scholarly journals Low serum iron is associated with anemia in CKD stage 1–4 patients with normal transferrin saturations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pei-Hua Yu ◽  
Ming-Yen Lin ◽  
Yi-Wen Chiu ◽  
Jia-Jung Lee ◽  
Shang-Jyh Hwang ◽  
...  
Keyword(s):  
Serum Iron ◽  
Reference Group ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Reactive Protein ◽  
Ckd Stage ◽  
Adjusted Logistic Regression ◽  
Stage 1 ◽  
Low Serum

AbstractLow transferrin saturation (TSAT), calculated by serum iron divided by total iron-binding capacity (TIBC), indicates iron deficiency. Because malnutrition and inflammation are associated with low TIBC in chronic kidney disease (CKD), TSAT might not reflect iron status or risk for anemia. We examined whether low serum iron was a risk factor for anemia in CKD patients with normal TSAT. Thus we compare the risk for anemia in 2500 CKD stage 1–4 patients divided by TSAT (cutoff: 20%) and serum iron (cutoff: 70 μg/dL in men, 60 μg/dL in women). Our results confirmed low TIBC (< 200 μg/dL) was associated with hypoalbuminemia and high C-reactive protein. In fully-adjusted logistic regression, both “normal TSAT low iron” and “low TSAT low iron” groups were associated with baseline anemia (hemoglobin < 11 g/dL) (odds ratios (OR) 1.56; 95% confidence interval (CI) 1.13–2.16 and OR 2.36; 95% CI 1.76–3.18, respectively) compared with the reference group (normal TSAT normal iron). Sensitivity tests with different cutoffs for TSAT and iron also showed similar results. In patients without anemia, both groups were associated with anemia after 1 year (OR 1.69; 95% CI 1.00–2.83 and OR 1.94; 95% CI 1.11–3.40, respectively). In conclusion, CKD stage 1–4 patients with normal TSAT but low serum iron are still at risk for anemia.

Impact of Transferrin Saturation on All-Cause Mortality in Patients on Maintenance Hemodialysis

2019 ◽  
Vol 48 (2) ◽  
pp. 158-166
Author(s):  
Madoka Sato ◽  
Norio Hanafusa ◽  
Ken Tsuchiya ◽  
Hiroshi Kawaguchi ◽  
Kosaku Nitta
Keyword(s):  
Mortality Rate ◽  
Reference Group ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Japanese Patients ◽  
Maintenance Hemodialysis ◽  
Kaplan Meier ◽  
Significant Independent Risk Factor ◽  
All Cause Mortality

Background: Transferrin saturation (TSAT) is an index that represents the iron-binding capacity of transferrin, which is the main transport protein for iron, and is widely used to evaluate iron status. Objective: To evaluate the prognostic importance of TSAT in Japanese patients on maintenance hemodialysis (MHD). Methods: A total of 398 patients on MHD were recruited and divided into 3 groups on the basis of their baseline TSAT levels (<20, 20–40, and >40%). Results: There was no difference in the proportion of patients on erythropoiesis-stimulating agents or iron supplements between the 3 groups. During a mean follow-up period of 52.2 ± 1 6.3 months, 130 patients died of cardiovascular causes (n = 63, 15.8%) or infection (n = 47, 11.8%). Compared with the reference group (TSAT 20–40%), patients with a TSAT <20% had a significantly higher all-cause mortality rate (6.44 vs. 9.55 events per 100 patient-years, p = 0.0452). Kaplan-Meier analysis showed that all-cause mortality rate was significantly higher in patients with TSAT <20% than in the other 2 groups (p = 0.0353). Conclusions: Low TSAT was a significant independent risk factor for all-cause mortality in a cohort of Japanese patients on MHD. The findings of this study suggest that the adverse clinical outcomes in patients with low TSAT can be partly attributed to infection-related iron deficiency.

Interaction Between Genotypes for HFE and TFR2 Genes Mutations and Iron Status in Brazilian Blood Donors

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5382-5382
Author(s):  
Rodolfo D Cancado ◽  
Paulo CJL Santos ◽  
Samuel Rostelato ◽  
Cristiane T Terada ◽  
Iris Gonzales ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Serum Iron ◽  
Blood Donors ◽  
Binding Capacity ◽  
Iron Status ◽  
Hereditary Hemochromatosis ◽  
Transferrin Saturation ◽  
The Body ◽  
Hfe Gene ◽  
Automation System

Abstract Hereditary hemochromatosis (HH) is a disorder characterized by increased intestinal iron absorption, which leads to a progressive accumulation of iron in the body. This iron overload has been associated with mutations in HFE gene (C282Y, H63D and S65C) and other genes. The objectives of this study were to assess the frequencies of functional mutations in HFE and TFR2 genes and to investigate their relationship with the iron status in a sample of blood donors. Blood donors (n=542) were recruited at the Hemocenter of the Santa Casa Hospital, Sao Paulo, Brazil. The genotypes for HFE (C282Y, H63D and S65C) TFR2 (Y250X and Q690P) gene mutations were evaluated by PCR-RFLP. The concentrations of serum iron and total iron-binding capacity (TIBC) were measured by automation system Advia®(Bayer Diagnostics) and serum ferritin by Axsym System®(Abbott Laboratories). The frequencies of HFE 282Y, HFE 63D and HFE 65C alleles were 2.1, 13.6 and 0.6%, respectively. The frequency C282Y allele (2.1%) in Brazilian blood donors is lower than that observed in blood donors from Northern Europe (5.1 to 8.2%, P&lt;0.05). The TFR2 250X and TFR2 690P alleles were not found in these subjects. The iron status was similar between HFE genotypes in women. However, men carrying HFE 282CY genotype had higher serum ferritin and lower TIBC concentrations when compared to the HFE 282CC genotype carriers. HFE 282CY genotype was also associated with higher transferrin saturation in men who donated blood at the first time. Moreover, male donors with HFE 63DD plus 63HD genotypes had higher serum iron and transferrin saturation when compared to those with HFE 63HH genotype. A relationship between HFE CY/HH/SS haplotype and lower TIBC concentrations was also found in men. The HFE 282Y and HFE 65C alleles were rare while the HFE 63D was frequent in blood donors. The mutations in TFR2 gene were not found in this study. The HFE 282Y and HFE 63D alleles were associated with alterations on iron status only in male blood donors.

Siltuximab Treatment Increases Hemoglobin (Hb) Levels: Preliminary Results From a Prospective Phase 1 Study In Refractory Solid Tumors

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5150-5150
Author(s):  
R. Kurzrock ◽  
E. Angévin ◽  
S. Cohen ◽  
J. Van Laethem ◽  
B. Rijnbeek ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Research Funding ◽  
Serum Iron ◽  
Binding Capacity ◽  
Iron Status ◽  
Phase 1 ◽  
Transferrin Saturation ◽  
Maximum Increase ◽  
Baseline Serum ◽  
Clinically Significant

Abstract Abstract 5150 Introduction: Siltuximab is a chimeric monoclonal antibody with high affinity for the inflammatory cytokine, IL-6, which is currently being studied in hematologic, solid malignancies and multicentric Castleman's disease (MCD). In addition to representing a therapeutic target, IL-6 is reported to play a key role in the etiology and symptoms of anemia of cancer. A possible mechanism is through up-regulation of hepatic production of hepcidin, the central iron-regulatory hormone. Siltuximab treatment has previously been shown to be associated with clinically significant Hb increases in MCD (a disorder caused by deregulated IL-6 production) and renal cell carcinoma. We have prospectively studied the Hb response in the context of a phase I study with siltuximab in patients with advanced solid tumors. Patients and Methods Siltuximab was administered intravenously to patients with any advanced solid tumor at increasing dose levels (2.8 or 5.5 mg/kg every 2 weeks, 11 or 15 mg/kg every 3 weeks). Hepcidin (C-ELISA), Hb, CRP (marker for inflammation) and iron status (serum iron, ferritin, transferrin saturation, total iron binding capacity) were measured at baseline and serially during treatment. IL-6 was not measured since interference of the drug with assay performance prevents accurate measurement of bioactive IL-6. The relationships between these biomarkers and Hb response (defined as a maximum Hb increase of ≥1 g/dL during treatment) were evaluated. Results: Forty-four pts (18 colorectal, 12 ovarian, 5 pancreatic, 9 other) received a median of 3 siltuximab cycles (range 1 – 25). Eight patients were excluded from analysis because they received blood transfusions or ESAs. There were no objective tumor responses (CR or PR). Baseline Hb ranged from 9.4–15.3 g/dL (median 12.2). All 36 evaluable patients had an increase in Hb (median 1.35 g/dL; range 0.1–3.2). Eleven (31%) patients had a maximum increase of ≥2 g/dL. Maximum Hb levels did not exceed the upper limit of normal. Baseline hepcidin (median 118.6 ng/mL; range 9.5–493.3) was positively correlated with baseline CRP (median 13.6 mg/L; range 0.42–152.0) (p<0.05) and ferritin (median 346 pmol/L; range 74.2–8543.1) (p<0.05) but not with baseline Hb or Hb response. For subjects with a Hb response of more than 2 g/dL an association was found with Day 8 hepcidin (p = 0.03) when controlled for baseline serum iron. Early hepcidin percentage change was not correlated with Hb response. Conclusion: Siltuximab treatment was associated with clinically meaningful Hb response in this moderately anemic refractory cancer population. The exact mechanism of action remains uncertain, however correlation with additional markers (e.g., soluble transferrin receptor, inflammatory markers such as IL-6) might also be important to identify patients most likely to respond to treatment and should be evaluated further in randomized trials. Disclosures: Kurzrock: Johnson & Johnson: Research Funding. Angévin:Johnson & Johnson: Research Funding. Cohen:Johnson & Johnson: Research Funding. Van Laethem:Johnson & Johnson: Research Funding. Rijnbeek:Johnson & Johnson: Employment. Vermeulen:Johnson & Johnson: Employment. Tromp:Johnson & Johnson: Employment. Li:Johnson & Johnson: Employment. Reddy:Johnson & Johnson: Employment. Cornfeld:Johnson & Johnson: Employment. Tabernero:Johnson & Johnson: Research Funding.

Influence of exhaustive aerobic exercise on some cytokines and serum iron parameters in canine experimental model

2016 ◽  
Vol 12 (2) ◽  
pp. 83-89 ◽  
Author(s):  
P. Dzhelebov ◽  
D. Gundasheva ◽  
M. Andonova ◽  
V. Tsoneva ◽  
P. Marutsov ◽  
...  
Keyword(s):  
Serum Iron ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Serum Levels ◽  
Exhaustive Exercise ◽  
Moderate Intensity ◽  
Control Group ◽  
Tnf Α ◽  
Factor Α

The aim of the experiment was to study the effect of exhaustive exercise on some cytokines and iron status parameters. We used 12 male, mongrel dogs divided into two groups – animals from experimental group were submitted to exercise at moderate intensity with exhaustion as the end-point; animals from control group did no exercise. Serum levels of tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), hepcidin prohormone, serum iron (SI), total iron binding capacity (TIBC) and transferrin saturation (TS) were measured before exercise (BE), right after exercise (0 hour) and on 2, 4, 24, 48 and 72 hours after exercise. SI, TIBC and TS were measured also on day 7 and 14 after exercise. Serum levels of TNF-α increased after the exhaustive exercise. Serum levels of IL-6 demonstrated an increase at 0 hour, but increase was not statistically significant compared to BE level. Serum levels of hepcidin prohormone marked a slight increase 48 hours after the exercise, but change was insignificant. Levels of SI decreased on hour 72 (P<0.01) and on day 7 (P<0.01) and 14 (P<0.05) after the exercise, as compared to BE level. Similar were changes in TS. TIBC decreased on 4, 24 and 72 hours (P<0.05) after exercise, but only compared to control group. In conclusion, exhaustive exercise causes inflammatory response and a significant decrease in SI levels.

scholarly journals Serum iron and serum ferritin levels in cholelithiasis: a randomized study

2018 ◽  
Vol 5 (4) ◽  
pp. 1411
Author(s):  
Bhavinder Kumar Arora ◽  
Anuj Kumar Yadav
Keyword(s):  
Serum Ferritin ◽  
Serum Iron ◽  
Iron Status ◽  
Gallstone Disease ◽  
Transferrin Saturation ◽  
Control Group ◽  
Case Group ◽  
Iron Store ◽  
Female Population ◽  
Low Serum

Background: The role of iron in the pathogenesis of gallstone disease has not been well established so far. Iron deficiency has been shown to alter the activity of several hepatic enzymes, leading to increased cholesterol saturation of bile in gall bladder and hence promoting cholesterol crystallization.Serum iron, total iron binding capacity and transferrin saturation are not good indicators of iron status in individuals. In infection free situation, serum ferritin is an ideal indicator for diagnosis of iron deficiency.Methods: The study was conducted as a prospective study in the department of Surgery. The study population was divided into two groups; Case group with 200 patients with gallstone disease and control group with 50 patients without gallstone disease. Serum iron and ferritin contents of both groups will be analyzed and compared with each other.Results: In this study the gallstones are more prevalent in female population than males in ratio of 5.4:1. Serum iron in males was low in 41.93% not comparable 20.8% of control suggesting that low serum iron is not associated with Cholelithiasis in male. In males, serum ferritin was low in 64.5% of cases and 16.66% of controls. Serum ferritin levels were normal in 35.50% of cases and 66.66% of controls and above normal in 16.66% of controls suggesting that low serum ferritin is associated with gall stones in males. In this study, low serum iron was seen in 23.07% of females comparable to 23% low serum iron in control females and low ferritin was seen in 35.50% of female cases as compare to 15.38% of controls.Conclusions: It was concluded that a low body store of serum iron is a risk factor for cholelithiasis in females and serum iron, serum ferritin may be used as marker of iron store so that low serum iron status could be diagnosed at early stage.

scholarly journals Study Iron Homeostasis of Infected and Non-Infected Iraqi Camels with Trypanosomiasis

2020 ◽  
Vol 44 (2) ◽  
pp. 35-44
Author(s):  
Laith S.G. Al-Rubaie
Keyword(s):  
Serum Iron ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Cutoff Point ◽  
Iron Binding ◽  
Dromedary Camels ◽  
Point Test ◽  
Iron Binding Capacity

Trypanosomiasis is one of the common parasitic diseases, which infects the dromedary camels and decreases the numbers of these animals in Iraq. To get the best knowledge of the changes of iron status in camels infected with trypanosomiasis, in an attempt to take advantage of these variables as markers for infection, we designed this study. The current study conducted in blood sample collection from155 dromedary camels, 33 were infected (21.29%), according to the status of infection with Trypanosoma evansi that depends on blood smear examination as a golden test. Results denote significant differences of infection ratio by sex and age, from total of 132 male tested, 29 (21.96%) infected, distributed into 12 (%41.37) of age ≤ 2 years and 17 (58.62) of ≥ 2 years. From 23 female tested, 4 (17.39%) were infected at age ≤ 2 years. Furthermore, the results of this study demonstrated significant (p˂0.05) decrease in total serum iron, transferrin saturation, ferritin, whereas increased in total iron binding capacity and unsaturated iron binding capacity in the infected male and female camels with different age. Analyzed data of iron status parameters denoted that the cutoff point test between sensitivity (97) and specificity (100) for serum iron is (≤67.26), for transferrin saturation is (≤17.23) between the sensitivity and specificity (100) and (≥378.66), for total iron binding capacity between the sensitivity and specificity (93.9 and 96.7) respectively. Also, the cutoff point test between the sensitivity (100) and specificity (96.7) for unsaturated iron binding capacity is (≥301.27) and ferritin concentration has a cutoff point is (≤ 249.88) for the sensitivity (100) and specificity (99.2). It could be concluded from what was stated in the results of the current study, that the measurement of the concentration of serum ferritin could be considered as a good marker for the T. evansi infection

scholarly journals Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Abidullah Khan ◽  
Wazir Muhammad Khan ◽  
Maimoona Ayub ◽  
Mohammad Humayun ◽  
Mohammad Haroon
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Strong Positive Correlation ◽  
Obese People ◽  
Strong Negative Correlation ◽  
Reactive Protein ◽  
Group A

Background. In clinical practice, serum ferritin is used as a screening tool to detect iron deficiency. However, its reliability in obesity has been questioned. Objectives. To investigate the role of ferritin in overweight and obese people, either as a marker of inflammation or iron deficiency. Methods. On the basis of body mass index (BMI), 150 participants were divided into three equal groups: A: BMI 18.5–25 kg/m2, B: BMI 25–30 kg/m2, and C: BMI>30 kg/m2. Serum iron, total iron binding capacity (TIBC), transferrin saturation, ferritin, C-reactive protein, and hemoglobin (Hb) were measured for each participant and analyzed through SPSS version 16. One-way ANOVA and Pearson’s correlation tests were applied. Results. Ferritin was the highest in group C (M=163.48±2.23, P<0.001) and the lowest in group A, (M=152.78±1.81, P<0.001). Contrarily to ferritin, transferrin was the lowest in group C, (M=30.65±1.39, P<0.001) and the highest in group A, (M=38.66±2.14, P<0.001). Ferritin had a strong positive correlation with both BMI (r=0.86, P<0.001) and CRP (r=0.87, P<0.001) and strong negative correlation with Hb, iron, TIBC, and transferrin saturation (P<0.001). Conclusion. Ferritin is a marker of inflammation rather than iron status in overweight and obese people. Complete iron profile including transferrin, rather than serum ferritin alone, can truly predict iron deficiency in such people.

scholarly journals Acute responses of iron indices in Quarter Horses during a 3-barrel racing exercise

2018 ◽  
Vol 87 (2) ◽  
pp. 109-114
Author(s):  
Clarisse S. Coelho ◽  
Mario Cappi Neto ◽  
Marcela B. Binda ◽  
Fernanda A. Teixeira ◽  
Renan S. Carvalho ◽  
...  
Keyword(s):  
Iron Metabolism ◽  
Serum Iron ◽  
Binding Capacity ◽  
Iron Status ◽  
Exercise Physiology ◽  
Transferrin Saturation ◽  
Haemoglobin Concentration ◽  
Kolmogorov Smirnov ◽  
Iron Binding Capacity ◽  
Iron Profile

Energy metabolism and physical performance are dependent on sufficient iron metabolism. Therefore, studies evaluating the iron profile are necessary to elucidate this trace mineral requirements and its role in the equine exercise physiology. The aim of this study was to evaluate the influence of barrel racing exercise on serum iron profile of Quarter horses. Twenty-two regularly trained Quarter horses (8 females and 14 males, 4.8 ± 2.4 years old, mean body weight 431.7 ± 33.9 kg) were enrolled in this study with the owner’s informed consent. All horses were evaluated at T0 (at rest), T1 (immediately after barrel racing trial), T2 (30 min after trial) and T3 (2 h after trial). At these time points, blood samples were taken to determine the packed cell volume (PCV), red blood cell count (RBC), haemoglobin concentration (Hb), total protein (TP), serum iron (SI), total iron-binding capacity (TIBC) and transferrin saturation (TSAT). Variables were analyzed for normality through Kolmogorov-Smirnov test and comparisons were made using Tukey test, considering P < 0.05. The imposed exercise challenge significantly altered PCV, RBC, haemoglobin concentration, TP, SI and TSAT, with higher values were recorded at T1. These findings can be linked to an increased demand as a result of physical activity. Significant changes occurred in the iron status in physically well-conditioned Quarter horses during the barrel racing exercise. Better understanding of iron metabolism in horses will help determine the actual necessity of supplementation.

scholarly journals Study of Glycation of Transferrin and its Effect on Biomarkers of Iron Status in Uncontrolled Diabetes Mellitus Patients

2020 ◽  
Author(s):  
Dunna Sabitha ◽  
E Manasvi Dawson ◽  
Shashank Nand Krishna Tiwari ◽  
P Swetha ◽  
Shaik Mohammad Naushad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Lower Percentage ◽  
Correlation Pattern ◽  
Uncontrolled Diabetes ◽  
Percentage Saturation

Introduction: Diabetes Mellitus (DM) is a metabolic condition linked by the inability to produce enough insulin and/or to respond to insulin. This can lead to a number of acute and chronic health problems. In erythrocytes, transferrin is the main source of iron. Alterations in transferrin glycation affect transferrin saturation because the affinity of transferrin for Fe3+ is extremely high but it decreases progressively with increasing glycation. Aim: To investigate the influence of uncontrolled diabetes on transferrin glycation and iron metabolism. Materials and Methods: A total of 136 samples from 3 groups of HbA1c levels (<6.0% non-diabetic, 6.4-8% diabetic, >8.0%-uncontrolled DM) were studied for the correlation pattern of iron with other variables. Chi square test and student’s t-test were performed to reveal the association between serum free iron levels and other variables with DM. Results: Serum iron has shown to be depleted significantly (p=0.02) along with percentage saturation (p=0.0006) with increase in diabetic severity. No significant differences were observed in serum ferritin in controlled DM and uncontrolled samples. Total Iron Binding Capacity (TIBC) was found to be significantly increased in uncontrolled DM samples (p=0.01). Abnormal transferrin was observed uncontrolled diabetes with subsequent depletion in transferrin, which in turn results in low serum iron, lower percentage saturation and high TIBC. Conclusion: Uncontrolled diabetes affects the glycation of transferrin also thus perturbating iron metabolism. The present study emphasises the need to monitor transferrin glycation status and iron deficiency anaemia in subjects with uncontrolled diabetes.

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