scholarly journals SIGNIFICANCE OF INFLAMMATION MARKERS DETERMINED IN PREGNANT WOMEN WITH ANEMIC SYNDROME AND OBESITY

2018 ◽  
Vol 20 (5) ◽  
pp. 639-646
Author(s):  
Т. S. Prokhorenko ◽  
A. P. Zima ◽  
T. V. Saprina ◽  
N. N. Musina ◽  
N. S. Shakhmanova ◽  
...  

The purpose of the present study was to specify a role of inflammatory mediators in pathogenesis of various types of anemia in pregnant obese women. We determined IL-1, IL-6, TNFα, C-reactive protein and hepcidin concentrations in blood serum of pregnant women with obesity depending on the type of anemic syndrome, either iron-deficiency anemia, or anemia of chronic diseases. We showed that the content of IL-6 in blood of the obese women exceeds the value of this index in healthy pregnant women (p < 0.05), and it does not depend on the presence and type of anemic syndrome. We found that the C-reactive protein concentration in pregnant women with obesity is higher than reference values (p < 0.05). Moreover, the contents of C-reactive protein in blood serum of pregnant women with anemia of chronic diseases is significantly higher (p < 0.05) than in women with iron deficiency anemia. Hepcidin concentration in blood of pregnant women with obesity and anemia of chronic disease was a specific feature: its content was significantly higher than in healthy pregnant women (p < 0.05), or in pregnant women with anemia-free obesity (p < 0.05). Hepcidin levels also exceeded 2-fold its contents in serum from pregnant women with obesity and iron deficiency anemia (p < 0.05). We have found that only pregnant women with obesity and anemia of chronic diseases have shown a positive correlation between the concentrations of C-reactive protein and blood levels of hepcidin (r = 0.733, p < 0.05), or IL-6 (r = 0.679, p < 0.05).The discussion concerns potential mechanisms of evolving anemia of chronic disease combined with subclinical inflammation in pregnant women with metabolic disorders. We conclude that a combination of obesity with gestational diabetes is a risk factor of anemia of chronic diseases in pregnant women. Development of an algorithm for differential diagnosis of iron deficiency anemia and anemia of chronic diseases in this cohort of patients is advisable for future studies in the area.

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Gabriela Amstad Bencaiova ◽  
Alexander Krafft ◽  
Roland Zimmermann ◽  
Tilo Burkhardt

Objective.We assess and compare the efficacy of anemia treatment in pregnant women with anemia of chronic disease with true iron deficiency and in women with iron deficiency anemia.Study Design.Fifty patients with moderate anemia (hemoglobin 8.0–9.9 g/dl) and iron deficiency (ferritin < 15 μg/l) were treated in the Anemia Clinic at the Department of Obstetrics.Results.All patients showed stimulation of erythropoiesis as evidenced by an increase in reticulocyte count at day eight of therapy and showed an increase in hemoglobin and hematocrit at the end of therapy (p<0.001). The target hemoglobin (≥10.5 g/dl) was achieved in 45/50 women (90%). 12 patients showed anemia of chronic disease with true iron deficiency (12/50; 24%). Seven women (7/12; 59%) with anemia of chronic disease and iron deficiency responded well to anemia treatment. 50% of women with anemia of chronic disease and iron deficiency (3/6) responded well to intravenous iron, and 67% (4/6) responded well to the combination of intravenous iron and recombinant human erythropoietin.Conclusion.Because of frequent true iron deficiency in pregnant women with anemia of chronic disease, anemia of chronic disease in pregnancy is often falsely diagnosed as iron deficiency anemia.


2020 ◽  
Vol 85 (5) ◽  
pp. 420-427
Author(s):  
Raisa Aringazina ◽  
Gulmira Zharmakhanova ◽  
Gulnara Kurmanalina ◽  
Anes Bekkuzhin ◽  
Bakhtiyar Kurmanalin

<b><i>Objectives:</i></b> Different forms of anemia are considered as the most frequent complication of the gestational period. By its etiology, pathogenesis, and clinical hematology, it is not a single disease. Among all forms of anemia occurring during pregnancy, iron deficiency anemia (IDA) is the most common, accounting for 80–95% of all cases. <b><i>Design:</i></b> The article describes a theoretical basis for the diagnosis of the anemic syndrome among pregnant women, the determining factors of its development, and the diagnostic methods at different gestational periods. <b><i>Participants/Materials, Setting, and Methods:</i></b> Diagnostic and prognostic values of iron balance indicators in the body were established for IDA during pregnancy to improve the outcome of childbirth. A total of 140 anemic patients were examined. The control group consisted of 50 pregnant women without anemia and other significant health problems, 48 IDA pregnant women, and 42 pregnant women with anemia caused by various chronic diseases, including rheumatoid arthritis. All patients of the main and control groups were registered on clinical records at the Family Planning Center in Aktobe city, Kazakhstan. <b><i>Results:</i></b> Ferrokinetic indicators were suggested for diagnosing IDA and anemia of chronic diseases. It was established that IDA is characterized by low ferritin levels during gestation, while increased ferritin and C-reactive protein are typical for anemia of chronic diseases. <b><i>Limitations:</i></b> Differential diagnostics was applied for pregnant women with IDA and anemia of chronic diseases to observe the dynamics of serum ferritin and C-reactive protein (CRP) levels at different gestational periods. The article presents the results of a study on ferrokinetics in pregnant women with IDA and anemia caused by inflammation or chronic diseases. Other causes of anemia leading to a decrease in hemoglobin (Hb) levels to &#x3c;90 g/L include hemoglobinopathies, which were not considered in this study. <b><i>Conclusions:</i></b> Determination of iron deficiency in pregnant women at different gestational periods will allow for identifying the risk group of anemic patients and deciding on the treatment. IDA (Hb &#x3c;100 g/L) can be effectively measured by ferritin level &#x3c;15 ng/mL, iron level of &#x3c;11.5 μmol/L, and transferrin level &#x3e;2.6 mg/L at <i>p</i> &#x3c; 0.001. Anemia due to chronic diseases (Hb &#x3c;100 g/L) can be effectively diagnosed with ferritin above 15 μg/L and CRP above 10 mg/L at <i>p</i> &#x3c; 0.001.


2017 ◽  
Vol 7 (2) ◽  
pp. 132-137
Author(s):  
Abdul Latif ◽  
Muhammad Rafiqul Alam ◽  
Asia Khanam ◽  
Farhana Hoque ◽  
Muhammad Abdur Rahim ◽  
...  

Background: Anemia is common in patients with chronic kidney disease (CKD) and this is generally anemia of chronic disease, but iron deficiency anemia (IDA) is also common. Soluble transferrin receptor (sTfR) is a useful marker for IDA. Present study was undertaken to assess the utility of sTfR as a marker of IDA in selected group of Bangladeshi patients with CKD.Methods: This cross-sectional study was conducted in the Department of Nephrology, BSMMU, Dhaka, Bangladesh from January 2013 to December 2014. Patients with anemia admitted in nephrology department whether on hemodialysis or not and medicine department of BSMMU were taken for study. The study population was further divided into two groups; Group A, patients who are having IDA and Group B, patients with ACD and a control group was also selected. Data were collected by face to face interview and laboratory investigations with a self-administered questionnaire.Results: The mean age of the patients in two study groups were 38.40±13.23 and 34.85±10.52 years respectively and male-female ratio were 0.5:1 and 1:0.5. Mean sTfR level was higher (4.81± 1.64 ?g/ml) in patients with IDA than (2.89±1.40 ?g/ml) in patients with ACD (p <0.0001). In our study mean ferritin level was 599.59± 449.15?g/L in ACD patients whereas 101.23±119.42 in IDA patients (p<0.0001). Total iron binding capacity (TIBC) was more in ACD patients with sTfRe”3?g/ml as compared to ACD patients with sTfR<3?g/ml. Transferrin saturation (TSAT) level was significantly decreased in ACD patients with sTfR ?3?g/ml as compared to ACD patients with sTfR<3?g/ml.Conclusion: sTfR has a comparable ability to S. ferritin in diagnosing IDA and ACD. However, sTfR and serum ferritin alone cannot definitely exclude co-existing iron deficiency in ACD. As sTfR is not affected by infection and/or inflammation, thus providing a non-invasive alternative to bone marrow study.Birdem Med J 2017; 7(2): 132-137


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