Deletional Alpha-Thalassemia Alleles in Amazon Blood Donors

Alpha-thalassemia is highly prevalent in the plural society of Brazil and is a public health problem. There is limited knowledge on its accurate frequency and distribution in the Amazon region. Knowing the frequency of thalassemia and the prevalence of responsible mutations is, therefore, an important step in the understanding and control program. Hematological and molecular data, in addition to serum iron and serum ferritin, from 989 unrelated first-time blood donors from Amazonas Hemotherapy and Hematology Foundation (FHEMOAM) were collected. In this study, the subjects were screened for −α3.7/4.2/20.5, −SEA, −FIL, and −MED deletions. Alpha-thalassemia screening was carried out between 2016 and 2017 among 714 (72.1%) male and 275 (27.9%) female donors. The aims of this analysis were to describe the distribution of various alpha-thalassemia alleles by gender, along with their genotypic interactions, and to illustrate the hematological changes associated with each phenotype. Amongst the patients, 5.35% (n = 53) were diagnosed with deletion –α−3.7 and only one donor with α−4.2 deletion. From the individuals with –α−3.7, 85.8% (n = 46) were heterozygous and 14.20% (n = 7) were homozygous. The frequency of the –α−3.7 deletion was higher in male (5.89%) than in female (4.0%). There is no significant difference in the distribution of –α−3.7 by gender (p=0.217). The –α20.5, −SEA, and −MED deletions were not found. All subjects were analyzed for serum iron and serum ferritin, with 1.04% being iron deficient (n = 5) and none with very high levels of stored iron (>220 µg/dL). Alpha-thalassemia-23.7kb deletion was the most common allele detected in Manaus blood donors, which is a consistent result, once it is the most common type of α-thalassemia found throughout the world. As expected, the mean of hematological data was significantly lower in alpha-thalassemia carriers (p<0.001), mainly homozygous genotype. Leukocytes and platelet count did not differ significantly. Due to the small number of individuals with iron deficiency found among blood donors, the differential diagnosis between the two types of anemia was not possible, even because minor changes were found among hematological parameters with iron deficiency and α-thalassemia. Despite this, the study showed the values of hematological parameters, especially MCV and MCH, are lower in donors with iron deficiency, especially when associated with α-thalassemia, and therefore, it may be useful to discriminate different types of microcytic anaemia. In conclusion, we believed screening for thalassemia trait should be included as part of a standard blood testing before blood donation. It should be noted that this was the first study to perform the screening for alpha deletions in blood donors from the Manaus region, and further studies are required to look at the effects of donated thalassemic blood.

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Regression Correction Equation to Adjust Serum Iron and Ferritin Concentrations Based on C-Reactive Protein and Albumin in Patients Receiving Primary and Secondary Care

Journal of Nutrition ◽

10.1093/jn/nxz008 ◽

2019 ◽

Vol 149 (5) ◽

pp. 877-883 ◽

Cited By ~ 3

Author(s):

Stephen T McSorley ◽

Alexander Tham ◽

Iain Jones ◽

Dinesh Talwar ◽

Donald C McMillan

Keyword(s):

Iron Deficiency ◽

Linear Regression ◽

Serum Ferritin ◽

Secondary Care ◽

Serum Iron ◽

C Reactive Protein ◽

Reactive Protein ◽

Iron Deficient ◽

Significant Difference ◽

Low Levels

ABSTRACT Background Systemic inflammation, even at low levels, can greatly interfere with measures of iron status, making diagnosis of iron deficiency difficult. The objective of the present study was to create linear regression correction equations to adjust serum ferritin and iron concentrations based on measurements of the acute-phase proteins C-reactive protein (CRP) and albumin. Methods Data from a cohort (1) of patients (n = 7226) in primary and secondary care who had serum ferritin, iron, CRP, and albumin measured at the same time point were examined. Linear regression coefficients were calculated for CRP and albumin with serum iron and ferritin as the outcome variables. Patients with ferritin <15 µg/L or serum iron <10 µmol/L were categorized as iron deficient. The equation was then applied to a cohort (2) of patients with colorectal cancer who had ferritin and iron measured preoperatively ( n = 356). Results In cohort 1 there was a significant difference in the proportions of patients with serum ferritin <15 µg/L and serum iron <10 µmol/L, respectively, when the unadjusted (7% and 55%), adjusted based on CRP alone (13% and 26%), adjusted based on albumin alone (11% and 37%), and adjusted based on both CRP and albumin (24% and 15%) values were compared (both P < 0.001). In cohort 2 there was a significant difference in the proportions of patients with serum ferritin <15 µg/L and serum iron <10 µmol/L, respectively, when the unadjusted (28% and 66%), adjusted based on CRP alone (39% and 57%), adjusted based on albumin alone (39% and 59%), and adjusted based on both CRP and albumin (46% and 44%) values were compared (P < 0.001 and P < 0.004). Conclusions In both cohorts the greatest increase in the proportion of patients meeting definitions of iron deficiency was found when adjustment was made for both CRP and albumin together. Even low levels of inflammation had a significant effect on serum iron and ferritin values.

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Serum iron and total iron-binding capacity compared with serum ferritin in assessment of iron deficiency.

Clinical Chemistry ◽

10.1093/clinchem/27.2.276 ◽

1981 ◽

Vol 27 (2) ◽

pp. 276-279 ◽

Cited By ~ 15

Author(s):

F Peter ◽

S Wang

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Serum Iron ◽

Binding Capacity ◽

Transferrin Saturation ◽

Total Iron ◽

Iron Binding ◽

Total Iron Binding Capacity ◽

Iron Deficient ◽

Iron Binding Capacity

Abstract Ferritin values for 250 selected sera were compared with values for iron, total iron-binding capacity (TIBC), and transferrin saturation, to assess the potential of the ferritin assay for the detection of latent iron deficiency. The specimens were grouped (50 in each group) according to their values for iron and TIBC. In Group 1 (low iron, high TIBC) the saturation and ferritin values both indicated iron deficiency in all but one. In the 100 specimens of Groups 2 (normal iron, high TIBC) and 4 (normal iron, high normal TIBC), the saturation values revealed 16 iron-deficient cases, the ferritin test 55. For Groups 3 (low iron, normal TIBC) and 5 (low iron, low TIBC), the ferritin test revealed fewer cases of iron deficiency than did the saturation values (37 cases vs 51 cases, in the 100 specimens). Evidently the ferritin test detects iron deficiency in many cases for whom the serum iron and TIBC tests are not positively indicative. The correlation of serum ferritin with iron, TIBC, and transferrin saturation in the five groups was good only in the case of specimens for which the TIBC was normal; if it was abnormal the correlation was very poor.

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Thyroid Status in Patients with Low Serum Ferritin Level

Bangladesh Journal of Medical Biochemistry ◽

10.3329/bjmb.v5i1.13424 ◽

2013 ◽

Vol 5 (1) ◽

pp. 5-11

Author(s):

S Akhter ◽

ZU Nahar ◽

S Parvin ◽

A Alam ◽

S Sharmin ◽

...

Keyword(s):

Thyroid Hormone ◽

Iron Deficiency ◽

Serum Ferritin ◽

Serum Ferritin Level ◽

Ferritin Level ◽

Thyroid Peroxidase ◽

Hormone Synthesis ◽

Tissue Iron ◽

Iron Deficient ◽

Significant Difference

Iron deficiency is the most important but preventable nutritional problem in Bangladesh. Thyroid peroxidase, an iron containing enzyme, is essential for initial two steps of thyroid hormone synthesis which is a component of tissue iron. Tissue iron diminishes early in the course of iron deficiency. So thyroid hormone level may be altered in iron deficient patients. This case-control study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2006 to June 2007. This study was done to find out the changes of thyroid hormonal activity in iron deficiency.In this study 72 subjects were selected from the out-patient department of the hospital. Patients with low serum ferritin level <12 mgm/L were selected as cases (n=36) and healthy persons with normal serum ferritin level were taken as controls. Serum ferritin, thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured in all study subjects. Values were expressed as mean ± SD. Unpaired 't' test and Pearson's correlation test were performed to see the level of significance and p value <0.05 was taken as significant. Serum ferritin level in cases and controls were 6.78±4.05 mgm/L and 79.04±28.08 mgm/L respectively which showed significant difference (P<0.0001).Serum TSH concentration in cases and controls were 3.32±1.54 mIU/L and 1.89±0.86 mIU/L respectively. Serum FT4 concentration in cases and controls were 11.66±1.77 pmol/L and 13/10±1.36 pmol/L respectively and that of FT3 were 3.00±0.68 and 3.31±0.61 pmol/L respectively. All showed significant difference between groups.Serum ferritin and Serum TSH showed significant negative correlation in controls whereas in cases they showed negative correlation which was not statistically significant.Both serum FT4 and FT3 revealed positive correlation with serum ferritin but that too was not significant statistically.Though the study failed to show any significant positive correlation between serum ferritin and thyroid hormones, lower level of thyroid status in iron deficient patients suggest that it could be a reflection of disturbed activities of iron dependent enzymes such as thyroid peroxidase that impairs thyroid hormone synthesis. However, a large scale study is recommeded to establish the fact.This study showed that there was significant difference in thyroid hormonal status between iron deficient patients and normal healthy persons. Therefore it can be concluded that iron deficiency may impair normal thyroid hormone status. DOI: http://dx.doi.org/10.3329/bjmb.v5i1.13424 Bangladesh J Med Biochem 2012; 5(1): 5-11

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Usefulness of Reticulocyte Hemoglobin Equivalent for Diagnosis of Iron Deficiency

Blood ◽

10.1182/blood.v128.22.3621.3621 ◽

2016 ◽

Vol 128 (22) ◽

pp. 3621-3621

Author(s):

Yasumichi Toki ◽

Katsuya Ikuta ◽

Masayo Yamamoto ◽

Mayumi Hatayama ◽

Motohiro Shindo ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Research Funding ◽

Serum Iron ◽

Blood Count ◽

Complete Blood Count ◽

Deficiency Anemia ◽

Enzyme Linked Immunosorbent Assay ◽

Iron Administration ◽

Significant Difference

Abstract Background: Anemia is a significant worldwide health problem, and approximately 30% of world people suffer from anemia, the half of which is iron deficiency (ID). The diagnosis of anemia requires the confirmation of a decrease in hemoglobin (Hb) concentration. For the diagnosis of iron deficiency anemia (IDA), the determinations of serum ferritin and iron related parameters must be necessary even if microcytic hypochromic anemia is confirmed. With recent technological advances, the Hb content of reticulocytes can be quantified by flow cytometry. Reticulocytes exist for 1-2 days in the peripheral blood and its Hb levels might be a good index of ID.There are several markers for the assessment of Hb content in reticulocytes, including reticulocyte Hb equivalent (RET-He) and reticulocyte Hb content (CHr). RET-He, which can be measured in the same sample used for complete blood count tests by the latest automated hematology analyzers, is considered to reflect iron content in reticulocytes. If RET-He is capable of evaluating ID, it must be useful for immediate diagnosis of IDA. Therefore, we evaluated the usefulness of RET-He for determining of ID. Methods: This prospective study was approved by the ethics committee of Asahikawa Medical University (authorization numbers 1356, 1679, and 1356-3). Blood samples were obtained from 211 patients (63 males and 148 females) from 14 to 91 years old. RET-He levels were determined using an automated hematology analyzer (XN-3000® or XE-5000®, Sysmex, Kobe, Japan). Serum iron, total iron binding capacity (TIBC), serum ferritin, and biochemical data were measured using an automated chemical analyzer. Soluble transferrin receptor (sTfR) was measured by an enzyme-linked immunosorbent assay. Anemia was defined as Hb level of <12 g/dL. ID state was defined as serum ferritin level of <12 ng/mL. Patients were classified into four groups which are IDA, ID, control, and anemia without ID groups according to their Hb and serum ferritin levels (Table 1). Laboratory parameters were compared among four groups. The changes of RET-He during oral iron administration were also determined for 21 IDA patients. Results: There were 72 (14 males and 58 females), 28 (12 males and 16 females), 67 (23 males and 44 females), and 44 (14 males and 30 females) patients in the IDA, ID, control, and anemia without ID groups, respectively. As shown in Table 1, The median RET-He levels were 22.3 pg (15.1-35.6 pg), 29.7 pg (19.2-34.9 pg), 34.0 pg (25.9-38.0 pg), and 32.5 pg (19.1-46.3 pg) in the IDA, ID, control, and anemia without ID groups, respectively. Patients in not only IDA but ID groups had significantly lower RET-He levels than those in control group (p < 0.001) while there was no significant difference in RET-He levels between anemia without ID and control. RET-He correlated positively with serum iron (r = 0.654) and transferrin saturation (TSAT) (r = 0.666), and correlated negatively with TIBC (r = -0.617) and sTfR (r = -0.655). There was no correlation between RET-He and serum ferritin when all patients were included in the analysis (r = 0.287); however, analysis of groups according to their iron status revealed a positive correlation between RET-He and serum ferritin in the IDA and ID groups (r = 0.604). The area under the ROC curve (AUC) detecting ID for RET-He was 0.902, whereas AUC for serum iron, TIBC, TSAT, and sTfR were 0.889, 0.879, 0.922 and 0.821, respectively. The cutoff value of RET-He with maximal sensitivity and specificity was 30.9 pg, and the cutoff RET-He value of 28.5 pg had a specificity of >90% (sensitivity, 68%; specificity 91%). Among patients receiving iron treatments, the Hb levels increased in 14 patients, whereas Hb values decreased or did not change in 7 patients. Serum ferritin and RET-He values seemed to change in parallel with changes in Hb levels. Conclusions: In the present study, our data showed the efficacy of RET-He for diagnosis of IDA and the usefulness for monitoring drug iron administration. Because other parameters related to ID such as iron and ferritin should be measured biochemically in serum, it takes a longer time to measure serum iron and ferritin levels when compared with complete blood count tests. We would therefore suggest that measurement of RET-He might be useful to diagnose IDA because its assessment is rapid, fully automated, and can be measured in same sample used for complete blood count test. Disclosures Toki: Sysmex Corporation: Research Funding. Ikuta:Sysmex Corporation: Research Funding. Yamamoto:Sysmex Corporation: Research Funding. Hatayama:Sysmex Corporation: Research Funding. Shindo:Sysmex Corporation: Research Funding. Fujiya:Sysmex Corporation: Research Funding. Okumura:Sysmex Corporation: Research Funding.

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Effect of blood donation on iron stores as evaluated by serum ferritin

Blood ◽

10.1182/blood.v50.3.441.bloodjournal503441 ◽

1977 ◽

Vol 50 (3) ◽

pp. 441-447 ◽

Cited By ~ 7

Author(s):

CA Finch ◽

JD Cook ◽

RF Labbe ◽

M Culala

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Blood Donors ◽

Serum Ferritin Level ◽

Blood Donation ◽

Ferritin Level ◽

Geometric Mean ◽

Iron Stores ◽

High Incidence ◽

First Time

Serum ferritin was measured in 2982 blood donors. First-time male donors had a geometric mean of 127 microgram/liter and female donors 46 microgram/liter. While values were essentially constant in the women between the ages of 18 and 45, there was a rapid increase in the men between 18 and 30 years of age consistent with the establishment of iron stores during that time. Blood donation was associated with a decrease in serum ferritin. One unit per year, equivalent to an increased requirement of 0.65 mg/day, halved the serum ferritin level in the male. More frequent donations were associated with further decreases. From the data obtained it would appear that male donors, while depleting their iron stores, were able to donate 2–3 U/yr without an appreciable incidence of iron deficiency. Women could donate only about half that amount, and more frequent donations were associated with a high incidence of iron deficiency and donor dropout. These data have provided information on the effect of graded amounts of iron loss through bleeding on iron balance.

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Correlation between vivax malaria infection and iron deficiency in children

Paediatrica Indonesiana ◽

10.14238/pi55.1.2015.44-9 ◽

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.

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Zinc protoporphyrin as screening test in female blood donors

Clinical Chemistry ◽

10.1093/clinchem/44.4.800 ◽

1998 ◽

Vol 44 (4) ◽

pp. 800-804 ◽

Cited By ~ 14

Author(s):

Else J Harthoorn-Lasthuizen ◽

Jan Lindemans ◽

Mart M A C Langenhuijsen

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Serum Ferritin ◽

Blood Donors ◽

Deficiency Anemia ◽

Zinc Protoporphyrin ◽

Ferritin Concentration ◽

Iron Deficient ◽

Serum Ferritin Concentration ◽

Low Serum

Abstract Erythrocyte zinc protoporphyrin (ZPP) was measured in 102 women blood donors to evaluate its usefulness in screening for evolving iron deficiency anemia, a reason for the deferral of donors. The results were compared with serum ferritin determinations. Five women were deferred before their first donation and eight women were deferred after one or two donations. Women with increased ZPP values all had low serum ferritin concentrations, indicating iron-deficient erythropoiesis that was caused by iron depletion. The positive predictive value of an increased ZPP in predicting deferral of the donor after one or two donations was 75%, whereas a serum ferritin concentration ≤12 μg/L predicted deferral in 26% of the donors. The results indicate that the ZPP test can be recommended as a feasible and inexpensive predonation test to determine a subset of donors with iron-deficient erythropoiesis at risk of developing iron deficiency anemia.

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The Effect of Repeated Blood Donations on the Iron Status of Iranian Blood Donors Attending the Iranian Blood Transfusion Organization

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.76.3.132 ◽

2006 ◽

Vol 76 (3) ◽

pp. 132-137 ◽

Cited By ~ 8

Author(s):

Mahmoud Djalali ◽

Tirang R. Neyestani ◽

Jamil Bateni ◽

Fereydoun Siassi

Keyword(s):

Iron Deficiency ◽

Blood Transfusion ◽

Serum Ferritin ◽

Blood Donors ◽

Blood Donation ◽

Iron Status ◽

Iron Loss ◽

Healthy Controls ◽

Blood Donations ◽

Group Frequency

Objective: Blood donation leads to substantial iron loss, as about 0.5 mg iron is lost per each milliliter of blood donated. If not compensated for efficiently, the iron loss may eventually lead to anemia, though non-anemic iron deficiency per se may be problematic. The aim of this study was to evaluate the effects of blood donation, and its frequency over a year’s time, on iron status of Iranian male blood donors attended blood transfusion stations of the Iranian Blood Transfusion Organization (IBTO). Design and setting: A cross-sectional, descriptive, and analytic study was conducted. 91 male volunteer blood donors aged from 20 to 50 years attending three IBTO stations located in central areas of Tehran, and 63 apparently healthy controls that were matched for age, gender, monthly income, height, and weight, were included in the study. Blood donors were divided into 4 groups according to the frequency of blood donation per year; i.e. 1, 2, 3, and 4 with 20, 30, 26, and 15 persons in each group, respectively. Just before blood donation, 10 mL venous blood sample was taken and divided into heparinized and non-heparinized tubes for determination of hemoglobin (Hb), hematocrit (Hct), serum iron (SI), total iron binding capacity (TIBC), ferritin, transferrin saturation (TS), and mean corpuscular hemoglobin concentration (MCHC). Dietary assessment was also done using 3 different questionnaires; i.e. general health, food frequency, and 24hr recall. Results: The levels of Hb, Hct, and iron status indices were all significantly lower in the subjects than in controls and a gradual but significant decrease in iron status indices in each time of blood donation was found. Serum ferritin showed significant correlations with age (r = 0.33, p < 0.001) and body-mass index (BMI) (r = 0.26, p = 0.03) only in the control group. Frequency of blood donation per year was also inversely correlated with Hb (r = -0.67, p < 0.001), Hct (r = -0.65, p < 0.001), MCHC (r = -0.56, p < 0.001), serum ferritin (r = -0.38, p < 0.001), SI (r = -0.62, p < 0.001), and TS (r = -0.61, p < 0.001), but was directly correlated with TIBC (r = 0.56, p < 0.001). Interestingly in blood donors, but not in healthy controls, serum ferritin levels showed weak but statistically significant correlations with daily intake of iron (r = 0.17, p < 0.05) and energy (r = 0.20, p = 0.03). Conclusion: Though repeated blood donations might diminish iron status, it could be safe to donate 2–3 U/year without an appreciable incidence of iron deficiency, provided that the pre-donation Hb and ferritin values are ≥ 14.7 g/dL and 58.9 μg/L, respectively. The male volunteers with Hb ≥ 14.2 g/dL and serum ferritin ≥ 57.2 μg/L could donate 1–2 U/year and those with Hb ≥ 13.1 g/dL and serum ferritin ≥ 35.3 μg/L could donate just once a year. Volunteers who undergo (repeated) blood donation should receive special nutritional care, especially in terms of iron and energy.

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Comparison of Hemoglobin Concentration Adjusted for Altitude and Serum Iron and Ferritin to Diagnose Anemia in Childhood in Highlands

Blood ◽

10.1182/blood.v128.22.2459.2459 ◽

2016 ◽

Vol 128 (22) ◽

pp. 2459-2459 ◽

Cited By ~ 2

Author(s):

Ximena Robalino ◽

Mercedes Balladares-Saltos ◽

Patricia Miño ◽

Marcela Guerendiain

Keyword(s):

Sea Level ◽

Serum Ferritin ◽

Serum Iron ◽

Conflicts Of Interest ◽

Hematological Parameters ◽

Iron Concentration ◽

Public Health Problem ◽

Hemoglobin Concentration ◽

World Health ◽

Deficiency Anemia

Abstract Introduction: Iron deficiency anemia in childhood is a public health problem, especially in developing countries, being one of the most prevalent nutritional disorders in Ecuador. The proper diagnosis of anemia at school age is a priority, because it is related to inadequate growth and cognitive development, low immunity and increased morbidity and mortality. In highlands, the anemia diagnosis is difficult due to hyperbaric hypoxia stimulates erythropoiesis and the low sensitivity of conventional methods. It was established that hemoglobin concentration increases with altitude, proposing that these values must be adjusted for the altitude of residence. Thus, different models were generated to correct hemoglobin. However, other authors have an opposite position, stating that the adjustment is not required. It should be noted that, unlike hemoglobin, the content of body ferritin is not affected by the elevation above sea level, therefore constitutes an alternative for the assessment of anemia in highlands. Hence, our objective was to evaluate different hematological parameters, including the hemoglobin correction, to diagnose anemia in children living in regions of high geographical altitude, in Ecuador. Methods: This study has been carried out in San Juan and Yaruquíes schools, located at 3240 and 2764 meters above sea level, respectively. It was included 140 preschool and school children, who participated in the EVANES study, aged 3 to 13 years old. The 60% were female. Serum iron and ferritin and hemoglobin and hematocrit concentrations were measured in blood. The hemoglobin was evaluated considering the uncorrected values and the concentration adjusted for the geographical altitude of each region, according to World Health Organization (WHO), Center for Disease Control (CDC; for children), Dirren (for children) and Cohen (for pregnant women) methods. Children with hemoglobin levels lower than 11.5 g/dl were considered anemic (n=18/16/18/12; WHO, CDC, Dirren et al and Cohen et al, respectively). This study was conducted in accordance to the ethical rules of the Helsinki Declaration and the current Ecuadorian law, which regulates clinical research on humans, and was approved by the Ethic Committee of the San Francisco de Quito University. Written informed consent was obtained from all schoolchildren parents or tutors. Results: The means of age, hematocrit, unadjusted hemoglobin, serum iron and ferritin were: 8.65 ± 2.16 years, 43.01 ± 2.66 %, 14.27 ± 0.90 g/dl, 14.28 ± 4.04 µmol/l and 30.95 ± 14.33 ng/ml, respectively. When the correction factors and equations were applied, the hemoglobin concentrations were 12.45 ± 0.88 g/dl (WHO), 12.54 ± 0.88 g/dl (CDC), 12.43 ± 0.88 g/dl (Dirren) and 12.73 ± 0.89 g/dl (Cohen). No differences between female and male were found in hematological parameters. According to unadjusted hemoglobin, no cases of anemia were determined. By applying the corrections, 13.5% (WHO), 12.0% (CDC), 13.5% (Dirren) and 9.0% (Cohen) of children were identified as anemic, and using serum ferritin and iron the percentages were 10.3% and 15.0%, respectively. When comparing the latters with the corrected hemoglobin, there were no differences in the frequency of anemia. However, of the 14 children assessed as anemic using ferritin, only 2 (0MS), 1 (CDC), 2 (Dirren) and 1 (Cohen) of them presented this condition applying the adjusted hemoglobin, and 11 to 16 non-anemic children were classified as anemic. On the other hand, taking into account adjusted hemoglobin, there were more cases of anemia among boys than girls (p<0.05), but considering the ferritin and iron, no differences were found between sexes. In relation to the adjusted hemoglobin (all methods), the children identified as anemic presented lower hematocrit and hemoglobin (uncorrected and adjusted) levels (p<0.001) than non-anemic. No differences were found between groups in ferritin and iron concentration. Conversely, when ferritin and iron were used to divide the children, only these parameters were different in anemic and non-anemic groups (p<0.001). Conclusions: According to our findings, the adjustment of hemoglobin concentration by geographical altitude may be an useful method to diagnose anemia in childhood at the population level but not individually. Serum ferritin is the most appropriate anemia indicator for the individual assessment in children living in highlands. Disclosures No relevant conflicts of interest to declare.

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Predicting the risk of anemia in pregnant women with different somatotypes

Pediatrician (St Petersburg) ◽

10.17816/ped11243-50 ◽

2020 ◽

Vol 11 (2) ◽

pp. 43-50

Author(s):

Tatiana I. Tsidaeva ◽

Kristina G. Tomaeva ◽

Sergey N. Gaidukov ◽

Nikolai N. Rukhliada ◽

Aida A. Cheldieva ◽

...

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Serum Ferritin ◽

Serum Iron ◽

Hematological Parameters ◽

First Trimester ◽

Deficiency Anemia ◽

Body Type ◽

Latent Iron Deficiency

The aim of the study: to study the frequency of anemia in pregnant women with different somatotypes and to develop a model for predicting the risk of this pathology. Materials and methods. 390 women were examined. Of the women studied 110 were mаcrosomatotype, 173 mesosomatotype, and 107 microsomatotype. Somatometry was performed according to R.N. Dorokhov for women in early pregnancy (before 910 weeks of gestation). In blood test the level of hemoglobin, red blood cells, and hematocrit is determined using the Medonic M-series hematological automatic analyzer. Serum iron levels were determined colorimetrically with ferrosine. Serum ferritin levels were determined spectrophotometrically using ELISA methods. Results. It was found that iron deficiency anemia was significantly more common in pregnant women of macro-and microsomatic body type compared to women with mesosomatotypes (p 0.05). Pregnant women with severe anemia were not found. There were iron deficiency anemia of mild and moderate severity, and latent iron deficiency. Hematological parameters (hematocrit, serum iron, serum ferritin) were significantly lower in pregnant women with latent iron deficiency compared to women without anemia (p 0.05). Using multiple regression analysis, we obtained the regression equation (formula), which predicts the development of iron deficiency anemia in pregnant women of different somatotypes. Conclusions. The calculations according to the presented formula, allows to predict with high accuracy the prognosis of iron deficiency anemia in pregnant women, and also allows to form among patients a high-risk group for the development of this disease in the first trimester of pregnancy when the pregnant woman is registered in the womens consultation, which will contribute to more effective implementation of therapeutic and preventive measures to prevent the development of this pathology.

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