scholarly journals Iron deficiency and athletic performance

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Csulak ◽  
N S Sydo ◽  
L H Horvath ◽  
T S Sydo ◽  
B B Babis ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Exercise Capacity ◽  
Iron Metabolism ◽  
Aerobic Capacity ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Sport Performance ◽  
Maximal Aerobic Capacity ◽  
Male Athletes ◽  
Innovation And Technology

Abstract Introduction Iron metabolism determines the oxygen transport of the blood, thereby affecting the exercise capacity and performance. In patients with heart failure iron deficiency is a major risk factor that predicts and influences patient's quality of life. In athletes diagnosing iron deficiency is also extremely important as it determines sport performance. Purpose Our aim is to study the correlation of iron metabolism parameters with exercise capacity in athletes. Methods Cardiopulmonary exercise test (CPET) was performed as part of detailed sports cardiology screening. We studied in athletes the changes of iron metabolism parameters (serum iron, transferrin, total iron-binding capacity (TIBC), ferritin) and correlation with the exercise physiology parameters. Results Our measurements were performed on 105 top athletes: swimmers (n=58,55%; male = 29; junior = 30; 20,4±4,6 y), football players (n=47, 45%; junior = 6; 23,2±5,4 y). Laboratory test verified hemoglobin (male = 153,8±9,4; female = 141,2±7,7 g/L; p<0,001) and hematocrit (male = 0,45±0,03; female = 0,42±0,02 L/L; p<0,001) value in a normal range for all. In women, significantly lower ferritin (67,8±76,2 vs. 98,9±48 μg/L; p<0,05) and higher TIBC (78,1±14,3 vs. 66,5±9,3 μmol/L; p<0,001) were observed. Young male athletes had significantly lower serum iron (16,1±6 vs. 21,2±7,5 μmol/L; p<0,05), ferritin (68±42,7 vs. 109,1±45,5 μg/L; p<0,01) and higher TIBC (76,1±11,0 vs. 64,3±7,4 μmol/L; p<0,001) compared to adults. During CPET male athletes had higher maximal aerobic capacity (52.2±4.4 vs. 55.9±5.5 mL/kg/min; p<0.001) and ventilation (115.8±16.1 vs. 153.2±26 L/min; p<0.001) compared to females. Maximal aerobic capacity and ventilation showed positive correlation with ferritin (p<0,0001). The ferritin cut-off value of iron supplementation was <100 μg/L. Iron supplementation was required in almost half of the athletes (n=49, 47%). Conclusion Diagnosing iron deficiency in athletes, complete iron panel containing ferritin is required. According to our results iron status determines performance, therefore iron deficiency screening and iron supplementation is essential. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): - Supported by the ÚNKP-20-3-I New National Excellence Program of the Ministry for Innovation and Technology from the Source of the National Research, Development and Innovation Fund - The research was financed by the Thematic Excellence Programme (2020-4.1.1.-TKP2020) of the Ministry for Innovation and Technology in Hungary, within the framework of the Therapeutic Development and Bioimaging programmes of the Semmelweis University.

scholarly journals A22 PREVALENCE OF IRON DEFICIENCY AND SUPPLEMENTATION PRACTICES FOR PATIENTS ON HOME PARENTERAL NUTRITION

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 289-291
Author(s):  
L Russell ◽  
R Mangat ◽  
J Plant ◽  
S Hansen ◽  
D Armstrong ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Parenteral Nutrition ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Deficiency Anemia ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Prescribing Practices ◽  
Sex Diagnosis ◽  
Funding Agencies

Abstract Background Iron deficiency (ID) is common in patients receiving parenteral nutrition (PN), likely due to a lack of iron in the PN formula. There is no clear consensus on how often serum iron should be tested or iron supplementation should be given, at which dose or route, in patients on long-term PN. Within the Hamilton Health Sciences (HHS) home PN (HPN) program, the prevalence of ID or iron deficiency anemia (IDA) is unknown. This knowledge will contribute to better iron prescribing practices with ultimate benefit on patient’s health. Aims To assess the prevalence of ID and IDA in patients enrolled in the HHS HPN Program. The secondary aim was to assess supplementation practices for patients enrolled in the HPN program according to gastrointestinal(GI) diagnosis and duration on PN. Methods We conducted a retrospective study including consecutive adult patients enrolled in the HHS-HPN program from January 2015 to November 2020. We collected data on demographics (age, sex, and GI diagnosis), iron supplementation (dose, duration, and route), and information related to iron-deficiency (hemoglobin, serum iron, ferritin, TIBC, and folate) at pre-set intervals (enrollment, 3, 6, 12, 18, 24, 30, 36, 48, 60 months) and last measured. ID was defined as ferritin ≤45μg/L or serum iron ≤9μmol/L. IDA was defined as hemoglobin <130g/L in men or <120g/L in women in the context of ID. Data were expressed as median (IQR) for continuous variables and n/N(%) for categorical variables. Chi2 was performed to assess differences between groups and logistic regression to assess predictors of ID and IDA. The analysis was conducted using SPSS software(v26). Results The analysis included 125 HPN patients (50 males, median age of 55 (40–65) years). Patients received PN for a median of 195 (83–521) days. The most common diagnoses were malignancy (36.8%) and inflammatory bowel disease (23.2%); the most common indications for HPN was short bowel (29.6%) and bowel obstruction (27.2%). Iron profiles were measured in 77% of patients. At enrollment, 42.2% of patients had ID and 38.9% had IDA. Only 13% of patients with ID and 22.8% with IDA had iron supplementation (Figure 1). A total of 38 patients received iron either oral or IV (oral=44.7% vs IV=55.3%; p=0.66). There was no correlation between low levels of serum iron or ferritin with iron supplementation (p=0.23, 0.45 respectively). Age, sex, diagnosis, or reason for PN did not correlate with ID or IDA at any time point. Conclusions Iron-deficiency and IDA are common in patients enrolled in the HHS HPN program independently of age, sex, diagnosis and reason for PN. Prospective studies are needed to implement the most effective way to ensure proper monitoring and treatment of iron deficiency in this population. Funding Agencies None

Anemia as a Complication of Bariatric Surgery: Frequency and Evidence for Progressive Negative Iron Balance.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1721-1721
Author(s):  
Annette von Drygalski ◽  
Deborah A. Andris ◽  
Scott Jackson ◽  
Peter R. Nuttleman ◽  
J. Klein ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Iron Deficiency ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Binding Capacity ◽  
Oral Iron ◽  
The Us ◽  
The Mean ◽  
And Gender ◽  
Folate And Vitamin B12

Abstract Bariatric surgery has become an important means to reduce obesity and its related morbidity. Bariatric surgeries in the US have increased from 14,000 in 1998 to 140,000 in 2004. Malabsorption and achlorhydria can complicate bariatric surgery and may lead to iron deficiency and anemia. In this setting, little is known about the prevalence and severity of anemia and the efficacy of oral iron replacement, a common part of post-surgical management. We reviewed the records at our institution of a large number (n=1125; 126 men; 999 women) of patients followed for up to 4 yrs post-procedure for the development of anemia and assessment of vitamin levels and iron stores. METHODS: Body mass index (BMI), hemoglobin (Hb), B12, folate, serum iron and ferritin values were extracted from electronic records of the patients at baseline, and 250 patients (33 men; 217 women) followed out to 4 yrs after Roux-en-Y gastric bypass. Anemia was defined by age- and gender-specific WHO criteria. RESULTS: Mean BMI fell from 50.1 (CI 49.6–50.6) at baseline to 33.1 (CI 29.8–36.4) at 4 yrs. Anemia was present in 12% of all patients at baseline and was similar between men (9%) and women (12%). At 18mos, 29% of woman <50yrs of age were anemic, compared to 9% of women >50 yrs (p=0.02). For patients followed out to 2–4 yrs, 21% were anemic and women <50 yrs were most affected (29%) compared to women >50 yrs (15%; p=0.02). The incidence of anemia among men did not change over the period of observation. In all patients the mean Hb decreased from 13.4 g/dL (CI 13.3–13.5) at baseline to 12.1 g/dL (CI 11.1–13.1; p<0.05) at 4yrs. Mean Hb in anemics was 10.4 g/dL. Baseline ferritin was 87 ng/mL (CI 75.2–99.7) for all patients and fell to 66 ng/mL(CI 51.2–80.0) at 18mos and 55 ng/mL (CI 43.3–66.2) by 2–4yrs. The percent of patients with ferritins <50 and <20 ng/mL at baseline were 23 and 11, respectively, and, of these, 15 and 25% were anemic. By yr 4, the percent of patients with ferritins <50 ng/mL rose to 66 and 21% were anemic; the percent with ferritin <20 was 4% and 33% were anemic. Again, women <50 yrs were most at risk with a mean ferritin of 35 ng/mL (CI 21.8–48.2); of these 5% had a ferritin <20 ng/mL and 37% of those were anemic. Of women > 50 years, the mean ferritin was 63 ng/mL (CI 45.3–80.5); 54% had ferritins <50 ng/mL and, of these, only 15% were anemic (p=0.04). Of the 4% with a ferritin <20 ng/mL, 25% were anemic. Mean B12 and folate levels remained stable and did not correlate with anemia. In contrast to ferritin, mean serum iron values did not decrease. Interpretation of this finding is difficult since total iron binding capacity was not measured simultaneously and supplemental iron intake might be confounding. CONCLUSIONS: although oral iron, folate and vitamin B12 supplements were routinely prescribed after surgery, anemia was a common complication and its frequency increased with time. Negative iron balance was progressive, despite oral iron supplementation. While iron deficiency did not account for all cases of anemia, it is sufficiently common to warrant careful evaluation of the ability of bariatric patients to absorb iron and/or comply with life-long oral iron supplementation. Given the rapidly increasing number of bariatric procedures in the US, all physicians should be alerted to the possible need for parenteral iron therapy to prevent anemia and its complications.

High Prevalence of Iron Deficiency In Anemic and Non Anemic Patients with Various Types of Cancer

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5145-5145
Author(s):  
Heinz Ludwig ◽  
Georg Endler ◽  
Brigitte Klement ◽  
Wolfgang Hüubl ◽  
Tim Cushway
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Multiple Testing ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Complete Blood Count ◽  
Clinical Symptoms ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Patients With Cancer

Abstract Abstract 5145 Introduction and aims: Iron deficiency as a major component in the pathogenesis of anemia in cancer is not acknowledged by most oncologists, possibly except when arising from GI blood loss. Iron deficiency is associated with clinical symptoms such as cognitive impairment, fatigue, and reduced exercise performance. New iron formulations are available that allow rapid iron supplementation with single infusions. This treatment could ameliorate symptoms of iron deficiency and correct anemia. Here, we studied iron parameters and their correlation with erythropoiesis and inflammatory markers in a large unselected cohort of patients with cancer. In addition, we investigated the suitability of serum ferritin and transferrin saturation (TSAT) as parameter for assessment of the iron status. Patients and methods: Data from 1627 patients (median age: 66.4 years, range: 20–97 years) presenting sequentially at the Center for Oncology and Hematology, Wilhelminenspital, Vienna between October 01, 2009 and January 26, 2010, have retrospectively been analyzed. Patients were at different stages of their disease or may not have had an established diagnosis at the time of testing. In patients with multiple testing during this period only the first sample taken was included. TSAT (n=1516), serum ferritin (n=887), serum iron, CRP, and complete blood count, were determined by using standard techniques. Commonly used definitions for absolute iron deficiency (AID), [TSAT <20% and serum ferritin <30ng/ml, in case serum ferritin was not available TSAT <10%] and for functional iron deficiency (FID), [TSAT <20% and serum ferritin ≥30ng/ml, in case serum ferritin was not available TSAT between 10 and 20%] have been applied. Fisher's exact test was used for comparison of frequencies and Pearson's product moment correlation coefficient for evaluation of correlation. Results: Table 1 shows the distribution of TSAT and serum ferritin categories in 1627 patients with cancer. AID was found in 116 patients (7.7%) of the 1516 patients for whom TSAT was available. Eighty-three (72%) of the AID patients presented with anemia (defined by hemoglobin <12g/dl). AID was most common in patients with colorectal and pancreatic cancer (12% and 11%, respectively), and not present in patients with testicular and prostate cancer (p=0.013). FID was diagnosed in 530 patients (35%) and 222 (42%) of them were found to be also anemic. Multivariate analysis revealed a statistically significant correlation between TSAT and serum ferritin (R=0.286, p<0.001), serum iron (R=0.874, p<0.001), hemoglobin (R=0.201, p<0.001) and CRP (R=-0.205, p<0.001) (figure 1). Serum ferritin, in contrast, did not correlate with serum iron (R=0.051, p=0.132), but correlated with hemoglobin (R=-0.259, p<0.001), TSAT (R=0.286, p<0.001), and CRP (R=0.396, p<0.001). Conclusion: AID (7.7%) and even more so FID (35%) are frequent co-morbidities in patients with various types of cancer. Seventy-two percent of patients with AID and 42% with FID presented with overt anemia. TSAT correlated closely with serum iron and hemoglobin levels and seems to be the preferred parameter for assessment of iron status in patients with chronic diseases often complicated by increased inflammation. Serum ferritin was found to be an inadequate parameter for assessment and monitoring of iron status. As iron deficiency has been linked with various symptoms, the question arises whether iron supplementation would benefit patients with FID without overt anemia. Future studies should evaluate the role of novel intravenous iron preparations in ameliorating the symptoms of iron deficiency with or without anemia. Disclosures: Klement: Vifor Pharma Ltd: Employment. Cushway:Vifor Pharma Ltd.: Employment.

scholarly journals The informativity of the markers of iron metabolism in the differential diagnosis of anemia of inflammation in children with chronic HBV infection

2021 ◽  
Vol 12 (5) ◽  
pp. 40-47
Author(s):  
F. I. Inoyatova ◽  
N. A. Ikramova ◽  
G. Z. Inogamova ◽  
Kh. M. Kadyrkhodzhayeva ◽  
F. G. Abdullayeva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Complete Blood Count ◽  
Hbv Infection ◽  
Reference Level ◽  
Chronic Hbv Infection ◽  
Chronic Hbv ◽  
Anemia Of Inflammation

Objective: To assess diagnostic importance of iron metabolism markers in the progression of anemia of inflammation (AI) in children with chronic HBV infection.Materials and methods: Among 148 examined children with chronic HBV infection 140 had AI, 60.7% of them with refractory (RA) and 39.3% with non-refractory (nRA) progression variant. Complete blood count was performed using hematologic automatic analyzer. Virologic verification of HBV was done by ELISA and PCR. ELISA was used to determine 25-hepcidin, serum iron, ferritin, trasferrin, sTfR, IL-1, IL-6. The index sTfR/log10Ft was calculated.Results: Performing the examination of children with chronic HBV infection we determined high prevalence of AI, equal to 94.6%, which was characterized by normocyte normochromic progression, thrombocytopenia, thrombocrit decrease in case of RA, and microcyte hypochromic progression with erythrocyte anisocytosis in case of nRA. Despite the high inflammatory index induced by HBV viral replication, children with RA had characteristic decrease in 25-hepcidin and transferrin parameters with background high values of ferritin, while nRA was characterized by rise of 25-hepcidin and transferrin spectrum with low values of serum iron and ferritin.Conclusions. In the genesis of AI in chronic HBV cases two pathogenic variants were determined: true iron deficiency with ferromarkers in the type of IDA characteristic for nRA and redistribution iron deficiency compliant to hemosiderosis characteristic for RA. Priority in the differential diagnosis of AI variants is given to the comparison of sTfR/log10Ft index parameters (RA<1.0; nRA>2.0) with reference level of 25-hepcidin<28,68ng/ml in case of RA, and >56,37ng/ml in case of nRA.

scholarly journals Effects of Pregnancy and Lactation on Iron Metabolism in Rats

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Guofen Gao ◽  
Shang-Yuan Liu ◽  
Hui-Jie Wang ◽  
Tian-Wei Zhang ◽  
Peng Yu ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Late Pregnancy ◽  
Deficiency Anemia ◽  
Iron Level ◽  
Lactation Period ◽  
Divalent Metal Transporter 1 ◽  
Iron Stores ◽  
Pregnancy And Lactation

In female, inadequate iron supply is a highly prevalent problem that often leads to iron-deficiency anemia. This study aimed to understand the effects of pregnancy and lactation on iron metabolism. Rats with different days of gestation and lactation were used to determine the variations in iron stores and serum iron level and the changes in expression of iron metabolism-related proteins, including ferritin, ferroportin 1 (FPN1), ceruloplasmin (Cp), divalent metal transporter 1 (DMT1), transferrin receptor 1 (TfR1), and the major iron-regulatory molecule—hepcidin. We found that iron stores decline dramatically at late-pregnancy period, and the low iron store status persists throughout the lactation period. The significantly increased FPN1 level in small intestine facilitates digestive iron absorption, which maintains the serum iron concentration at a near-normal level to meet the increase of iron requirements. Moreover, a significant decrease of hepcidin expression is observed during late-pregnancy and early-lactation stages, suggesting the important regulatory role that hepcidin plays in iron metabolism during pregnancy and lactation. These results are fundamental to the understanding of iron homeostasis during pregnancy and lactation and may provide experimental bases for future studies to identify key molecules expressed during these special periods that regulate the expression of hepcidin, to eventually improve the iron-deficiency status.

Chromosomal localization, hematologic characterization, and iron metabolism of the hereditary erythroblastic anemia (hea) mutant mouse

Blood ◽  
2004 ◽  
Vol 104 (5) ◽  
pp. 1511-1518 ◽  
Author(s):  
Robert A. White ◽  
Steven G. McNulty ◽  
Shelly Roman ◽  
Uttam Garg ◽  
Eric Wirtz ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Elevated Serum ◽  
Cell Number ◽  
Chromosome 17 ◽  
Hematopoietic Stem ◽  
Mouse Mutants ◽  
Tissue Iron ◽  
Blood Smears

Abstract Understanding iron metabolism has been enhanced by identification of genes for iron deficiency mouse mutants. We characterized the genetics and iron metabolism of the severe anemia mutant hea (hereditary erythroblastic anemia), which is lethal at 5 to 7 days. The hea mutation results in reduced red blood cell number, hematocrit, and hemoglobin. The hea mice also have elevated Zn protoporphyrin and serum iron. Blood smears from hea mice are abnormal with elevated numbers of smudge cells. Aspects of the hea anemia can be transferred by hematopoietic stem cell transplantation. Neonatal hea mice show a similar hematologic phenotype to the flaky skin (fsn) mutant. We mapped the hea gene near the fsn locus on mouse chromosome 17 and show that the mutants are allelic. Both tissue iron overloading and elevated serum iron are also found in hea and fsn neonates. There is a shift from iron overloading to iron deficiency as fsn mice age. The fsn anemia is cured by an iron-supplemented diet, suggesting an iron utilization defect. When this diet is removed there is reversion to anemia with concomitant loss of overloaded iron stores. We speculate that the hea/fsn gene is required for iron uptake into erythropoietic cells and for kidney iron reabsorption.

scholarly journals Ferroportin in Erythrocytes: Importance for Iron Homeostasis and its Role in Infection

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. SCI-27-SCI-27
Author(s):  
Tracey Rouault
Keyword(s):  
Oxidative Stress ◽  
Iron Deficiency ◽  
Iron Overload ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Iron Homeostasis ◽  
Erythroid Cells ◽  
Intracellular Iron ◽  
The Impact ◽  
In Erythroid Cells

Ferroportin (FPN), the only known vertebrate iron exporter, transports iron from intestinal, splenic, and hepatic cells into the blood to provide iron to other tissues and cells in vivo. Most of the circulating iron is consumed by erythroid cells to synthesize hemoglobin. Recently, we found that erythroid cells not only consume large amounts of iron, but also return significant amounts of iron to the blood. Erythroblast-specific Fpn knockout (Fpn KO) mice developed lower serum iron levels in conjunction with tissue iron overload and increased FPN expression in spleen and liver without changing hepcidin levels. Our results also showed that Fpn KO mice, which suffer from mild hemolytic anemia, were sensitive to phenylhydrazine-induced oxidative stress but were able to tolerate iron deficiency upon exposure to a low-iron diet and phlebotomy, supporting that the anemia of Fpn KO mice resulted from erythrocytic iron overload and resulting oxidative injury rather than a red blood cell (RBC) production defect. Moreover, we found that the mean corpuscular volume (MCV) values of gain-of-function FPN mutation patients were positively associated with serum transferrin saturations, whereas MCVs of loss-of-function FPN mutation patients were not, supporting that erythroblasts donate iron to blood through FPN in response to serum iron levels. Our results indicate that FPN of erythroid cells has an unexpectedly essential role in maintaining systemic iron homeostasis and protecting RBCs from oxidative stress, providing insight into the pathophysiology of FPN diseases. When malaria parasites invade red blood cells (RBCs), they consume copious amounts of hemoglobin, and severely disrupt iron regulation in humans. Anemia often accompanies malaria disease; however, iron supplementation therapy inexplicably exacerbates malarial infections. We recently found that the iron exporter ferroportin (FPN) was highly abundant in RBCs, and iron supplementation suppressed its activity. Conditional deletion of the Fpn gene in erythroid cells resulted in accumulation of excess intracellular iron, cellular damage, hemolysis, and increased fatality in malaria-infected mice. In humans, a prevalent FPN mutation,Q248H (glutamine to histidine at position 248), prevented hepcidin-induced degradation of FPN and protected against severe malaria disease. FPNQ248H appears to have been positively selected in African populations in response to the impact of malaria disease. Thus, FPN protects RBCs against oxidative stress and malaria infection. Zhang DL, Wu J, Shah BN et al. Erythrocytic ferroportin reduces intracellular iron accumulation, hemolysis, and malaria risk. Science. 2018;359 (6383):1520-1523. Zhang DL, Ghosh MC, Ollivierre H, Li Y, Rouault TA. Ferroportin deficiency in erythroid cells causes serum iron deficiency and promotes hemolysis due to oxidative stress. Blood. 2018;132 (19):2078-2087. Zhang DL, Rouault TA. How does hepcidin hinder ferroportin activity. Blood. 2018;131 (8):840-842. Disclosures No relevant conflicts of interest to declare.

Changes in iron parameters in patients (pts) with chemotherapy-induced anemia (CIA) receiving darbepoetin alfa (DA) every 3 weeks with and without intravenous iron supplementation

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19621-19621
Author(s):  
T. Suto ◽  
J. F. Vansteenkiste ◽  
T. Mossman ◽  
T. Pinter
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Darbepoetin Alfa ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Binding Capacity ◽  
Tumor Type ◽  
Open Label ◽  
Iv Iron ◽  
Iron Parameters

19621 Background: There is growing interest in the use of intravenous (IV) iron supplementation in pts receiving erythropoiesis- stimulating agents (ESAs). We present an exploratory analysis of iron parameters in pts with CIA enrolled in a phase IIIb, randomized, open- label, study of DA administered with either IV iron or oral/no iron. Methods: Eligible pts had a non-myeloid malignancy and CIA (baseline Hb < 11g/dL). Pts received DA 500 mcg every 3 weeks (Q3W) using the Aranesp (darbepoetin alfa) prefilled SureClick autoinjector. Pts were randomly allocated (1:1) to receive either DA + 200 mg IV iron (200 mg Q3W with DA Q3W or two 100 mg doses within 3 weeks) or DA + oral/no iron. Randomization was stratified by tumor type and baseline Hb (< or = 10 g/dL). The primary endpoint was % pts achieving a hematopoietic response (Hb = 12 g/dL or increase = 2 g/dL). Results: 396 randomized pts received 1 dose of DA (IV-iron arm = 200; oral/no-iron arm = 196). Mean (SD) age was 61.0 (11.5) yrs; 61% (n = 240) were women; 28% (n = 111) had lung/gynecological tumors. Pt demographics were similar between arms. 44 (11%) pts had baseline iron deficiency (TSAT < 15%; serum ferritin < 100 μg/L); 5 (2%) in the IV iron arm and 23 (12%) in the oral/no-iron arm developed it. 141 (36%) pts had baseline functional iron deficiency (serum iron < 60 μg/dL; serum ferritin > 20 μg/L; TSAT < 20%); 54 (27%) in the IV arm and 67 (35%) in the oral/no-iron arm developed it. See table for iron parameters. Improved Hb-based responses in the IV-iron arm will be presented. Conclusions: Pts who received DA Q3W + IV iron appeared less likely to develop iron deficiency; iron deficiency may reduce responsiveness to ESAs. These pts also appeared to have a larger increase in mean serum ferritin levels. In contrast, mean serum iron, %TSAT, total iron binding capacity, and reticulocytes appeared to be similar in the 2 arms for most of the study period, suggesting that these iron parameters are not influenced by IV iron. No significant financial relationships to disclose. [Table: see text]

scholarly journals Effect of Emblica Officinalis (amloki) on iron status in pregnant women with iron deficiency anaemia

2019 ◽  
Vol 14 (1) ◽  
pp. 1-6
Author(s):  
Tahmina Akter ◽  
Qazi Shamima Akhter
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Binding Capacity ◽  
Iron Status ◽  
Ferritin Level ◽  
Deficiency Anemia ◽  
Iron Level ◽  
Emblica Officinalis

Background: Common clinical practice of prescribing Iron supplementation for Iron deficiency anemia (IDA) in pregnancy is associated with a number of side effects. Emblica officinalis (amloki) is a well known dietary supplement used by traditional practitioners to treat anemia. Objective: To evaluate the effects of oral supplementation of Emblica officinalis on iron status in pregnant women with IDA. Methods: This prospective interventional study was carried out in the Department of Physiology, Dhaka Medical College (DMC), Dhaka from July 2016 to June 2017 on 43 pregnant women aged 18 to 36 years between 13th to 20th weeks of gestation with IDA. They were recruited from the Out-patient department of Obstetrics and Gynaecology, DMC Hospital. Among them 24 were supplemented with amloki and iron (IAS) and 19 women received only iron supplementation (IS). Study variables were estimated at the baseline and after 45 days of supplementation. Serum iron, ferritin and Total iron binding capacity (TIBC) were estimated following standard laboratory methods. Data were expressed as mean ± SD. Paired and Unpaired Student’s t-test were used for statistical analysis. Results: Serum iron levels were significantly higher (p<0.001) and serum TIBC were significantly lower (p<0.001) in both groups after supplementation compared to their baseline value. But post supplementation serum ferritin level was significantly higher (p<0.01) only in IAS group compared to that of the baseline. Again, after intervention, serum iron level was significantly higher (p<0.05) and serum TIBC was significantly lower (p<0.01) in IAS group when compared with those of IS group. Conclusions: Data concluded that oral Emblica officinalis supplement along with iron was more effective than only iron supplementation to improve serum iron status in pregnant women with IDA. J Bangladesh Soc Physiol. 2019, June; 14(1): 1-6

scholarly journals Associations Between Single Nucleotide Polymorphisms in Iron-Related Genes and Iron Status in Multiethnic Populations

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2105-2105
Author(s):  
Christine E. McLaren ◽  
Stela McLachlan ◽  
Chad P. Garner ◽  
Chris D. Vulpe ◽  
Victor R. Gordeuk ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Iron Deficiency ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Binding Capacity ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Tf Gene ◽  
Iron Binding Capacity

Abstract Abstract 2105 The existence of multiple inherited disorders of iron metabolism in man, rodents and other vertebrates suggests genetic contributions to iron deficiency. We hypothesized that common variants in genes involved in iron metabolism may modulate susceptibility or resistance to the development of iron deficiency in humans. To examine the association between single nucleotide polymorphisms (SNPs) in key genes involved in iron metabolism pathways, we previously performed a genome-wide association study using DNA collected from white men aged ≥25 y and women ≥50 y in the Hemochromatosis and Iron Overload Screening (HEIRS) Study with serum ferritin (SF) ≤12 μg/L (cases) and controls (SF >100 μg/L in men, SF >50 μg/L in women). We now report on a multiethnic follow-up association study of HEIRS participants. Candidate SNPs were identified from our GWAS and the scientific literature. Population samples of whites, African Americans, Hispanics, and Asians from the U.S. and Canada were analyzed separately for association between SNPs and case-control status and each of seven quantitative outcomes including serum iron, total iron-binding capacity (TIBC), unsaturated iron-binding capacity (UIBC), transferrin saturation, SF, serum transferrin receptor, and body iron. There were 1084 white (357 cases, 727 controls), 153 Asian (51 cases, 102 controls), 221 African American (77 cases, 144 controls) and 233 of 239 Hispanic individuals (79 cases, 160 controls) that passed quality control. For the African-American and Hispanic samples, ancestry proportions were estimated based on genotypes of ancestry informative markers. Regression analysis was used to examine the association between case-control status and quantitative serum iron measures and 1134, 1115, 1113 and 1134 SNP genotypes in the white, African-American, Hispanic, and Asian population samples, respectively. Model predictors included age, sex, the estimated ancestry proportion (for African American and Hispanic only), genotype, and measured covariates that showed nominally significant associations with the outcome. Three chromosomal regions showed evidence of association across multiple populations, including SNPs in the TF gene on chromosome 3q22, the TMPRSS6 gene on chromosome 22q12, and loci on chromosome 18q21. SNP rs1421312 in TMPRSS6 was associated with serum iron in whites (p=4.7×10−7) and was replicated in African Americans (p=0.0012).Twenty SNPs in the TF gene region were significantly associated with TIBC in the white sample (p<4.4×10−5); six SNPs were replicated in other ethnicities (p< 0.01). SNP rs10904850 in the CUBN gene on 10p13 was significantly associated with serum iron in the African-American sample (P=1.0×10−5). Mutations in the TMPRSS6 gene have been implicated in iron-refractory iron deficiency anemia through linkage studies. We found a novel SNP in TMPRSS6 that was associated with serum iron in whites and replicated in African Americans, suggesting a role for this SNP in increasing the risk of iron deficiency in affected persons. Our results confirm known associations with iron measures and give evidence of their role in different ethnic groups, a unique aspect of this study, suggesting origins in a common founder. Disclosures: No relevant conflicts of interest to declare.

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