1
|
Fehsel K. Metabolic Side Effects from Antipsychotic Treatment with Clozapine Linked to Aryl Hydrocarbon Receptor (AhR) Activation. Biomedicines 2024; 12:2294. [PMID: 39457607 PMCID: PMC11505606 DOI: 10.3390/biomedicines12102294] [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: 05/31/2024] [Revised: 09/30/2024] [Accepted: 10/07/2024] [Indexed: 10/28/2024] Open
Abstract
Metabolic syndrome (MetS) is the most common adverse drug reaction from psychiatric pharmacotherapy. Neuroreceptor blockade by the antipsychotic drug clozapine induces MetS in about 30% of patients. Similar to insulin resistance, clozapine impedes Akt kinase activation, leading to intracellular glucose and glutathione depletion. Additional cystine shortage triggers tryptophan degradation to kynurenine, which is a well-known AhR ligand. Ligand-bound AhR downregulates the intracellular iron pool, thereby increasing the risk of mitochondrial dysfunction. Scavenging iron stabilizes the transcription factor HIF-1, which shifts the metabolism toward transient glycolysis. Furthermore, the AhR inhibits AMPK activation, leading to obesity and liver steatosis. Increasing glucose uptake by AMPK activation prevents dyslipidemia and liver damage and, therefore, reduces the risk of MetS. In line with the in vitro results, feeding experiments with rats revealed a disturbed glucose-/lipid-/iron-metabolism from clozapine treatment with hyperglycemia and hepatic iron deposits in female rats and steatosis and anemia in male animals. Decreased energy expenditure from clozapine treatment seems to be the cause of the fast weight gain in the first weeks of treatment. In patients, this weight gain due to neuroleptic treatment correlates with an improvement in psychotic syndromes and can even be used to anticipate the therapeutic effect of the treatment.
Collapse
Affiliation(s)
- Karin Fehsel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Bergische Landstrasse 2, 40629 Duesseldorf, Germany
| |
Collapse
|
2
|
He L, Yang J, Lin S, Shi K, Fang Y. Frailty detection with routine blood tests using data from the english longitudinal study of ageing (ELSA). Eur Geriatr Med 2024:10.1007/s41999-024-01038-2. [PMID: 39190227 DOI: 10.1007/s41999-024-01038-2] [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: 05/01/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE Frailty is a rising global health issue in ageing society. Easily accessible and sensitive tools are needed for frailty monitoring while routine blood factors can be potential candidates. METHODS Data from 1907 participants (aged 60 years or above) were collected from the 4th to 9th wave of the English longitudinal study of ageing. 14 blood factors obtained from blood tests were included in the analysis. A 52-item frailty index (FI) was calculated for frailty evaluation. Logistic regression and Cox proportional hazards analysis were used to explore the relationships between baseline blood factors and the incidence of frailty over time respectively. All analyses were controlled for age and sex. RESULTS The mean age of participants was 67.3 years and 47.2% of them were male. Our study identified that 8 blood factors (mean corpuscular haemoglobin, HDL, triglyceride, ferritin, hsCRP, dehydroepiandrosterone, haemoglobin, and WBC) involved in inflammatory, nutritional and metabolic processes were associated with frailty. The combined model with these 8 blood factors had an AUC of 0.758 at cross-sectional level. In the Cox proportional hazards analysis, higher triglyceride (HR: 1.30, 95%CI: 1.07 ~ 1.59), WBC (HR: 1.16, 95%CI: 1.05 ~ 1.28), and lower HDL (HR: 0.58, 95%CI: 0.38 ~ 0.90) at baseline were linked to greater risk of developing frailty within 10 years. Compared to adults without abnormal blood factors at baseline, the hazard ratios of participants with two or more abnormal blood factors were almost twofold higher in developing frailty over time. CONCLUSIONS Routine blood factors, particularly triglyceride, HDL and WBC, could be used for frailty screening in clinical practice and estimate the development of frailty over time.
Collapse
Affiliation(s)
- Lingxiao He
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Jinzhu Yang
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Shujing Lin
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Kanglin Shi
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Ya Fang
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
| |
Collapse
|
3
|
Vassilopoulou E, Venter C, Roth-Walter F. Malnutrition and Allergies: Tipping the Immune Balance towards Health. J Clin Med 2024; 13:4713. [PMID: 39200855 PMCID: PMC11355500 DOI: 10.3390/jcm13164713] [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: 07/22/2024] [Revised: 08/04/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024] Open
Abstract
Malnutrition, which includes macro- and micronutrient deficiencies, is common in individuals with allergic dermatitis, food allergies, rhinitis, and asthma. Prolonged deficiencies of proteins, minerals, and vitamins promote Th2 inflammation, setting the stage for allergic sensitization. Consequently, malnutrition, which includes micronutrient deficiencies, fosters the development of allergies, while an adequate supply of micronutrients promotes immune cells with regulatory and tolerogenic phenotypes. As protein and micronutrient deficiencies mimic an infection, the body's innate response limits access to these nutrients by reducing their dietary absorption. This review highlights our current understanding of the physiological functions of allergenic proteins, iron, and vitamin A, particularly regarding their reduced bioavailability under inflamed conditions, necessitating different dietary approaches to improve their absorption. Additionally, the role of most allergens as nutrient binders and their involvement in nutritional immunity will be briefly summarized. Their ability to bind nutrients and their close association with immune cells can trigger exaggerated immune responses and allergies in individuals with deficiencies. However, in nutrient-rich conditions, these allergens can also provide nutrients to immune cells and promote health.
Collapse
Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Department of Clinical Sciences and Community Health, Univertià degli Studi die Milano, 20122 Milan, Italy
| | - Carina Venter
- Pediatrics, Section of Allergy & Immunology, University of Colorado Denver School of Medicine, Children’s Hospital Colorado, Box B518, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Franziska Roth-Walter
- Messerli Research Institute, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Medical University of Vienna and University of Vienna, 1210 Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| |
Collapse
|
4
|
Kono HN, Ada Mengome MF, Pongui Ngondza B, Sibi Matotou RH, Ndong Akomezoghe L, Ekomi B, Moutombi Ditombi BC, Koumba Lengongo JV, Ndong Ngomo JM, M’Bondoukwé NP, Bisseye C, Mawili-Mboumba DP, Bouyou Akotet MK. C-reactive protein and high-sensitivity C-reactive protein levels in asymptomatic intestinal parasite carriers from urban and rural areas of Gabon. PLoS Negl Trop Dis 2024; 18:e0011282. [PMID: 38768226 PMCID: PMC11142663 DOI: 10.1371/journal.pntd.0011282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/31/2024] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Chronic carriage of intestinal parasitic infections (IPIs) can induce chronic inflammation and dysbiosis, which are risk factors for non-communicable diseases. The objective of this study was to determine the relationship between IPI carriage and inflammation in a population of volunteers living in Gabon. METHODOLOGY AND PRINCIPAL FINDINGS A cross-sectional study was conducted from September 2020 to November 2021 in asymptomatic volunteers aged 18 years old and over, residing in different areas of Gabon: Libreville (urban area) and Koula-Moutou and Bitam (rural areas). The detection of IPIs was carried out using four common microscopic techniques. C-reactive protein (CRP), and high-sensitivity C-reactive protein (hsCRP) were measured and levels were compared according to the presence or absence of IPI. Overall, 518 participants were included, 64.5% (n = 334) of whom resided in urban area and 35.5% (n = 184) in rural areas. The median age was 35 years (27; 46). The prevalence of asymptomatic IPIs was 29.9% (n = 155), with a significantly higher frequency in rural areas than in urban area (adjusted OR 6.6 (CI 3.2-13.8), p < 0.01). Protozoa were more frequent than soil-transmitted helminths (STHs) in both areas: 81.6% (n = 40) in urban area and 69.8% (n = 74) in rural areas. STHs were predominant in rural areas (48.1% vs 22.4% in urban area. In case of IPI, the median values of CRP (15 (13-15) mg/L vs 13.0 (11.1-14.9) mg/L) and hsCRP (4.2 (1.4-13.0) mg/L vs 2.2(0.4-6.1) mg/L) were higher (p<0.01). Elevated hsCRP and CRP were significantly more frequent in parasitized individuals (for hsCRP: 22.6%, n = 35; for CRP: 52.9%, n = 82); in particular among STH carriers (for hsCRP: 65.9%, n = 27, for CRP: 36.6%, n = 15) (p < 0.01). CONCLUSIONS/SIGNIFICANCE This first study showed that asymptomatic IPIs, particularly STH carriage are associated with high CRP and hsCRP levels. Further larger and longitudinal studies are needed to elucidate the global and specie-specific enteropathogens link with chronic inflammation.
Collapse
Affiliation(s)
- Helena Noéline Kono
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Mérédith Flore Ada Mengome
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Bedrich Pongui Ngondza
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
| | - Roger Hadry Sibi Matotou
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
| | - Luccheri Ndong Akomezoghe
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Unité Mixte de Recherche sur les Agents Infectieux et leur Pathologie (UMRAIP), Université des Sciences de la Santé, Owendo, Gabon
| | - Bernadette Ekomi
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
| | - Bridy Chesly Moutombi Ditombi
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Unité Mixte de Recherche sur les Agents Infectieux et leur Pathologie (UMRAIP), Université des Sciences de la Santé, Owendo, Gabon
| | - Jeanne Vanessa Koumba Lengongo
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
| | - Jacques Mari Ndong Ngomo
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Unité Mixte de Recherche sur les Agents Infectieux et leur Pathologie (UMRAIP), Université des Sciences de la Santé, Owendo, Gabon
| | - Noé Patrick M’Bondoukwé
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Unité Mixte de Recherche sur les Agents Infectieux et leur Pathologie (UMRAIP), Université des Sciences de la Santé, Owendo, Gabon
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Unité Mixte de Recherche sur les Agents Infectieux et leur Pathologie (UMRAIP), Université des Sciences de la Santé, Owendo, Gabon
| | - Marielle Karine Bouyou Akotet
- Department of Parasitology-Mycology-Tropical Medicine, Université des Sciences de la Santé (USS), Owendo, Gabon
- Centre de REcherche biomédicale en pathogènes Infectieux et Pathologies Associées (CREIPA), Libreville, Gabon
- Unité Mixte de Recherche sur les Agents Infectieux et leur Pathologie (UMRAIP), Université des Sciences de la Santé, Owendo, Gabon
| |
Collapse
|
5
|
Skrypnik K, Schmidt M, Olejnik-Schmidt A, Harahap IA, Suliburska J. Influence of supplementation with iron and probiotic bacteria Lactobacillus plantarum and Lactobacillus curvatus on selected parameters of inflammatory state in rats on a high-fat iron-deficient diet. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2024; 104:4411-4424. [PMID: 38339838 DOI: 10.1002/jsfa.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/27/2023] [Accepted: 01/23/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND A high-fat (HF) diet, diet iron deficiency and iron supplementation may affect inflammatory parameters. Probiotics influence both iron metabolism and inflammation. We compared the inflammatory state in rats on a HF iron-deficient diet receiving oral iron, Lactobacillus plantarum and Lactobacillus curvatus in different combinations. METHODS This was a two-stage experiment. In groups C (n = 8) and HF (n = 8), rats ate a control or HF diet, respectively, for 16 weeks. In the group HFDEF (n = 48), rats ate a HF iron-deficient diet for 8 weeks (first stage) and were subsequently divided into 6 groups (n = 8 each) receiving the following for a further 8 weeks (second stage): HFDEF - a HF iron-deficient diet; HFDEFFe - a HF iron-deficient diet with iron; HFDEFLp and HFDEFLc - a HF iron-deficient diet with L. plantarum or L. curvatus, respectively; and HFDEFFeLp and HFDEFFeLc - a HF iron-deficient diet with iron and L. plantarum or L. curvatus, respectively. Body composition analysis and blood sampling was performed. Markers of iron status and levels of total antioxidant status (TAS), C-reactive protein (CRP), tumour necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were measured in the blood. RESULTS TAS was higher in the HFDEF group (756.57 ± 489.53 ng mL-1) versus the HFDEFLc group (187.04 ± 47.84 ng mL-1; P = 0.022). No more differences were found between groups, or in TAS, CRP, TNF-α and IL-6 concentrations. Also, no differences were found between groups for alanine and aspartate aminotransferases, glucose, total cholesterol, low- and high-density lipoproteins and triglycerides. TAS level was positively correlated with ferritin concentration, IL-6 with TAS and TNF-α with hepcidin level. CONCLUSIONS Supplementation with L. plantarum, L. curvatus and iron in combinations exerts no influence on inflammatory status, lipid profile, hepatic function and serum fasting glucose in rats on a HF iron-deficient diet. © 2024 Society of Chemical Industry.
Collapse
Affiliation(s)
- Katarzyna Skrypnik
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland
| | - Marcin Schmidt
- Department of Food Biotechnology and Microbiology, Poznan University of Life Sciences, Poznan, Poland
| | - Agnieszka Olejnik-Schmidt
- Department of Food Biotechnology and Microbiology, Poznan University of Life Sciences, Poznan, Poland
| | - Iskandar Azmy Harahap
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland
| |
Collapse
|
6
|
Muñoz MPS, Ramirez ZPB, Rodriguez ELM, Blandón JDR, Aguiñaga SA, Orozco CAO, Yáñez ARE. Transferrin Saturation, Serum Ferritin, and C-Reactive Protein vs. Serum Ferritin for an optimal Iron Deficiency Diagnosis in Candidates for Bariatric Surgery. Obes Surg 2024; 34:1174-1184. [PMID: 38367125 DOI: 10.1007/s11695-024-07081-z] [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: 10/01/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Iron has different physiological processes and is regulated by hepcidin that is also an acute phase reactant, which increases with inflammation. Obesity produces a pro-inflammatory state, affecting directly the normal regulation of iron, causing ferritin (FER) deficiency. FER is used as the only indicator of the status of iron in patients with obesity, so the majority of them would be underdiagnosed, leading to a high prevalence of iron deficiency (ID) and anemia. The aim of this study is to evaluate the diagnostic tests: transferrin saturation (TS), FER, and C-reactive protein (CRP) vs. FER with the objective of analyzing the most accurate variable for the diagnosis of ID. MATERIALS AND METHODS We present a cross-sectional, analytical, and retrospective study, evaluating the diagnostic tests in 96 patients, to whom two methods were applied for the diagnosis of ID: method 1 (FER < 30 ng/mL) and method 2 divided into 2A (FER < 30 ng/mL), 2B (FER 30-100 ng/mL + CRP ≥ 5 mg/L), 2C (FER 100-300 ng/mL + CRP ≥ 5 mg/L + TS < 20%), and 2D (TS < 20%). RESULTS The prevalence of ID obtained using method 1 was 30.2% while 69.8% presented ID using total method 2, confirming an underdiagnosis of 39.6%. CONCLUSION The inflammatory state in patients with obesity must be considered in the diagnosis of ID. The use of TS, FER, and CRP has greater validity than the use of serum FER for the diagnosis of ID in patients with obesity.
Collapse
Affiliation(s)
- M Patricia Sánchez Muñoz
- Bariatric and Metabolic Surgery Clinic, The Civil Hospital of Guadalajara "Dr Juan I. Menchaca", Salvador Quevedo and Zubieta 750, Eastern Independence, C.P: 44340, Guadalajara, Jalisco, Mexico
| | - Zuleyma P Bello Ramirez
- Bariatric and Metabolic Surgery Clinic, The Civil Hospital of Guadalajara "Dr Juan I. Menchaca", Salvador Quevedo and Zubieta 750, Eastern Independence, C.P: 44340, Guadalajara, Jalisco, Mexico.
| | - Eduardo L Martínez Rodriguez
- Bariatric and Metabolic Surgery Clinic, The Civil Hospital of Guadalajara "Dr Juan I. Menchaca", Salvador Quevedo and Zubieta 750, Eastern Independence, C.P: 44340, Guadalajara, Jalisco, Mexico
| | - José D Reyes Blandón
- Bariatric and Metabolic Surgery Clinic, The Civil Hospital of Guadalajara "Dr Juan I. Menchaca", Salvador Quevedo and Zubieta 750, Eastern Independence, C.P: 44340, Guadalajara, Jalisco, Mexico
| | - Soledad Aldana Aguiñaga
- Bariatric and Metabolic Surgery Clinic, The Civil Hospital of Guadalajara "Dr Juan I. Menchaca", Salvador Quevedo and Zubieta 750, Eastern Independence, C.P: 44340, Guadalajara, Jalisco, Mexico
| | - César A Ortiz Orozco
- General Surgery Department, The Civil Hospital of Guadalajara "Dr Juan I. Menchaca", Salvador Quevedo and Zubieta 750, Eastern Independence, C.P: 44340, Guadalajara, Jalisco, Mexico
| | - Allison R Esparza Yáñez
- University Center for Biological and Agricultural Sciences, University of Guadalajara, Ramón Padilla Sanchez 2100, The Needles, C.P: 44600, Zapopan, Jalisco, Mexico
| |
Collapse
|
7
|
Paszczyk B, Czarnowska-Kujawska M, Klepacka J, Tońska E. Health-Promoting Ingredients in Goat's Milk and Fermented Goat's Milk Drinks. Animals (Basel) 2023; 13:907. [PMID: 36899767 PMCID: PMC10000185 DOI: 10.3390/ani13050907] [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: 02/07/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
The present study aimed to determine the content of health-promoting compounds, and fatty acids, with particular emphasis on the content of cis9trans11 C18:2 (CLA) acid, selected minerals, folates in organic and commercial goat's milk and fermented goat's milk drinks. The analyzed milk and yoghurts had various contents of particular groups of fatty acids, CLA, minerals, and folates. Raw organic goat's milk had a significantly (p < 0.05) higher content of CLA (3.26 mg/g fat) compared to commercial milk (2.88 mg/g fat and 2.54 mg/g fat). Among the analyzed fermented goat's milk drinks, the highest CLA content (4.39 mg/g fat) was determined in commercial natural yoghurts, while the lowest one was in organic natural yoghurts (3.28 mg/g fat). The highest levels of calcium (1322.9-2324.4 µg/g), phosphorus (8148.1-11,309.9 µg/g), and copper (0.072-0.104 µg/g) were found in all commercial products and those of manganese (0.067-0.209 µg/g) in organic products. The contents of the other assayed elements (magnesium, sodium, potassium, iron, and zinc) did not depend on the production method, but only on the product type, i.e., the degree of goat's milk processing. The highest folate content in the analyzed milks was found in the organic sample (3.16 µg/100 g). Organic Greek yoghurts had a several times higher content of folates, reaching 9.18 µg/100 g, compared to the other analyzed fermented products.
Collapse
Affiliation(s)
| | | | - Joanna Klepacka
- Department of Commodity and Food Analysis, The Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, 10-726 Olsztyn, Poland
| | | |
Collapse
|
8
|
Mironova OI, Panferov AS. Anemia of chronic diseases: current state of the problem and perspectives. TERAPEVT ARKH 2023; 94:1349-1354. [PMID: 37167177 DOI: 10.26442/00403660.2022.12.201984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
Anemia of chronic diseases is a condition, that accompanies several chronic conditions, that have inflammation as an underlying cause. The article covers current concepts of pathogenesis, evaluation and treatment of this type of anemia. The new perspectives in the development of investigational methods and treatment are discussed. The new methods of iron deficiency assessment in patients with systemic inflammation are discussed separately.
Collapse
|
9
|
de Godoi Rezende Costa Molino C, Woll L, Wieczorek M, Abderhalden LA, Lanz P, Schaer DJ, Spahn DR, Orav EJ, Egli A, Bischoff-Ferrari HA. Association between iron deficiency and hospitalization rate in community-dwelling older adults: A 3-year prospective observational study of DO-HEALTH. Am J Clin Nutr 2023; 117:12-21. [PMID: 36789930 DOI: 10.1016/j.ajcnut.2022.11.001] [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: 06/09/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Iron deficiency (ID) is associated with negative health outcomes in older adults. However, data on the impact of ID on the number of hospitalizations and length of hospital stay (LOS) is lacking. OBJECTIVE To explore the associations between baseline ID and the number of hospitalizations and between baseline ID and at least one LOS ≥5 days in community-dwelling older adults. METHODS This is a secondary observational analysis of a randomized controlled trial including 2157 community-dwelling adults aged ≥70 years without major diseases at baseline. The main exposure was defined as ID (soluble transferrin receptor [sTfR] concentrations >28.1 nmol/L) at baseline. The primary outcome was the number of hospitalizations over a 3-year follow-up. The secondary outcome was having at least one LOS ≥5 days over the study period among individuals with one or more hospitalizations. Interaction between ID and anemia (hemoglobin <130 g/L for men and <120 g/L for women) was also investigated. RESULTS Baseline sTfR concentration was determined in 2141 participants (median age 74.0 years). At 3 year, 1497 hospitalizations were reported with an incidence rate of hospitalization of 0.26 per person-year (95% CI: 0.24, 0.28). Overall, baseline ID was associated with a 24% increased incidence rate of hospitalization (incidence rate ratio: 1.24; 95% CI: 1.05, 1.45) over 3 years. This association was independent of anemia status at baseline since the interaction between ID and anemia at baseline was not significant. Moreover, ID was not significantly associated with having a LOS ≥5 days (OR: 1.40; 95% CI: 1.00, 1.97) among participants with at least one hospitalization over 3 years. CONCLUSIONS ID is associated with increased hospitalization rate and not associated with LOS ≥5 days among generally healthy older adults. Efforts to minimize ID in older adults may improve overall health and optimize healthcare costs.
Collapse
Affiliation(s)
- Caroline de Godoi Rezende Costa Molino
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Laurence Woll
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Maud Wieczorek
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Lauren A Abderhalden
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Patricia Lanz
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Dominik J Schaer
- Clinic for Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Donat R Spahn
- Institute of Anesthesiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - E John Orav
- Department of Biostatistics, Harvard School of Public Health, Boston, USA
| | - Andreas Egli
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland; University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland.
| |
Collapse
|
10
|
Ooi SL, Pak SC, Campbell R, Manoharan A. Polyphenol-Rich Ginger ( Zingiber officinale) for Iron Deficiency Anaemia and Other Clinical Entities Associated with Altered Iron Metabolism. Molecules 2022; 27:6417. [PMID: 36234956 PMCID: PMC9573525 DOI: 10.3390/molecules27196417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
Ginger (Zingiber officinale) is rich in natural polyphenols and may potentially complement oral iron therapy in treating and preventing iron deficiency anaemia (IDA). This narrative review explores the benefits of ginger for IDA and other clinical entities associated with altered iron metabolism. Through in vivo, in vitro, and limited human studies, ginger supplementation was shown to enhance iron absorption and thus increase oral iron therapy's efficacy. It also reduces oxidative stress and inflammation and thus protects against excess free iron. Ginger's bioactive polyphenols are prebiotics to the gut microbiota, promoting gut health and reducing the unwanted side effects of iron tablets. Moreover, ginger polyphenols can enhance the effectiveness of erythropoiesis. In the case of iron overload due to comorbidities from chronic inflammatory disorders, ginger can potentially reverse the adverse impacts and restore iron balance. Ginger can also be used to synthesise nanoparticles sustainably to develop newer and more effective oral iron products and functional ingredients for IDA treatment and prevention. Further research is still needed to explore the applications of ginger polyphenols in iron balance and anaemic conditions. Specifically, long-term, well-designed, controlled trials are required to validate the effectiveness of ginger as an adjuvant treatment for IDA.
Collapse
Affiliation(s)
- Soo Liang Ooi
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Sok Cheon Pak
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Ron Campbell
- The Oaks Medical Practice, The Oaks, NSW 2570, Australia
| | - Arumugam Manoharan
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| |
Collapse
|
11
|
Roth-Walter F. Iron-Deficiency in Atopic Diseases: Innate Immune Priming by Allergens and Siderophores. FRONTIERS IN ALLERGY 2022; 3:859922. [PMID: 35769558 PMCID: PMC9234869 DOI: 10.3389/falgy.2022.859922] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/03/2022] [Indexed: 12/12/2022] Open
Abstract
Although iron is one of the most abundant elements on earth, about a third of the world's population are affected by iron deficiency. Main drivers of iron deficiency are beside the chronic lack of dietary iron, a hampered uptake machinery as a result of immune activation. Macrophages are the principal cells distributing iron in the human body with their iron restriction skewing these cells to a more pro-inflammatory state. Consequently, iron deficiency has a pronounced impact on immune cells, favoring Th2-cell survival, immunoglobulin class switching and primes mast cells for degranulation. Iron deficiency during pregnancy increases the risk of atopic diseases in children, while both children and adults with allergy are more likely to have anemia. In contrast, an improved iron status seems to protect against allergy development. Here, the most important interconnections between iron metabolism and allergies, the effect of iron deprivation on distinct immune cell types, as well as the pathophysiology in atopic diseases are summarized. Although the main focus will be humans, we also compare them with innate defense and iron sequestration strategies of microbes, given, particularly, attention to catechol-siderophores. Similarly, the defense and nutritional strategies in plants with their inducible systemic acquired resistance by salicylic acid, which further leads to synthesis of flavonoids as well as pathogenesis-related proteins, will be elaborated as both are very important for understanding the etiology of allergic diseases. Many allergens, such as lipocalins and the pathogenesis-related proteins, are able to bind iron and either deprive or supply iron to immune cells. Thus, a locally induced iron deficiency will result in immune activation and allergic sensitization. However, the same proteins such as the whey protein beta-lactoglobulin can also transport this precious micronutrient to the host immune cells (holoBLG) and hinder their activation, promoting tolerance and protecting against allergy. Since 2019, several clinical trials have also been conducted in allergic subjects using holoBLG as a food for special medical purposes, leading to a reduction in the allergic symptom burden. Supplementation with nutrient-carrying lipocalin proteins can circumvent the mucosal block and nourish selectively immune cells, therefore representing a new dietary and causative approach to compensate for functional iron deficiency in allergy sufferers.
Collapse
Affiliation(s)
- Franziska Roth-Walter
- Comparative Medicine, The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University of Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- *Correspondence: Franziska Roth-Walter ;
| |
Collapse
|
12
|
Stahl-Gugger A, de Godoi Rezende Costa Molino C, Wieczorek M, Chocano-Bedoya PO, Abderhalden LA, Schaer DJ, Spahn DR, Orav EJ, Vellas B, da Silva JAP, Kressig RW, Egli A, Bischoff-Ferrari HA. Prevalence and incidence of iron deficiency in European community-dwelling older adults: an observational analysis of the DO-HEALTH trial. Aging Clin Exp Res 2022; 34:2205-2215. [PMID: 35304704 PMCID: PMC9464157 DOI: 10.1007/s40520-022-02093-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/03/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Iron deficiency is associated with increased morbidity and mortality in older adults. However, data on its prevalence and incidence among older adults is limited. The aim of this study was to investigate the prevalence and incidence of iron deficiency in European community-dwelling older adults aged ≥ 70 years. METHODS Secondary analysis of the DO-HEALTH trial, a 3-year clinical trial including 2157 community-dwelling adults aged ≥ 70 years from Austria, France, Germany, Portugal and Switzerland. Iron deficiency was defined as soluble transferrin receptor (sTfR) > 28.1 nmol/L. Prevalence and incidence rate (IR) of iron deficiency per 100 person-years were examined overall and stratified by sex, age group, and country. Sensitivity analysis for three commonly used definitions of iron deficiency (ferritin < 45 μg/L, ferritin < 30 μg/L, and sTfR-ferritin index > 1.5) were also performed. RESULTS Out of 2157 participants, 2141 had sTfR measured at baseline (mean age 74.9 years; 61.5% women). The prevalence of iron deficiency at baseline was 26.8%, and did not differ by sex, but by age (35.6% in age group ≥ 80, 29.3% in age group 75-79, 23.2% in age group 70-74); P < 0.0001) and country (P = 0.02), with the highest prevalence in Portugal (34.5%) and the lowest in France (24.4%). As for the other definitions of iron deficiency, the prevalence ranged from 4.2% for ferritin < 30 µg/L to 35.3% for sTfR-ferritin index > 1.5. Occurrences of iron deficiency were observed with IR per 100 person-years of 9.2 (95% CI 8.3-10.1) and did not significantly differ by sex or age group. The highest IR per 100 person-years was observed in Austria (20.8, 95% CI 16.1-26.9), the lowest in Germany (6.1, 95% CI 4.7-8.0). Regarding the other definitions of iron deficiency, the IR per 100 person-years was 4.5 (95% CI 4.0-4.9) for ferritin < 45 µg/L, 2.4 (95% CI 2.2-2.7) for ferritin < 30 µg/L, and 12.2 (95% CI 11.0-13.5) for sTfR-ferritin index > 1.5. CONCLUSIONS Iron deficiency is frequent among relatively healthy European older adults, with people aged ≥ 80 years and residence in Austria and Portugal associated with the highest risk.
Collapse
Affiliation(s)
- Alenka Stahl-Gugger
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - Caroline de Godoi Rezende Costa Molino
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - Maud Wieczorek
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - Patricia O Chocano-Bedoya
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Lab, University of Fribourg, Fribourg, Switzerland
| | - Lauren A Abderhalden
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - Dominik J Schaer
- Clinic for Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Donat R Spahn
- Institute of Anesthesiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - E John Orav
- Department of Biostatistics, Harvard School of Public Health, Boston, USA
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Center Hospitalo-Universitaire de Toulouse, Toulouse, France
- UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - José A P da Silva
- Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, and University of Basel, Basel, Switzerland
| | - Andreas Egli
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland.
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland.
- University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland.
| |
Collapse
|
13
|
Scherbakov N, Sandek A, Valentova M, Mayer A, von Haehling S, Jankowska E, Anker SD, Doehner W. Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke. J Clin Med 2022; 11:595. [PMID: 35160047 PMCID: PMC8836993 DOI: 10.3390/jcm11030595] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Introduction: Iron deficiency (ID) contributes to impaired functional performance and reduced quality of life in patients with chronic illnesses. The role of ID in stroke is unclear. The aim of this prospective study was to evaluate the prevalence of ID and to evaluate its association with long-term functional outcome in patients with ischemic stroke. (2) Patients and Methods: 140 patients (age 69 ± 13 years, BMI 27.7 ± 4.6 kg/m², mean ± SD) admitted to a university hospital stroke Unit, with acute ischemic stroke of the middle cerebral artery were consecutively recruited to this observational study. Study examinations were completed after admission (3 ± 2 days after acute stroke) and at one-year follow up (N = 64, 382 ± 27 days after stroke). Neurological status was evaluated according to the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS). Muscle isometric strength of the non-affected limb was assessed by the maximum handgrip test and knee extension leg test. ID was diagnosed with serum ferritin levels ≤ 100 µg/L (ID Type I) or 100-300 µg/L if transferrin saturation (TSAT) < 20% (ID Type II). (3) Results: The prevalence of ID in acute stroke patients was 48% (N = 67), with about two-thirds of patients (N = 45) displaying ID Type I and one-third (N = 22) Type II. Handgrip strength (HGS) and quadriceps muscle strength were reduced in patients with ID compared to patients without ID at baseline (HGS: 26.5 ± 10.4 vs. 33.8 ± 13.2 kg, p < 0.001 and quadriceps: 332 ± 130 vs. 391 ± 143 N, p = 0.06). One year after stroke, prevalence of ID increased to 77% (p = 0.001). While an improvement of HGS was observed in patients with normal iron status, patients with ID had no improvement in HGS difference (4.6 ± 8.3 vs. -0.7 ± 6.5 kg, p < 0.05). Patients with ID remained with lower HGS compared to patients with normal iron status (28.2 ± 12.5 vs. 44.0 ± 8.6 kg, p < 0.0001). (4) Conclusions: Prevalence of ID was high in patients after acute stroke and further increased one year after stroke. ID was associated with lower muscle strength in acute stroke patients. In patients with ID, skeletal muscle strength did not improve one year after stroke.
Collapse
Affiliation(s)
- Nadja Scherbakov
- Berlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.M.); (S.D.A.); (W.D.)
- Center for Stroke Research Berlin (CSB), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
| | - Anja Sandek
- Department of Cardiology and Pneumology, University of Göttingen, 37073 Göttingen, Germany; (A.S.); (M.V.); (S.v.H.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Miroslava Valentova
- Department of Cardiology and Pneumology, University of Göttingen, 37073 Göttingen, Germany; (A.S.); (M.V.); (S.v.H.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Antje Mayer
- Berlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.M.); (S.D.A.); (W.D.)
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen, 37073 Göttingen, Germany; (A.S.); (M.V.); (S.v.H.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Ewa Jankowska
- Institute of Heart Disease, Wroclaw Medical University, 50-367 Wroclaw, Poland;
- Institute of Heart Disease, University Hospital, 50-367 Wroclaw, Poland
| | - Stefan D. Anker
- Berlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.M.); (S.D.A.); (W.D.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
- Division of Cardiology and Metabolism-Heart Failure, Cachexia & Sarcopenia, Department of Cardiology (CVK), Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Wolfram Doehner
- Berlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.M.); (S.D.A.); (W.D.)
- Center for Stroke Research Berlin (CSB), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
| |
Collapse
|