scholarly journals Effects of modest iron loading on iron indices in healthy individuals

2018 ◽  
Vol 125 (6) ◽  
pp. 1710-1719 ◽  
Author(s):  
Nicole K. Bart ◽  
Sara L. Hungerford ◽  
M. Kate Curtis ◽  
Hung-Yuan Cheng ◽  
Jennifer L. Southern ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Iron Status ◽  
Intravenous Iron ◽  
Controlled Study ◽  
Saline Control ◽  
Iron Loading ◽  
Vascular Response ◽  
Iron Deficient ◽  
Hemoglobin Mass ◽  
Sustained Hypoxia

Intravenous iron administration is typically indicated in individuals who have iron deficiency refractory to oral iron. However, in certain chronic disease states such as heart failure, it may be beneficial to administer intravenous iron to individuals who are not strictly iron deficient. The purpose of this study was to define a dose-response relationship between clinical indices of iron status and modest loading with intravenous iron in healthy, iron-replete participants. This was a double-blind, controlled study involving 18 male participants. Participants were block-randomized 2:1 to the iron and saline (control) groups. Participants in the iron group received 3.75 mg/kg body wt up to a maximum of 250 mg of intravenous iron, once a month for 6 mo, provided that their ferritin remained measured <300 µg/l within the week before a dose was due and their transferrin saturation remained <45%. Otherwise they received a saline infusion, as did the control participants. Iron indices were measured monthly during the study. The pulmonary vascular response to sustained hypoxia and total hemoglobin mass were measured before, at 3 mo (hemoglobin mass only), and at 6 mo as variables that may be affected by iron loading. Serum ferritin was robustly elevated by intravenous iron by 0.21 µg·l−1·mg−1of iron delivered (95% confidence interval: 0.15–0.26 µg·l−1·mg−1), but the effects on all other iron indices did not reach statistical significance. The pulmonary vascular response to sustained hypoxia was significantly suppressed by iron loading at 6 mo, but the hemoglobin mass was unaffected. We conclude that the robust effect on ferritin provides a quantitative measure for the degree of iron loading in iron-replete individuals.NEW & NOTEWORTHY There has been an increasing interest in administering intravenous iron to patients to alter their iron status. Here, we explore various indices of iron loading and show that in healthy volunteers serum ferritin provides a robust indicator of the amount of iron loaded, with a value of 21 µg/l increase in ferritin per 100 mg of iron loaded.

scholarly journals Evaluation of the iron status of a population

Blood ◽  
1976 ◽  
Vol 48 (3) ◽  
pp. 449-455 ◽  
Author(s):  
JD Cook ◽  
CA Finch ◽  
NJ Smith
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Red Cell ◽  
Adult Males ◽  
Packed Red Blood Cells ◽  
Iron Deficient ◽  
Menstruating Women ◽  
Prevalence Of Anemia

Abstract The iron status of a population of 1564 subjects living in the northwestern United States was evaluated by measurements of transferrin saturation, red cell protoporphyrin, and serum ferritin. The frequency distribution of these parameters showed no distinct separation between normal and iron-deficient subjects. When only one of these three parameters was abnormal (transferrin saturation below 15%, red cell protoporphyrin above 100 mug/ml packed red blood cells, serum ferritin below 12 ng/ml), the prevalence of anemia was only slightly greater (10.9%) than in the entire sample (8.3%). The prevalence of anemia was increased to 28% in individuals with two or more abnormal parameters, and to 63% when all three parameters were abnormal. As defined by the presence of at least two abnormal parameters, the prevalence of iron deficiency in various populations separated on the basis of age and sex ranged from 3% in adolescent and adult males to 20% in menstruating women. It is concluded that the accuracy of detecting iron deficiency in population surveys can be substantially improved by employing a battery of laboratory measurements of the iron status.

scholarly journals The Iron Status of Sickle Cell Anaemia Patients in Ilorin, North Central Nigeria

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Musa A. Sani ◽  
James O. Adewuyi ◽  
Abiola S. Babatunde ◽  
Hannah O. Olawumi ◽  
Rasaki O. Shittu
Keyword(s):  
Sickle Cell ◽  
Serum Ferritin ◽  
Transferrin Receptor ◽  
Sickle Cell Anaemia ◽  
Iron Status ◽  
Serum Transferrin ◽  
Cross Sectional ◽  
Serum Transferrin Receptor ◽  
Iron Deficient ◽  
The Mean

Objectives. Sickle cell anaemia (SCA) is one of the commonest genetic disorders in the world. It is characterized by anaemia, periodic attacks of thrombotic pain, and chronic systemic organ damage. Recent studies have suggested that individuals with SCA especially from developing countries are more likely to be iron deficient rather than have iron overload. The study aims to determine the iron status of SCA patients in Ilorin, Nigeria.Methods. A cross-sectional study of 45 SCA patients in steady state and 45 non-SCA controls was undertaken. FBC, blood film, sFC, sTfR, and sTfR/log sFC index were done on all subjects.Results. The mean patients’ serum ferritin (589.33 ± 427.61 ng/mL) was significantly higher than the mean serum ferritin of the controls (184.53 ± 119.74 ng/mL). The mean serum transferrin receptor of the patients (4.24 ± 0.17 μg/mL) was higher than that of the controls (3.96 ± 0.17 μg/mL) (p=0.290). The mean serum transferrin receptor (sTfR)/log serum ferritin index of the patients (1.65 ± 0.27 μg/mL) was significantly lower than that of the control (1.82 ± 0.18 μg/mL) (p=0.031).Conclusion. Iron deficiency is uncommon in SCA patients and periodic monitoring of the haematological, biochemical, and clinical features for iron status in SCA patients is advised.

scholarly journals Effect of Maternal Iron Deficiency Anemia on the Iron Store of Newborns in Ethiopia

Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Betelihem Terefe ◽  
Asaye Birhanu ◽  
Paulos Nigussie ◽  
Aster Tsegaye
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Complete Blood Count ◽  
Iron Status ◽  
Hemoglobin Concentration ◽  
Deficiency Anemia ◽  
Iron Store ◽  
Cross Sectional ◽  
Iron Deficient

Iron deficiency anemia among pregnant women is a widespread problem in developing countries including Ethiopia, though its influence on neonatal iron status was inconsistently reported in literature. This cross-sectional study was conducted to compare hematologic profiles and iron status of newborns from mothers with different anemia status and determine correlation between maternal and neonatal hematologic profiles and iron status in Ethiopian context. We included 89 mothers and their respective newborns and performed complete blood count and assessed serum ferritin and C-reactive protein levels from blood samples collected from study participants. Maternal median hemoglobin and serum ferritin levels were 12.2 g/dL and 47.0 ng/mL, respectively. The median hemoglobin and serum ferritin levels for the newborns were 16.2 g/dL and 187.6 ng/mL, respectively. The mothers were classified into two groups based on hemoglobin and serum ferritin levels as iron deficient anemic (IDA) and nonanemic (NA) and newborns of IDA mothers had significantly lower levels of serum ferritin (P=0.017) and hemoglobin concentration (P=0.024). Besides, newborns’ ferritin and hemoglobin levels showed significant correlation with maternal hemoglobin (P=0.018;P=0.039) and ferritin (P=0.000;P=0.008) levels. We concluded that maternal IDA may have an effect on the iron stores of newborns.

scholarly journals The Effectiveness of Transdermal Iron Patches in Athletes With Suboptimal Iron Status (Part 1)

2020 ◽  
Vol 30 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Rachel McCormick ◽  
Brian Dawson ◽  
Marc Sim ◽  
Leanne Lester ◽  
Carmel Goodman ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Repeated Measures ◽  
Iron Status ◽  
Maximal Oxygen Consumption ◽  
Oral Iron ◽  
Iron Stores ◽  
Beneficial Effects ◽  
Parallel Group ◽  
Gastrointestinal Side Effects ◽  
Hemoglobin Mass

The authors compared the effectiveness of two modes of daily iron supplementation in athletes with suboptimal iron stores: oral iron (PILL) versus transdermal iron (PATCH). Endurance-trained runners (nine males and 20 females), with serum ferritin concentrations <50 μg/L, supplemented with oral iron or iron patches for 8 weeks, in a parallel group study design. Serum ferritin was measured at baseline and fortnightly intervals. Hemoglobin mass and maximal oxygen consumption () were measured preintervention and postintervention in PATCH. A linear mixed effects model was used to assess the effectiveness of each mode of supplementation on sFer. A repeated-measures analysis of variance was used to assess hemoglobin mass and outcomes in PATCH. There was a significant time effect (p < .001), sex effect (p = .013), and Time × Group interaction (p = .009) for sFer. At Week 6, PILL had significantly greater sFer compared with PATCH (15.27 μg/L greater in PILL; p = .019). Serum ferritin was 15.53 μg/L greater overall in males compared with females (p = .013). There were no significant differences in hemoglobin mass (p = .727) or (p = .929) preintervention to postintervention in PATCH. Finally, there were six complaints of severe gastrointestinal side effects in PILL and none in PATCH. Therefore, this study concluded that PILL effectively increased sFer in athletes with suboptimal iron stores, whereas PATCH showed no beneficial effects.

scholarly journals Prevalence of Iron Deficiency in Pregnancy: A Single Centre Canadian Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4896-4896
Author(s):  
Grace Tang ◽  
Andrea Lausman ◽  
Jessica Petrucci ◽  
Jameel Abdulrehman ◽  
Rosane Nisenbaum ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Serum Ferritin ◽  
Iron Status ◽  
Tertiary Care ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Iron Deficient ◽  
In Pregnancy

Abstract Background Iron deficiency (ID) is the most common and widespread nutritional deficiency in both developing and developed countries (WHO, 2001; Mei et al., 2011). Women of child bearing age are at the highest risk, but this risk increases even more during pregnancy. The expansion of blood volume, growth of the fetus and placenta increase demand for iron to approximately 5.0mg/day by the third trimester (Met et al., 2011). Common symptoms of ID during pregnancy include fatigue, shortness of breath, and difficulty concentrating (WHO, 2001). Poor prenatal iron status is associated with diminished cognitive performance, language ability, and motor functions in the child (Tamura et al, 2002). For the mother, it is associated with risk of blood transfusion and post-partum depression. Despite international recommendations and guidelines on the management of ID in pregnancy, it remains a problem of epidemic proportions and is often unrecognized and left untreated. To increase awareness of ID, a quality improvement project, IRON Deficiency project in Pregnancy: Maternal Iron Optimization (IRON MOM) was implemented January 1st, 2017 at St. Michael's Hospital (SMH), in Toronto, Canada. Phase 1 of the project involved adapting lab requisitions and workflow in the obstetrics clinic to incorporate routine measurement of ferritin in week 12, 16 and 28 of pregnancy. As part of the IRON MOM, laboratory requisitions were modified to include ferritin as part of routine screening for all pregnant women. Objective The primary objective of this study was to assess the prevalence of ID in pregnant women consistently screened for ID after the implementation of the IRON MOM quality improvement project at a tertiary hospital in Toronto, Canada. Methods Administrative laboratory data was collected from the electronic medical record system at SMH, Toronto, Canada between January 1 and December 31, 2017. Suboptimal iron stores was defined as serum ferritin between 30-50μg/L. ID was defined as serum ferritin between 15-29μg/L, and severe ID was defined as <15μg/L. Significant anemia was defined as hemoglobin levels <100 g/L. Descriptive statistics were used to calculate proportions. SAS version 9.4 was used to perform the analyses. Results In 2017, 2400 ferritin tests were completed on pregnant women at our institution. A total of 76.8% (1844/2400) of tests demonstrated iron deficiency with a ferritin <30μg/L. Of those, 30.2% (726/2400) had ferritin between 15-29μg/L, and 46.6% (1118/2400) were severely iron deficient with a ferritin <15μg/L (Figure 1). 3282 hemoglobin checks, at delivery, occurred in this same one-year period and 10.5% (345/3282) were significantly anemic (<100 g/L). Of those, 6.2% (204/3282) had hemoglobin levels between 90-99g/L, 2.6% (85/3282) had hemoglobin levels between 80-89g/L, and 1.7% (56/3282) had hemoglobin levels <80g/L. Conclusion We found an extremely high prevalence of ID in our pregnant patient population. This confirms that ID remains an underappreciated problem, even at a tertiary care centre. Our findings highlight a tremendous gap in awareness, which demands strategies to improve knowledge translation. Future directions include the simplification and digitization of IRON MOM to empower pregnant patients to advocate for their care. Figure 1. Figure 1. Disclosures Lausman: Ferring: Other: gave a talk.

scholarly journals Scoping into Non Iron Deficiency Anemia: Reflection from the Rural India

2021 ◽  
Author(s):  
Somen Saha ◽  
Tapasvi Puwar ◽  
Deepak Saxena ◽  
Komal Shah ◽  
Apurva kumar Pandya ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Status ◽  
Treatment Protocol ◽  
Haemoglobin Concentration ◽  
Deficiency Anemia ◽  
Iron Storage ◽  
Iron Deficient ◽  
Postnatal Women ◽  
Automated Immunoassay

AbstractIntroductionAnaemia is one of the leading public health problems. India accounts for the highest prevalence of anaemia in the world. Anaemia programs in India focus on screening and management of anaemia based on haemoglobin estimation, treatment is being given irrespective of status of iron as well as other micronutrient storage. The present study assesses the prevalence of anaemia and iron deficiency (ID) based on low serum ferritin status among antenatal and postnatal women in Devbhoomi Dwarka District of Gujarat.MethodsA total of 258 pregnant (AN) and postnatal (PN) women drawn from 27 primary health centres were studied. Anaemia was evaluated based on haemoglobin concentration obtained from venous whole blood, using auto-analyser. Serum ferritin was used to evaluate iron status in the study. Serum ferritin was assessed using the direct chemiluminescence method using MINI VIDAS which is a compact automated immunoassay system based on the Enzyme Linked Fluorescent Assay (ELFA) principles.ResultsOverall, Anaemia (low Hb) and ID (low s. ferritin) was observed in 65.9% and 27.1% respectively. Out of anaemic participants, about 38.2% reported ID while the remaining 61.8% had normal s. ferritin (i.e. non-iron deficient anaemia). Anaemia was reported 69.1% in AN women and 57.1% in PN women. The ID was reported higher (30.9%) in AN woman than PN women (17.1%). However, the prevalence of anaemia, as well as IDA decreased from the first to the third trimester.ConclusionTwo out of every three women were anaemic; one out of four were anaemic with depleted iron storage. Importantly, two out of five women had anaemia but iron storage was sufficient. Strategy to prevent and correct anaemia must include screening for iron and non-iron deficiency anaemia and follow appropriate treatment protocol for both types of anaemia.

scholarly journals Correlation between vivax malaria infection and iron deficiency in children

2015 ◽  
Vol 55 (1) ◽  
pp. 44
Author(s):  
Desmansyah Desmansyah ◽  
Rini Purnamasari ◽  
Theodorus Theodorus ◽  
Sulaiman Waiman
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Vivax Malaria ◽  
Malaria Infection ◽  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Hemoglobin Level ◽  
Ferritin Concentration ◽  
Iron Deficient

Background Iron deficiency is considered to be a major public health problem around the world due to its high prevalence as well as its effect on growth, development, and infection-resistance in children. In malaria-endemic areas, malaria infection is thought to contribute to the occurrence of iron deficiency, by means of hepcidin and hemolysis mechanisms. Objective To assess the prevalence of asymptomatic vivax malaria, compare hemoglobin levels and iron status parameters between vivax malaria-infected and uninfected children, assess the prevalence of iron deficiency, and evaluate a possible correlation between vivax malaria infection and iron deficiency. Methods This cross-sectional study was conducted from February to April 2013 at Sanana City of Sula Islands District, North Maluku. Six parameters were evaluated in 5-11-year-old children: malaria parasite infection, hemoglobin level, serum iron concentration, total iron-binding capacity (TIBC), serum transferrin saturation, and serum ferritin concentration. Results Among 296 children aged 5-11 years, 75 (25.3%) were infected with Plasmodium vivax. In infected children, hemoglobin, serum iron, transferrin saturation, TIBC and serum ferritin were significantly lower than in non-infected children (P<0.01). Using a serum ferritin cut-off of <15 μg/dL, 142 (48.0%) of the children were found to be iron deficient. There was a strong correlation between vivax malaria infection and iron deficiency (OR 3.573; 95%CI 2.03-6.29). ConclusionThe prevalence of asymptomatic vivax malaria infection was 25.3%. The hemoglobin level and iron status parameters in vivax malaria-infected subjects were significantly lower than in uninfected children. The prevalence of iron deficiency was 48.0% for all study subjects. Malaria vivax infection was correlated with iron deficiency in 5-11-year-old children at Sanana City.

scholarly journals Optimization of Epoetin Therapy with Intravenous Iron Therapy in Hemodialysis Patients

2000 ◽  
Vol 11 (3) ◽  
pp. 530-538
Author(s):  
ANATOLE BESARAB ◽  
NEETA AMIN ◽  
MUHAMMAD AHSAN ◽  
SUSAN E. VOGEL ◽  
GARY ZAZUWA ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Control Group ◽  
Zinc Protoporphyrin ◽  
Study Group ◽  
Iron Deficient

Abstract. Iron deficiency limits the efficacy of recombinant human erythropoietin (rhEPO) therapy in end-stage renal disease (ESRD) patients. Functional iron deficiency occurs with serum ferritin >500 ng/ml and/or transferrin saturation (TSAT) of 20 to 30%. This study examines the effects of a maintenance intravenous iron dextran (ivID) protocol that increased TSAT in ESRD hemodialysis patients from conventional levels of 20 to 30% (control group) to those of 30 to 50% (study group) for a period of 6 mo. Forty-two patients receiving chronic hemodialysis completed a 16- to 20-wk run-in period, during which maintenance ivID and rhEPO were administered in amounts to achieve average TSAT of 20 to 30% and baseline levels of hemoglobin of 9.5 to 12.0 g/dl. After the run-in period, 19 patients randomized to the control group received ivID doses of 25 to 150 mg/wk for 6 mo. Twenty-three patients randomized to the study group received four to six loading doses of ivID, 100 mg each, over a 2-wk period to achieve a TSAT >30% followed by 25 to 150 mg weekly to maintain TSAT between 30 and 50% for 6 mo. Both regimens were effective in maintaining targeted hemoglobin levels. Fifteen patients in the control group and 17 patients in the study group finished the study in which the primary outcome parameter by intention to treat analysis was the rhEPO dose needed to maintain prestudy hemoglobin levels. Maintenance ivID requirements in the study group increased from 176 to 501 mg/mo and were associated with a progressive increase in serum ferritin to 658 ng/ml. Epoetin dose requirements for the study group decreased by the third month and remained 40% lower than for the control group, resulting in an overall cost savings in managing the anemia. Secondary indicators of iron-deficient erythropoiesis were also assessed. Zinc protoporphyrin did not change in either group. Reticulocyte hemoglobin content increased only in the study group from 28.5 to 30.1 pg. It is concluded that maintenance of TSAT between 30 and 50% reduces rhEPO requirements significantly over a 6-mo period.

scholarly journals The relationship between BMI and iron status in iron-deficient adolescent Iranian girls

2009 ◽  
Vol 12 (12) ◽  
pp. 2377-2381 ◽  
Author(s):  
MH Eftekhari ◽  
H Mozaffari-Khosravi ◽  
F Shidfar
Keyword(s):  
At Risk ◽  
Serum Ferritin ◽  
Adolescent Girls ◽  
Weight Status ◽  
Iron Status ◽  
Risk Indicators ◽  
Nutritional Risk ◽  
Fe Deficiency ◽  
Inverse Association ◽  
Iron Deficient

AbstractObjectiveMany Iranian adolescent girls are Fe-deficient, but it is unclear whether Fe deficiency is associated with other nutritional risk indicators. The present study aimed to investigate the association between Fe deficiency and weight status (measured as BMI) among a representative sample of adolescent girls.DesignA cross-sectional study. Fe-deficient high-school girls (with or without anaemia) were selected by systematic random sampling among all students in grades 1 to 4 from high schools for girls. Blood samples were collected and analysed for Hb, haematocrit, serum ferritin, Fe and total Fe binding capacity. Weight and height were measured. BMI was calculated and compared with age- and gender-specific BMI reference values.SettingSouth Iran.SubjectsA total of 431 adolescent girls aged 13–20 years.ResultsSome 15·3 % of the participants were at risk for overweight and 9·5 % of them were overweight. An inverse association was found between serum ferritin and BMI (r = −0·38, β = −0·21, P < 0·001). Anaemia was more prevalent among overweight Fe-deficient adolescents than among those Fe-deficient and at risk for overweight or normal weight (34·1 % v. 28·8 % v. 27·8 %, respectively; P < 0·001).ConclusionsAn inverse association was found between BMI and serum ferritin. Overweight adolescents demonstrated an increased prevalence of Fe-deficiency anaemia. It seems that both abnormalities of weight and Fe status should simultaneously be targeted in overweight female adolescents.

Iron Status of Female Runners

1993 ◽  
Vol 3 (2) ◽  
pp. 222-231 ◽  
Author(s):  
Russell R. Pate ◽  
Bonnie J. Miller ◽  
J. Mark Davis ◽  
Chris A. Slentz ◽  
Lisa A. Klingshirn
Keyword(s):  
Serum Ferritin ◽  
Reference Group ◽  
Binding Capacity ◽  
Iron Status ◽  
Hemoglobin Concentration ◽  
Mean Corpuscular Hemoglobin ◽  
Running Activity ◽  
Iron Deficient ◽  
Increased Risk ◽  
Chi Square Analysis

This study was designed to observe iron status and prevalence of iron deficient conditions in adult female habitual runners (n=111) and inactive females of comparable age (n=65). The runners were significantly lower (p<.05) than the reference group in mean serum ferritin (SF), total iron binding capacity, and red blood cell count, but significantly higher (p<.05) in mean corpuscular hemoglobin. The groups did not differ significantly in hemoglobin concentration, hematocrit, serum iron, percent saturation of transfenin, or red cell protoporphyrin. Chi square analysis indicated that iron depletion (SF <20 ng·ml-1) was significantly more prevalent (p<.005) in the runners than in the controls. Anemia was extremely rare in both groups. A multiple regression analysis revealed significant negative associations between serum ferritin and coffeeltea intake (p<.001) and running activity (p<.05). These results indicate that habitual runners, as compared with inactive women, are at increased risk for iron deficient states but that full-blown anemia is a rare consequence of this deficient iron status.

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