Iron supplementation prevents a decline in iron stores and enhances strength performance in elite female volleyball players during the competitive season

The primary aim of this study was to examine the effects of 11 weeks of iron supplementation on hematological and strength markers in elite female volleyball players. Twenty-two volleyball players (aged 27.0 ± 5.6 years) from 2 Spanish First National League teams participated and were counterbalanced into 1 of 2 groups based upon iron status: (i) control group (CG, n = 11); or (ii) iron treatment group (ITG, n = 11), which received 325 mg/day of ferrous sulphate daily. Subjects performed their team’s regimen of training or match play every day. Both groups were tested for hematological and strength levels at 2 points: (i) baseline (T0, before preseason) and (ii) 11 weeks later (T11, post-testing). Hematological parameters were serum iron (sFe), serum ferritin (FER), transferrin saturation index (TSI), and hemoglobin (Hb); strength assessments were bench press, military press, half-squat, power clean, clean and jerk, and pull-over. CG experienced a significant decrease (p < 0.05) for sFe (T0, 112.7 ± 31.5; T11, 69.0 ± 20.5 μg·dL−1; –33.9%), FER (T0, 60.2 ± 28.6; T11, 38.2 ± 16.4 ng·mL−1; –34.6%), TSI (T0, 29.4% ± 9.5%; T11, 17.4% ± 5.1%; –35.3%), and Hb (T0, 14.1 ± 1.0; T11, 13.0 ± 0.8 g·L−1; –7.44%); however, ITG experienced no changes (p > 0.05). Consequently, in ITG all hematological parameters were significantly greater (p < 0.05) than CG at T11. There was greater (p < 0.05) percent increase in the clean and jerk (CG: +5.1% ± 20.9 vs. ITG: +29.0% ± 21.3%), power clean (CG: –5.8% ± 30.3% vs. ITG: +44.6% ± 56.6%), and total mean strength (CG: +10.9% ± 3.2% vs. ITG: +26.2% ± 3.6%) in ITG. Our findings suggest that oral iron supplementation prevents iron loss and enhances strength in female volleyball players during the competitive season.

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Eleven Weeks of Iron Supplementation Does Not Maintain Iron Status for an Entire Competitive Season in Elite Female Volleyball Players: A Follow-Up Study

Nutrients ◽

10.3390/nu10101526 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1526 ◽

Cited By ~ 3

Author(s):

Juan Mielgo-Ayuso ◽

Michael Zourdos ◽

Julio Calleja-González ◽

Alfredo Córdova ◽

Diego Fernandez-Lázaro ◽

...

Keyword(s):

Iron Supplementation ◽

Iron Status ◽

Ferrous Sulphate ◽

Transferrin Saturation ◽

Previous Trial ◽

Time Interaction ◽

Competitive Season ◽

Volleyball Players ◽

Power Clean

Background: Even though iron supplementation can be effective, it is necessary to be cautious of toxicity and aim to do no harm, therefore, it is important to examine the length of time the benefits of iron supplementation can be maintained following its cessation. The main purpose of this study was to analyze if iron stores and strength performance were maintained in elite female volleyball players for the final 18 weeks of a competitive season following the cessation of 11 weeks of iron supplementation. Methods: Twenty-two volleyballers (age: 27.0 ± 5.6 years.) were assigned to two groups (iron treatment group-ITG, n = 11 or control gropu-CG, n = 11) at the beginning of a previous trial (T0) and ITG consumed 325mg/d of ferrous sulphate for 11 weeks (T11). Then, in the present study iron status and strength were measured again 10 (T21) and 18 weeks later (T29) after the cessation of supplementation. Results: At the end of the previous trial (T11), ITG maintained iron status as measured by hematological parameters (serum iron-sFE, serum ferritin-FER, transferrin saturation index-TSI, and hemogloblin-Hb), however, CG showed a decrease in these markers at T11. Further, from T0 to T11 ITG experienced greater (p < 0.05) changes in clean and jerk, power clean, and total mean strength (TMS-sum of all strength tests) than CG. In the present, follow-up investigation, there was a group-by-time interaction in favor of CG vs. ITG from T11 to T21 for FER (p = 0.028) and Hb (p = 0.042). Further, there was an increase for CG (p < 0.001) in power clean for CG from T11 (38.4 ± 1.7 kg) to T21 (41.3 ± 1.9 kg) and T29 (41.8 ± 1.7 kg), but no change for power clean in ITG (p > 0.05). A group-by-time interaction from T11 to T29 occurred in favor of CG for half-squat (p = 0.049) and TMS (p = 0.049). Conclusion: Our findings suggest that the benefits of iron supplementation are not sustained in elite female volleyballers if supplementation is ceased for 18 weeks.

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Maternal zinc during oral iron supplementation in pregnancy: a preliminary study

Clinical Science ◽

10.1042/cs0760059 ◽

1989 ◽

Vol 76 (1) ◽

pp. 59-65 ◽

Cited By ~ 14

Author(s):

David L. Bloxam ◽

Norman R. Williams ◽

Rosie J. D. Waskett ◽

Patricia M. Pattinson-Green ◽

Yogini Morarji ◽

...

Keyword(s):

Iron Supplementation ◽

Zinc Concentration ◽

Iron Status ◽

Ferrous Sulphate ◽

Control Group ◽

Zinc Status ◽

Lower Plasma ◽

Zinc Concentrations ◽

Preliminary Study ◽

Maternal Iron

1. To investigate the possible effect of iron ingestion on maternal zinc status, one group of women was given 94 mg of iron per day as ferrous sulphate with multivitamins during the second and third trimesters of their pregnancies and another, control, group was given a placebo of multivitamins without iron. 2. The subjects given iron developed significantly lower plasma zinc concentrations than those in the control group. This effect on zinc was maximal by 6 weeks, whilst that on maternal iron status was slower. 3. There was no parallel decrease of zinc concentration in maternal mixed leucocytes, or of plasma heat-labile alkaline phosphatase activity, suggesting that there was a redistribution of zinc between plasma and tissues. 4. The results indicate that iron supplementation during pregnancy alters the disposition of zinc in the mother.

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Melatonin Improves Erythropoietin Hyporesponsiveness via Suppression of Inflammation

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666190528120357 ◽

2019 ◽

Vol 14 (3) ◽

pp. 203-208

Author(s):

Evan Noori Hameed ◽

Haydar F. Hadi AL Tukmagi ◽

Hayder Ch Assad Allami

Keyword(s):

Iron Status ◽

Transferrin Saturation ◽

Control Group ◽

Base Line ◽

Inadequate Response ◽

Inflammatory Parameters ◽

Tnf Α ◽

Before And After ◽

And Control ◽

Controlled Clinical Study

Background: Inadequate response to Erythropoietin Stimulating Agents (ESA) despite using relatively larger doses regimen represents a potential risk factor of Cardiovascular (CV) related mortality in addition to health-care economic problems in anemic patients with Chronic Kidney Disease (CKD). Erythropoietin (EPO) hyporesponsiveness related to inflammation has been increased progressively. Melatonin is well known as a potent anti-inflammatory agent. Therefore, the current study was designed to evaluate whether melatonin could improve anemic patients response to EPO. Methods: This single controlled clinical study was carried out in 41 CKD patients with hemoglobin (Hb) levels less than 11g/dl divided randomly in a 1:1 ratio into 2 groups; treatment group who received 5mg melatonin plus their regular treatments and control group who received their regular treatments only. Hematological and iron status parameters include Hb level, serum iron (S. iron), Transferrin Saturation Ratio (TSAT) and serum ferritin (S. ferritin) in addition to inflammatory parameters that include tissue necrotic factor alfa (TNF-α), interleukin-1beta (IL-1β) and interleukin-6 (IL-6) determined before and after 12 weeks of treatment. Results: Melatonin remarkably increases the Hb level with a significant increase in S. iron and TSAT compared to baseline. The elevation of S. iron and TSAT was significantly higher in the melatonin group. Additionally, all inflammatory markers estimated were reduced significantly by melatonin compared to base line and control group. Conclusion: The results of the current study showed that melatonin has an advantageous effect on improving EPO response in anemic patients with CKD.

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Osmotic Fragility in Essential Hypertension Revisited: A Correlation with Iron Status and Lipid Profile

10.20944/preprints201909.0147.v1 ◽

2019 ◽

Author(s):

Hussein Kadhem Al-Hakeim ◽

Zainab Hussein Alhillawi ◽

Sahatha Raoof Al-Ani

Keyword(s):

Essential Hypertension ◽

Lipid Profile ◽

Total Cholesterol ◽

Iron Status ◽

Transferrin Saturation ◽

Osmotic Fragility ◽

Control Group ◽

Vascular Walls ◽

Healthy Control ◽

Iron Parameters

Background: Essential hypertension is a major public health associated with increase pressure on the vascular walls and red blood cells (RBCs). In the present work, osmotic fragility (OF) of RBCs was reexamined in the means of its correlation with two risk factor; iron status and lipid profile. Experimental: OF, iron status parameters, and lipid profile components were measured in 60 patients and compared with the results of 30 controls. Results: The results showed a significant increase in all iron indices of hypertensive patients in comparing with healthy control group except TIBC, UIBC, and transferrin concentrations, which decrease in these patients in comparing with control group. Serum TGs, total cholesterol, VLDLc, and LDLc were increased while there is no significant in serum HDLc in patients to comparing with control group. There is no significant change in OF between patients and controls where p=0.173. The iron status parameters and lipid profile components were dependent on sex and smoking state. Hemoglobin and PCV were correlated significantly with total cholesterol and LDLc. Transferrin saturation showed a positive correlation with cholesterol, LDLc, and TGs, but negatively correlated with HDLc. No significant correlation between all the measured parameters and OF in HT patients. There is a significant correlation between serum ferritin and systolic BP and between Hb and systolic BP. Conclusion: No significant effect on the OF in HT patients. HT patients have elevated level of iron parameters in comparing with controls. OD has no correlation with iron status parameters or with lipid profile components.

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Assessment of Gastrointestinal Symptoms and Non-transferrin Bound Iron After Oral Ferrous Sulfate and Iron-enriched Aspergillus Oryzae Supplementation in Women (P24-039-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p24-039-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Amanda Bries ◽

Chong Wang ◽

Brian Wels ◽

Isaac Agbemafle ◽

Olivia Meier ◽

...

Keyword(s):

Oxidative Stress ◽

Side Effects ◽

Ferrous Sulfate ◽

Serum Iron ◽

Iron Supplementation ◽

Iron Status ◽

Transferrin Saturation ◽

Oral Iron ◽

Deficiency Anemia ◽

Iron Supplements

Abstract Objectives Iron deficiency anemia (IDA) is a widespread nutritional deficiency. Iron supplementation with ferrous sulfate (FeSO4) is the most common strategy to treat IDA; however, the compliance with daily FeSO4 administration is poor, due to contraindicating side effects. Previously, we have reported that A. oryzae (Ultimine®; ULT) is a novel iron source. Therefore, the objective of this study was to determine the biochemical assessment, non-transferrin bound iron (NTBI) and commonly related gastrointestinal side effects to assess the safety of A. oryzae compared to FeSO4. Methods Female participants (n = 16) with serum ferritin concentrations 40 µg/L were randomized to a double-blind, 9-wk cross-over study with a 3-wk placebo washout period between treatments. Oral iron supplements (65 mg Fe), FeSO4 and ULT were administered for 21 consecutive days for each subject. Side effect questionnaires were collected 3d/wk over the 9-wk study period. Side effects and biochemical markers (nausea, heartburn, abdominal pain, fatigue, headache, diarrhea, constipation, oxidative stress and liver and kidney function) from iron supplementation were evaluated, along with serum iron, % transferrin saturation (TS) and NBTI 8 h curves. Results Serum iron, TS, and NTBI were all markedly higher with FeSO4 at each time-point from 2–8 hours (P < 0.001) compared to ULT, whereas NTBI was undetected. Among treatments, FeSO4 resulted in higher inflammation, though not statistically significant. Compliance based on returned pills was higher with ULT (97.3%) than placebo and FeSO4 (95.2% and 93.2%, respectively). Subjects taking FeSO4 reported abdominal discomfort 2% more than ULT, which was not significantly different. FeSO4 caused marginally higher incidence of combined nauseation, constipation and diarrhea when subjects were taking FeSO4 (P < 0.07). Iron status was maintained similarly by both oral iron supplements. Oxidative stress, inflammation, kidney and liver function markers were not elevated with ULT supplementation, suggesting safety of its consumption. Conclusions Better compliance and less gastrointestinal related side effects were reported with ULT compared to FeSO4, while maintaining normal iron status. Our data suggests ULT is a safe oral iron supplement for treatment of IDA. Funding Sources Cura Global Health, Inc.

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P0673INVERSE ASSOCIATION OF TRANSFERRIN SATURATION WITH MORTALITY RISK IN CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0673 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Xin Li ◽

Kristin Danielson ◽

Innas Forsal ◽

Ken Iseri ◽

Lu Dai ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Transplantation ◽

Kidney Disease ◽

Mortality Risk ◽

Iron Supplementation ◽

Iron Status ◽

Transferrin Saturation ◽

Resistance Index ◽

Competing Risk ◽

Dialysis Patients

Abstract Background and Aims Transferrin saturation (TSAT) is an indicator of iron deficiency or overload, but its relationship with mortality in patients with different stages of chronic kidney disease (CKD) is unclear. We investigated the association of TSAT with mortality in CKD patients. Method In 479 CKD patients (97 CKD3-4 patients, 298 CKD5 non-dialysis patients and 84 peritoneal dialysis patients; median age 58 years, 67% males, 33% cardiovascular disease, CVD, and 29% diabetes), biomarkers of iron status (plasma iron, TSAT, transferrin and ferritin), systemic inflammation (high sensitivity C-reactive protein, hsCRP, and interleukin-6, IL-6) and nutritional status were assessed. During median follow-up of 35.6 months, 139 (29%) patients died, and 176 (37%) patients underwent renal transplantation. Patients were stratified into low (n=157) and high (n=322) TSAT tertile groups. All-cause and CVD mortality risk were analyzed with competing risk regression with renal transplantation as competing risk. Results TSAT [median 23% (IQR 17-30%)] was negatively associated with presence of DM and CVD, body mass index, hsCRP, IL-6, Framingham´s CVD risk score (FRS), erythropoietin resistance index (ERI) and iron supplementation, and positively associated with hemoglobin, ferritin and s-albumin. In competing risk analysis, low tertile of TSAT was independently associated with increased all-cause mortality risk (sHR=1.50, 95%CI 1.05-2.14) after adjusting for CKD stages, 1-SD of FRS, 1-SD of hemoglobin, 1-SD of hsCRP, 1-SD of ESA dose and iron supplementation (Figure 1). Conclusion TSAT was inversely associated with mortality risk in CKD patients. When evaluating clinical outcomes of CKD patients, iron status using TSAT as a predictive marker, should be considered.

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Serum Soluble Transferrin Receptor in Heterozygous β-Thalassaemia: Application in the Diagnosis of Iron Deficiency and as Hematologic Marker of Erythroid Activity According to Thalassaemic Genotypes (β0 vs β+).

Blood ◽

10.1182/blood.v108.11.3828.3828 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3828-3828

Author(s):

Jose Manuel Calvo-Villas ◽

María Francisca Zapata ◽

Ivan Alvarez ◽

Silvia de la Iglesia ◽

Jorge Cuesta ◽

...

Keyword(s):

Iron Deficiency ◽

Transferrin Receptor ◽

Biochemical Parameters ◽

Iron Status ◽

Direct Sequencing ◽

Saturation Index ◽

Transferrin Saturation ◽

Soluble Transferrin Receptor ◽

Iron Deficient ◽

Significant Difference

Abstract Although an increased level of serum soluble transferrin receptor (sTfR) have been found in both heterozygous β-thalassaemia patients with iron deficiency and in those with more severe genotype (β0), it is not a useful marker of iron deficiency status associated to β-thalassaemia. The aim of this study was to analyse the use of two biochemical parameters (sTfR and sTfR/log of ferritin ratio) to determine the iron status and to evaluate the degree of erythropoietic activity in a group of 221 β-thalassaemic heterozigotes patients (155 β0 and 66 β+). Serum ferritin and transferrin saturation index were measured in order to establish the iron status. Of the whole group, 51 patients were iron defficient (βthal-ID) while the remaining 170 were iron sufficient (βthal-IS). Based on the combination of β-thalassaemia genotype and iron status, patients were classified into four subgroups: β0thalassaemia and iron-sufficient (β0thal-IS) (n=124); β0thalassaemia and iron-deficient (β0thal-ID) (n=31); β+thalassaemia and iron-sufficient (β+thal-IS) (n=46); β+thalassaemia and iron-deficient (β+thal-ID) (n=20). 258 healthy and 56 iron-deficient individuals were used as controls. All the haematological parameters were measured by using analyzer Coulter® GEN-S™. Haemoglobins A2 (Hb A2) and F (HbF) were analysed by high performance liquid chromatography and molecular analysis was performed by real-time PCR and direct sequencing techniques. Chemical, inmunoturbidimetrical and nephelometric methods were used to measure iron status as well as sTfR. Comparison of haemalogical and biochemical parameters between subgroups was performed by using the t-student test and correlation analysis was calculated by using least-squares regression model. Mean sTfR level obtained was 2.63 ± 0.8 mg/dL and 2.57 ± 1.1 mg/dL in βthal-ID and βthal-IS patients respectively (p=0.783). Soluble transferrin receptor showed a positive correlation with HbA2, HbF and reticulocyte count values in βthal-IS patients (r=0.208 [p<0.05], r=0.440 [p<0.0001] and r=0.393 [p<0.00001] respectively) while it did not reach a significant correlation in βthal-ID patients. Mean sTfR/log sFt ratio was 2.75 ± 1.6 and 1.34 ± 0.5 in βthal-ID and βthal-IS patients (p<0.001). Interestingly, sTfR level was significantly higher in β0thal-IS patients when compared with β+thal-IS patients (2.76 ± 0.9 vs 1.42 ± 0.4) (p<0.001) as a result of an increased globin chains imbalance related to the β0 genotype. In the other hand, in the comparison between β0thal-ID and β+thal-ID subgroups neither sTfr level (2.71 ± 0.7 vs 2.40 ± 1.1) (p=0.417) nor sTfR/log sFt ratio (2.93 ± 1.7 vs 2.24 ± 1.3) (p=0.371) showed significant difference. In summary, sTfR/log sFt ratio is a valid parameter for diagnosis of iron deficiency associated to heterozygous β-thalassaemia. Unlike the findings observed in β-thalassaemic heterozigotes with normal iron status, sTfR level is not useful to evaluate the genotype severity in those with iron deficiency. Consequently, iron status should be determined before using sTfR as a parameter to provide a reliable estimation of the ineffective erythropoiesis related to the severity of β-thalassaemia genotypes.

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

Blood ◽

10.1182/blood.v116.21.5145.5145 ◽

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.

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Attenuation of angiotensin converting enzyme inhibitor induced cough by iron supplementation: role of nitric oxide

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/1470320311399604 ◽

2011 ◽

Vol 12 (4) ◽

pp. 491-497 ◽

Cited By ~ 3

Author(s):

Payal Bhalla ◽

Narinder Pal Singh ◽

Krishnan Ravi

Keyword(s):

Nitric Oxide ◽

Angiotensin Converting Enzyme ◽

Angiotensin Converting Enzyme Inhibitor ◽

Iron Supplementation ◽

Enzyme Inhibitor ◽

Ferrous Sulphate ◽

Control Group ◽

Converting Enzyme ◽

Converting Enzyme Inhibitor ◽

Observation Period

The present study examined whether (1) the cough associated with angiotensin converting enzyme inhibitor therapy is attenuated by oral intake of iron and anti-oxidants, and (2) nitric oxide (NO) has any role in this attenuation. Of the 100 patients under investigation, cough occurred in 28 of them with preponderance in females. All the 28 patients were followed up for six weeks: the first two weeks were the observation period and the remaining four weeks the experimentation period. After the observation period, 11 patients received a single oral dose of ferrous sulphate (200 mg), eight received vitamin E (200 mg, o.d.) and vitamin C (150 mg, o.d.) and nine were given placebo during the experimentation period. Cough scoring, serum NO and malondialdehyde (MDA) levels were determined during both the periods. While there were significant decreases in cough scores, NO and MDA levels between these two periods in the iron group, cough scores and MDA level decreased significantly in the anti-oxidant group. None of these parameters changed in the control group. NO level was found to be increased significantly in patients who developed cough ( n = 28) compared with those who did not cough ( n = 72). These results suggest that iron supplementation suppresses cough in patients on ACE-I therapy through its effect on NO generation.

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Justification of Universal Iron Supplementation for Infants 6-12 months in Regions with a High Prevalence of Thalassemia

10.21203/rs.3.rs-624967/v1 ◽

2021 ◽

Author(s):

Phakatip Sinlapamongkolkul ◽

Pacharapan Surapolchai ◽

Vip Viprakasit

Keyword(s):

Iron Deficiency ◽

Iron Supplementation ◽

Complete Blood Count ◽

Iron Status ◽

Transferrin Saturation ◽

University Hospital ◽

Deficiency Anemia ◽

Increased Risk ◽

Thalassemia Minor ◽

Hb E

Abstract Background Many clinicians hesitate adopting a universal infant iron supplementation program due to the risk of increased iron absorption for those with thalassemia. We aimed to determine thalassemia prevalence in 6- to 12-month old infants, along with the iron status of those with and without thalassemia. Procedures: We performed a cross-sectional descriptive study of infants attending the Well Baby Clinic at Thammasat University Hospital for routine checkups. Complete blood count, hemoglobin electrophoresis, iron parameters, and molecular genetics for common α- and β-thalassemia were evaluated. Results Overall, 97 of 206 (47%) participants had thalassemia minor, the majority having Hb E traits. None had thalassemia intermedia or major. Familial history of anemia or thalassemia presented an increased risk of detecting thalassemia minor in offspring (OR 5.18; 95% CI 2.60-10.33, p = 0.001). There were no statistical differences in transferrin saturation, serum ferritin and hepcidin between iron-replete infants with thalassemia minor and those without. However, one-third of infants with thalassemia minor (31/97) also had iron deficiency anemia (IDA), with a similar risk of having iron deficiency to infants without thalassemia. There was no hepcidin suppression in our infants with thalassemia minor as compared to controls. Conclusions Both thalassemia and IDA are endemic to Southeast Asia. Infants with thalassemia minor, particularly with Hb E and α-thalassemia traits, are at risk of IDA. Our short-term universal iron supplementation program for 6 to 12-month old infants does not appear to increase the risk of those with thalassemia minor developing iron overload in the future.

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