scholarly journals Using iron profiles to identify anemia of chronic disease in anemic children with tuberculosis

2011 ◽  
Vol 51 (4) ◽  
pp. 217
Author(s):  
Reni Wigati ◽  
Endang Windiastuti ◽  
Badriul Hegar
Keyword(s):  
Chronic Disease ◽  
Iron Homeostasis ◽  
Binding Capacity ◽  
Community Health Center ◽  
Transferrin Saturation ◽  
Cross Sectional Study ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Cross Sectional ◽  
Organ Specific

Background Anemia of chronic disease (ACD) is commonly found in patients with chronic inflammation or infection. By examining soluble transferrin receptor or bone marrow iron, ACD was found in 80% of anemic adult tuberculosis (TB) patients. Iron profile, another tool to differentiate ACD from iron deficiency anemia (IDA), is both less expensive and less invasive. Few studies have been reported on iron profiles of anemic children with TB in Indonesia.Objective We aimed to use iron profiles to determine the proportion of ACD in anemic children with tuberculosis.Methods A cross-sectional study on anemic children with TB who came to Cipto Mangunkusumo Hospital and Tebet Puskesmas (community health center) was performed in September-November 2010. Iron profiles included the measurements of serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TF), and serum ferritin (SF).Results Our study comprised of 66 subjects, with a median age of 3.8 years (6 months–18 years). Most subjects had normal SI (85%), normal TIBC (71%), low transferrin saturation (51%), and normal SF (71%). Only 10 children had iron homeostasis disorder and 6 of these were diagnosed as having ACD. Thus, iron profiles failed to prove that iron metabolism was disturbed. The profile of children with organ-specific TB was more consistent with ACD compared to the profile of childhood TB. [SI 29.1 (11-83) vs 44 (10-151) μg/dL; TIBC 239.3 (100.80) vs 299.0 (58.51) μg/dL; TF 18.3 (4-100) vs 15 (1-53) %; and SF 154 (34.9-655) vs 36.1 (2.5-213.4) μg/L].Conclusion The proportion of ACD (9%) diagnosed by using iron profiles was not as high as previously reported. Further research using newer techniques is needed to detect ACD in anemic children with TB. [

Dysregulated monocyte iron homeostasis and erythropoietin formation in patients with anemia of chronic disease

Blood ◽  
2006 ◽  
Vol 107 (10) ◽  
pp. 4142-4148 ◽  
Author(s):  
Igor Theurl ◽  
Verena Mattle ◽  
Markus Seifert ◽  
Mariagabriella Mariani ◽  
Christian Marth ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Iron Homeostasis ◽  
Hereditary Spherocytosis ◽  
Regulatory Protein ◽  
Significant Negative Correlation ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Iron Storage ◽  
Iron Retention ◽  
Reduced Activity

Anemia of chronic disease (ACD) is frequently found in patients with chronic immune activation. Since most studies on ACD pathophysiology were performed with cell culture or animal models but not in humans, we examined 37 ACD patients suffering from autoimmune diseases or infections, 10 subjects with iron-deficiency anemia (IDA), 10 anemic patients with hereditary spherocytosis (HS), and 27 age-matched controls. Although hemoglobin concentrations were comparable between ACD and IDA patients, the latter presented with significantly higher serum erythropoietin concentrations than ACD patients. The significant negative correlation between erythropoietin and hemoglobin levels observed in IDA patients was also found in a group of anemic but not hypoferremic hereditary spherocytosis subjects, but not in ACD patients. Increased serum concentrations of the hepcidin precursor prohepcidin were paralleled by a decreased expression of the iron exporter ferroportin in circulating monocytes of ACD patients. In the latter cells, increased amounts of the iron storage protein ferritin and a reduced activity of iron-regulatory protein indicated monocyte iron accumulation. Our data indicate that hypoferremia in ACD may result from downregulation of ferroportin expression by hepcidin and cytokines with subsequent iron retention in monocytes. Together with a diminished erythropoietin formation, the impaired iron recirculation from monocytes may be central in the pathophysiology of ACD in humans.

scholarly journals Transferrin saturation concentrations associated with telomeric ageing: a population-based study

2017 ◽  
Vol 117 (12) ◽  
pp. 1693-1701 ◽  
Author(s):  
Chol Shin ◽  
Inkyung Baik
Keyword(s):  
Binding Capacity ◽  
Linear Regression Analysis ◽  
Transferrin Saturation ◽  
High Sensitivity ◽  
Multiple Linear Regression Analysis ◽  
Population Based ◽  
Cross Sectional Study ◽  
The Body ◽  
Coefficient Estimate ◽  
Cross Sectional

AbstractThere are limited data on the association between Fe overload and leucocyte telomere length (LTL), known as a useful biomarker of the replicative ageing of cells. The aim of the study was to evaluate associations between Fe-status biomarkers and LTL. A cross-sectional study included 1174 men and women aged 50–79 years who provided blood samples for assays of Fe-status biomarkers including ferritin, transferrin saturation (TSAT), total Fe-binding capacity (TIBC) and relative LTL. They were free of hepatitis, potential infection or Fe deficiency. In multiple linear regression analysis adjusted for potential confounding variables, log-transformed LTL was positively associated with TIBC (adjusted coefficient estimate for its highest quartile: 0·17 (se 0·03), P<0·001) and inversely associated with TSAT (adjusted coefficient estimate for its third and fourth quartiles: −0·09 (se 0·03), P<0·01). These associations were consistent after additional adjustment for serum concentrations of high-sensitivity C-reactive protein, alanine transaminase and aspartate transaminase. In particular, participants with not only abnormally high concentrations (>45 %) but also with high-normal concentrations (35–45 %) of TSAT had shorter LTL compared with those with low-normal concentrations (<30 %) (P<0·05). We also observed that less-active or obese persons with high TSAT concentrations had shorter LTL than others. Our findings that cellular ageing is influenced not only by Fe overload but also by high-normal concentrations of TSAT support the hypothesis regarding the detrimental effects of labile Fe, which has a potent pro-oxidant activity in the body.

scholarly journals Prevalence of Iron Deficiency Anemia among University Students in Hodeida Province, Yemen

Anemia ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Abdullah Ahmed Al-alimi ◽  
Salem Bashanfer ◽  
Mohammed Abdo Morish
Keyword(s):  
Iron Deficiency ◽  
University Students ◽  
Iron Deficiency Anemia ◽  
Binding Capacity ◽  
Harmful Effect ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Deficiency Anemia ◽  
Major Public Health Problem ◽  
Cross Sectional

Background. Iron deficiency anemia (IDA) is one of the most common types of nutritional anemia in the worldwide and considered a major public health problem in developing countries especially in Yemen. Therefore, this cross-sectional study was conducted to determine the prevalence and risk factors of IDA among apparently healthy Yemeni students at Hodeida University. Method. Five hundred blood samples (326 males and 174 females) were collected randomly from medical students at Hodeida University. Participants were subjected to different tests including complete blood counts (CBC), serum ferritin (SF), serum iron (SI), and total iron binding capacity (TIBC). Moreover, a questionnaire was designed to collect demographics, food and drink habits, and socioeconomic status. Result. The overall prevalence of IDA was 30.4%  (n=152), of whom 54.00% were females (n=82) and 46.0% were males (n=70). Students aged 20–22 years were found more anemic with prevalence 59.2% than students aged 17–19 years (25.0%) and 23–25 years (15.8%). Statistical analysis showed regularly having breakfast had significant (p < 0.001) role in preventing development of IDA compared with irregularly having breakfast. Infrequent consumption of vegetables/fruits; meat, fish, chicken; tea drinking; low household income; smoking and khat (Catha edulis) chewing showed a significant role (p < 0.001) in provoking of IDA, whereas consumption of coffee and cola showed insignificant influence (p=0.585; p=0.513) on IDA. Conclusion. This study revealed that the majority of university students, especially females, have IDA that might become worse by malnutrition, lifestyle habits, and lack of awareness. Our results suggest that IDA can be prevented by providing proper knowledge on the healthful diet, improved lifestyle, and harmful effect of IDA to the students.

scholarly journals Zinc Protoporphyrin Is a Reliable Marker of Functional Iron Deficiency in Patients with Inflammatory Bowel Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 366
Author(s):  
Eleni Leventi ◽  
Aysegül Aksan ◽  
Carl Thomas Nebe ◽  
Jürgen Stein ◽  
Karima Farrag
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Chronic Inflammation ◽  
Bowel Disease ◽  
Iron Homeostasis ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Zinc Protoporphyrin ◽  
Anemia Of Chronic Disease ◽  
Inflammatory Bowel

Iron deficiency (ID) is a common manifestation of inflammatory bowel disease (IBD), arising primarily due to chronic inflammation and/or blood loss. There is no gold standard for ID diagnosis, which is often complicated by concomitant inflammation. Zinc protoporphyrin (ZnPP) correlates with parameters of iron homeostasis and has been identified as a promising marker for ID, irrespective of inflammation. We investigated the diagnostic performance of ZnPP in ID, iron deficiency anemia, anemia of chronic disease and mixed anemia in a cross-sectional study in 130 patients with IBD. Different parameters were compared by receiver operator characteristic (ROC) analysis as detectors of iron-restricted erythropoiesis (IRE). IRE was detected in 91 patients (70.0%); fifty-nine (64.8%) had absolute ID and 23 (25.4%) functional ID. When inflammation was present, ZnPP was a more reliable sole biomarker of IRE than MCV, transferrin saturation (TSAT) or ferritin (AUC; 0.855 vs. 0.763, 0.834% and 0.772, respectively). The specificity of TSAT was significantly lower than ZnPP when inflammation was present (38% vs. 71%, respectively). We conclude that ZnPP is a reliable biomarker of functional ID in patients with IBD and more dependable than ferritin or TSAT, which are influenced by chronic inflammation. We propose that ZnPP may also have utility in patients with other chronic diseases.

Regulation of iron homeostasis in anemia of chronic disease and iron deficiency anemia: diagnostic and therapeutic implications

Blood ◽  
2009 ◽  
Vol 113 (21) ◽  
pp. 5277-5286 ◽  
Author(s):  
Igor Theurl ◽  
Elmar Aigner ◽  
Milan Theurl ◽  
Manfred Nairz ◽  
Markus Seifert ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Homeostasis ◽  
Chronic Arthritis ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Regulatory Pathways ◽  
Therapeutic Implications ◽  
Iron Retention

Abstract The anemia of chronic disease (ACD) is characterized by macrophage iron retention induced by cytokines and the master regulator hepcidin. Hepcidin controls cellular iron efflux on binding to the iron export protein ferroportin. Many patients, however, present with both ACD and iron deficiency anemia (ACD/IDA), the latter resulting from chronic blood loss. We used a rat model of ACD resulting from chronic arthritis and mimicked ACD/IDA by additional phlebotomy to define differing iron-regulatory pathways. Iron retention during inflammation occurs in macrophages and the spleen, but not in the liver. In rats and humans with ACD, serum hepcidin concentrations are elevated, which is paralleled by reduced duodenal and macrophage expression of ferroportin. Individuals with ACD/IDA have significantly lower hepcidin levels than ACD subjects, and ACD/IDA persons, in contrast to ACD subjects, were able to absorb dietary iron from the gut and to mobilize iron from macrophages. Circulating hepcidin levels affect iron traffic in ACD and ACD/IDA and are more responsive to the erythropoietic demands for iron than to inflammation. Hepcidin determination may aid to differentiate between ACD and ACD/IDA and in selecting appropriate therapy for these patients.

The association between iron and vitamin D status in Arab adolescents

2019 ◽  
Vol 23 (7) ◽  
pp. 1208-1213 ◽  
Author(s):  
Mohammad S Masoud ◽  
Sobhy M Yakout ◽  
Omar S Al-Attas ◽  
Majed S Alokail ◽  
Nasser M Al-Daghri
Keyword(s):  
Vitamin D ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Vitamin D Metabolites ◽  
Micronutrient Deficiencies ◽  
Vitamin D Status ◽  
Cross Sectional ◽  
School Project

AbstractObjective:Both vitamin D and Fe micronutrient deficiencies are common in Saudi Arabia but the association between them is unclear. The present study aimed to determine whether Fe indices are associated with vitamin D status and other metabolic markers in Arab adolescents.Design:Single-centre, cross-sectional study gathering anthropometrics, glucose and lipid profile. Serum 25-hydroxyvitamin D (25(OH)D), Fe, total iron-binding capacity (TIBC), transferrin saturation (%) and other parameters were measured.Setting:Vitamin D School Project Database, King Saud University (2014–2016).Participants:Arab adolescents aged 10–17 years randomly selected from the Vitamin D School Project Database (170 Saudi students; 100 girls, seventy boys).Results:Among Fe indices, only TIBC was found to be significantly and inversely associated with 25(OH)D (r = −0·20; P < 0·01) and only in girls (r = −0·20; P < 0·05). Among cardiometabolic parameters, serum Fe was associated with TAG in boys (r = 0·36; P < 0·01) and inversely associated with HDL-cholesterol in girls (r = −0·29; P < 0·05). Age was the most significant predictor of serum Fe for all participants, accounting for 5 % (R2 = 0·05; P = 0·004) of variance perceived. Serum 25(OH)D and age, on the other hand, were the most significant predictors for TIBC, accounting for 10·1 % (R2 = 0·10; P < 0·001) of variance perceived.Conclusions:Among healthy Arab adolescents, the association between vitamin D and Fe indices, particularly TIBC, is modest, inverse and sex-dependent. Larger studies with inclusion of markers such as hepcidin and ferritin, vitamin D metabolites and endogenous sex hormones may provide a clearer view of this complex association.

scholarly journals Iron Deficiency and Erythropoiesis: New Diagnostic Approaches

2003 ◽  
Vol 49 (10) ◽  
pp. 1573-1578 ◽  
Author(s):  
Carlo Brugnara
Keyword(s):  
Chronic Disease ◽  
Iron Deficiency ◽  
Transferrin Saturation ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Body Iron ◽  
Iron Stores ◽  
Human Erythropoietin ◽  
Iron Deficient

Abstract Iron deficiency anemia is one of the most common diseases worldwide. In the majority of cases, the presence of hypochromic microcytic anemia and biochemical evidence for depletion of body iron stores makes the diagnosis relatively straightforward. However, in several clinical conditions, classic biochemical indices such as serum iron, transferrin saturation, and ferritin may not be informative or may not change rapidly enough to reflect transient iron-deficient states (functional iron deficiency), such as the ones that develop during recombinant human erythropoietin (r-HuEPO) therapy. The identification and treatment of iron deficiency in settings such as r-HuEPO therapy, anemia of chronic disease, and iron deficiency of early childhood may be improved by the use of red cell and reticulocyte cellular indices, which reflect in almost real time the development of iron deficiency and the response to iron therapy. In the anemia of chronic disease, measurements of plasma cytokines and iron metabolism regulators such as hepcidin (when available) may be helpful in the characterization of the pathophysiologic basis of this condition. The ratio of serum transferrin receptor (sTfR) to serum ferritin (R/F ratio) has been shown to have excellent performance in estimating body iron stores, but it cannot be used widely because of the lack of standardization for sTfR assays. The combination of hematologic markers such as reticulocyte hemoglobin content, which decreases with iron deficiency, and R/F ratio may allow for a more precise classification of anemias.

scholarly journals Iron Status in Preschool Children with Normal Hemoglobin, Egypt

2021 ◽  
Vol 9 (B) ◽  
pp. 1342-1346
Author(s):  
Osama El-Asheer ◽  
Mary S. Naeem ◽  
Fardos H. Abd El Aal ◽  
Madleen A. A. Abdou ◽  
Khalil Abdel Khalek Mohamed
Keyword(s):  
Preschool Children ◽  
Serum Ferritin ◽  
Complete Blood Count ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Cross Sectional Study ◽  
Healthy Children ◽  
Sectional Study ◽  
Cross Sectional

BACKGROUND: Iron deficiency (ID) anemia remains a common cause of anemia in young children. However, the more significant than anemia itself is the ID without anemia that also adversely affect neurocognitive development and unfortunately some of these effects may be irreversible. AIM: This study is a cross-sectional study aimed to asses iron status in preschool children with normal hemoglobin (Hgb) level attending Assiut University Children Hospital. METHODS: The cross-sectional study including 68 apparently healthy children aged 1–6 years old during the period from January 1, 2015 to June 30, 2015, They were subjected to detailed history, physical examination, and the following laboratory investigations: Complete blood count, Serum iron, Total Iron Binding Capacity, Serum ferritin, and Transferrin saturation. RESULTS: Low serum ferritin and low transferrin saturation were detected in 41.2% and 47% respectively of our studied children who have normal Hgb levels. CONCLUSION: Normal Hgb doesn’t exclude ID that should be screened in healthy children to prevent the possible long-term effects of ID on their cognation and mental development.

scholarly journals The presence of anemia in patients with leg ulcer: laboratory test

2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Beatriz Guitton Renaud Baptista de Oliveira ◽  
Joyce Beatriz de Abreu Castro ◽  
Emilly Freire Novaes Silva Lisboa ◽  
Hye Chung Kang ◽  
Márcia de Assunção Ferreira
Keyword(s):  
Lower Limb ◽  
Hemoglobin Concentration ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Cross Sectional ◽  
Venous Ulcers ◽  
Wound Assessment ◽  
Chronic Lower Limb Ulcers

ABSTRACT Objective: To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. Method: This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. Results: 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. Conclusion: The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.

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