Subclinical Iron Deficiency in Non-Anemic Individuals: A Retrospective Analysis of Korean Health Examinees

2019 ◽  
Vol 143 (1) ◽  
pp. 26-32
Author(s):  
Eun-Hee Nah ◽  
Han-Ik Cho ◽  
Seon Cho ◽  
Suyoung Kim
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Reproductive Age ◽  
Iron Level ◽  
Distribution Width ◽  
Elderly Males ◽  
Males And Females

Objectives: Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed. Methods: This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%. Results: The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15–49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03–1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345–0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298–0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001–1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895–0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945–0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793–0.960 in males; 0.872, 95% CI 0.853–0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001). Conclusions: Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia.

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

1981 ◽  
Vol 27 (2) ◽  
pp. 276-279 ◽  
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.

scholarly journals Inherited microcytic anemias

Hematology ◽  
2020 ◽  
Vol 2020 (1) ◽  
pp. 465-470
Author(s):  
Maria Domenica Cappellini ◽  
Roberta Russo ◽  
Immacolata Andolfo ◽  
Achille Iolascon
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Iron Metabolism ◽  
Red Blood Cell ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Distribution Width

Abstract Inherited microcytic anemias can be broadly classified into 3 subgroups: (1) defects in globin chains (hemoglobinopathies or thalassemias), (2) defects in heme synthesis, and (3) defects in iron availability or iron acquisition by the erythroid precursors. These conditions are characterized by a decreased availability of hemoglobin (Hb) components (globins, iron, and heme) that in turn causes a reduced Hb content in red cell precursors with subsequent delayed erythroid differentiation. Iron metabolism alterations remain central to the diagnosis of microcytic anemia, and, in general, the iron status has to be evaluated in cases of microcytosis. Besides the very common microcytic anemia due to acquired iron deficiency, a range of hereditary abnormalities that result in actual or functional iron deficiency are now being recognized. Atransferrinemia, DMT1 deficiency, ferroportin disease, and iron-refractory iron deficiency anemia are hereditary disorders due to iron metabolism abnormalities, some of which are associated with iron overload. Because causes of microcytosis other than iron deficiency should be considered, it is important to evaluate several other red blood cell and iron parameters in patients with a reduced mean corpuscular volume (MCV), including mean corpuscular hemoglobin, red blood cell distribution width, reticulocyte hemoglobin content, serum iron and serum ferritin levels, total iron-binding capacity, transferrin saturation, hemoglobin electrophoresis, and sometimes reticulocyte count. From the epidemiological perspective, hemoglobinopathies/thalassemias are the most common forms of hereditary microcytic anemia, ranging from inconsequential changes in MCV to severe anemia syndromes.

Association of serum iron and response to immune checkpoint inhibitors (ICIs) in metastatic clear cell renal cell carcinoma (mccRCC).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 723-723
Author(s):  
Nityam Rathi ◽  
David D. Stenehjem ◽  
Neeraj Agarwal ◽  
Andrew W Hahn ◽  
Deepika Sirohi ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Iron ◽  
Clear Cell ◽  
Checkpoint Inhibitors ◽  
Transferrin Saturation ◽  
Iron Level ◽  
Eligibility Criteria ◽  
Cell Renal Cell Carcinoma ◽  
Serum Iron Level ◽  
Iron Profile

723 Background: ICIs have improved survival in mRCC patients (pts), yet response rates (RR) to these treatments are variable. Biomarkers predictive of response to ICIs may improve outcomes for mccRCC pts. Genes that promote tumor-specific iron accumulation such as hepcidin (HAMP) or transferrin (TF) are significantly correlated with decreased overall survival in clear cell RCC (TCGA-KIRC). Iron deficiency in cancer patients is positively correlated with tumor stage and inversely proportional to treatment response (PMID: 23567147). Here, we investigate whether serum iron profile may be associated with response to ICIs in mccRCC pts. Methods: Clinical data was obtained from an mRCC registry at the Huntsman Cancer Institute, University of Utah. Analyses were limited to mccRCC pts who had serum iron studies within 6 months before initiating an ICI and had been assessed for RR. ICIs included nivolumab + ipilimumab, atezolizumab, or nivolumab alone. Responses were defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by RECIST criteria. Clinical benefit (CB) was defined as CR + PR + SD. Descriptive statistics were used to assess associations between iron stores and response to ICIs and IMDC criteria. Results: 36 pts met all aforementioned eligibility criteria (29 were of IMDC intermediate risk, 7 were of IMDC poor risk). 5 pts received a first-line ICI, and the remaining 31 pts received ICIs as salvage therapy. Pts with CB had a significantly higher median serum iron level compared to those with no CB (59 vs 38.5 ug/dL; p=0.024). Furthermore, pts with normal transferrin saturation (TSAT %) were more likely to derive CB from ICIs (p=0.048). No association was found between serum ferritin (a marker of inflammation and tissue iron) and response to ICIs. Conclusions: In this hypothesis-generating study, increased serum iron, and TSAT levels within the normal range are associated with an increased likelihood of response to ICIs in pts with mccRCC. Once validated, these results may establish serum iron profile as a predictive marker of response to ICIs, in addition to providing the rationale for ruling out iron deficiency before starting ICIs.

scholarly journals Prevalence and associated risk factors of iron deficiency without anemia among school adolescents in Mbouda, Western Cameroon

2022 ◽  
Author(s):  
Odile Tadzong Mamokem ◽  
Wiliane Jean Takougoum Marbou ◽  
Marie Modestine Kana Sop ◽  
Bruno Phélix Telefo
Keyword(s):  
Risk Factors ◽  
Iron Deficiency ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
School Site ◽  
Mean Values ◽  
Significant Difference ◽  
Associated Risk Factors ◽  
Iron Binding Capacity

Background: Adolescents are a particularly vulnerable age group to iron deficiency without anemia (IDWA). This study aimed at determining the prevalence and associated risks factors of IDWA among apparently healthy school teenagers in Mbouda, West-Cameroon.Methods: The 778 blood samples were randomly collected from adolescents aged 10-19 years of four schools in Mbouda. Appropriate indicators including haemoglobin and haematocrit, serum iron, ferritin, transferrin, and total iron binding capacity, transferrin saturation were determined using standard methods.Results: The overall prevalence of IDWA was 40.4%. High significant difference in the mean values of serum iron (p≤0.001), serum ferritin (p≤0.001), TIBC (p=0.007), CST (p≤0.001) were observed in participants with IDWA compared to those without IDWA. The sociodemographic risk factors of IDWA in school adolescents were school site (p=0.022; 0.14 (0.90-1.43) and period of menstruation (p=0.015; 1.48 (1.083-2.03). Consumption of roots-tubers [OR: 0.92 (0.48-1.77)] legumes [OR: 2.65 (1.91-3.67)], cereals [OR: 0.90 (0.67-1.22)], increased the risk of IDWA while consumption of vegetables [OR: 0.29 (0.22-0.39)], eggs [OR: 0.66 (0.49-0.90)], and fish-shrimp [OR: 0.172 (0.10-0.295)] decreased the risk of IDWA. Meal consumption frequency had a statistically significant association with IDWA (p≤0.001).Conclusions: This study identified that IDWA was a major public health in adolescents. This study will help in planning and implementation of the policy for prevention of IDWA in adolescents.

scholarly journals The U-shaped association of serum iron level with COVID-19 severity: Is iron a potential therapeutic target?

2021 ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
University Hospital ◽  
Iron Level ◽  
Inadequate Response ◽  
Serum Iron Level ◽  
Median Serum ◽  
Iron Binding Capacity

AbstractObjectiveTo evaluate the association between iron metabolism indicators and disease severity in hospitalized patients with coronavirus disease 2019 (COVID-19).DesignTwo-center observational studySettingA university hospital and a core hospital in Yokohama, JapanPatientsAdults with COVID-19 whose serum iron levels were measured within the first 5 days of hospitalization were included. Patients who refused mechanical ventilation were excluded from the study.Measurements and Main ResultsOne hundred thirty-six patients were included in this study. We analyzed the association between COVID-19 severity and serum iron, total iron binding capacity (TIBC), and transferrin saturation (TSAT) levels. Disease severity was defined as the worst respiratory status during hospitalization. Serum iron levels were significantly lower in patients with mild respiratory failure (RF) (n=55, median serum iron level: 24 [interquartile range: 19–42] mg/dL) than in the non-RF group (n=44, 40 [24–80] mg/dL) and the severe RF group (n=37, 60 [23.5–87] mg/dL); however, there were no significant differences in iron levels between the non-RF and severe RF groups (non-RF vs. mild RF: p=0.019, non-RF vs. severe RF: p>0.999, and mild RF vs. severe RF: p=0.009). That is, there was a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron or TSAT levels were independently associated with development of severe RF.ConclusionsA U-shaped association between serum iron level and RF severity in hospitalized COVID-19 patients was observed. Higher serum iron levels in COVID-19 patients with RF are associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

scholarly journals Anaemia, iron deficiency and vitamin A status among school-aged children in rural Kazakhstan

2005 ◽  
Vol 8 (6) ◽  
pp. 564-571 ◽  
Author(s):  
Masahiro Hashizume ◽  
Momoko Chiba ◽  
Atsuko Shinohara ◽  
Shigehiro Iwabuchi ◽  
Satoshi Sasaki ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin A ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Serum Retinol ◽  
Cross Sectional ◽  
School Aged Children ◽  
Vitamin A Status ◽  
Cross Sectional Design

AbstractObjectivesTo investigate the prevalence of anaemia and iron deficiency and vitamin A status among school-aged children in rural Kazakhstan and identify factors associated with anaemia in this population.DesignA cross-sectional design.SettingSchool-aged children in rural Kazakhstan.SubjectsSocio-economic and anthropometric information was collected from 159 school-aged children living in the Kzyl-Orda region of Kazakhstan. Blood samples were collected and the concentrations of haemoglobin (Hb), serum iron, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum retinol and β-carotene, total iron binding capacity (TIBC), transferrin saturation (TS) and other haematological indices were measured.ResultsAmong the 159 children, the prevalence of anaemia and iron deficiency defined by the multiple criteria model (SF, TS and EP) was 27% and 13%, respectively. Nine per cent had iron-deficiency anaemia and 21% had serum retinol value <1.05 μmol l−1. Mean SF and serum iron concentrations and TS were significantly lower in anaemic children than in their non-anaemic peers, while TIBC and EP were significantly higher in children with anaemia. Hb was significantly correlated with serum iron and retinol concentrations. Serum retinol and SF concentrations and mean corpuscular volume were significantly correlated with Hb by multiple regression analysis.ConclusionsAnaemia among school-aged children in rural Kazakhstan appears to be related to iron indices and vitamin A status.

scholarly journals Co-existence of Iron Deficiency in Beta Thalassaemia Trait

2017 ◽  
Vol 19 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Nur Mohammad ◽  
MA Jalil Chowdhury ◽  
Md Rafiqul Alam ◽  
Amin Lutful Kabir ◽  
Mohammad Ferdous Ur Rahaman ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Binding Capacity ◽  
Venous Blood ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Iron Level ◽  
Nutritional Disorder ◽  
Beta Thalassaemia ◽  
Iron Deficient ◽  
Thalassaemia Trait

Background: Beta-Thalassaemia Trait (β-TT) is common in this subcontinent as well as Bangladesh. 3% of our total population is documented to have β-TT. Iron deficiency anemia (IDA), remains one of the most severe and important nutritional disorder in the world especially in Bangladesh. Microcytic hypochromic blood picture is common manifestation of both disorders. Purpose of the present study was to see whether both can co-exist.Methods: This was a cross sectional study carried out in Department of Internal Medicine, Bangabandu Sheikh Mujib Medical University (BSMMU), Dhaka from January-2014 to August-2015. Total 54 participants were selected from Haematology outpatient department (OPD), BSMMU. All of them had β-TT confirmed by Capillary Haemoglobin Electrophoresis. Proper counseling was done and informed consent was taken. Relevant history was taken and examination was done. Five ml of venous blood was collected and sent to Biochemistry department to measure serum iron, ferritin and tissue iron binding capacity (TIBC). Transferrin saturation (T.Sat) was calculated by formula (iron/TIBC) X100.Results: Total 54 patients who fulfilled the recruitment criteria were finally analyzed. Among them 85% (46) patients were females and 15% (8) were males. Median age was 30 years (range11-80 yrs). Most of the patients 78 % (42) belong to the age group between 15 to 44 years. Mean (±SD) HbA2 (%) was 5.35 (±1.39), Hb (%) 9.04± (1.39), MCV (fl)- 67.02 (±10.39), MCH (pg)- 21.06 (±3.99), RDW (%)- 17.77 (±3.85). Among them 44.4% (24) had low iron (<40μg/dl), 29.6 % (16) had low ferritin (15μgm/L), 33.3% (18) had high TIBC (>407μg/dl), and 50% (27) had low transferrin saturation (<16%). 13% (7) patients were found to be iron deficiency considering all parameters and 63% (34) patients were iron deficient in at least one parameter.Conclusions: The present study shows the frequent occurrence of iron deficiency (29.6%) in subjects with β-TT which is a potentially correctable clinical condition. Proper assessment of iron level among the β-TT should be done and those who are iron deficient, should be treated promptly which may improve their general wellbeing.J MEDICINE Jan 2018; 19 (1) : 44-48

scholarly journals Role of Serum and Urinary Hepcidin in Young Females of Reproductive Age in North India

2021 ◽  
Author(s):  
Shaveta Laller ◽  
Seema Patel ◽  
Deepa Haldar
Keyword(s):  
Iron Deficiency ◽  
Quantitative Estimation ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Reproductive Age ◽  
North India ◽  
Enzyme Linked Immunosorbent Assay ◽  
College Hospital ◽  
Female Population ◽  
Young Females

Abstract Introduction Iron deficiency is one of the most common nutritional disorders in the world affecting young females of the reproductive age group. Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of hepcidin in iron deficiency and to see its correlation with different iron indices. Methods This cross-sectional study was conducted in the Department of Biochemistry, SGT Medical College Hospital and Research Institute, Budhera, Gurugram, Haryana, India. It included 200 nonpregnant female students aged between 18 and 25 years. Estimation of hepcidin was by enzyme-linked immunosorbent assay. Quantitative estimation of serum iron, total iron-binding capacity (TIBC), and transferrin saturation was done via semi-autoanalyzer. Statistical analysis was done using SPSS v22. Results The reference range of urinary hepcidin established in this study was 110 to 969 ng/mg creatinine (mean ± standard deviation 328.3 ± 195.07 ng/mg creatinine). Serum hepcidin and urinary hepcidin had a significant correlation with iron indices. Area under the curve of urinary hepcidin was obtained with best combination of diagnostic sensitivity (82.6%) and specificity (83.1%) at a cutoff value of > 15.7 ng/mL and ≤ 199 ng/mg, respectively. Conclusion Since ferritin, TIBC, transferrin saturation, and hepcidin each represent different aspects of iron metabolism, incorporating hepcidin in the present diagnostics and combined evaluation of these indices may accord enhanced clinical information. Hepcidin would help to stratify the vulnerable young healthy female population in early stages of iron deficiency and guide proper interventions to reduce morbidity.

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 The U-shaped association of serum iron level with disease severity in adult hospitalized patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Level ◽  
Inadequate Response ◽  
Lower Serum ◽  
Serum Iron Level ◽  
Iron Binding Capacity

AbstractCoronavirus disease 2019 (COVID-19) is an emerging infectious disease that leads to severe respiratory failure (RF). It is known that host exposure to viral infection triggers an iron-lowering response to mitigate pathogenic load and tissue damage. However, the association between host iron-lowering response and COVID-19 severity is not clear. This two-center observational study of 136 adult hospitalized COVID-19 patients analyzed the association between disease severity and initial serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels. Serum iron levels were significantly lower in patients with mild RF than in the non-RF group; however, there were no significant differences in iron levels between the non-RF and severe RF groups, depicting a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron and TSAT levels were independently associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

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