1
|
Günther F, Straub RH, Hartung W, Fleck M, Ehrenstein B, Schminke L. Association of Serum Soluble Transferrin Receptor Concentration With Markers of Inflammation: Analysis of 1001 Patients From a Tertiary Rheumatology Center. J Rheumatol 2024; 51:291-296. [PMID: 38224988 DOI: 10.3899/jrheum.2023-0654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Soluble transferrin receptor (sTfR) is considered to be a useful biomarker for the diagnosis of iron deficiency, especially in the setting of inflammation, as it is thought to not be affected by inflammation. We analyzed the relationship between sTfR levels and inflammatory markers in patients with known or suspected inflammatory rheumatic disease (IRD). METHODS Blood samples of 1001 patients with known or suspected IRD referred to a tertiary rheumatology center were analyzed. Study participants were classified as patients with active IRD and patients with inactive IRD or without IRD. Correlation analyses were used to explore the relationship between sTfR levels and inflammatory markers (ie, C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]). We applied multiple linear regression analysis to evaluate the predictive value of CRP levels for sTfR concentrations after adjustment for potential confounding factors. RESULTS There were positive correlations between inflammatory markers (CRP, ESR) and serum sTfR levels (ρ 0.44, ρ 0.43, respectively; P < 0.001), exceeding the strength of correlation between inflammatory markers and the acute phase reactant ferritin (ρ 0.30, ρ 0.23, respectively; P < 0.001). Patients with active IRD demonstrated higher serum sTfR levels compared to patients with inactive or without IRD (mean 3.99 [SD 1.69] mg/L vs 3.31 [SD 1.57] mg/L; P < 0.001). After adjustment for potential confounding factors, CRP levels are predictive for serum sTfR concentrations (P < 0.001). CONCLUSION The study provides evidence against the concept that sTfR is a biomarker not affected by inflammation.
Collapse
Affiliation(s)
- Florian Günther
- F. Günther, MD, W. Hartung, MD, B. Ehrenstein, MD, L. Schminke, MD, Department of Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach;
| | - Rainer H Straub
- R.H. Straub, MD, Department of Internal Medicine I, University Medical Center, Regensburg
| | - Wolfgang Hartung
- F. Günther, MD, W. Hartung, MD, B. Ehrenstein, MD, L. Schminke, MD, Department of Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach
| | - Martin Fleck
- M. Fleck, MD, Department of Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach, and Department of Internal Medicine I, University Medical Center, Regensburg, Germany
| | - Boris Ehrenstein
- F. Günther, MD, W. Hartung, MD, B. Ehrenstein, MD, L. Schminke, MD, Department of Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach
| | - Louisa Schminke
- F. Günther, MD, W. Hartung, MD, B. Ehrenstein, MD, L. Schminke, MD, Department of Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach
| |
Collapse
|
2
|
De la Cruz-Góngora V, Villalpando S, Shamah-Levy T. Overview of Trends in Anemia and Iron Deficiency in the Mexican Population From 1999 to 2018-19. Food Nutr Bull 2024; 45:57-64. [PMID: 38661355 DOI: 10.1177/03795721241240014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Despite the emergence of diverse programs in Mexico to address anemia and micronutrient deficiencies in disadvantaged groups, progress on reducing their prevalence has stagnated. In Mexico, anemia surveillance at the population level is conducted through the National Health and Nutrition Survey ENSANUT (for its acronym in Spanish). OBJECTIVE To overview the trends in anemia and iron deficiency (ID) from 1999 to 2018-19 in the Mexican population before COVID-19 pandemic. METHODS Data from five nationwide surveys in Mexico were used. Where available, data on anemia, ID, and ID anemia (IDA) were extracted from ENSANUTs 1999, 2006, 2012, 2016, and 2018-19 in participants from 1 to 99 years old. Blood sample collection methods were similar across surveys (1999-2018) where capillary drop blood was used to estimate Hb using a HemoCue and serum blood samples to measure ferritin and C-reactive protein concentration. RESULTS The trend in anemia prevalence shows a U-shape from 1999 to 2018-19 in <60 years old. In older adults (≥60 years), an increasing trend was observed. Anemia declined progressively from 1999 to 2012 but increased from 2016 to 2018-19 in comparison with 2012. In contrast, ID declined from 2006 to 2018-19, mainly in children, while IDA did not change over this period. In older adults, ID prevalence remained constant over time. CONCLUSIONS The shifting trend in anemia prevalence across ENSANUTs 1999 through 2018-19 did not mimic the decreasing trend of ID over the same period of time. Other noncausal factors seem to play an important role in the variability of hemoglobin measurements.
Collapse
Affiliation(s)
- Vanessa De la Cruz-Góngora
- Centre for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Mexico
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Ireland
| | - Salvador Villalpando
- Centre for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Teresa Shamah-Levy
- Centre for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Mexico
| |
Collapse
|
3
|
Ma H, Deng W, Chen H, Ding X. Association between dietary inflammatory index and anemia in US adults. Front Nutr 2024; 10:1310345. [PMID: 38268667 PMCID: PMC10805879 DOI: 10.3389/fnut.2023.1310345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background and aims Anemia is a widespread global health concern, and recent research has unveiled a link between anemia and inflammation. The Dietary Inflammation Index (DII) is a novel tool used to assess the overall inflammatory potential of an individual's diet. However, until now, there have been no studies demonstrating a connection between DII and anemia. This study aimed to explore the relationship between DII and the risk of anemia among Americans, as well as to examine the influence of other risk factors on this association. Methods Data from 32,244 patients were collected from the National Health and Nutrition Examination Survey (NHANES) database spanning from 1999 to 2018. Using multivariable logistic regression, we examined the correlation between DII and anemia. Subgroup analyses and smoothed curve analyses were conducted to further investigate the association between DII and anemia. Results The analysis revealed a significant positive association between higher DII scores and increased anemia risk in the American population (Odds Ratio [OR] = 1.06, 95% Confidence Interval [CI] = 1.03 to 1.09, p < 0.0001). This association remained consistent in subgroup analyses, encompassing various age groups, distinct Body Mass Index (BMI) categories, varying diabetes mellitus statuses, histories of hypertension, females, individuals with a RIP <3.5, and Non-Hispanic Black individuals. Notably, the association was particularly significant among non-smokers. Smoothed curve fitting analysis demonstrated a linear relationship between DII and the prevalence of anemia. Conclusion Our findings underscore a positive correlation between the inflammatory potential of one's diet and the risk of anemia, especially when coupled with other risk factors. Consequently, reducing the consumption of pro-inflammatory foods may serve as one of the effective measures against the development of anemia. Given the variations in gender, age, BMI, and chronic diseases observed in our study, tailored policies could better cater to the specific needs of diverse populations.
Collapse
Affiliation(s)
- Huimiao Ma
- Department of Hematology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Wenqi Deng
- Beijing University of Chinese Medicine, Beijing, China
| | - Haiyan Chen
- Department of Hematology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoqing Ding
- Department of Hematology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
4
|
Padilla-Valdez MM, Díaz-Iñiguez MI, Ortuño-Sahagún D, Rojas-Mayorquín AE. Neuroinflammation in fetal alcohol spectrum disorders and related novel therapeutic approaches. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166854. [PMID: 37611676 DOI: 10.1016/j.bbadis.2023.166854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
Fetal alcohol spectrum disorders (FASD) is an umbrella term to describe the neurological effects of prenatal alcohol exposure (PAE). It has been extensively characterized that PAE causes cell proliferation disruption, heterotopias, and malformations in various brain regions and there is increasing evidence that neuroinflammation is responsible for some of these neurotoxic effects. Despite evidence of its importance, neuroinflammation is not usually considered at diagnosis or treatment for FASD. Here, we discuss the literature regarding anti- inflammatory drugs and nutraceuticals, which hold promise for future therapeutical interventions in these disorders.
Collapse
Affiliation(s)
- Mayra Madeleine Padilla-Valdez
- Departamento de Ciencias Ambientales, Universidad de Guadalajara, Centro Universitario de Ciencias Biológicas y Agropecuarias, Guadalajara 45200, Mexico; Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, C.P 44340 Guadalajara, JAL, Mexico
| | - María Isabel Díaz-Iñiguez
- Departamento de Ciencias Ambientales, Universidad de Guadalajara, Centro Universitario de Ciencias Biológicas y Agropecuarias, Guadalajara 45200, Mexico; Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, C.P 44340 Guadalajara, JAL, Mexico
| | - Daniel Ortuño-Sahagún
- Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, C.P 44340 Guadalajara, JAL, Mexico.
| | - Argelia Esperanza Rojas-Mayorquín
- Departamento de Ciencias Ambientales, Universidad de Guadalajara, Centro Universitario de Ciencias Biológicas y Agropecuarias, Guadalajara 45200, Mexico.
| |
Collapse
|
5
|
De la Cruz-Góngora V, Palazuelos-González R, Domínguez-Flores O. Micronutrient Deficiencies in Older Adults in Latin-America: A Narrative Review. Food Nutr Bull 2023:3795721231214587. [PMID: 38146136 DOI: 10.1177/03795721231214587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND The population in Latin America and Caribbean (LAC) has experienced a major demographic transition with increased numbers of older adults (OA). This change brings opportunities in the public health sector to implement health prevention interventions and delay the onset of geriatric syndromes. Micronutrients play an important role in the maintenance of biological function which contributes to longevity. Micronutrient deficiencies (MD) in OA increase the risk for onset of chronic comorbidities and geriatric syndromes. AIM To review and summarize the existing data on micronutrient status in OA in the LAC region and discuss the gaps and challenges in public health approaches to address deficiencies. METHODS Literature review in Medline for records describing nutritional biomarkers in older adults (≥ 60y) from community dwelling and population-based studies in LAC. RESULTS Few countries (including Chile, Ecuador, Costa Rica, Brazil, and Mexico) have documented one or more nutritional deficiencies for OA in national health surveys, however across the entire region, evidence of micronutrient levels is scarce. Some surveys have documented a high prevalence and large heterogeneity in the prevalence of vitamin D followed by B12 deficiency, being the 2 MDs most studied due their effects on cognition, frailty, and bone mineral density in the OA population. Other MD including C, E, A, copper, zinc, iron, and selenium have also been reported. CONCLUSION Information on the micronutrient status in OA from LAC is poorly documented. Research and capacity building initiatives in the region are crucial to develop tailored strategies that address the specific nutritional needs and challenges faced by the ageing population in Latin-America.
Collapse
Affiliation(s)
- Vanessa De la Cruz-Góngora
- Center for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Global Brain Health Institute, Trinity College, Dublin, Ireland
| | | | - Omar Domínguez-Flores
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| |
Collapse
|
6
|
Brittenham GM, Moir-Meyer G, Abuga KM, Datta-Mitra A, Cerami C, Green R, Pasricha SR, Atkinson SH. Biology of Anemia: A Public Health Perspective. J Nutr 2023; 153 Suppl 1:S7-S28. [PMID: 37778889 DOI: 10.1016/j.tjnut.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/04/2023] [Accepted: 07/31/2023] [Indexed: 10/03/2023] Open
Abstract
Our goal is to present recent progress in understanding the biological mechanisms underlying anemia from a public health perspective. We describe important advances in understanding common causes of anemia and their interactions, including iron deficiency (ID), lack of other micronutrients, infection, inflammation, and genetic conditions. ID develops if the iron circulating in the blood cannot provide the amounts required for red blood cell production and tissue needs. ID anemia develops as iron-limited red blood cell production fails to maintain the hemoglobin concentration above the threshold used to define anemia. Globally, absolute ID (absent or reduced body iron stores that do not meet the need for iron of an individual but may respond to iron supplementation) contributes to only a limited proportion of anemia. Functional ID (adequate or increased iron stores that cannot meet the need for iron because of the effects of infection or inflammation and does not respond to iron supplementation) is frequently responsible for anemia in low- and middle-income countries. Absolute and functional ID may coexist. We highlight continued improvement in understanding the roles of infections and inflammation in causing a large proportion of anemia. Deficiencies of nutrients other than iron are less common but important in some settings. The importance of genetic conditions as causes of anemia depends upon the specific inherited red blood cell abnormalities and their prevalence in the settings examined. From a public health perspective, each setting has a distinctive composition of components underlying the common causes of anemia. We emphasize the coincidence between regions with a high prevalence of anemia attributed to ID (both absolute and functional), those with endemic infections, and those with widespread genetic conditions affecting red blood cells, especially in sub-Saharan Africa and regions in Asia and Oceania.
Collapse
Affiliation(s)
- Gary M Brittenham
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
| | - Gemma Moir-Meyer
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Kelvin Mokaya Abuga
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ananya Datta-Mitra
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States
| | - Carla Cerami
- The Medical Research Council Unit, The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States
| | - Sant-Rayn Pasricha
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia; Diagnostic Haematology, The Royal Melbourne Hospital; and Clinical Haematology at the Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Parkville, VIC Australia
| | - Sarah H Atkinson
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Paediatrics, University of Oxford, Oxford, UK
| |
Collapse
|
7
|
Mutumba R, Mbabazi J, Pesu H, Greibe E, Olsen MF, Briend A, Mølgaard C, Ritz C, Mupere E, Filteau S, Friis H, Grenov B. Micronutrient Status and Other Correlates of Hemoglobin among Children with Stunting: A Cross-Sectional Study in Uganda. Nutrients 2023; 15:3785. [PMID: 37686816 PMCID: PMC10489905 DOI: 10.3390/nu15173785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
In low-income countries, undernutrition and infections play a major role in childhood anemia. Stunted children may be at particular risk of anemia. In a cross-sectional study nested in a nutrition trial among 12-59-month-old stunted children in eastern Uganda, we measured hemoglobin (Hb) and markers of iron, cobalamin, folate and vitamin A status. We assessed low micronutrient status, socio-demography, stunting severity, inflammation and malaria as correlates of Hb and anemia using linear and logistic regression analyses, respectively. Of 750 stunted children, the mean ± SD age was 32.0 ± 11.7 months and 55% (n = 412) were male. The mean Hb was 104 ± 15 g/L and 65% had anemia, Hb < 110 g/L. In a multivariable model with age, sex and inflammation, the following were associated with lower Hb: serum ferritin < 12 µg/L (-5.6 g/L, 95% CI: -8.6; -2.6), transferrin receptors > 8.3 mg/L (-6.2 g/L, 95% CI: -8.4; -4.0), plasma folate <20 nmol/L (-4.6 g/L, 95% CI: -8.1;-1.1), cobalamin < 222 pmol/L (-3.0 g/L, 95% CI: -5.4; -0.7) and serum retinol-binding protein < 0.7 µmol/L (-2.0 g/L, 95% CI: -4.1; 0.2). In addition, severe stunting, inflammation and malaria were negative correlates. Anemia is common among stunted children in eastern Uganda; micronutrient deficiencies, inflammation and malaria are associated with low Hb.
Collapse
Affiliation(s)
- Rolland Mutumba
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda;
| | - Joseph Mbabazi
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda;
| | - Hannah Pesu
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
| | - Eva Greibe
- Department of Clinical Biochemistry, Aarhus University Hospital, 8200 Aarhus N, Denmark;
| | - Mette F. Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
| | - André Briend
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
- Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
| | - Christian Ritz
- National Institute of Public Health, University of Southern Denmark, 5230 Odense M, Denmark;
| | - Ezekiel Mupere
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda;
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
| | - Benedikte Grenov
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark; (J.M.); (H.P.); (M.F.O.); (A.B.); (C.M.); (H.F.); (B.G.)
| |
Collapse
|
8
|
Peng YF, Zhang QS, Luo WG. The Clinical Usefulness of Mean Corpuscular Hemoglobin Concentration in Patients with Pneumoconiosis. Int J Gen Med 2023; 16:3171-3177. [PMID: 37533840 PMCID: PMC10391047 DOI: 10.2147/ijgm.s417962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
Aim We investigated the clinical usefulness of mean corpuscular hemoglobin concentration (MCHC) in patients with pneumoconiosis. Methods We retrospectively investigated the medical records from 52 patients with pneumoconiosis, and erythrocyte parameters were analyzed in pneumoconiosis patients with different stages. Results Here, we found that the values of MCHC were significantly lower in III stage pneumoconiosis than those with I/II stage (p = 0.024), and there was no significantly difference in MCHC between smoking pneumoconiosis patients and non-smoking pneumoconiosis patients. A negatively correlation between MCHC and disease stage was observed in patients with pneumoconiosis (r = -0.298, p = 0.032). In multiple linear regression analysis, the MCHC was found to be independently associated with advanced pneumoconiosis in patients with pneumoconiosis (p=0.011). The results of logistic regression analysis indicated that decreased MCHC was an independent risk factor of advanced pneumoconiosis in patients with pneumoconiosis (OR: 0.936, CI95%: 0.877-0.999, p = 0.046). Receiver operating characteristic curve analysis showed that the optimal cutoff value of MCHC was 330 g/L to identify advanced pneumoconiosis with the area under the curve of 0.694 (CI95%:0.550-0.839, p = 0.018). Conclusion The decreased MCHC is associated with advanced pneumoconiosis, and MCHC may be used as a monitoring marker for follow-up of pneumoconiosis patients.
Collapse
Affiliation(s)
- You-Fan Peng
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, People’s Republic of China
| | - Qing-Song Zhang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, People’s Republic of China
| | - Wei-Gui Luo
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, People’s Republic of China
| |
Collapse
|
9
|
Cui F, Sun J, Mi H, Li B, Tang L, Wang R, Du Y, Guo B, Li Y, Shi M. Chronic intermittent hypobaric hypoxia improves iron metabolism disorders via the IL-6/JAK2/STAT3 and Epo/STAT5/ERFE signaling pathways in metabolic syndrome rats. J Trace Elem Med Biol 2023; 79:127259. [PMID: 37413927 DOI: 10.1016/j.jtemb.2023.127259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/09/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
AIM Our previous study demonstrated that chronic intermittent hypobaric hypoxia (CIHH) improved iron metabolism disorder in obese rats through the downregulation of hepcidin. This study aimed to observe the molecular mechanism of CIHH in improving iron metabolism disorders, especially by Janus kinase/signal transducer and activation of the transcription (JAK/STAT) signaling pathway in metabolic syndrome (MS) rats. METHODS Six-week-old male Sprague-Dawley rats were randomly divided into four groups: CON, CIHH (subjected to hypobaric hypoxia simulating 5000-m altitude for 28 days, 6 h daily), MS (induced by high fat diet and fructose water), and MS+CIHH. The serum levels of glucose, lipid metabolism, iron metabolism, interleukin-6 (IL-6), erythropoietin (Epo) and hepcidin were measured. The protein expressions of JAK2, STAT3, STAT5, bone morphogenetic protein 6 (BMP6), small mothers against decapentaplegic 1 (SMAD1) and hepcidin were examined. The mRNA expressions of erythroferrone (ERFE) and hepcidin were analyzed. RESULTS The MS rats displayed obesity, hyperglycemia, hyperlipidemia, iron metabolism disorder, increased IL-6 and hepcidin serum levels, upregulation of JAK2/STAT3 signaling pathway, decreased Epo serum levels, downregulation of STAT5/ERFE signaling pathway in spleen, upregulation of BMP/SMAD signaling pathway in liver, and increased hepcidin mRNA and protein expression compared to CON rats. All the aforementioned abnormalities in MS rats were ameliorated in MS + CIHH rats. CONCLUSIONS CIHH improved iron metabolism disorders, possibly by inhibiting IL-6/JAK2/STAT3 and activating Epo/STAT5/ERFE signaling pathway, thus downregulating hepcidin in MS rats.
Collapse
Affiliation(s)
- Fang Cui
- Department of Clinical Laboratory, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China; Department of Electron Microscope Laboratory Centre, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Jie Sun
- Department of Clinical Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, PR China
| | - Haichao Mi
- Department of Laboratory Medicine, Linyi Peoples' Hospital, Linyi 276000, PR China
| | - Bo Li
- Department of Emergency, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, 050001, Hebei, PR China
| | - Longmei Tang
- School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China
| | - Ruotong Wang
- Department of Clinical Laboratory, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China
| | - Yutao Du
- Department of Clinical Laboratory, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China
| | - Bingyan Guo
- Department of Cardiovascular Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China
| | - Yongjun Li
- Department of Clinical Laboratory, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China
| | - Min Shi
- Department of Clinical Laboratory, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China.
| |
Collapse
|
10
|
Collado M, Castillo M, Muñoz de Mier GJ, de la Pinta C, Peña C. The Diet as a Modulator of Tumor Microenvironment in Colorectal Cancer Patients. Int J Mol Sci 2023; 24:ijms24087317. [PMID: 37108477 PMCID: PMC10139215 DOI: 10.3390/ijms24087317] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers in Western countries and remains the second most common cause of cancer death worldwide. Many studies show the importance of diet and lifestyle in the incidence of CRC, as well as in CRC prevention. However, this review summarizes those studies that analyze the impact of nutrition on tumor microenvironment modulation and cancer progression. We review the available information about the effects of specific nutrients on cancer cell progression and on the different cells within the tumor microenvironment. Diet and nutritional status in the clinical management of colorectal cancer patients are also analyzed. Finally, future perspectives and challenges are discussed, with a view to improving CRC treatments by employing nutritional approaches. These promise great benefits and will eventually improve CRC patients' survival.
Collapse
Affiliation(s)
- Manuel Collado
- Medical Oncology Department, Ramón y Cajal University Hospital-IRYCIS, Alcalá University, 28034 Madrid, Spain
| | - Marién Castillo
- Facultad de Ciencias de la Salud, Universidad Alfonso X El Sabio (UAX), Avenida de la Universidad, 1, 28691 Villanueva de la Cañada, Spain
| | - Gemma Julia Muñoz de Mier
- Facultad de Ciencias de la Salud, Universidad Alfonso X El Sabio (UAX), Avenida de la Universidad, 1, 28691 Villanueva de la Cañada, Spain
| | - Carolina de la Pinta
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Alcalá University, 28034 Madrid, Spain
| | - Cristina Peña
- Medical Oncology Department, Ramón y Cajal University Hospital-IRYCIS, Alcalá University, 28034 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
| |
Collapse
|
11
|
Shimmi SC, Eldosouky HF, Hossain Parash MT, Wan Saudi WS. Probability of Concurrent Deficiency of Vitamin D and Iron in Hypothyroidism: A Cross-Sectional Study. Cureus 2023; 15:e37152. [PMID: 37153231 PMCID: PMC10161284 DOI: 10.7759/cureus.37152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Hypothyroidism is the most common pathophysiological condition that affects mostly females in both developed and developing countries. Data on hypothyroidism among adult females are essential to understand the underactive status of the thyroid gland among the female population and its correlated effects on a deficiency of vitamin D and iron, as effective prevention of osteoporotic changes and iron deficiency anemia is possible. Therefore, the present study was designed to investigate the probability of concurrent iron and vitamin D deficiency among the adult hypothyroid female population of Abu Dhabi, UAE. MATERIALS AND METHODS This cross-sectional study was carried out from September 2019 to July 2021 among 500 adult females aged 18 to 45 years old in Sheikh Shakhbout Medical City (SSMC) and Sheikh Khalifa Medical City (SKMC), Abu Dhabi, UAE. After obtaining written informed consent, subjects' demographic characteristics (sun exposure, dressing code, food consumption), anthropometry (height, weight, BMI), and biochemical parameters (thyroid profile, vitamin D profile, iron profile, and blood indices) were measured. RESULTS In this study, serum vitamin D and iron levels were significantly (p<0.01) decreased in the hypothyroid female group (study group). The serum vitamin D and iron levels showed a significant negative (p<0.01) correlation with thyroid-stimulating hormone (TSH). Out of 250 study group participants, 61 had a concurrent deficiency of serum vitamin D and iron, yielding a probability (P of low vitamin D and iron and hypothyroidism) of 0.244, which indicates that if 1000 hypothyroid patients are tested for serum vitamin D and iron levels, 24 patients are probable to have low vitamin D and iron. CONCLUSION The study concluded that vitamin D and iron bi-deficiency were observed in adult hypothyroid females in Abu Dhabi, UAE. So, the routine check-up of thyroid function and vitamin D and iron profiles should be done early. Therefore, early vitamin D and iron deficiencies can be detected, and supplements can be given to prevent further health complications like osteoporosis and iron deficiency anemia.
Collapse
Affiliation(s)
- Sadia Choudhury Shimmi
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Hossameldin F Eldosouky
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - M Tanveer Hossain Parash
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Wan Salman Wan Saudi
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| |
Collapse
|
12
|
Woźniak M, Borkowska A, Jastrzębska M, Sochal M, Małecka-Wojciesko E, Talar-Wojnarowska R. Clinical and Laboratory Characteristics of Anaemia in Hospitalized Patients with Inflammatory Bowel Disease. J Clin Med 2023; 12:jcm12072447. [PMID: 37048531 PMCID: PMC10095056 DOI: 10.3390/jcm12072447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 04/14/2023] Open
Abstract
Anaemia is the most common extraintestinal manifestation of inflammatory bowel disease (IBD). Due to its multifactorial etiopathogenesis, the differential diagnosis and treatment of anaemia in IBD is a significant clinical problem. The main aim of our study was to assess the usefulness of laboratory parameters, including hepcidin, in differential diagnoses of anaemia in hospitalized IBD patients. This study also estimated the impact of anaemia on the length of hospitalization and its relationship with clinical data of analyzed patients. The study included 118 adult patients diagnosed with IBD-55 with ulcerative colitis (UC) and 63 with Crohn's disease (CD). Anaemia was significantly more frequent in patients with CD-42 (66.7%)-compared to 31 (56.4%) patients with UC (p = 0.033). The prevalence of anaemia increased significantly with the severity of IBD and the extent of inflammatory changes in the endoscopic examination. Hospitalization time was significantly longer in patients with anaemia, especially in the group with UC. Ferritin concentrations < 30 ng/mL were found only in 15 (20.55%) IBD patients (9 with UC and 6 with CD), and ferritin < 100 ng/mL was observed in 22 (30.14%) patients, equally frequent with UC and CD (p > 0.05). Significantly higher concentrations of transferrin were observed in patients with anaemia in the course of UC compared to CD (2.58 ± 0.90 g/L vs. 2.15 ± 0.82 g/L; p = 0.037). On the other hand, saturation of transferrin < 16% was equally common in UC and CD patients. In our study, hepcidin levels in anaemic UC patients were significantly lower compared to UC without anaemia (p = 0.042), with no similar differences in CD independently of anaemia presence (p = 0.565). To conclude, we observed a high incidence of anaemia in patients with IBD and its significant impact on the length of hospitalization in UC. Routinely determined single laboratory parameters are not sufficient for the differential diagnosis of anaemia, and a complex laboratory assessment, including of hepcidin levels, is necessary for the full picture of anaemia in the course of IBD.
Collapse
Affiliation(s)
- Małgorzata Woźniak
- Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Anna Borkowska
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Marta Jastrzębska
- Department of Gastroenterology, Health Care Center, 26-200 Konskie, Poland
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Ewa Małecka-Wojciesko
- Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | | |
Collapse
|
13
|
Zhang T, Zhang J, Wang H, Li P. Correlations between glucose metabolism of bone marrow on 18 F-fluoro-D-glucose PET/computed tomography and hematopoietic cell populations in autoimmune diseases. Nucl Med Commun 2023; 44:212-218. [PMID: 36597726 PMCID: PMC9907693 DOI: 10.1097/mnm.0000000000001657] [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: 08/16/2022] [Accepted: 11/25/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aims to investigate which hematopoieticcell populations, clinical factors, and laboratory values are associated with FDG uptake in bone marrow (BM) on FDG PET/CT in patients with autoimmune diseases. METHODS Forty-six patients with autoimmune disease who underwent FDG PET/CT and BM aspiration (BMA) between 2017 and 2022 were enrolled. The max and mean standard uptake values (SUVmax and SUVmean, SUVs) of FDG in BM, liver, and spleen were measured, and the bone marrow-to-liver SUVs ratios (BLRmax and BLRmean, BLRs) and spleen-to-liver SUVs ratios (SLRmax and SLRmean, SLRs) were calculated. BMA and clinical and laboratory parameters were collected and evaluated for association with BLRs and SLRs. RESULTS The patients were divided into the Grade II group (20; 43.5%) and Grade III groups (26; 56.5%) according to hemopoietic activity. The BLRmax ( P = 0.021), proportion of granulocytes ( P = 0.011), metamyelocytes ( P = 0.009), myelocytes ( P = 0.024), and monocytes ( P = 0.037) in BM were significantly higher in the Grade II group. Multivariate (stepwise) linear regression analyses showed that the proportion of granulocytes in BM was the strongest and only independent factor ( P < 0.0001) associated with BLRmax with an adjusted R2 of 0.431 in model 1. In model 2, ferritin ( P = 0.018), CRP ( P = 0.025), and the proportion of metamyelocytes ( P = 0.043) in BM were correlated with BLRmax with an adjusted R2 of 0.414. CONCLUSION The FDG uptake in BM is associated with hemopoietic activity and is regulated by hyperplastic granulocytes, particularly immature metamyelocytes, in patients with autoimmune diseases. Glucose metabolism in the BM correlates with the severity of systemic inflammation.
Collapse
Affiliation(s)
- Tong Zhang
- Department of Nuclear Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jifeng Zhang
- Department of Nuclear Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongjia Wang
- Department of Nuclear Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ping Li
- Department of Nuclear Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
14
|
de Leur K, Pouw NMC, Lopez J, Waals-Prinzen L, Ceelie H, van der Zwan-van Beek EM. The alternative Thomas-plot: A new tool for effective anemia diagnostics. Int J Lab Hematol 2023; 45:96-103. [PMID: 36168666 DOI: 10.1111/ijlh.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/18/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The Thomas-plot has proven to be a helpful tool to discriminate between different types of anemia. This plot combines the reticulocyte hemoglobin content (Ret-He) with the soluble transferrin receptor (sTfR)/log ferritin (fer) ratio. In this study, we designed an alternative Thomas-plot in which Ret-He is combined with the transferrin (Tf)/log ferritin ratio. We validated both Thomas-plots in a population of anemic patients and compared the performance to the current laboratory diagnostics of anemia. METHODS A total of 536 anemic patients were included. The first 188 patients were used to generate ROC curves to define the optimal cut-off values for both Thomas-plots. With the following 348 patients included we studied the performance of the alternative and classical Thomas-plots compared to current anemia diagnostics. RESULTS Cut-off values were defined (Ret-He: 31.2 pg, sTfR/log(fer): 0.91, and Tf/log(fer): 1.71). With both Thomas-plots the amount of e causa ignota (ECI) cases dropped from 39% to 27%. A more in depth analysis on the iron status of anemia of chronic disease (ACD) patients and a subdivision between latent and classical iron deficiencies could be made with the help of both plots. A shift from classical iron deficiency anemia (IDA) cases according to the classical Thomas-plot toward functional IDA according to the alternative Thomas-plot was observed. CONCLUSION The alternative Thomas-plot is an effective tool that gives a more in depth view on the iron status of anemic patients. In addition, it is easier to implement due to the use of transferrin rather than the soluble transferrin receptor.
Collapse
Affiliation(s)
- Kitty de Leur
- Klinisch Chemisch Laboratorium en Trombosedienst, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
| | - Nadine M C Pouw
- Klinisch Chemisch Laboratorium en Trombosedienst, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
| | - Jordy Lopez
- Klinisch Chemisch Laboratorium en Trombosedienst, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
| | - Lenneke Waals-Prinzen
- Klinisch Chemisch Laboratorium en Trombosedienst, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
| | - Huib Ceelie
- Klinisch Chemisch Laboratorium en Trombosedienst, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
| | | |
Collapse
|
15
|
Maas LA, Krishna M, Parian AM. Ironing It All Out: A Comprehensive Review of Iron Deficiency Anemia in Inflammatory Bowel Disease Patients. Dig Dis Sci 2023; 68:357-369. [PMID: 35930123 DOI: 10.1007/s10620-022-07599-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/10/2022] [Indexed: 12/09/2022]
Abstract
Iron deficiency anemia affects approximately 45% of patients with inflammatory bowel disease (IBD), negatively impacts the quality of life in this patient population, and significantly burdens our healthcare system. The pathogenesis of iron deficiency in IBD patients is multifactorial, including intestinal bleeding, malabsorption, and inadequate oral intake. Regular screening and diagnosis in these patients are imperative, and often patients have mixed iron deficiency anemia and anemia of chronic disease, especially in those with active inflammation. Iron may be replenished either orally or intravenously. While oral iron is safe, affordable, and easy to administer, patients often suffer from intolerable gastrointestinal side effects, and particularly in IBD patients, oral iron may increase inflammation and contribute to flares. Therefore, although it is substantially underused, intravenous (IV) iron is considered first-line treatment for patients with active disease, severe anemia, oral iron intolerance, and erythropoietin requirements. Several IV iron formulations are available, and iron sucrose and ferric carboxymaltose are the most frequently used and well studied in patients with IBD. However, iron isomaltoside could potentially become a popular choice among providers given its safety, efficacy, and convenience. Overall, screening, diagnosis, and treatment of iron deficiency anemia are important in patients with IBD. Individual patient characteristics, risks, and benefits, and advantages and disadvantages, should be considered when determining the best route and formulation for iron repletion.
Collapse
|
16
|
The role of iron in chronic inflammatory diseases: from mechanisms to treatment options in anemia of inflammation. Blood 2022; 140:2011-2023. [PMID: 35994752 DOI: 10.1182/blood.2021013472] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022] Open
Abstract
Anemia of inflammation (AI) is a highly prevalent comorbidity in patients affected by chronic inflammatory disorders, such as chronic kidney disease, inflammatory bowel disease, or cancer, that negatively affect disease outcome and quality of life. The pathophysiology of AI is multifactorial, with inflammatory hypoferremia and iron-restricted erythropoiesis playing a major role in the context of disease-specific factors. Here, we review the recent progress in our understanding of the molecular mechanisms contributing to iron dysregulation in AI, the impact of hypoferremia and anemia on the course of the underlying disease, and (novel) therapeutic strategies applied to treat AI.
Collapse
|
17
|
Solomakhina NI, Lishuta AS, Dementieva AV. Hepcidin as a Regulator of Iron Metabolism and Mediator of Inflammation in Patients with Chronic Heart Failure and Anemia of Chronic Diseases of the Elderly and Senile Age. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-09-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aim. To study the role of hepcidin as a regulator of iron metabolism and a mediator of inflammation in elderly and senile patients with chronic heart failure (CHF) with anemia of chronic diseases (ACD).Material and methods. The levels of hemogram parameters, ferrokinetics (serum iron, ferritin, transferrin, erythropoietin, hepcidin), inflammation [C-reactive protein (CRP), interleukin-6 (IL-6)], as well as correlations between hepcidin and these parameters were studied in patients with CHF with ACD (n=35), with CHF without anemia (n=35) and in elderly and senile patients without CHF and anemia (control group; n=20).Results. Normal levels of hepcidin (9.17±0.97 ng/ml) and the only significant correlation of hepcidin with the ferrokinetic parameter – serum iron [r(S)=0.480, p<0.05] were found in the control group. Normal levels of hepcidin (12.01±1.19 ng/ml) and two significant correlations of hepcidin with the ferrokinetic parameter – ferritin [r(S)=0.525, p<0.05] and transferrin [r(S)=-0.343, p<0.05] were found in the CHF without anemia group. Significantly elevated levels of hepcidin (23.81±3.63 ng/ml) were found in the CHF with ACD group compared to the CHF without anemia group (p=0.008) and the control group (p=0.003). Also, five significant correlations of hepcidin with hemogram parameters – hemoglobin [r(S)=-0.461, p<0.05] and the average concentration of hemoglobin in the erythrocyte [r(S)=-0.437, p<0.05]; with ferrokinetic parameters – ferritin [r(S)=0.596,p<0.05] and transferrin [r(S)=-0.474, p<0.05]; with inflammation parameters – CRP [r(S)=0.561, p<0.05] were found in the CHF with ACD group.Conclusion. The increased level of hepcidin in CHF patients with ACD and the formation of links of hepcidin with indicators of inflammation reflect its role as a mediator of inflammation, and the formation of connections with indicators of hemogram and ferrokinetics – its role as a regulator of iron metabolism involved in the development of ACD in elderly and senile CHF patients.
Collapse
Affiliation(s)
- N. I. Solomakhina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. S. Lishuta
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. V. Dementieva
- Hospital for War Veterans No. 1 of the Moscow Department of Health
| |
Collapse
|
18
|
Usefulness of Soluble Transferrin Receptor in the Diagnosis of Iron Deficiency Anemia in Rheumatoid Arthritis Patients in Clinical Practice. Int J Rheumatol 2022; 2022:7067262. [PMID: 36275413 PMCID: PMC9581666 DOI: 10.1155/2022/7067262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/14/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Aim. We analyzed the added value of sTfR measurement in routine clinical practice to standard parameters (SP) of iron deficiency in the detection of iron deficiency anemia (IDA) in patients with rheumatoid arthritis (RA). Methods. Blood samples from 116 patients with RA were analyzed in a prospective study. Based on biochemical parameters, patients were classified as having IDA, anemia of chronic disease (ACD), IDA with concomitant ACD (ACD/IDA), or “other anemia.” Sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of sTfR and SP of iron status alone and in combination were calculated for the diagnosis of IDA in general, i.e., IDA or ACD/IDA. Results. In the whole sample, with regard to the diagnosis of iron deficiency (IDA or ACD/IDA), sTfR had a higher sensitivity compared both to the combined use of SP and to the combination of SP with sTfR (80.9% versus 66.7/54.8%). Specificity, PPV and NPV did not differ substantially. When patients were stratified in groups with high (CRP levels above the median, i.e., 24.1 mg/l) and low (CRP levels less or equal to the median) inflammation, the diagnostic superiority of sTfR was restricted to patients with high inflammation. In this group, the diagnostic performance of sTfR was superior both to the combined use of SP and the combination of SP with sTfR with higher sensitivity (100% versus 52.4%) and NPV (100% versus 77.7/76.7%) and comparable specificity and PPV. Conclusion. For the detection of iron depletion (IDA or ACD/IDA) in anemic RA patients, sTfR is superior to SP of iron deficiency only in highly inflammatory states.
Collapse
|
19
|
The relationship between anemia and obesity. Expert Rev Hematol 2022; 15:911-926. [PMID: 36189499 DOI: 10.1080/17474086.2022.2131521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Obesity is linked to a variety of unfavourable outcomes, including anaemia, which is a serious global public health problem. The prevalence of obesity along with anaemia suggests a relationship between obesity and anaemia. Recent studies have demonstrated strong associations between anaemia and obesity, chronic diseases, ageing, hepato-renal impairment, chronic infection, autoimmune diseases, and widespread malignancy. Thus, the intersection point of obesity and anaemia is an important area of attention. AREA COVERED This paper reviews the pathophysiology of obesity and anaemia. Then, It deliberates the relationship between obesity and different types of anaemia and other clinical forms associated with anaemia. EXPERT OPINION Obesity, especially obesity-related to excessive visceral fat distribution, is accompanied by several disturbances at the endothelial, hormonal, and inflammatory levels. These disturbances induce activation of several mechanisms that contribute to the anaemic state. Over-weight patients with chronic anaemias are required to maintain the related vitamins and minerals at optimum levels and appropriate BMI. In addition, a regular clinical follow-up is essential to be scheduled to reduce the risk of complications associated with anaemia in obese patients.
Collapse
|
20
|
González-Fernández D, Nemeth E, Pons EDC, Sinisterra OT, Rueda D, Starr L, Sangkhae V, Murillo E, Scott ME, Koski KG. Multiple Indicators of Undernutrition, Infection, and Inflammation in Lactating Women Are Associated with Maternal Iron Status and Infant Anthropometry in Panama: The MINDI Cohort. Nutrients 2022; 14:nu14173497. [PMID: 36079755 PMCID: PMC9460351 DOI: 10.3390/nu14173497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 02/06/2023] Open
Abstract
Maternal infections, nutrient deficiencies, and inflammation (MINDI) co-exist in lactating indigenous women in Panama, but their impact on maternal iron status and infant growth is unknown. For this secondary analysis of cross-sectional data of lactating mothers from our MINDI cohort, we investigated associations of MINDI variables with maternal anemia, elevated serum transferrin receptor (sTfR), low serum iron, hepcidin, ferritin, and infant weight-for-age (WAZ), length-for-age (LAZ), and head-circumference-for-age (HCAZ) Z-scores in 99 mother-infant dyads. A bootstrapping resampling procedure preselected covariates for inclusion in multivariable regressions models from chronic maternal infections and nutritional status [folate, vitamins A, D, retinol-binding protein (RBP), insulin-growth factor-1 (IGF-1)] and inflammation [C-reactive protein (CRP), cytokines, platelet indices] indicators. Anemia was prevalent (53.5%) but underestimated due to widespread low plasma volume (<2.2 L, 79.9%) and was associated with indicators of malnutrition [lower IGF-1, body mass index (BMI), vitamin D, and intake of green/leafy vegetables], but not inflammation. Higher CRP was associated with lower serum iron, and higher hepcidin and ferritin, whereas maternal platelets were associated with lower HCAZ (β = −0.22), WAZ (β = −0.17), and LAZ (β = −0.17). Higher LAZ was also associated with maternal serum vitamin D (β = 0.23), whereas maternal iron supplementation lowered LAZ (β = −0.22). Assessment of iron status in this MINDI cohort is complex and supplementation strategies must consider consequences for both the mother and the infant.
Collapse
Affiliation(s)
- Doris González-Fernández
- School of Human Nutrition, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada
| | - Elizabeta Nemeth
- Center for Iron Disorders, David Geffen School of Medicine, University of California, Los Angeles, CA 90089, USA
| | | | | | - Delfina Rueda
- “Comarca Ngäbe-Buglé” Health Region, Panamanian Ministry of Health, Panama City, Panama
| | - Lisa Starr
- Department of Biochemistry, University of Panama, Panama City, Panama
| | - Veena Sangkhae
- Center for Iron Disorders, David Geffen School of Medicine, University of California, Los Angeles, CA 90089, USA
| | - Enrique Murillo
- Department of Biochemistry, University of Panama, Panama City, Panama
| | - Marilyn E. Scott
- Institute of Parasitology, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada
| | - Kristine G. Koski
- School of Human Nutrition, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada
- Correspondence: ; Tel.: +1-514-398-7845
| |
Collapse
|
21
|
Influences of Vitamin D and Iron Status on Skeletal Muscle Health: A Narrative Review. Nutrients 2022; 14:nu14132717. [PMID: 35807896 PMCID: PMC9268405 DOI: 10.3390/nu14132717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
There is conflicting evidence of the roles vitamin D and iron have in isolation and combined in relation to muscle health. The purpose of this narrative review was to examine the current literature on the roles that vitamin D and iron have on skeletal muscle mass, strength, and function and how these nutrients are associated with skeletal muscle health in specific populations. Secondary purposes include exploring if low vitamin D and iron status are interrelated with skeletal muscle health and chronic inflammation and reviewing the influence of animal-source foods rich in these nutrients on health and performance. PubMed, Scopus, SPORT Discus, EMBAE, MEDLINE, and Google Scholar databases were searched to determine eligible studies. There was a positive effect of vitamin D on muscle mass, particularly in older adults. There was a positive effect of iron on aerobic and anaerobic performance. Studies reported mixed results for both vitamin D and iron on muscle strength and function. While vitamin D and iron deficiency commonly occur in combination, few studies examined effects on skeletal muscle health and inflammation. Isolated nutrients such as iron and vitamin D may have positive outcomes; however, nutrients within food sources may be most effective in improving skeletal muscle health.
Collapse
|
22
|
Moisidis-Tesch CM, Shulman LP. Iron Deficiency in Women's Health: New Insights into Diagnosis and Treatment. Adv Ther 2022; 39:2438-2451. [PMID: 35488139 DOI: 10.1007/s12325-022-02157-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/31/2022] [Indexed: 02/08/2023]
Abstract
Iron deficiency (ID), with or without anemia, is commonly found worldwide and affects the health and wellbeing of pregnant and nonpregnant women. Symptoms of ID- which include fatigue, pica (ice craving), restless legs syndrome, poor concentration and work function, increased susceptibility to infection, and cardiovascular stress- can cause significant morbidity and reduced quality of life. The etiologies of iron deficiency in women are usually specific to each community. In the developing world, iron deficiency is usually associated with poor iron intake and parasitic infections, whereas in higher income regions, iron deficiency is typically the result of heavy, abnormal uterine bleeding, and pregnancy. Iron-poor diets and poor iron absorption resulting from gut disorders can also play a role. Diagnosis of iron deficiency is usually straightforward and characterized by a low ferritin level; however, the diagnosis can be challenging in women with concomitant inflammatory disorders, in which case a low percent transferrin saturation, performed after an overnight fast, can inform on the need for iron. Therapy is frequently initiated with oral iron salts; however, use of these oral regimens is commonly associated with adverse events, mostly gastrointestinal in nature, that have been shown to adversely impact compliance, continuation, and the achievement of therapeutic goals. A further impediment to the effectiveness of oral iron is its poor absorption because of comorbidity (i.e., celiac disease, gastritis, etc.), surgery (bariatric), or physiologic inhibitory mechanisms. As such, intravenous (IV) iron regimens are increasingly being used to treat ID, as such regimens have been shown to avoid the gastrointestinal adverse events commonly associated with oral regimens. Indeed, IV iron has been shown to provide adequate iron replacement in women with functional iron deficiencies as well as those with ID resulting from inflammatory disorders- patients often resistant to oral iron therapy. More recent IV iron regimens have been shown to provide iron replacement in a safe and effective manner, being associated with more salutary adverse event profiles than earlier IV iron regimens. In fact, these iron regimens can provide a complete replacement dose in a single 15-60-min visit.
Collapse
|
23
|
Bhurosy T, Jishan A, Boland PM, Lee YH, Heckman CJ. Underdiagnosis of iron deficiency anemia among patients with colorectal cancer: an examination of electronic medical records. BMC Cancer 2022; 22:435. [PMID: 35449093 PMCID: PMC9022310 DOI: 10.1186/s12885-022-09542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Timely diagnosis and management of iron deficiency anemia (IDA) in colorectal cancer (CRC) patients improves overall quality of life and survival. This study assessed the proportion of CRC patients who were formally diagnosed with IDA and factors that predict a formal diagnosis of IDA and receiving iron therapy. Methods We retrieved electronic medical records (EMRs) of CRC patients from a large comprehensive cancer center in the Northeastern part of the United States (n = 499). We abstracted sociodemographic characteristics, relevant laboratory results, IDA diagnosis, and iron supplementation from the EMRs. We assessed relationships between participant characteristics, a diagnosis of IDA and receiving iron therapy through adjusted logistic regressions. Results IDA was formally diagnosed in 26 (5.2%) individuals judged by EMR documentation. Only 153 (30.7%) participants had iron laboratory results available. Among the 153 patients with iron panel data available, 113 (73.9%) had iron deficiency. Seventy-six had absolute iron deficiency as shown by ferritin levels below 100 ng/mL and iron saturation less than 20% and 37 had functional iron deficiency as shown by ferritin levels between 100 and 500 ng/mL and iron saturation less than 20%. 12% of all patients had documentation of iron therapy receipt. A formal diagnosis of IDA was not associated with any of the covariates. Conclusions Iron deficiency anemia is under-diagnosed among CRC patients and most likely under-documented in clinical notes. Rates of iron repletion are low, suggesting that many patients with IDA are untreated. Future research should explore provider-level and other strategies for improving assessment and diagnosis of IDA among CRC patients.
Collapse
Affiliation(s)
- Trishnee Bhurosy
- Department of Population Health, Hofstra University, Hempstead, New York, 11549, USA.
| | - Anika Jishan
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Patrick M Boland
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Yen-Han Lee
- Department of Public Health and Sports Medicine, Missouri State University, Springfield, MO, 65897, USA
| | - Carolyn J Heckman
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| |
Collapse
|
24
|
Iron deficiency and biomarkers of inflammation: a 3-year prospective analysis of the DO-HEALTH trial. Aging Clin Exp Res 2022; 34:515-525. [PMID: 34533774 PMCID: PMC8894209 DOI: 10.1007/s40520-021-01955-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/03/2021] [Indexed: 12/12/2022]
Abstract
Background The longitudinal association between iron deficiency and inflammatory biomarkers levels has not been fully explored among relatively healthy older adults. Aims To assess whether iron deficiency at baseline and at any yearly follow-up time point, with or without anemia, was associated with changes from baseline in high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels over 3 years. Methods This is a post-hoc observational analysis of DO-HEALTH, a double-blind, randomized controlled trial including 2157 European community-dwelling adults age 70+. The outcomes were changes from baseline in hs-CRP and IL-6 levels, measured at 12, 24, and 36 months of follow-up. Iron deficiency was defined by soluble transferrin receptor levels > 28.1 nmol/L and baseline anemia by hemoglobin levels < 130 g/L for men and < 120 g/L for women. Results In total, 2141 participants were included in the analyses (mean age: 74.9 years, 61.5% of women, 26.8% with iron deficiency). Baseline iron deficiency was associated with greater increase in IL-6 levels (mean difference in change: 0.52 ng/L, 95%CI 0.03–1.00, P = .04) over 3 years. Iron deficiency at any yearly time point was associated with higher increases in hs-CRP (mean difference in change: 1.62 mg/L, 95%CI 0.98–2.26, P < .001) and IL-6 levels (mean difference in change: 1.33 ng/L, 95%CI 0.87–1.79, P < .001) over 3 years. No significant interaction between iron deficiency and anemia was found, suggesting that the results are independent of the anemic status. Conclusions These findings suggest that iron deficiency may play a role in low-grade chronic inflammation among relatively healthy older adults. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01955-3.
Collapse
|
25
|
Reticulocyte Hemoglobin Equivalent: Diagnostic Performance in Assessment of Iron Deficiency in Patients with Hypothyroidism. Anemia 2021; 2021:9071057. [PMID: 34804607 PMCID: PMC8604597 DOI: 10.1155/2021/9071057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/24/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Iron deficiency affects approximately 30% of the world population and is frequently encountered in hypothyroid patients. Early recognition and prompt treatment of iron deficiency in hypothyroid patients lead to a favorable outcome. The aim of this study is to prove the usefulness of reticulocyte hemoglobin equivalent (Ret-He) as a reliable and effective tool in diagnosis of iron deficiency in hypothyroid patients. Materials and Methods 154 patients with hypothyroidism were included in the study. They were divided into 4 groups. Group 1 included 66 hypothyroid patients without iron deficiency. They were taken as controls. Group 2 included 66 hypothyroid patients with iron deficiency anemia (IDA). Group 3 included 12 hypothyroid patients with iron deficiency but without anemia (ID). Group 4 included 10 hypothyroid patients which had concomitant iron deficiency with anemia of chronic disorder (ACDC). Ret-He was measured by analyzing blood samples on System XN 350. Thyroid profile, serum ferritin, and biochemical data were measured by an automated analyzer. Statistical analysis was performed by using SPSS 23. Results Ret-He was significantly lower with (p < 0.001) in group 2 (hypothyroid patients with IDA), group 3 (hypothyroid patients with ID), and in group 4 (hypothyroid patients with ACDC) as compared to controls in group 1 (hypothyroid patients without iron deficiency). After ROC analysis area under the curve (AUC) of Ret-He for hypothyroid patients with IDA was 0.96 at cutoff 28.5 pg with sensitivity of 93% and specificity of 90%. AUC of Ret-He in the hypothyroid group with ACDC was 0.99 at cutoff 30.8 pg with sensitivity of 90% and specificity of 90%. AUC of Ret-He in hypothyroid patients with ID was 0.97 at cutoff 31.7 pg with sensitivity of 91% and specificity of 70%. Conclusion Ret-He is a reliable, rapid, and cost-effective tool for diagnosing iron deficiency in hypothyroid patients.
Collapse
|
26
|
Oliveira BGRBD, Castro JBDA, Lisboa EFNS, Kang HC, Ferreira MDA. The presence of anemia in patients with leg ulcer: laboratory test. Rev Bras Enferm 2021; 75:e20210064. [PMID: 34614085 DOI: 10.1590/0034-7167-2021-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. METHOD This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. RESULTS 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. CONCLUSION The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.
Collapse
Affiliation(s)
| | | | | | - Hye Chung Kang
- Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil
| | | |
Collapse
|
27
|
Remez VP, Danilova IG, Gette IF, Brilliant SA, Pozdina VA. Antianemic Effect of a Composition Containing Iron-Potassium-Sodium Hexacyanoferrate, Iron Sulfate, Potassium Sulfate, and Pharmacopoeial Microcellulose. Pharm Chem J 2021. [DOI: 10.1007/s11094-021-02426-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
28
|
Zou LX, Sun L, Hua RX, Wu Y. Serum Hepcidin-25 and All-Cause Mortality in Patients Undergoing Maintenance Hemodialysis. Int J Gen Med 2021; 14:3153-3162. [PMID: 34262329 PMCID: PMC8274829 DOI: 10.2147/ijgm.s313777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/16/2021] [Indexed: 12/18/2022] Open
Abstract
Background Hepcidin plays an important role in iron homeostasis, inhibits intestinal iron absorption and iron release from hepatocytes and macrophages, while its clinical utility remained unclear. This study aimed to investigate the associations between hepcidin-25 and mortality in MHD patients. Methods This was a prospective observational cohort of 161 MHD patients, with 2-year follow-up. We investigated the relationships between the variables in our dataset, including serum hepcidin-25, demographic characteristics as well as other clinical parameters. Results The median value of baseline serum hepcidin-25 was 31.0 (12.1, 57.3) ng/mL; therefore, the patients were stratified into two groups (low-level hepcidin-25 group, and high-level hepcidin-25 group). The serum iron, serum ferritin, transferrin saturation (TSAT), and hsCRP were higher, pre-dialysis creatinine and albumin were lower, and the scores of health-related qualities of life were worse in the high-level hepcidin-25 group than in the low-level hepcidin-25 group. Maximal information-based nonparametric exploration analysis suggested that serum hepcidin-25 was associated with ferritin, TSAT, and all-cause mortality. The patients with hepcidin-25<31 ng/mL had better survival outcomes than those with hepcidin-25≥31 ng/mL during the 24-month follow-up (Log rank test, P = 0.0017). For per 10ng/mL increase of serum hepcidin-25, the hazard ratio (HR) for all-cause mortality was 1.225 (95% confidence interval [CI]1.085-1.382, P<0.001), which remained significant after multivariate adjustments. Conclusion Serum hepcidin-25 was associated with ferritin and TSAT, and could be an independent predictor for all-cause mortality in MHD patients. Further research with larger sample size and longer-term follow-up is still needed.
Collapse
Affiliation(s)
- Lu-Xi Zou
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Ling Sun
- Department of Nephrology, Xuzhou Central Hospital, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Rui-Xue Hua
- XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Yu Wu
- XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| |
Collapse
|
29
|
Banerjee S, Katiyar P, Kumar L, Kumar V, Saini SS, Krishnan V, Sircar D, Roy P. Black pepper prevents anemia of inflammation by inhibiting hepcidin over-expression through BMP6-SMAD1/ IL6-STAT3 signaling pathway. Free Radic Biol Med 2021; 168:189-202. [PMID: 33771600 DOI: 10.1016/j.freeradbiomed.2021.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 01/03/2023]
Abstract
Hepcidin, a circulatory hepatic peptide hormone, is associated with systemic iron homeostasis. Inflammation leads to an increase in hepcidin expression, which dysregulates body iron level. The related disorder, anemia of inflammation, is the second most prevalent anemia-related disorder worldwide. In the present study, we conducted in vitro and in vivo studies to evaluate the effect of black pepper (BP) and its major bioactive alkaloid, piperine, on anemia of inflammation. The initial in vitro study using human hepatocyte cell line, HepG2, confirmed that among different black pepper extracts: methanol (BPME), ethanol (BPEE) and aqueous (BPAE), BPME to be most effective in downregulating transcription of hepcidin gene. Further, BPME and piperine significantly downregulated hepcidin protein expression at 200 μg/ml and 100 μM concentrations, respectively. In the next phase, BPME and piperine were found to significantly attenuate BMP-6 and IL-6 induced hepcidin overexpression by downregulating the increased level of pSMAD1 and pSTAT3 proteins, respectively. For in vivo study, we first subcutaneously injected male BALB/c mice with oil of turpentine, thrice within a period of two weeks, in order to enhance the expression of hepcidin. After that, the intraperitoneal administration of BPME and piperine at 70 and 25 mg/kg body weight, respectively, on alternate days for a period of another two weeks resulted in downregulation of hepcidin overexpression in diseased mice, as confirmed by RT-PCR and immunoblot analysis. The histopathology of liver tissue confirmed increased iron bioavailability in BPME and piperine treated animals. The molecular docking-based interaction studies demonstrated the binding potential of piperine with SMAD1 and STAT3 proteins. The binding patterns supported the proposed inhibition of hepcidin activating proteins. All together, these findings suggest black pepper as a therapeutic candidate for the treatment of anemia of inflammation.
Collapse
Affiliation(s)
- Somesh Banerjee
- Molecular Endocrinology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
| | - Parul Katiyar
- Molecular Endocrinology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
| | - Lokesh Kumar
- Molecular Endocrinology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
| | - Vijay Kumar
- Laboratory of Structural Microbiology, Regional Centre for Biotechnology, Faridabad, 121001, Haryana, India.
| | - Shashank Sagar Saini
- Plant Molecular Biology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
| | - Vengadesan Krishnan
- Laboratory of Structural Microbiology, Regional Centre for Biotechnology, Faridabad, 121001, Haryana, India.
| | - Debabrata Sircar
- Plant Molecular Biology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
| | - Partha Roy
- Molecular Endocrinology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
| |
Collapse
|
30
|
Afsar RE, Kanbay M, Ibis A, Afsar B. In-depth review: is hepcidin a marker for the heart and the kidney? Mol Cell Biochem 2021; 476:3365-3381. [PMID: 33942218 DOI: 10.1007/s11010-021-04168-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/21/2021] [Indexed: 12/15/2022]
Abstract
Iron is an essential trace element involved in oxidation-reduction reactions, oxygen transport and storage, and energy metabolism. Iron in excess can be toxic for cells, since iron produces reactive oxygen species and is important for survival of pathogenic microbes. There is a fine-tuning in the regulation of serum iron levels, determined by intestinal absorption, macrophage iron recycling, and mobilization of hepatocyte stores versus iron utilization, primarily by erythroid cells in the bone marrow. Hepcidin is the major regulatory hormone of systemic iron homeostasis and is upregulated during inflammation. Hepcidin metabolism is altered in chronic kidney disease. Ferroportin is an iron export protein and mediates iron release into the circulation from duodenal enterocytes, splenic reticuloendothelial macrophages, and hepatocytes. Systemic iron homeostasis is controlled by the hepcidin-ferroportin axis at the sites of iron entry into the circulation. Hepcidin binds to ferroportin, induces its internalization and intracellular degradation, and thus inhibits iron absorption from enterocytes, and iron release from macrophages and hepatocytes. Recent data suggest that hepcidin, by slowing or preventing the mobilization of iron from macrophages, may promote atherosclerosis and may be associated with increased cardiovascular disease risk. This article reviews the current data regarding the molecular and cellular pathways of systemic and autocrine hepcidin production and seeks the answer to the question whether changes in hepcidin translate into clinical outcomes of all-cause and cardiovascular mortality, and cardiovascular and renal end-points.
Collapse
Affiliation(s)
- Rengin Elsurer Afsar
- Department of Nephrology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | - Mehmet Kanbay
- Department of Nephrology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Avsin Ibis
- Department of Nephrology, Afyon Kocatepe Devlet Hastanesi, Afyon, Turkey
| | - Baris Afsar
- Department of Nephrology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| |
Collapse
|
31
|
Weiler S, Nairz M. TAM-ing the CIA-Tumor-Associated Macrophages and Their Potential Role in Unintended Side Effects of Therapeutics for Cancer-Induced Anemia. Front Oncol 2021; 11:627223. [PMID: 33842333 PMCID: PMC8027083 DOI: 10.3389/fonc.2021.627223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 03/01/2021] [Indexed: 12/21/2022] Open
Abstract
Cancer-induced anemia (CIA) is a common consequence of neoplasia and has a multifactorial pathophysiology. The immune response and tumor treatment, both intended to primarily target malignant cells, also affect erythropoiesis in the bone marrow. In parallel, immune activation inevitably induces the iron-regulatory hormone hepcidin to direct iron fluxes away from erythroid progenitors and into compartments of the mononuclear phagocyte system. Moreover, many inflammatory mediators inhibit the synthesis of erythropoietin, which is essential for stimulation and differentiation of erythroid progenitor cells to mature cells ready for release into the blood stream. These pathophysiological hallmarks of CIA imply that the bone marrow is not only deprived of iron as nutrient but also of erythropoietin as central growth factor for erythropoiesis. Tumor-associated macrophages (TAM) are present in the tumor microenvironment and display altered immune and iron phenotypes. On the one hand, their functions are altered by adjacent tumor cells so that they promote rather than inhibit the growth of malignant cells. As consequences, TAM may deliver iron to tumor cells and produce reduced amounts of cytotoxic mediators. Furthermore, their ability to stimulate adaptive anti-tumor immune responses is severely compromised. On the other hand, TAM are potential off-targets of therapeutic interventions against CIA. Red blood cell transfusions, intravenous iron preparations, erythropoiesis-stimulating agents and novel treatment options for CIA may interfere with TAM function and thus exhibit secondary effects on the underlying malignancy. In this Hypothesis and Theory, we summarize the pathophysiological hallmarks, clinical implications and treatment strategies for CIA. Focusing on TAM, we speculate on the potential intended and unintended effects that therapeutic options for CIA may have on the innate immune response and, consequently, on the course of the underlying malignancy.
Collapse
Affiliation(s)
- Stefan Weiler
- National Poisons Information Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.,Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Eidgenossische Technische Hochschule Zurich, Zurich, Switzerland
| | - Manfred Nairz
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
32
|
Graczykowska K, Kaczmarek J, Wilczyńska D, Łoś-Rycharska E, Krogulska A. The Consequence of Excessive Consumption of Cow's Milk: Protein-Losing Enteropathy with Anasarca in the Course of Iron Deficiency Anemia-Case Reports and a Literature Review. Nutrients 2021; 13:828. [PMID: 33802302 PMCID: PMC8000842 DOI: 10.3390/nu13030828] [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: 02/10/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 01/18/2023] Open
Abstract
Cow's milk is a key component of a child's diet. While the consumption of even trace amounts can result in allergy to its proteins and/or hypolactasia, excessive cow's milk consumption can result in numerous health complications, including iron deficiency, due to the diet being improperly balanced. Although the incidence of iron deficiency has declined, it remains the most widespread nutritional deficiency globally and the most common cause of anemia. One rare consequence of anemia caused by iron deficiency is protein-losing enteropathy; however, the mechanisms of its development are unclear. The following manuscript, based on a literature review, presents two rare cases of children, a 16-month-old boy and a 2.5-year-old girl, who developed severe microcytic anemia, enteropathy with hypoalbuminemia, and anasarca as a result of excessive cow's milk consumption. It highlights the possible relationship between excessive consumption of cow's milk in children and severe iron deficiency anemia with accompanying hypoalbuminemia; it may also result in serious clinical conditions, even in children that do not demonstrate food hypersensitivity.
Collapse
Affiliation(s)
- Karolina Graczykowska
- SRC Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Joanna Kaczmarek
- SRC Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Dominika Wilczyńska
- Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland; (D.W.); (E.Ł.-R.); (A.K.)
| | - Ewa Łoś-Rycharska
- Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland; (D.W.); (E.Ł.-R.); (A.K.)
| | - Aneta Krogulska
- Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland; (D.W.); (E.Ł.-R.); (A.K.)
| |
Collapse
|
33
|
Vreugdenhil M, Akkermans MD, van Swelm RPL, Laarakkers CM, Houdijk ECAM, Bakker B, Clement-de Boers A, van der Kaay DCM, de Vries MC, Woltering MC, Mul D, van Goudoever JB, Brus F. Serum hepcidin concentrations in relation to iron status in children with type 1 diabetes. Pediatr Hematol Oncol 2021; 38:108-123. [PMID: 33026897 DOI: 10.1080/08880018.2020.1820650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Chronic low-grade inflammation in type 1 diabetes (T1D) might increase hepcidin synthesis, possibly resulting in functional iron deficiency (FID). We hypothesized that in T1D children with FID, hepcidin concentrations are increased compared to those with normal iron status and those with absolute iron deficiency (AID). We evaluated hepcidin concentrations in T1D children in relation to iron status, and investigated whether hepcidin is useful in assessing FID. A cross-sectional study was conducted. FID was defined as elevated zinc protoporphyrin/heme ratio and/or red blood cell distribution width, and AID as low serum ferritin concentration. Post-hoc analyses with different definitions of FID were performed, using transferrin saturation and reticulocyte hemoglobin content. Serum hepcidin concentrations were measured using mass-spectrometry. The IRODIAB-study is registered at www.trialregister.nl (NTR4642). This study included 215 T1D children with a median age of 13.7 years (Q1-Q3: 10.1-16.3). The median (Q1-Q3) hepcidin concentration in patients with normal iron status was 1.8 nmol/l (0.9-3.3), in AID-patients, 0.4 nmol/l (0.4-0.4) and in FID-patients, 1.6 nmol/l (0.7-3.5). Hepcidin concentrations in FID-patients were significantly higher than in AID-patients (p < 0.001). Irrespective of FID-definition used, hepcidin concentrations did not differ between FID-patients and patients with normal iron status. This might be explained by the influence of various factors on hepcidin concentrations, and/or by differences in response of iron parameters over time. Single hepcidin measurements do not seem useful in assessing FID in T1D children. Multiple hepcidin measurements over time in future studies, however, might prove to be more useful in assessing FID in children with T1D.
Collapse
Affiliation(s)
- Mirjam Vreugdenhil
- Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands
| | - Marjolijn D Akkermans
- Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands
| | - Rachel P L van Swelm
- Department of Laboratory Medicine, Translational Metabolic Laboratory (TML 830), Hepcidinanalysis.com, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Coby M Laarakkers
- Department of Laboratory Medicine, Translational Metabolic Laboratory (TML 830), Hepcidinanalysis.com, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Euphemia C A M Houdijk
- Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands
| | - Boudewijn Bakker
- Department of Pediatrics, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Agnes Clement-de Boers
- Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands
| | - Daniëlle C M van der Kaay
- Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands
| | - Martine C de Vries
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Claire Woltering
- Department of Pediatrics, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Dick Mul
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics, Amsterdam University Medical Center, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Frank Brus
- Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands
| |
Collapse
|
34
|
Alageeli AA, Alqahtany FS, Algahtani FH. The Role of Reticulocyte Hemoglobin Content for the Diagnosis of Functional Iron Deficiency in Hemodialyzed patients. Saudi J Biol Sci 2021; 28:50-54. [PMID: 33424282 PMCID: PMC7783634 DOI: 10.1016/j.sjbs.2020.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 11/26/2022] Open
Abstract
The effectiveness of reticulocyte hemoglobin content (CHr) had been reported to detect early functional iron deficiency especially among Chronic kidney disease (CKD) patients. CHr is more superior to classic biochemical indices in reflecting transient iron-deficiency status, therefore improving diagnosis and treatment. This study was conducted to determine the sensitivity of CHr in the diagnosis of functional iron deficiency (FID) in hemodialyzed patients. One hundred hemodialyzed patients along with 60 healthy controls were recruited and blood specimens were collected. Venous blood was used for hematological and biochemical investigations collected via 3 ml lavender-top tubes for hematological tests including CBC, blood film, ESR and CHr, and red-top tube for biochemical tests including TIBC, SF and CRP. A statistically significant decrease was noted in CHr values between hemodialysis patients and the control group (24.8 ± 2.0 pg vs. 30.9 ± 1.3 pg, p<0.001). CHr values showed a significant correlations with RBCs, Hb- hemoglobin, Hct- hematocrit level, MCV- mean corpuscular volume, MCH- mean corpuscular hemoglobin, MCHC, RDW- red cell distribution width , SI-Serum Iron, TIBC- Total iron binding capacity and TSAT- Transferrin saturation. The present study showed that CHr in comparison to the conventional hematological and biochemical markers commonly used to diagnose iron deficiency.
Collapse
Affiliation(s)
- Ali A. Alageeli
- Department of Clinical Laboratory Sciences, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
| | - Fatmah S. Alqahtany
- Department of Pathology, Hematopathology Unit, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Farjah H. Algahtani
- Department of Medicine, Division of Oncology/Hematology, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
35
|
Nairz M, Weiss G. Iron in infection and immunity. Mol Aspects Med 2020; 75:100864. [PMID: 32461004 DOI: 10.1016/j.mam.2020.100864] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/25/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Iron is an essential micronutrient for virtually all living cells. In infectious diseases, both invading pathogens and mammalian cells including those of the immune system require iron to sustain their function, metabolism and proliferation. On the one hand, microbial iron uptake is linked to the virulence of most human pathogens. On the other hand, the sequestration of iron from bacteria and other microorganisms is an efficient strategy of host defense in line with the principles of 'nutritional immunity'. In an acute infection, host-driven iron withdrawal inhibits the growth of pathogens. Chronic immune activation due to persistent infection, autoimmune disease or malignancy however, sequesters iron not only from infectious agents, autoreactive lymphocytes and neoplastic cells but also from erythroid progenitors. This is one of the key mechanisms which collectively result in the anemia of chronic inflammation. In this review, we highlight the most important interconnections between iron metabolism and immunity, focusing on host defense against relevant infections and on the clinical consequences of anemia of inflammation.
Collapse
Affiliation(s)
- Manfred Nairz
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Austria; Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Austria.
| |
Collapse
|
36
|
Analysis of Biochemical Parameters in Children with Chronic Tonsillitis. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:129-135. [PMID: 32874684 PMCID: PMC7445641 DOI: 10.12865/chsj.46.02.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022]
Abstract
Chronic tonsillitis are frequent in pediatric pathology with numerous involved risk factors and pathogenic mechanisms. In this study, epidemiological data and biochemical values addressed to inflammation and mineral, lipid and hepatic metabolism were analyzed for 37 children of school age with chronic tonsillitis. We found that in the majority of cases, chronic tonsillitis was associated with increasing number of blood circulating inflammatory cells, high values of transaminases, cholesterol, triglycerides and low values of procalcitonin, C-reactive protein, calcium, vitamin D and serum iron. The results indicated relations of the biochemical profile analyzed with risk factors and systemic mechanisms for initiation and maintenance of chronic tonsillitis, aspects that can be used to optimize the prognosis of chronic tonsillitis in children.
Collapse
|
37
|
The Estimation of Blood Paramagnetic Center Changes during Burns Management with Biodegradable Propolis-Nanofiber Dressing. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:3675603. [PMID: 32685093 PMCID: PMC7341434 DOI: 10.1155/2020/3675603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
The evolution of the paramagnetic center system in blood during the healing of skin burn wounds dressed with a biodegradable apitherapeutic nanofiber dressing was examined. The aim of this study was to determine the changes in paramagnetic centers in blood during the influence of apitherapeutic nanofiber dressings on the healing process. The blood samples were tested before burn infliction (day 0) and, respectively, on the 10th and 21st days of the experiment. Paramagnetic centers in the blood of the pig used as the model animal were examined with an X-band (9.3 GHz) electron paramagnetic resonance spectroscopy. The EPR spectra were measured with Bruker spectrometer at 230 K with a modulation frequency of 100 kHz. The EPR lines of the high spin Fe3+ in methemoglobin, high spin Fe3+ in transferrin, Cu2+ in ceruloplasmin, and free radicals were observed in the multicomponent spectra of blood. For the application of the apitherapeutic nanofiber dressing, the amplitudes of the EPR signals of Fe3+ in methemoglobin were similar up to 10 days. For the experiment with the apitherapeutic formulation, the heights of EPR signals of Fe3+ in transferrin were lower after 10 days and 21 days of therapy, compared to day 0. For the application of the apitherapeutic formulation the signals of Cu2+ in ceruloplasmin and free radicals, strongly decreased after 10 days of therapy, and after 21 days it increased to the initial values characteristic for day 0. The apitherapeutic formulation caused that after 21 days the EPR spectrum of Cu2+ in ceruloplasmin and free radicals was considerably high. The apitherapeutic formulation interaction after 10 days and after 21 days of therapy resulted in the low EPR lines of Fe3+ in methemoglobin. EPR spectra of blood may be useful for presentation of the changes in its paramagnetic centers during the healing process of the burn wounds.
Collapse
|
38
|
Yusuf FLA, Wijnands JM, Kingwell E, Zhu F, Evans C, Fisk JD, Zhao Y, Sutherland JM, Patrick DM, Marrie RA, Tremlett H. Fatigue, sleep disorders, anaemia and pain in the multiple sclerosis prodrome. Mult Scler 2020; 27:290-302. [PMID: 32250183 DOI: 10.1177/1352458520908163] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND There is increasing evidence of prodromal multiple sclerosis (MS). OBJECTIVE The aim of this study was to determine whether fatigue, sleep disorders, anaemia or pain form part of the MS prodrome. METHODS This population-based matched cohort study used linked administrative and clinical databases in British Columbia, Canada. The odds of fatigue, sleep disorders, anaemia and pain in the 5 years preceding the MS cases' first demyelinating claim or MS symptom onset were compared with general population controls. The frequencies of physician visits for these conditions were also compared. Modifying effects of age and sex were evaluated. RESULTS MS cases/controls were assessed before the first demyelinating event (6863/31,865) or MS symptom onset (966/4534). Fatigue (adj.OR: 3.37; 95% CI: 2.76-4.10), sleep disorders (adj.OR: 2.61; 95% CI: 2.34-2.91), anaemia (adj.OR: 1.53; 95% CI: 1.32-1.78) and pain (adj.OR: 2.15; 95% CI: 2.03-2.27) during the 5 years preceding the first demyelinating event were more frequent among cases, and physician visits increased for cases relative to controls. The association between MS and anaemia was greater for men; that between MS and pain increased with age. Pre-MS symptom onset, sleep disorders (adj.OR: 1.72; 95% CI: 1.12-2.56) and pain (adj.OR: 1.53; 95% CI: 1.32-1.76) were more prevalent among cases. CONCLUSION Fatigue, sleep disorders, anaemia and pain were elevated before the recognition of MS. The relative anaemia burden was higher in men and pain more evident among older adults.
Collapse
Affiliation(s)
- Fardowsa LA Yusuf
- UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - José Ma Wijnands
- UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Elaine Kingwell
- UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Feng Zhu
- UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Charity Evans
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - John D Fisk
- Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada
| | - Yinshan Zhao
- UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/BC Centre for Improved Cardiovascular Health, Vancouver, BC, Canada
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - David M Patrick
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Health Sciences Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Helen Tremlett
- UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
39
|
Red meat and egg intake and serum ferritin concentrations in Colombian children: results of a population survey, ENSIN-2015. J Nutr Sci 2020; 9:e12. [PMID: 32257183 PMCID: PMC7103465 DOI: 10.1017/jns.2020.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The present study aimed to (a) establish the frequency of consumption of red meat and eggs; (b) determine serum ferritin levels (μg/l); and (c) establish the relationship between serum ferritin and the consumption of red meat and eggs. In Colombia during 2014–2018, an analytical study was conducted in 13 243 Colombian children between the ages of 5 and 17 years, based on cross-sectional data compiled by ENSIN-2015 (Encuesta Nacional de la Situación Nutricional en Colombia-2015) on serum ferritin levels and dietary consumption based on a questionnaire of the frequency of consumption. Using simple and multiple linear regression, with the serum ferritin level as the dependent variable and the frequency of consumption as the main explanatory variable, the crude and adjusted partial regression coefficients (β) between serum ferritin levels and consumption were calculated. The frequency of habitual consumption of red meat was 0⋅49 (95 % CI 0⋅47, 0⋅51) times/d. The frequency of habitual egg consumption was 0⋅76 (95 % CI 0⋅74, 0⋅78) times per d. The mean serum ferritin level in men was 41⋅9 (95 % CI 40⋅6, 43⋅1) μg/l and in women, 35⋅7 (95 % CI 34⋅3, 37⋅7) μg/l (P < 0⋅0001). The adjusted β between the consumption of red meat and eggs and serum ferritin levels were β = 3⋅0 (95 % CI 1⋅2, 4⋅7) and β = 2⋅5 (95 % CI 1⋅0, 3⋅9) for red meat and eggs, respectively. In conclusion, red meat and eggs are determinants of serum ferritin levels in Colombia and, therefore, could be considered public policy options to reduce anaemia and Fe deficiency.
Collapse
|
40
|
Atopic Disease and Anemia in Korean Patients: Cross-Sectional Study with Propensity Score Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061978. [PMID: 32197291 PMCID: PMC7142528 DOI: 10.3390/ijerph17061978] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 02/07/2023]
Abstract
Atopic disease is associated with chronic inflammation, and anemia has been reported in patients with inflammatory disorders such as rheumatoid arthritis, chronic obstructive pulmonary disease, and irritable bowel disease. The objective of this study was to determine whether atopic disease is associated with an increased risk of anemia. A cross-sectional study with propensity score weighting was conducted using a health insurance review agency claims dataset comprised of randomized patients who used the Korean national health system at least once in 2016. The association between atopic disease (asthma, atopic dermatitis, allergic rhinitis) and anemia (iron deficiency anemia (IDA) and/or anemia of inflammation (AI)) was examined. A total of 1,468,033 patients were included in this study. The IDA/AI prevalence was 3.1% (45,681 patients). After propensity score weighting, there were 46,958 and 45,681 patients in the non-anemic and anemic groups, respectively. The prevalence of IDA/AI in patients with atopic dermatitis, allergic rhinitis, or asthma had an odds ratio (OR) of 1.40 (95% confidence interval (CI), 1.33–1.48; p < 0.001), 1.17 (95% CI, 1.14–1.21; p < 0.001), and 1.32 (95% CI, 1.28–1.36; p < 0.001), respectively. In addition, the prevalence of IDA increased with higher numbers of atopic diseases. In conclusion, the prevalence of IDA/AI was higher in patients with atopic disease, even after adjusting for demographic characteristics and other risk factors. Further study is needed to distinguish between IDA and AI and to enhance understanding of the etiology of anemia in patients with inflammatory conditions.
Collapse
|
41
|
Wang YS, Yao HJ, Bo LJ, Zhao YP, Zhang YL, Zhang FK. [Expression and influencing factors of hepcidin in classical paroxysmal nocturnal hemoglobinuria]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:818-821. [PMID: 31775479 PMCID: PMC7364984 DOI: 10.3760/cma.j.issn.0253-2727.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
目的 研究铁调素在经典型阵发性睡眠性血红蛋白尿症(PNH)患者血清中的表达及其影响因素。 方法 以2016年3月至2017年3月36例经典型PNH患者为研究对象,采用ELISA方法检测血清铁调素水平,并结合患者铁稳态状况和临床资料,分析经典型PNH患者血清铁调素水平与血清铁蛋白(SF)、可溶性转铁蛋白受体、C反应蛋白、EPO、网织红细胞绝对值、网织红细胞血红蛋白等血液学参数的相关性。 结果 36例经典型PNH患者血清铁调素水平为32.03(23.11,118.48)µg/L,明显低于正常对照组的181.42(106.80,250.53)µg/L(z=−5.107,P<0.001)。其中,铁蛋白正常经典型PNH患者血清铁调素水平为56.41(44.60,95.06)µg/L,经典型PNH伴缺铁组血清铁调素水平为23.75(21.77,30.35)µg/L,均低于正常对照组;而经典型PNH伴铁蛋白升高组血清铁调素水平为336.19(304.19,375.08)µg/L,高于正常对照组、铁蛋白正常经典型PNH组及经典型PNH伴缺铁组。多重线性回归分析显示SF、转铁蛋白饱和度和血清白蛋白水平是经典型PNH患者血清铁调素水平的独立影响因素。 结论 经典型PNH患者血清铁调素水平减低,其表达主要受铁代谢因素影响。
Collapse
Affiliation(s)
- Y S Wang
- Institute of Hematology and Blood Disease Hospital, CAMS & PUMC, National Clinical Research Center for Blood Diseases, Tianjin 300020, China
| | | | | | | | | | | |
Collapse
|
42
|
Ntenda PAM, Chilumpha S, Mwenyenkulu ET, Kazambwe JF, El-Meidany W. Clinical malaria and the potential risk of anaemia among preschool-aged children: a population-based study of the 2015-2016 Malawi micronutrient survey. Infect Dis Poverty 2019; 8:95. [PMID: 31760954 PMCID: PMC6876103 DOI: 10.1186/s40249-019-0607-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Anaemia and malaria are common and life-threatening diseases among preschool-aged children in many tropical and subtropical areas, and Malawi is no exception. Accordingly, this study aimed to examine the association of referral clinical malaria with anemia (hemoglobin [Hb] < 110 g/L) in preschool-aged children in Malawi. Methods Using cross-sectional data obtained from the 2015–2016 Malawi Micronutrient Survey (MNS), multivariate logistic regression models were constructed using surveylogistic to account for the complex survey design. Blood samples of 1051 children aged 6–59 months were evaluated for malaria (using rapid diagnostic test [RDT] – SD BIOLINE Malaria Ag P.f/Pan test histidine-rich protein (HRP-II)™), Hb (using HemoCue 301), α-1-acid glycoprotein (AGP), and serum ferritin biomarkers (using simple sandwich enzyme-linked immunosorbent assay technique, ELISA) and inherited blood disorders from dry blood samples (DBS) using polymerize chain reaction (PCR). Diagnosis of clinical malaria was made on the basis of fever and a positive rapid diagnostic test (RDT). Results Of the 1051 PSC analysed, 29% had anaemia while 24.4% had a referral to the hospital due to malaria. After adjustments for known confounders, PSC with a history of referral clinical malaria had increased odds of being anaemic (adjusted odds ratio [aOR] = 4.63, 95% confidence interval [CI]: 2.90–7.40), P < 0.0001. Conclusions This study found that clinical malaria increased the risk of anaemia in PSC. Thus, elimination of malaria-causing parasites from the PSC’s blood should be rapid and complete in order to prevent the progression of uncomplicated malaria to a chronic infection that can lead to the development of malaria-related anaemia.
Collapse
Affiliation(s)
- Peter Austin Morton Ntenda
- Malaria Alert Centre, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi.
| | - Sosten Chilumpha
- Ministry of Health and Population, Department of Planning and Policy Development, PO Box 30377, Lilongwe, Malawi
| | | | - Jane Flora Kazambwe
- NBS Bank PLC, Head Office NBS House Corner Chipembere Highway & Johnstone Roads Ginnery Corner Blantyre, P.O. Box 32251, Chichiri, Blantyre 3, Malawi
| | - Walaa El-Meidany
- Department of Nutrition, High Institute of Public Health, Alexandria University, Hiph 65 El-Horreya Avenue. El-Ibrahimia, Alexandria, Egypt
| |
Collapse
|
43
|
Rhew K, Oh JM. Association between atopic disease and anemia in pediatrics: a cross-sectional study. BMC Pediatr 2019; 19:455. [PMID: 31760939 PMCID: PMC6876088 DOI: 10.1186/s12887-019-1836-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/15/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Atopic diseases, such as atopic dermatitis, allergic rhinitis, and asthma, are inflammatory diseases common in pediatric patients. This study investigated whether these inflammatory atopic diseases were associated with anemia in pediatrics. METHODS A cross-sectional study was conducted using a pediatric dataset from the Health Insurance Review and Assessment Service (HIRA) of South Korea in 2016. Multivariable logistic regression, adjusting for demographic covariates was used for analyse the association between atopic disease and iron deficiency anemia (IDA). RESULTS A total of 846,718 pediatric patients were included in the study. Of these, 19,594 (2.31%) had a diagnosis of IDA. The logistic regression analyses including covariates revealed there were association between atopic disease and IDA. The adjusted OR (aOR) of IDA was 1.42 (95% CI, 1.37-1.47) for atopic dermatitis, 1.25 (95% CI, 1.21-1.29) for allergic rhinitis, and 1.71 (95% CI, 1.65-1.76) for asthma. IDA was more prevalent in patients with multiple comorbid atopic diseases, with aOR of 1.30 (95% CI, 1.25-1.35), 1.81 (95% CI, 1.73-1.89), and 2.58 (95% CI, 2.43-2.73) for 1, 2, or 3 atopic diagnoses. There was no evidence of multicollinearity among covariates. CONCLUSIONS Our findings suggest that atopic disease was associated with IDA. Further study is needed to clarify the distinction between IDA and/or AI to better understand the cause of anemia in patients with inflammatory diseases.
Collapse
Affiliation(s)
- Kiyon Rhew
- College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.,College of Pharmacy, Dongduk Women's University, 60 Hwarang-ro 13-gil, Seongbuk-gu, Seoul, 02748, Republic of Korea
| | - Jung Mi Oh
- College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea. .,Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
| |
Collapse
|
44
|
Zárate-Ortiz AG, Melse-Boonstra A, Rodríguez-Ramírez S, Hernández-Cordero S, Feskens EJM. Dietary Patterns and the Double Burden of Malnutrition in Mexican Adolescents: Results from ENSANUT-2006. Nutrients 2019; 11:E2753. [PMID: 31766194 PMCID: PMC6893405 DOI: 10.3390/nu11112753] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/04/2019] [Accepted: 11/08/2019] [Indexed: 12/14/2022] Open
Abstract
Mexico is facing the double burden of malnutrition, and adolescents are not an exception. Diet plays an important role, both in causing overweight and undernutrition. This study aimed to describe the dietary patterns (DPs) of Mexican adolescents and to examine its association with nutritional status using data from adolescents aged 12-19 years (n = 7380) from the National Survey of Health and Nutrition (ENSANUT-2006). Principal component analysis was used to derivate the DPs. Associations between DP and nutritional status were determined by prevalence ratio (PR). Four DPs were identified: nontraditional and breakfast-type, Western, plant-based, and protein-rich. The prevalence of overweight and obesity was higher in adolescents who scored high on the Western pattern (PR: 1.15, 95% CI: 1.08-1.21) or on the plant-based pattern (PR: 1.09, 95% CI: 1.03-1.17). The Western pattern was positively associated with anemia in girls (PR: 1.18, 95% CI: 1.03-1.35), while the nontraditional and breakfast-type pattern was inversely associated with anemia in adolescents aged 12-15 years (PR: 0.87, 95% CI: 0.76-0.99) and in girls (PR: 0.84, 95% CI: 0.75-0.97). The Western and plant-based patterns were simultaneously associated with overweight-obesity and at least one indicator of undernutrition. In the context of the double burden of malnutrition, dietary advice must consider malnutrition in all its forms.
Collapse
Affiliation(s)
- Arli Guadalupe Zárate-Ortiz
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen 6708WE, The Netherlands; (A.G.Z.-O.)
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen 6708WE, The Netherlands; (A.G.Z.-O.)
| | - Sonia Rodríguez-Ramírez
- Research Center of Nutrition and Health, National Institute for Public Health, Cuernavaca 62100, Mexico
| | | | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen 6708WE, The Netherlands; (A.G.Z.-O.)
| |
Collapse
|
45
|
Cacoub P, Vandewalle C, Peoc’h K. Using transferrin saturation as a diagnostic criterion for iron deficiency: A systematic review. Crit Rev Clin Lab Sci 2019; 56:526-532. [DOI: 10.1080/10408363.2019.1653820] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Patrice Cacoub
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Université, Paris, France
- Institut Natinal de la santé et de la Recherche Médicale (INSERM), Paris, France
- Centre Natinal de la Recherche Scientifique (CNRS), Paris, France
- Department of Internal Medicine and Clinical Immunology, Assistance Publique-Hopitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | | | - Katell Peoc’h
- Unité de Formation et Recherche (UFR) de Médecine Xavier Bichat, Centre de Recherche Sur L’Inflammation (CRI), Université Paris Diderot, Paris, France
- APHP, Unité Fonctionnelle (UF) de Biochimie Clinique, Hôpital Beaujon, Clichy, France
| |
Collapse
|
46
|
Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci 2019; 1450:15-31. [PMID: 31008520 PMCID: PMC6697587 DOI: 10.1111/nyas.14092] [Citation(s) in RCA: 258] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/04/2019] [Accepted: 03/18/2019] [Indexed: 12/14/2022]
Abstract
Anemia affects a third of the world's population and contributes to increased morbidity and mortality, decreased work productivity, and impaired neurological development. Understanding anemia's varied and complex etiology is crucial for developing effective interventions that address the context-specific causes of anemia and for monitoring anemia control programs. We outline definitions and classifications of anemia, describe the biological mechanisms through which anemia develops, and review the variety of conditions that contribute to anemia development. We emphasize the risk factors most prevalent in low- and middle-income countries, including nutritional deficiencies, infection/inflammation, and genetic hemoglobin disorders. Recent work has furthered our understanding of anemia's complex etiology, including the proportion of anemia caused by iron deficiency (ID) and the role of inflammation and infection. Accumulating evidence indicates that the proportion of anemia due to ID differs by population group, geographical setting, infectious disease burden, and the prevalence of other anemia causes. Further research is needed to explore the role of additional nutritional deficiencies, the contribution of infectious and chronic disease, as well as the importance of genetic hemoglobin disorders in certain populations.
Collapse
Affiliation(s)
| | - Parminder S. Suchdev
- Department of Pediatrics, Emory University, Atlanta, Georgia
- Emory Global Health Institute, Emory University, Atlanta, Georgia
- Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
47
|
Predicting hepcidin level using inflammation markers and iron indicators in patients with anemia of chronic disease. Hematol Transfus Cell Ther 2019; 41:342-348. [PMID: 31519530 PMCID: PMC6978530 DOI: 10.1016/j.htct.2019.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/11/2019] [Accepted: 03/29/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recently, a small peptide called Hepcidin, was found to have an important role in regulating the iron metabolism in anemia of chronic disease (ACD) patients. Hepcidin is regulated by a variety of conditions at the transcriptional level. Therefore, our study aims to predict the level of hepcidin serum using inflammation markers and iron indicators in patients afflicted with ACD and observe how this severity of inflammation separated the level of interleukin-6 (IL-6), as well the as hepcidin level. METHODS A cross-sectional data analysis was conducted on 80 ACD adult patients treated at the Sanglah Teaching Hospital in Bali, Indonesia. We used hepcidin serum and several markers, such as the hemoglobin level, inflammation markers, renal function tests, IL-6, and iron indicators, to predict the hepcidin level. RESULTS This study recruited 80 ACD patients, comprising 45 men (56.3%) and 35 women (43.7%). The mean age of the participants was 43±16.5 years. Only IL-6, ferritin and serum creatinine correlate significantly with serum hepcidin from seven variables that were previously eligible to enter the analysis. This study found the model to predict the hepcidin level using IL-6 ferritin and the creatinine level as the hepcidin level (predicted)=-23.76+0.396 (IL 6)+0.448 (ferritin)+0.310 (creatinine). CONCLUSION This study has revealed that the creatinine level, ferritin and IL-6 can be used to predict the hepcidin level in patients with anemia of chronic disease. It is to be hoped that further cohort studies can validate our formula to predict the hepcidin level.
Collapse
|
48
|
Wang Y, Zhang Z, Liu Y, Jing H, Ke X, Dong F. Use of carbon monoxide breath test to assess red blood cell lifespan in newly diagnosed multiple myeloma patients. J Breath Res 2019; 13:046008. [PMID: 31234157 DOI: 10.1088/1752-7163/ab2c12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To clarify the role of red blood cell (RBC) lifespan in anemia of multiple myeloma (MM), RBC lifespan was detected in 40 newly diagnosed MM patients by measuring exhaled endogenous carbon monoxide concentration. Mean RBC lifespan was significantly reduced in MM patients (63 ± 23 d) than healthy controls (116 ± 17 d). RBC lifespan in MM patients without anemia (78 ± 21 d) was also significantly lower than for healthy controls. RBC lifespan in MM patients with anemia (52 ± 18 d) was significantly lower than those without. Besides, RBC lifespan in MM patients with renal insufficiency (50 ± 16 d) was lower than those without (66 ± 23 d). RBC lifespan was significantly negatively correlated with % reticulocytes, erythropoietin concentration, % clonal plasma cells, β2-microglobulin (MG) level, and creatinine level. Receiver operator characteristics curve was used to determine a cut-off point (61 d) to predict effect of RBC lifespan on chemotherapy. Overall response rates were significantly higher in MM patients with RBC lifespan ≥61 d than those <61 d. In conclusion, RBC lifespan of MM patients is reduced, and severely shortened RBC lifespan may be involved in the occurrence of anemia in MM patients. The chemotherapeutic effect of MM patients can be predicted by RBC lifespan.
Collapse
Affiliation(s)
- Yanfang Wang
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, People's Republic of China
| | | | | | | | | | | |
Collapse
|
49
|
Yoon KL. Can iron be a risk factor for coronary lesions in Kawasaki disease? KOREAN JOURNAL OF PEDIATRICS 2019; 62:297-298. [PMID: 31208167 PMCID: PMC6702113 DOI: 10.3345/kjp.2019.00311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/07/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Kyung Lim Yoon
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| |
Collapse
|
50
|
Hemogram and iron indices in renal anemia and the amelioration with Carica papaya leaf extract applied on albino rat model. Biosci Rep 2019; 39:BSR20181699. [PMID: 30936264 PMCID: PMC6487265 DOI: 10.1042/bsr20181699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/10/2019] [Accepted: 03/15/2019] [Indexed: 11/17/2022] Open
Abstract
The present study was designed to look at the hematological disorders in gentamicin nephrotoxicity model, as kidney is considered as one of the hemopoietic organs. In a previous study, novel and classical kidney injury biomarkers were utilized to evaluate the nephroprotective potential of Carica papaya leaf extract (CPLE) in the same model in albino rats. Gentamicin (100 mg/kg, subcutaneously, for 21 consecutive days) resulted in significant decreases in red blood cell (RBC) count, hemoglobin concentration (HGB), and packed cell volume (PCV) value, with minimal alterations in erythrocytic indices. Leucogram showed leukocytosis, granulocytosis, and thrombocytopenia. Erythropoietin (EPO) levels were also drastically decreased by the end of the experimental course. Serum iron, unsaturated iron-binding capacity (UIBC), total iron binding capacity (TIBC), transferrin saturation %, and serum transferrin concentration values were significantly decreased in contrast to ferritin, which was increased. When concurrently administered with gentamicin, CPLE (150 and 300 mg/kg, orally via gastric tube, for 21 days) significantly protected against the drastic effects of the former on the blood profile with improving potentials on erythrogram, leukogram, thrombocytes, EPO, iron and its indices, in a dose-dependent manner. These data may suggest CPLE as an appreciated blood homeostatic and nephroprotective agent from a natural source that could be a good remedy in conditions associated with blood disorders.
Collapse
|