Serum ferritin compared with other indices of iron status in children and teenagers undergoing maintenance hemodialysis.

1979 ◽  
Vol 25 (5) ◽  
pp. 741-744 ◽  
Author(s):  
D Ellis
Keyword(s):  
Serum Ferritin ◽  
Reticulocyte Count ◽  
Iron Status ◽  
Diagnostic Testing ◽  
Intravenous Iron ◽  
Visual Assessment ◽  
Maintenance Hemodialysis ◽  
Iron Intake ◽  
Iron Supplements ◽  
Patients Âgés

Abstract To determine how best to assess iron status, I studied 12 young renal patients (ages 5.5 to 20 years) undergoing regular hemodialysis treatments. Iron balance was estimated by monitoring iron loss ascribable to blood loss during dialysis and diagnostic testing, and iron intake in the form of oral and intravenous iron supplements and blood transfusions. Traditional methods of evaluating iron status--measurement of hemoglobin, erythrocyte indices, reticulocyte count, iron, and transferrin--were compared with measurement of serum ferritin. The serum ferritin measurements provided superior information. In three cases this method was superior to visual assessment of bone marrow stained for iron.

scholarly journals The association between red and processed meat consumption and iron intakes and status among British adults

2003 ◽  
Vol 6 (4) ◽  
pp. 341-350 ◽  
Author(s):  
Sigrid Gibson ◽  
Margaret Ashwell
Keyword(s):  
Serum Ferritin ◽  
Iron Status ◽  
Cross Sectional Study ◽  
Processed Meat ◽  
Iron Intake ◽  
Cross Sectional ◽  
Iron Supplements ◽  
Haem Iron ◽  
Processed Meat Consumption ◽  
Red And Processed Meat

AbstractObjective:To examine the association between consumption of red and processed meat (RPM) and iron intakes and status in adults.Design:Further analysis of the Dietary and Nutritional Survey of British Adults, a cross-sectional study of 2197 adults aged 16–64 years carried out in 1986/7.Subjects and methods:Adults (836 men and 838 women) with serum ferritin measurements, who were not taking iron supplements, were classified into four groups according to RPM consumption (from 7-day weighed records). Iron absorbed was estimated from equations based on haem and non-haem iron and the influence of iron stores.Results:Women who ate least meat (<90gday-1) had three times the risk of a low iron intake (below the Lower Reference Nutrient Intake) compared with high consumers of RPM (>140gday-1). Men who ate no RPM also had a higher risk of low iron intake. Using an estimate of minimal values for iron losses, there was a twofold difference in the potential risk of negative iron balance between women non-RPM consumers and high RPM consumers. Status measurements indicated that, among women, anaemia was least prevalent (6%) among high consumers compared with 12–14% among average RPM consumers. Inverse trends were also observed for serum ferritin in both sexes.Conclusions:Low consumption of RPM has implications for iron intakes and iron status in men and women, since the risk of negative iron balance and its consequences are increased. Dietary messages must consider these implications and provide appropriate advice.

Hematological Status of Male Runners in Relation to the Extent of Physical Training

1992 ◽  
Vol 2 (4) ◽  
pp. 366-375 ◽  
Author(s):  
John D. Robertson ◽  
Ronald J. Maughan ◽  
Ann C. Milne ◽  
Ronald J.L. Davidson
Keyword(s):  
Serum Ferritin ◽  
Iron Status ◽  
Normal Population ◽  
Venous Blood ◽  
Biological Significance ◽  
Iron Intake ◽  
Dietary Analysis ◽  
Control Subjects ◽  
Blood Biochemical ◽  
Biochemical Indices

Blood biochemical indices of iron status were measured in venous blood from 20 runners and 6 control subjects. All subjects were.male, ages 20 to 40 years, and stable with regard to body weight and degree of physical activity. Dietary analysis was undertaken using a 7-day weighed food intake. There was no evidence of iron deficiency: hemoglobin concentrations and serum femtin levels were within the normal population range for all individuals. However, serum ferritin was negatively correlated with the amount of training. Daily iron intake appeared to be adequate; iron intake was correlated with protein intake but not related to training or energy intake. Serum ferritin, an indicator of iron status, was significantly correlated with vitamin C intake but not iron intake. Serum transferrin concentration was higher in the group of athletes undertaking a high weekly training load compared with the control subjects, suggesting an alteration in iron metabolism although there was no evidence of increased erythropoiesis. The biological significance of this is unclear.

scholarly journals Iron Age or New Age: Ironing out the Diagnosis of Anaemia of Inflammation from Iron Deficiency Anaemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3354-3354
Author(s):  
Nicola J Svenson ◽  
Russell Patmore ◽  
Heidi J Cox ◽  
James R Bailey ◽  
Stephen Holding
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Iron Status ◽  
Diagnostic Testing ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Gastrointestinal Disorders ◽  
Serum Hepcidin ◽  
Iron Parameters

Abstract Introduction Iron deficiency anaemia (IDA) and anaemia of chronic inflammation (AI) are the most prevalent causes of iron related anaemia in subjects with gastrointestinal disorders contributing significantly to morbidity and mortality. Diagnosis of IDA and AI is not always straight forward and currently a combination of several serum parameters (ferritin, transferrin, transferrin saturation, iron and C-reactive protein) is required. Subjects with a mixed aetiology can be difficult to interpret using traditional serum parameters, particularly in the presence of an inflammatory process. Hepcidin (a 25 amino-acid peptide hormone) in conjunction with reticulocyte haemoglobin equivalent (RetHe) has the potential to differentiate IDA from AI and in cases of mixed aetiology replacing the traditional laboratory parameters (serum iron, CRP, transferrin saturation and ferritin). Aim The aim of the study was to evaluate the performance of a commercially available ELISA assay and investigate whether hepcidin and RetHe can differentiate AI from mixed aetiology. Method The study investigated 77 patients with gastrointestinal disorders associated with anaemia in a secondary care setting using a traditional pathway of 6 tests (figure 1): Complete Blood Count (CBC), Reticulocytes, serum ferritin, CRP, transferrin, serum Iron. Hepcidin concentration was measured using a commercially available ELISA method (DRG Diagnostic GmbH, Marburg, Germany), CBC and RetHe using a Sysmex XE-2100 CBC analyser, iron parameters and CRP using Beckman Coulter platforms. Results Hepcidin correlated well with ferritin R2 = 0.79, p<0.0001. The results were compared to traditional parameters with Receiver Operator Curves (ROC) used to determine diagnostic cut off concentrations (table 1). Table 1. Sensitivity and specificity of serum ferritin and serum hepcidin used to determine diagnostic cut off values. Selected cut off values IDA AI Serum ferritin 30.0µg/L Sensitivity 83% Specificity 64% Sensitivity 55% Specificity 75% Serum hepcidin 8ng/mL Sensitivity 73% Specificity 72% Sensitivity 70% Specificity 67% Serum hepcidin 40ng/mL Sensitivity 98% Specificity 32% Sensitivity 25% Specificity 91% Ferritin was unable to distinguish IDA from AI in mixed aetiology situations. This gives rise to a new proposed 2 step pathway (figure 2) using 3 tests: CBC, RetHe and hepcidin differentiating IDA from AI in mixed aetiology cases indicating the cause of the anaemia. The RetHe value can then be used to predict the response to oral iron. Conclusion Serum hepcidin may not yet replace serum ferritin as the preferred iron status marker, but in conjunction with RetHe it may distinguish mixed aetiology subjects. This offers the potential development of a clearer clinical pathway for investigation of difficult subjects, including reduction in the number of tests required during anaemia investigations and shorter diagnosis times. The advantage of hepcidin together with RetHe over traditional iron parameters is both as a real time marker of iron status and an indication of likelihood of response to iron therapy. The patient would benefit from a shorter recovery time, unnecessary testing, reduction in ineffective treatment and overall reduction in costs. Figure 1. Current diagnostic testing pathway using 6 independent tests with serum ferritin used as the primary indicator of iron stores. Figure 1. Current diagnostic testing pathway using 6 independent tests with serum ferritin used as the primary indicator of iron stores. Figure 2. Suggestion of a new 2 step diagnostic testing pathway with serum hepcidin as the primary indicator and reticulocyte haemoglobin equivalent as the predictor of iron deficiency and response to oral iron. Figure 2. Suggestion of a new 2 step diagnostic testing pathway with serum hepcidin as the primary indicator and reticulocyte haemoglobin equivalent as the predictor of iron deficiency and response to oral iron. Disclosures Patmore: Janssen: Honoraria; Gilead: Honoraria.

scholarly journals Association of Iron Status and Intake During Pregnancy with Neuropsychological Outcomes in Children Aged 7 Years: The Prospective Birth Cohort Infancia y Medio Ambiente (INMA) Study

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2999 ◽  
Author(s):  
Victoria Arija ◽  
Carmen Hernández-Martínez ◽  
Mónica Tous ◽  
Josefa Canals ◽  
Mónica Guxens ◽  
...  
Keyword(s):  
Working Memory ◽  
Serum Ferritin ◽  
Iron Status ◽  
Population Based ◽  
Maternal Serum ◽  
Iron Intake ◽  
Good State ◽  
Trail Making ◽  
Neuropsychological Outcomes ◽  
Maternal Iron

Early iron status plays an important role in prenatal neurodevelopment. Iron deficiency and high iron status have been related to alterations in child cognitive development; however, there are no data about iron intake during pregnancy with other environmental factors in relation to long term cognitive functioning of children. The aim of this study is to assess the relationship between maternal iron status and iron intake during pregnancy and child neuropsychological outcomes at 7 years of age. We used data from the INMA Cohort population-based study. Iron status during pregnancy was assessed according to serum ferritin levels, and iron intake was assessed with food frequency questionnaires. Working memory, attention, and executive function were assessed in children at 7 years old with the N-Back task, Attention Network Task, and the Trail Making Test, respectively. The results show that, after controlling for potential confounders, normal maternal serum ferritin levels (from 12 mg/L to 60 mg/L) and iron intake (from 14.5 mg/day to 30.0 mg/day), respectively, were related to better scores in working memory and executive functioning in offspring. Since these functions have been associated with better academic performance and adaptation to the environment, maintaining a good state of maternal iron from the beginning of pregnancy could be a valuable strategy for the community.

scholarly journals Plasma Hepcidin Increases with Prolonged Running in Male, but Not Female, Collegiate Distance Runners with Low Iron Stores

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1777-1777
Author(s):  
David Barney ◽  
James Ippolito ◽  
Claire Berryman ◽  
Stephen Hennigar
Keyword(s):  
Serum Ferritin ◽  
Iron Status ◽  
Total Iron ◽  
Negative Regulator ◽  
Dietary Iron ◽  
Iron Intake ◽  
Distance Runners ◽  
Vo2 Max ◽  
Iron Stores ◽  
Males And Females

Abstract Objectives Hepcidin is a negative regulator of extracellular iron availability and dietary iron absorption. Previous studies have shown that hepcidin increases with prolonged endurance exercise, but not in those with low iron stores (serum ferritin &lt;30 ng/mL). The objective of this study was to determine the plasma hepcidin response to exercise, compared to rest, in highly trained male and female collegiate distance runners. Methods In a cross-over design, healthy male (n = 14; age 20.2 ± 1.4 y; BMI 20.4 ± 1.6 kg/m2; VO2 max 69.8 ± 5.6 mL/kg/min) and female (n = 14; age 20.1 ± 1.4 y, P = 0.79; BMI 18.1 ± 1.6 kg/m2, P &lt; 0.001; VO2 max 62.5 ± 4.2 mL/kg/min, P &lt; 0.001) collegiate distance runners performed a bout of running (males: 109.8 ± 8.7 min, 15.0 ± 1.3 miles; females: 87.7 ± 10.4 min, P &lt; 0.0001, 11.3 ± 1.5 miles, P &lt; 0.0001) or no activity (rest) separated by 2 weeks. Indicators of iron status and plasma hepcidin were determined at baseline and three hours after exercise or rest. Dietary iron and total iron intake (dietary iron + iron from supplements) were determined by Food Frequency Questionnaires. Results Serum ferritin (males: 24.0 ± 15.9 ng/mL, females: 19.4 ± 9.5 ng/mL, P = 0.39) and plasma hepcidin (males: 22.3 ± 20.6 ng/mL, females: 24.6 ± 19.6 ng/mL, P = 0.77) did not differ between males and females at baseline. Baseline hemoglobin (males: 14.5 ± 0.8 g/dL, females: 13.4 ± 1.0 g/dL, P &lt; 0.01) and hematocrit (males: 45.3 ± 2.2%, females: 42.1 ± 2.6%, P &lt; 0.01) were greater in males compared to females. Dietary iron intake (males: 18.6 ± 6.3 mg/d, females: 17.1 ± 6.4 mg/d, P = 0.55) and total iron intake (males: 48.7 ± 32.9 mg/d, females: 64.6 ± 32.3 mg/d, P = 0.22) did not differ between males and females. Plasma hepcidin increased with exercise compared to rest in males (change from rest: 30.3 ± 42.0 ng/mL, P = 0.02) but not in females (change from rest: 0.8 ± 32.0 ng/mL, P = 0.93). Change in plasma hepcidin with exercise was correlated with sex (R = 0.380, P = 0.05) and BMI (R = 0.383, P = 0.04), but not baseline ferritin, run time, run distance, hemoglobin, hematocrit, dietary iron, or total iron intake (P &gt; 0.05 for all). Conclusions The post-exercise hepcidin response occurs in male, but not female, collegiate distance runners with low iron stores. These findings indicate that declines in iron status in female distance runners are independent of exercise-induced hepcidin. Funding Sources Intramural funds to S.R.H.

Iron Nutrition and the Female Athlete: Countermeasures for the Prevention of Poor Iron Status

2011 ◽  
Vol 16 (3) ◽  
pp. 195-200 ◽  
Author(s):  
Laura J. Bass ◽  
James P. McClung
Keyword(s):  
Female Athlete ◽  
Female Athletes ◽  
Iron Status ◽  
Iron Nutrition ◽  
Deficiency Anemia ◽  
Dietary Iron ◽  
Iron Intake ◽  
Fortified Foods ◽  
Iron Supplements ◽  
Advantages And Disadvantages

Iron is a trace element found in the diet and is essential for cognition and energy metabolism. Poor iron status is a concern for female athletes, who might not consume adequate levels of dietary iron and could experience elevated iron loss from physiologic processes associated with physical activity. Physical performance and cognitive decrements have been demonstrated in female athletes with iron deficiency anemia; both improve with increased iron intake. Two approaches for increasing iron intake in female athletes are the consumption of iron supplements and increasing dietary intake of foods high in iron to include iron-fortified foods. Both of these approaches have advantages and disadvantages that should be considered when treating female athletes with poor iron status.

The Effectiveness of Daily and Alternate Day Oral Iron Supplementation in Athletes With Suboptimal Iron Status (Part 2)

2020 ◽  
Vol 30 (3) ◽  
pp. 191-196
Author(s):  
Rachel McCormick ◽  
Alex Dreyer ◽  
Brian Dawson ◽  
Marc Sim ◽  
Leanne Lester ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Iron Supplementation ◽  
Iron Status ◽  
Oral Iron ◽  
Mixed Effects Models ◽  
Iron Intake ◽  
Linear Mixed Effects ◽  
Gastrointestinal Side Effects ◽  
Hemoglobin Mass ◽  
Trained Runners

The authors compared the effectiveness of daily (DAY) versus alternate day (ALT) oral iron supplementation in athletes with suboptimal iron. Endurance-trained runners (nine males and 22 females), with serum ferritin (sFer) concentrations <50 μg/L, supplemented with oral iron either DAY or ALT for 8 weeks. Serum ferritin was measured at baseline and at fortnightly intervals. Hemoglobin mass (Hbmass) was measured pre- and postintervention in a participant subset (n = 10). Linear mixed-effects models were used to assess the effectiveness of the two strategies on sFer and Hbmass. There were no sFer treatment (p = .928) or interaction (p = .877) effects; however, sFer did increase (19.7 μg/L; p < .001) over the 8-week intervention in both groups. In addition, sFer was 21.2 μg/L higher (p < .001) in males than females. No Hbmass treatment (p = .146) or interaction (p = .249) effects existed; however, a significant effect for sex indicated that Hbmass was 140.85 g higher (p = .004) in males compared with females. Training load (p = .001) and dietary iron intake (p = .015) also affected Hbmass. Finally, there were six complaints of severe gastrointestinal side effects in DAY, but only one in ALT. In summary, both supplement strategies increased sFer in athletes with suboptimal iron status; however, the ALT approach was associated with lower incidence of gastrointestinal upset.

Duplicate portion sampling gives the most accurate iron intake estimate: Implications for iron status of female students

2018 ◽  
Vol 88 (3-4) ◽  
pp. 190-198 ◽  
Author(s):  
Maryam Ghaseminasab Parizi ◽  
Hadith Tangestani ◽  
Samane Rahmdel ◽  
Seyed Mohammad Aqaeinejad R. ◽  
Seyedeh Maryam Abdollahzadeh ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Iron Status ◽  
Female Students ◽  
Assessment Methods ◽  
Dietary Iron ◽  
Iron Intake ◽  
Childbearing Age ◽  
Duplicate Portion Sampling ◽  
Food Composition Tables ◽  
Duplicate Portion

Abstract. Iron deficiency (ID) is one of the most common nutritional problems in the developing world, affecting primarily women of childbearing age. Poor dietary iron intake is a major reason of ID. Accurate measurement of iron intake is of crucial importance to combat the problem. The daily dietary iron intake of 67 female students aged between 20-30 years (a mean BMI of 21.8±3.4 kg/m2) was evaluated using three assessment methods: atomic absorption spectrometry of 3-day food duplicate samples, and food composition tables (FCTs) in combination with either food frequency questionnaire (FFQ) or dietary records. Iron status was examined using hematological and biochemical tests. The dietary iron intake determined by duplicate portion sampling (DPS; 4.12±1.84 mg/day) was significantly lower than the FCT-based estimates ( P<0.001), and it was less than ¼ of the recommended dietary allowance of 18 mg/day. No significant correlation was found between DPS technique and FCT-based assessment methods. Fifty percent of the participants had small or depleted iron stores (serum ferritin< 30 ng/mL), but only 4.5% had ID anemia (serum ferritin< 12 ng/mL and hemoglobin<12 g/dL). Dietary iron intakes and FFQ-based intakes of vitamin C were not significantly correlated with all the investigated hematological parameters. In order to take some steps toward more practical approaches to combat this health problem, development of an accurate iron intake assessment seems to be the first priority. In this regard, improvement and validation of national FCTs would be a promising solution.

scholarly journals Iron deficiency in pregnancy

2010 ◽  
Vol 3 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Lawrence P McMahon
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Diagnostic Testing ◽  
Oral Intake ◽  
Intravenous Iron ◽  
Developing Nations ◽  
Treatment Regimens ◽  
Oral Formulations ◽  
Oral Supplements ◽  
In Pregnancy

Iron deficiency (ID) and related anaemia (IDA) during pregnancy are highly prevalent worldwide in both developed and developing nations although the causes are often different. At conception, many women lack sufficient iron stores to meet the increased requirements of pregnancy, which are calculated at approximately 1200 mg. Appraisal of iron status in pregnant women is problematic, however the most reliable available diagnostic test is a serum ferritin < 20 µg/L. ID is often associated with other nutritional disorders, and there is frequently a secondary cause or association. A greater oral intake is usually insufficient to meet the increased demands of pregnancy, however regular oral supplements (given either daily or intermittently) can often meet maternal needs and avoid associated neonatal complications of IDA. Over-treatment with iron should be avoided, but intravenous administration is useful when deficiency is discovered late, is severe, or if the woman is intolerant of oral formulations. This paper reviews the current literature, and addresses differences in the prevalence and causes of ID betwen developed and developing nations. It examines gestational iron requirements, distinguishes between ID and IDA, and highlights difficulties in diagnostic testing. Finally, it appraises the evidence for and against different treatment regimens, ranging from food fortification to intravenous iron infusions, according to availability and to need.

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