [PMID: 33362380 PMCID: PMC7723662 DOI: 10.3748/wjg.v26.i45.7242] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/10/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency. Iron-deficiency anemia (IDA) often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women, and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%. However, few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.
AIM To review current evidence and guidelines concerning IDA management in gastrointestinal bleeding patients to develop recommendations for its diagnosis and therapy.
METHODS Five gastroenterology experts formed the Digestive Bleeding and Anemia Workgroup and conducted a systematic literature search in PubMed and professional association websites. MEDLINE (via PubMed) searches combined medical subject headings (MeSH) terms and the keywords “gastrointestinal bleeding” with “iron-deficiency anemia” and “diagnosis” or “treatment” or “management” or “prognosis” or “prevalence” or “safety” or “iron” or “transfusion” or “quality of life”, or other terms to identify relevant articles reporting the management of IDA in patients over the age of 18 years with gastrointestinal bleeding; retrieved studies were published in English between January 2003 and April 2019. Worldwide professional association websites were searched for clinical practice guidelines. Reference lists from guidelines were reviewed to identify additional relevant articles. The recommendations were developed by consensus during two meetings and were supported by the published literature identified during the systematic search.
RESULTS From 494 Literature citations found during the initial literature search, 17 original articles, one meta-analysis, and 13 clinical practice guidelines were analyzed. Based on the published evidence and clinical experience, the workgroup developed the following ten recommendations for the management of IDA in patients with gastrointestinal bleeding: (1) Evaluation of hemoglobin and iron status; (2) Laboratory testing; (3) Target treatment population identification; (4) Indications for erythrocyte transfusion; (5) Treatment targets for erythrocyte transfusion; (6) Indications for intravenous iron; (7) Dosages; (8) Monitoring; (9) Indications for intravenous ferric carboxymaltose treatment; and (10) Treatment targets and monitoring of patients. The workgroup also proposed a summary algorithm for the diagnosis and treatment of IDA in patients with acute or chronic gastrointestinal bleeding, which should be implemented during the hospital stay and follow-up visits after patient discharge.
CONCLUSION These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding, which ultimately may improve health outcomes in these patients.
Collapse
Affiliation(s)
- José Cotter
- Department of Gastroenterology, Hospital da Senhora da Oliveira-Guimarães, Guimarães 4835-044, Portugal
- Department of Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga 4710-057, Portugal
- Department of Life and Health Sciences Research Institute (ICVS)/3B’s, PT Government Associate Laboratory, Braga 4710-057, Portugal
| | - Cilénia Baldaia
- Department of Gastroenterology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon 1649-035, Portugal
- Department of University Clinic of Medicine II, Faculty of Medicine, University of Lisbon, Lisbon 1649-028, Portugal
| | - Manuela Ferreira
- Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-075, Portugal
- Department of Faculty of Medicine, University of Coimbra, Coimbra 3004-504, Portugal
| | - Guilherme Macedo
- Department of Gastroenterology, Centro Hospitalar de São João, Porto 4200-319, Portugal
- Department of Gastroenterology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
- Department of Gastroenterology and Hepatology Training Center, World Gastroenterology Organization, Porto 4200-319, Portugal
| | - Isabel Pedroto
- Department of Gastroenterology, Centro Hospitalar do Porto, Porto 4099-001, Portugal
- Department of Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto 4050-313, Portugal
| |
Collapse
|
81
|
Effect of germination on the nutritional profile of quinoa (
Cheopodium quinoa
Willd.) seeds and its anti‐anemic potential in Sprague–Dawley male albino rats. Cereal Chem 2020. [DOI: 10.1002/cche.10366] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
82
|
Predictors of iron-deficiency anemia in primary care older adults: a real-world European multi-country longitudinal study. Aging Clin Exp Res 2020; 32:2211-2216. [PMID: 31893385 DOI: 10.1007/s40520-019-01454-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/16/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Iron deficiency is a major cause of anemia in older people. Increasing the knowledge on the predictors of iron-deficiency anemia (IDA) may facilitate its timely diagnosis. AIM To investigate the predictors of IDA in older people in four European countries. DESIGN AND SETTING Retrospective longitudinal study. Primary care patients aged 65 or older (N = 24,051) in four European countries. METHODS IDA predictors were estimated using multivariate Cox regression based on information gathered from national primary care databases: Italy (years 2002-2013), Belgium, Germany and Spain (years 2007-2012). Adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) were estimated. RESULTS In Spain and Belgium, men were at greater risk of IDA than women, while they had a lower risk in Italy. Weakness, irritability, alopecia and xerostomia were signs and symptoms significantly associated with IDA. Concurrent diseases, potential causes of anemia, positively associated with IDA were small bowel polyposis, stomach cancer, obesity, gastritis and peptic ulcer, esophagitis, Crohn's disease, celiac disease, lymphangiectasis, gastrectomy or gastric atrophy, gut resection or bypass, and cardiac prosthetic valve. Aspirin users had a 12-35% higher hazard of IDA than non-users. Similarly, corticosteroids and anti-acids were positively associated with IDA. A higher level of comorbidity was associated with an increased hazard of IDA in all countries. CONCLUSIONS Specific signs and symptoms, chronic conditions, a greater comorbidity burden, and specific pharmacological treatments registered in primary care databases represent relevant predictors and correlates of incident IDA in older people in Europe. General practitioners might employ this information to obtain early diagnosis of IDA in community-dwelling older adults.
Collapse
|
83
|
Impacts of Green Tea on Joint and Skeletal Muscle Health: Prospects of Translational Nutrition. Antioxidants (Basel) 2020; 9:antiox9111050. [PMID: 33126483 PMCID: PMC7692648 DOI: 10.3390/antiox9111050] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/14/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis and sarcopenia are two major joint and skeletal muscle diseases prevalent during aging. Osteoarthritis is a multifactorial progressive degenerative and inflammatory disorder of articular cartilage. Cartilage protection and pain management are the two most important strategies in the management of osteoarthritis. Sarcopenia, a condition of loss of muscle mass and strength, is associated with impaired neuromuscular innervation, the transition of skeletal muscle fiber type, and reduced muscle regenerative capacity. Management of sarcopenia requires addressing both skeletal muscle quantity and quality. Emerging evidence suggests that green tea catechins play an important role in maintaining healthy joints and skeletal muscle. This review covers (i) the prevalence and etiology of osteoarthritis and sarcopenia, such as excessive inflammation and oxidative stress, mitochondrial dysfunction, and reduced autophagy; (ii) the effects of green tea catechins on joint health by downregulating inflammatory signaling mediators, upregulating anabolic mediators, and modulating miRNAs expression, resulting in reduced chondrocyte death, collagen degradation, and cartilage protection; (iii) the effects of green tea catechins on skeletal muscle health via maintaining a dynamic balance between protein synthesis and degradation and boosting the synthesis of mitochondrial energy metabolism, resulting in favorable muscle homeostasis and mitigation of muscle atrophy with aging; and (iv) the current study limitations and future research directions.
Collapse
|
84
|
Kowsar R, Komeili M, Sadeghi N, Sadeghi K. Multistep analysis reveals the relationship between blood indices at the time of ovum pick-up and in vitro embryo production in heifers. Theriogenology 2020; 159:153-164. [PMID: 33157453 DOI: 10.1016/j.theriogenology.2020.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/08/2020] [Accepted: 10/22/2020] [Indexed: 10/23/2022]
Abstract
The inflammatory factors of complete blood count (CBC) are associated with a decrease in the in vitro embryo production (IVP) outcome in women. The relation between the blood indices and in vitro fertilization (IVF) outcomes in bovines remains to be elucidated. Using ovum pick-up (OPU), oocytes were retrieved from heifers (n = 60) and inseminated separately with sperm. The blastocyst formation was recorded on day 7 after insemination for each animal and the blood indices were evaluated at the time of OPU. Then, heifers were classified on the basis of (1) blastocyst formation, cleaved vs. failed, or (2) inflammation, low-grade inflammation (lymphocyte counts > 5.6 × 109/L) vs. no inflammation (lymphocyte counts < 5.6 × 109/L). Oocytes derived from heifers with higher lymphocytes, red blood cells (RBC), platelets, hematocrit, red cell distribution width (RDW-SD) and plateletcrit values and lower monocytes, eosinophils, mean corpuscular hemoglobin (MCH) and MCH concentration (MCHC) successfully developed to the blastocyst stage. Heifers with low-grade inflammation numerically had a higher percentage of blastocyst formation than normal heifers. The principle component analysis (PCA) showed that blastocyst formation had the strongest positive association with RDW-cv and RDW-SD, while having a strong negative association with mean corpuscular volume (MCV), hemoglobin, MCHC and MCH. The PCA determined that the number of grade A COCs and the percentage of COCs reached the cleavage stage had a negative association with white blood cells (WBC), lymphocytes, basophils and monocytes, and a positive correlation with platelet to lymphocyte ratio, platelet distribution width (PDW) and plateletcrit. Network mapping detected close similarities between BFR and RDW-SD, MPV, and lymphocytes. The area under the receiver operating characteristic curve (AUC) identified that, eosinophils (AUC 0.80), RDW-SD (AUC 0.76), monocytes (AUC 0.76) and lymphocytes (AUC 0.76) had a good predictive ability to detect heifers with high OPU-IVP outcome (≥60%). In conclusion, these findings suggest that CBC indices at the time of OPU were associated with the IVF outcome and may be incorporated into protocols for the identification of heifers with high potential for blastocyst formation.
Collapse
Affiliation(s)
- Rasoul Kowsar
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran.
| | - Mehdi Komeili
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| | - Nima Sadeghi
- FKA, Animal Husbandry and Agriculture Co., Isfahan, Iran
| | - Khaled Sadeghi
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| |
Collapse
|
85
|
Lai SW, Tsai KZ, Lin YP, Liu PY, Lin YK, Chang PY, Dai MS, Chao TY, Han CL, Lin GM. Association of red blood cell size and physical fitness in a military male cohort: The CHIEF study. Scand J Med Sci Sports 2020; 31:295-302. [PMID: 32979255 DOI: 10.1111/sms.13836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/05/2020] [Accepted: 09/16/2020] [Indexed: 12/28/2022]
Abstract
Anemia manifested as reduced red blood cell (RBC) amounts or hemoglobin levels has been associated with lower cardiorespiratory fitness. However, the relationship of smaller RBC with physical fitness was unknown. We included 2933 non-anemic military males (hemoglobin levels: 11.1-15.9 g/dL and mean corpuscular volume (MCV) <100 fL) in Taiwan during 2014. Aerobic fitness was assessed by time for a 3000-meter run, and anaerobic fitness was evaluated by numbers of sit-ups and push-ups, each performed within 2 minutes. Multiple linear and logistic regression models adjusting for age, service specialty, lipid profiles, and hemoglobin levels were used to determine the associations. Microcytosis and normocytosis were defined as MCV ≤ 70 fL (n = 190) and MCV > 70 fL (n = 2743), respectively. The linear regression shows that as compared with microcytosis, normocytosis was associated with more numbers of sit-ups performed within 2 minutes (β = 1.51, P-value = 0.02). The logistic regression also reveals that those males with microcytosis had higher probability as the worst 10% performers in the 2-minute push-up test (odds ratio: 1.91, 95% confidence intervals: 1.18-3.12). By contrast, there was no association of microcytosis with 3000-meter running time. Our study suggests that non-anemic microcytosis was associated with lower anaerobic fitness but not with aerobic fitness. Whether the causative factors for microcytosis such as iron deficiency status and thalassemia trait unavailable in the study might account for the relationship needs further investigations.
Collapse
Affiliation(s)
- Shiue-Wei Lai
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Kun-Zhe Tsai
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu Chi General Hospital, New Taipei City, Taiwan
| | - Pang-Yen Liu
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Cardiovascular Medicine, School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yu-Kai Lin
- Departments of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ping-Ying Chang
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Shen Dai
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tsu-Yi Chao
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Hematology and Oncology, Cancer Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.,Department of Medical Research and Education, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Gen-Min Lin
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
86
|
Evaluation of radial peripapillary capillary density in patients with newly diagnosed iron deficiency anemia. Int Ophthalmol 2020; 41:399-407. [PMID: 32924077 DOI: 10.1007/s10792-020-01589-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the effects of iron deficiency anemia (IDA) on radial peripapillary capillary vessel density (RPCvd) and retinal nerve fiber layer (RNFL) thickness. METHODS Forty patients with IDA, and 46 healthy participants, were enrolled in this study. Optical coherence tomography angiography was used to determine RNFL thickness and RPCvd measurements. In addition, hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and ferritin laboratory values were evaluated. RESULTS Analysis of retinal regions (whole images, peripapillary, superior-hemi, inferior-hemi, inferior-nasal, inferior-temporal, temporal-inferior, temporal-superior, superior-nasal) showed that RPCvd values were significantly lower in patients with IDA compared to the control group values (p < 0.05 for all). However, there were no significant differences in RNFL thickness values between the IDA patient group and the control group (p > 0.05 for all). In addition, there were significant positive correlations between RPCvd values and hematological values for Hb, HCT, MCV, MCH, MCHC, and ferritin. CONCLUSION It is important to identify changes in retinal vascularity to prevent possible ocular problems in patients with IDA. Specifically, the significant positive correlations between RPCvd values and hematological values suggest that anemia treatment is important for optic nerve perfusion.
Collapse
|
87
|
Babikir M, Ahmad R, Soliman A, Al-Tikrity M, Yassin MA. Iron-Induced Thrombocytopenia: A Mini-Review of the Literature and Suggested Mechanisms. Cureus 2020; 12:e10201. [PMID: 33042656 PMCID: PMC7534506 DOI: 10.7759/cureus.10201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Anemia constitutes a major global health burden, and iron deficiency is the most common cause of it. Iron deficiency and replacement affect not only hemoglobin (Hb) levels but also other hematological parameters such as platelet count. In this mini-review, we explore thrombocytopenia as a side effect of iron replacement therapy. We searched for relevant articles published in English, and all case reports/series of iron-induced thrombocytopenia were collected and analyzed. A total of 11 case reports and one case series were found relating to very low Hb at a baseline level of 5.25 +/- 2.2 g/dl and variable platelet count at baseline that dropped in 9 +/-3 days to an average of 121 +/- 112 x 109/L, which in most of the cases was self-corrected. The parenteral route was more commonly reported to be associated with thrombocytopenia, and discontinuation of therapy was needed in two patients. The mechanisms, prevalence, and clinical significance of thrombocytopenia associated with iron replacement are unknown; several effects of iron on the primary hematopoietic cells and stromal cell lines have been proposed, such as influence on common progenitors, effects on cytokines, and thrombopoietic effect of erythropoietin, which is directly affected by iron levels. Iron replacement can lead to significant thrombocytopenia. Further research is needed to describe the exact incidence, mechanism, and clinical significance of thrombocytopenia associated with iron supplementation.
Collapse
Affiliation(s)
- Mona Babikir
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Rita Ahmad
- Family Medicine, Hamad Medical Corporation, Doha, QAT
| | - Ashraf Soliman
- Pediatric Endocrinology, Hamad Medical Corporation, Doha, QAT
| | | | | |
Collapse
|
88
|
Grzeszczak K, Kwiatkowski S, Kosik-Bogacka D. The Role of Fe, Zn, and Cu in Pregnancy. Biomolecules 2020; 10:E1176. [PMID: 32806787 PMCID: PMC7463674 DOI: 10.3390/biom10081176] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 12/15/2022] Open
Abstract
Iron (Fe), copper (Cu), and zinc (Zn) are microelements essential for the proper functioning of living organisms. These elements participatein many processes, including cellular metabolism and antioxidant and anti-inflammatory defenses, and also influence enzyme activity, regulate gene expression, and take part in protein synthesis. Fe, Cu, and Zn have a significant impact on the health of pregnant women and in the development of the fetus, as well as on the health of the newborn. A proper concentration of these elements in the body of women during pregnancy reduces the risk of complications such as anemia, induced hypertension, low birth weight, preeclampsia, and postnatal complications. The interactions between Fe, Cu, and Zn influence their availability due to their similar physicochemical properties. This most often occurs during intestinal absorption, where metal ions compete for binding sites with transport compounds. Additionally, the relationships between these ions have a great influence on the course of reactions in the tissues, as well as on their excretion, which can be stimulated or delayed. This review aims to summarize reports on the influence of Fe, Cu, and Zn on the course of single and multiple pregnancies, and to discuss the interdependencies and mechanisms occurring between Fe, Cu, and Zn.
Collapse
Affiliation(s)
- Konrad Grzeszczak
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Danuta Kosik-Bogacka
- Independent Laboratory of Pharmaceutical Botany, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| |
Collapse
|
89
|
Anemia ferropénica en la premenopausia. Aten Primaria 2020; 52:511-513. [PMID: 32165020 PMCID: PMC7393557 DOI: 10.1016/j.aprim.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/02/2019] [Accepted: 10/12/2019] [Indexed: 11/24/2022] Open
|
90
|
Diagnosis, treatment, and work impact of iron deficiency anemia in a Portuguese urban community. Porto Biomed J 2020; 5:e064. [PMID: 32734009 PMCID: PMC7386539 DOI: 10.1097/j.pbj.0000000000000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/29/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Little is known about iron deficiency anemia (IDA)'s treatment in Portugal. We aim to estimate the proportion of anemia, IDA, and iron deficiency without anemia; characterize the diagnostic procedures and prescription patterns; assess anemia's impact over work absenteeism, in a Local Health Unit. Material and methods Cross-sectional study that evaluated complete blood counts, iron-containing prescriptions, comorbidities, economic failure, and disability certificates issued in 2015 at the Local Health Unit. Results We evaluated 62,794 complete blood count. The proportion of anemia was 16.5%, higher in patients with economic failure, pregnant women, and patients with congestive heart failure. Of the patients with anemia 87.8% had not serum iron and/or ferritin dosing, and of those with serum iron/ferritin levels tested 50.6% had IDA. IDA was higher in pregnant women, women aged ≥15 years and in patients with congestive heart failure. Approximately 56.2% of patients with IDA did not receive iron-containing medication, and in 38% of the cases the prescribed dose was subtherapeutic. Of the total iron prescriptions 44.1% were association therapies. Anemia accounted for 5.2% of the disability certificates issued in 2015 (1749 workdays lost). Discussion Most patients with anemia are not being adequately evaluated and a major proportion does not undergo treatment or has subtherapeutic doses of iron. These results may explain the anemia's impact on work capacity. Conclusion This is one of the largest studies on anemia in Portugal. An effort to adapt to the established recommendations is urged, to minimize the consequences of this disease.
Collapse
|
91
|
Patel K, Memon Z, Mazurkiewicz R. Management of Iron-Deficiency Anemia on Inpatients and Appropriate Discharge and Follow-Up. J Hematol 2020; 9:5-8. [PMID: 32362978 PMCID: PMC7188379 DOI: 10.14740/jh626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background The aims of the study were to identify appropriate supplementation of iron for inpatients and to identify factors involved in appropriate discharge documentation and follow-up. Methods This was a retrospective analysis of 103 patients at a community hospital in New York City. Results A total of 57 (57/103, 55.3%) patients were admitted due to symptomatic anemia. Twenty (20/103, 19.4%) of those with iron-deficiency anemia had either esophagogastroduodenoscopy or colonoscopy. Gastroenterologist or hematologist was consulted for 45/103 (43.7%). Inpatient iron supplementation was given for 62/103 (60.2%) of patients; and 43/103 (41.7%) had blood transfusion. Upon discharge, 50/103 (48.5%) had appropriate documentation of iron-deficiency anemia on discharge paperwork. Appropriate follow-up was done for 54/103 (52.4%). Iron supplementation was provided for 53/103 (51.5%) of patients. Having inpatient esophagogastroduodenoscopy or colonoscopy, blood transfusion, or symptomatic anemia had a statistical significance for likelihood of appropriate discharge documentation. Conclusions Iron-deficiency anemia can have high rates of mortality and morbidity in the population. Appropriate discharge of patients with iron-deficiency anemia and factors related to this are paramount for clinicians in order to have the best patient outcomes.
Collapse
Affiliation(s)
- Kishan Patel
- Department of Internal Medicine, Lenox Hill Hospital, New York, NY, USA
| | - Zain Memon
- Department of Internal Medicine, Lenox Hill Hospital, New York, NY, USA
| | | |
Collapse
|
92
|
Elbarbary M, Honda T, Morgan G, Guo Y, Guo Y, Kowal P, Negin J. Ambient Air Pollution Exposure Association with Anaemia Prevalence and Haemoglobin Levels in Chinese Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093209. [PMID: 32380747 PMCID: PMC7246731 DOI: 10.3390/ijerph17093209] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Health effects of air pollution on anaemia have been scarcely studied worldwide. We aimed to explore the associations of long-term exposure to ambient air pollutants with anaemia prevalence and haemoglobin levels in Chinese older adults. METHODS We used two-level linear regression models and modified Poisson regression with robust error variance to examine the associations of particulate matter (PM) and nitrogen dioxide (NO2) on haemoglobin concentrations and the prevalence of anaemia, respectively, among 10,611 older Chinese adults enrolled in World Health Organization (WHO) Study on global AGEing and adult health (SAGE) China. The average community exposure to ambient air pollutants (PM with an aerodynamic diameter of 10 μm or less (PM10), 2.5 μm or less (PM2.5), 1 μm or less (PM1) and nitrogen dioxide (NO2)) for each participant was estimated using a satellite-based spatial statistical model. Haemoglobin levels were measured for participants from dried blood spots. The models were controlled for confounders. RESULTS All the studied pollutants were significantly associated with increased anaemia prevalence in single pollutant model (e.g., the prevalence ratios associated with an increase in inter quartile range in three years moving average PM10 (1.05; 95% CI: 1.02-1.09), PM2.5 (1.11; 95% CI: 1.06-1.16), PM1 (1.13; 95% CI: 1.06-1.20) and NO2 (1.42; 95% CI: 1.34-1.49), respectively. These air pollutants were also associated with lower concentrations of haemoglobin: PM10 (-0.53; 95% CI: -0.67, -0.38); PM2.5 (-0.52; 95% CI: -0.71, -0.33); PM1 (-0.55; 95% CI: -0.69, -0.41); NO2 (-1.71; 95% CI: -1.85, -1.57) respectively. CONCLUSIONS Air pollution exposure was significantly associated with increased prevalence of anaemia and decreased haemoglobin levels in a cohort of older Chinese adults.
Collapse
Affiliation(s)
- Mona Elbarbary
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (G.M.); (J.N.)
- Correspondence: ; Tel.: +61-416405016
| | - Trenton Honda
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA;
| | - Geoffrey Morgan
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (G.M.); (J.N.)
- School of Public Health, University Centre for Rural Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine at School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia;
| | - Yanfei Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China;
| | - Paul Kowal
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Joel Negin
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (G.M.); (J.N.)
| |
Collapse
|
93
|
Wu FJ, Li IH, Chien WC, Shih JH, Lin YC, Chuang CM, Cheng YD, Kao LT. Androgen deprivation therapy and the risk of iron-deficiency anaemia among patients with prostate cancer: a population-based cohort study. BMJ Open 2020; 10:e034202. [PMID: 32213519 PMCID: PMC7170598 DOI: 10.1136/bmjopen-2019-034202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES The administration of androgen deprivation therapy (ADT) to patients with metastatic prostate cancer might be associated with some adverse effects such as anaemia; however, few studies have been performed in East Asian populations. This study aimed to investigate the association between ADT and iron-deficiency anaemia (IDA) among patients with prostate cancer in a population-based nationwide cohort. DESIGN Cohort study. SETTING Taiwan. PARTICIPANTS Data for the cohort study were retrieved from the Taiwan National Health Insurance Research Database. Propensity score matching was used to select 7262 patients with prostate cancer who received ADT as the study group and 3631 patients who did not receive ADT as the control group. PRIMARY AND SECONDARY OUTCOME MEASURES This study individually tracked patients over a 3-year study period and identified those who were subsequently diagnosed with IDA following the index date. RESULTS The incidence rates of IDA in the study and control groups were 1.66 (95% CI CI 1.45 to 1.86) and 1.01 per 100 person-years (95% CI 0.78 to 1.25), respectively. Furthermore, proportional Cox regression revealed an HR of 1.62 (95% CI 1.24 to 2.12) for IDA in the study group after adjusting for patients' age, monthly income, geographic location, residential urbanisation level and incidence of hyperlipidaemia, diabetes, hypertension, coronary heart disease, inflammatory bowel disease, other cancers and gastrointestinal bleeding. CONCLUSION Compared with its non-use among patients with prostate cancer, ADT use was associated with a higher risk of IDA.
Collapse
Affiliation(s)
- Fang-Jen Wu
- Department of Pharmacy, West Garden Hospital, Taipei, Taiwan
| | - I-Hsun Li
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
- Department of Pharmacology, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Jui-Hu Shih
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chun Lin
- Research Center of Biostatistics, Taipei Medical University, Taipei, Taiwan
| | - Chin-Min Chuang
- Emergency Department, China Medical University Hospital, Taichung City, Taiwan
| | - Yih-Dih Cheng
- Department of Pharmacy, China Medical University Hospital, Taichung City, Taiwan
| | - Li-Ting Kao
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
94
|
A Review of Intravenous Iron Replacement Medications for Nurse Practitioners. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2019.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
95
|
Gettle LS, Harden A, Bridges M, Albon D. Prevalence and Risk Factors for Iron Deficiency in Adults With Cystic Fibrosis. Nutr Clin Pract 2020; 35:1101-1109. [PMID: 31994790 DOI: 10.1002/ncp.10454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Iron deficiency is common in cystic fibrosis (CF), but previous prevalence studies often reported results confounded by acute exacerbations. This single-center retrospective study aimed to identify the prevalence of iron deficiency in a stable adult CF population, identify the risk factors associated with iron deficiency, and compare common laboratory indicators of iron status. METHODS Medical charts of 105 patients aged 18-67 were reviewed to determine the prevalence of anemia. Of these patients, a subgroup of 67 were included in analyses of iron deficiency, defined as serum ferritin < 12 ng/mL and/or percent transferrin saturation (TSAT) < 16%. Data on sex, age, body mass index, anemia status, vitamin deficiencies, presence of comorbidities, colonization with Pseudomonas aeruginosa, and use of acid blockers and CF transmembrane conductance regulator modulators were collected to evaluate relationship of iron deficiency with these clinical factors. κ agreements between serum iron, ferritin, transferrin, and TSAT were compared. RESULTS In this stable CF population, the prevalence of iron deficiency was 41.8% (n = 67), and the prevalence of anemia was 33.3% (n = 105). Iron deficiency was associated with presence of anemia (P < .001), vitamin A deficiency (P = .012), and moderate (P = .047) and severe lung disease (P = .045) compared with mild lung disease. Transferrin agreed poorly with other iron status indicators. CONCLUSION Iron deficiency is common in CF, although prevalence rates can vary widely depending on the laboratory parameters used. CF centers should consider routine screening for iron deficiency.
Collapse
Affiliation(s)
- Lucy S Gettle
- Department of Nutrition Services, University of Virginia Health System, Charlottesville, Virginia, USA.,Division of Pulmonary and Critical Care, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Adrienne Harden
- Department of Nutrition Services, University of Virginia Health System, Charlottesville, Virginia, USA.,Department of Nutrition Services, Southside Regional Medical Center, Petersburg, Virginia, USA
| | - Meagan Bridges
- Department of Nutrition Services, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Dana Albon
- Division of Pulmonary and Critical Care, University of Virginia Health System, Charlottesville, Virginia, USA
| |
Collapse
|
96
|
Aleem A, Alsayegh F, Keshav S, Alfadda A, Alfadhli AA, Al-Jebreen A, Al-Kasim F, Almuhaini A, Al-Zahrani H, Batwa F, Denic S, Jazzar A, Owaidah T, Qari M, Qari Y, Taha M. Consensus Statement by an Expert Panel on the Diagnosis and Management of Iron Deficiency Anemia in the Gulf Cooperation Council Countries. Med Princ Pract 2020; 29:371-381. [PMID: 31698356 PMCID: PMC7445696 DOI: 10.1159/000503707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Iron deficiency (ID) and ID anemia (IDA) are common in the member states of the Gulf Cooperation Council (GCC). The unique genetic and lifestyle factors of the patient population in the region have necessitated the development of recommendations to help educate health-care professionals on appropriate diagnosis and management of ID/IDA. METHODS A panel of regional experts, including gastroenterologists and hematologists with expertise in the treatment of IDA, was convened to develop regional practice recommendations for ID/IDA. After reviewing the regional and international literature, the expert panel developed consensus recommendations for screening, diagnosis, and treatment of patients with IDA in the GCC region. RESULTS The recommendations proposed were customized to the patient population keeping in view the increasingly recognized burden of coeliac disease, high fertility and obesity rates, high prevalence of alpha- and beta-thalassemia traits, and poor tolerance and low treatment compliance with oral iron therapy. CONCLUSIONS This consensus statement proposes recommendations for screening, diagnosis, and treatment of IDA in the GCC region.
Collapse
Affiliation(s)
- Aamer Aleem
- Department of Medicine, Division of Hematology/Oncology, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia,
| | - Faisal Alsayegh
- Department of Medicine, Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Satish Keshav
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Abdulrahman Alfadda
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmad Awad Alfadhli
- Gastroenterology and Hepatology Center, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Abdulrahman Al-Jebreen
- Department of Medicine, Division of Gastroenterology, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Fawaz Al-Kasim
- Department of Pediatric Hematology/Oncology, Children Hospital, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ali Almuhaini
- Department of Internal Medicine, Division of Clinical Hematology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Hazzaa Al-Zahrani
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Faisal Batwa
- King Khaled National Guard Hospital, Jeddah, Saudi Arabia
| | - Srdjan Denic
- Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ahmad Jazzar
- Gastroenterology Section, Gulf Diagnostic Center Hospital, Abu Dhabi, United Arab Emirates
| | - Tarek Owaidah
- King Faisal Specialist Hospital and Research Center, Alfaisal University, Riyadh, Saudi Arabia
| | - Mohamad Qari
- Hematology Department, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Yousef Qari
- King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mazen Taha
- Department of Medicine, Division of Gastroenterology/Hepatology, Tawam Hospital, Al Ain, United Arab Emirates
| |
Collapse
|
97
|
Abstract
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies, and has a number of physiological manifestations. Early, or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity. Oral iron preparations have a high incidence of intolerable side effects, and are ineffective in certain forms of iron deficiency. Consequently, intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency. The newer, more stable iron preparations in particular purport to have a lower incidence of side effects, and are now used across a range of different patient populations. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency. SEARCH METHODS On 18 October 2019 we electronically searched CENTRAL, MEDLINE, Embase, two further databases and two trials registries 2019. We handsearched the references of full-text extracted studies, and contacted relevant study authors for additional data. SELECTION CRITERIA We included randomised controlled trials that compared any intravenous iron preparation to placebo in adults. We excluded other forms of comparison such as oral iron versus placebo, intramuscular iron versus placebo, or intravenous iron studies where other iron preparations were used as the comparator. We also excluded studies involving erythropoietin therapy or obstetric populations. DATA COLLECTION AND ANALYSIS Two review authors screened references for eligibility, extracted data and assessed risk of bias. We resolved differences in opinion through discussion and consensus, and where necessary, involved a third review author to adjudicate disputes. We contacted study authors to request additional data where appropriate. The primary outcome measures were haemoglobin concentration at the end of follow-up, and quality-of-life scores at end of follow-up. Secondary outcome measures were serum ferritin, peak oxygen consumption (as measured by cardiopulmonary exercise testing), adverse effects (graded as mild to moderate and severe) and bacterial infection. We pooled data for continuous outcomes, which we then reported as mean differences (MDs) with 95% confidence intervals (CIs). We reported quality-of-life metrics as standardised mean difference (SMD), and then converted them back into a more familiar measure, the Piper Fatigue Scale. We analysed dichotomous outcomes as risk ratios (RRs). Given an expected degree of heterogeneity, we used a random-effects model for all outcomes. We performed the analysis with the software package Review Manager 5. MAIN RESULTS This review includes 11 studies with 1074 participants. Outcome metrics for which data were available (haemoglobin concentration, quality-of-life scores, serum ferritin, peak oxygen consumption and mild to moderate adverse effects) were similar across the included studies. The incidence of severe adverse events across all studies was zero. None of the studies measured bacterial infection as a specific outcome metric. Substantial heterogeneity influenced the results of the meta-analysis, arising from differing patient populations, definitions of iron deficiency, iron preparations and dosing regimens, and time to end of follow-up. Consequently, many outcomes are reported with small group sizes and wide confidence intervals, with a subsequent downgrading in the quality of evidence. The level of bias in many included studies was high, further reducing confidence in the robustness of the results. We found that intravenous iron therapy may lead to a small increase in haemoglobin concentration of limited clinical significance compared to placebo (MD 3.04 g/L, 95% CI 0.65 to 5.42; I2 = 42%; 8 studies, 548 participants; low-quality evidence). Quality-of-life scores (Piper Fatigue Scale MD 0.73, 95% CI 0.29 to 1.18; I2 = 0%; studies = 3) and peak oxygen consumption (MD 2.77 mL/kg/min, 95% CI -0.89 to 6.43; I2 = 36%; 2 studies, 32 participants) were associated with very low-quality evidence, and we remain uncertain about the role of intravenous iron for these metrics. We were unable to present pooled estimates for the outcomes of serum ferritin at the end of follow-up or mild to moderate adverse effects due to extreme statistical heterogeneity. Ultimately, despite the results of the meta-analysis, the low- or very low-quality evidence for all outcomes precludes any meaningful interpretation of results beyond suggesting that further research is needed. We performed a Trial Sequential Analysis for all major outcomes, none of which could be said to have reached a necessary effect size. AUTHORS' CONCLUSIONS Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient populations, beyond stating that it may result in a small, clinically insignificant increase in haemoglobin concentration. However, the certainty for even this outcome remains limited. Robust data for the effectiveness of intravenous iron for non-anaemic iron deficiency is still lacking, and larger studies are required to assess the effect of this therapy on laboratory, patient-centric, and adverse-effect outcomes.
Collapse
Affiliation(s)
- Lachlan F Miles
- The University of MelbourneCentre for Integrated Critical Care151 Barry StreetParkvilleVictoriaAustralia3010
| | | | - Georgina Imberger
- RigshospitaletCochrane AnaesthesiaBlegdamsvej 9,Afsnit 3342KøbenhavnDenmark2100
| | - David Story
- The University of MelbourneMelbourneAustralia
| | | |
Collapse
|
98
|
Ceylan H, Budak H, Kocpinar EF, Baltaci NG, Erdogan O. Examining the link between dose-dependent dietary iron intake and Alzheimer's disease through oxidative stress in the rat cortex. J Trace Elem Med Biol 2019; 56:198-206. [PMID: 31525623 DOI: 10.1016/j.jtemb.2019.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/01/2019] [Accepted: 09/08/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Neurodegenerative diseases such as Alzheimer's and Parkinson's disease are characterized by the progressive deterioration of the structure and function of the nervous system. A number of environmental risk factors including potentially toxic elements such as iron, lead to negative effects on many metabolic reactions as well as neuroprotection. The aim of this study is to reveal whether long-term iron overload is one of the underlying factors in the pathogenesis of Alzheimer's disease (AD). METHODS 15 young-adult male rats were randomly divided into 5 groups treated with iron through drinking water for 4 months. Following feeding, the iron content, reduced glutathione (GSH), and hydrogen peroxide (H2O2) levels of cortex tissues were measured. Specific enzyme activities were determined spectrophotometrically. mRNA expression profiles were measured using real-time PCR (qPCR). RESULTS Iron levels were elevated in case of non-toxic (0.87 and 3 μg/mL) iron administration. However, no changes were observed in toxic (30 and 300 μg/mL) iron administration. GSH and H2O2 levels altered with long-term iron overload. Glutathione peroxidase (GPx) enzyme activities significantly increased in all groups, while glutathione S-transferase (GST) activity increased only in case of 0.87 and 30 μg/mL iron administration. Expression levels of neuroprotective and AD-related genes were altered by 3 μg/mL iron overload in a dose-dependent manner. The expression and activity of acetylcholinesterase (AChE) were elevated at 3 μg/mL iron concentration. CONCLUSION The findings of the present study allow us to conclude that long-term dietary iron intake, especially at a dose of 3 μg/mL demonstrates negative effects on the rat cortex by provoking antioxidant metabolism and AD pathology in a dose-dependently.
Collapse
Affiliation(s)
- Hamid Ceylan
- Science Faculty, Department of Molecular Biology and Genetics, Atatürk University, Erzurum, Turkey.
| | - Harun Budak
- Science Faculty, Department of Molecular Biology and Genetics, Atatürk University, Erzurum, Turkey
| | - Enver Fehim Kocpinar
- Science Faculty, Department of Molecular Biology and Genetics, Atatürk University, Erzurum, Turkey; Vocational School, Department of Medical Services and Techniques, Muş Alparslan University, Mus, Turkey
| | - Nurdan Gonul Baltaci
- Science Faculty, Department of Molecular Biology and Genetics, Atatürk University, Erzurum, Turkey
| | - Orhan Erdogan
- Science Faculty, Department of Molecular Biology and Genetics, Atatürk University, Erzurum, Turkey
| |
Collapse
|
99
|
Li Z, Ti M, Yang K, Li X, Wu L, He Y. Colorimetric detection of iron (II) using 4-mercaptobenzoic acid and 3,3′,5,5′-tetramethylbenzidine modified silver nanoparticles. Microchem J 2019. [DOI: 10.1016/j.microc.2019.104254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
100
|
Laengsri V, Shoombuatong W, Adirojananon W, Nantasenamat C, Prachayasittikul V, Nuchnoi P. ThalPred: a web-based prediction tool for discriminating thalassemia trait and iron deficiency anemia. BMC Med Inform Decis Mak 2019; 19:212. [PMID: 31699079 PMCID: PMC6836478 DOI: 10.1186/s12911-019-0929-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/14/2019] [Indexed: 01/07/2023] Open
Abstract
Background The hypochromic microcytic anemia (HMA) commonly found in Thailand are iron deficiency anemia (IDA) and thalassemia trait (TT). Accurate discrimination between IDA and TT is an important issue and better methods are urgently needed. Although considerable RBC formulas and indices with various optimal cut-off values have been developed, distinguishing between IDA and TT is still a challenging problem due to the diversity of various anemic populations. To address this problem, it is desirable to develop an improved and automated prediction model for discriminating IDA from TT. Methods We retrospectively collected laboratory data of HMA found in Thai adults. Five machine learnings, including k-nearest neighbor (k-NN), decision tree, random forest (RF), artificial neural network (ANN) and support vector machine (SVM), were applied to construct a discriminant model. Performance was assessed and compared with thirteen existing discriminant formulas and indices. Results The data of 186 patients (146 patients with TT and 40 with IDA) were enrolled. The interpretable rules derived from the RF model were proposed to demonstrate the combination of RBC indices for discriminating IDA from TT. A web-based tool ‘ThalPred’ was implemented using an SVM model based on seven RBC parameters. ThalPred achieved prediction results with an external accuracy, MCC and AUC of 95.59, 0.87 and 0.98, respectively. Conclusion ThalPred and an interpretable rule were provided for distinguishing IDA from TT. For the convenience of health care team experimental scientists, a web-based tool has been established at http://codes.bio/thalpred/ by which users can easily get their desired screening test result without the need to go through the underlying mathematical and computational details.
Collapse
Affiliation(s)
- V Laengsri
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.,Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - W Shoombuatong
- Center of Data Mining and Medical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - W Adirojananon
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - C Nantasenamat
- Center of Data Mining and Medical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - V Prachayasittikul
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - P Nuchnoi
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand. .,Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.
| |
Collapse
|