TMT Quantitative Proteomics Analysis Reveals the Effects of Transport Stress on Iron Metabolism in the Liver of Chicken

Abnormal iron metabolism can cause oxidative stress in broilers, and transport stress (TS) may potentially influence iron metabolism. However, the mechanisms by which TS affects iron metabolism are unclear. This study used quantitative proteome analysis based on tandem mass tag (TMT) to investigate the effects of TS on liver iron metabolism in broilers. Broilers (n = 24) reared under the same conditions were selected randomly into the transported group for 4 h (T2) and non-transported group (T1). Results showed that the serum iron level and total iron-binding capacity of broilers in the T2 were significantly higher than those in the T1 (p < 0.05). The liver iron content of broilers in the T2 (0.498 ± 0.058 mg·gprot−1) was significantly higher than that in the T1 (0.357 ± 0.035 mg·gprot−1), and the iron-stained sections showed that TS caused the enrichment of iron in the liver. We identified 1139 differentially expressed proteins (DEPs). Twelve DEPs associated with iron metabolism were identified, of which eight were up-regulated, and four were down-regulated in T2 compared with T1. Prediction of the protein interaction network for DEPs showed that FTH1, IREB2, and HEPH play vital roles in this network. The results provide new insights into the effects of TS on broilers’ liver iron metabolism.

Haemoglobin, Serum Iron Level and Cardiovascular Status in Advanced Stages of Chronic Kidney Disease Patients admitted in A Tertiary Care Centre

Background: Anaemia due to advanced stages of chronic kidney disease increases morbidity of patients. Early detection and correction of anaemia may be helpful in preventing the progress of the disease & its cardiovascular outcomes. The objective of this study was to evaluate hemoglobin, serum iron level and cardiovascular status in advanced of CKD patients. Methods: This was a cross sectional observational study on 150 cases of diagnosed advanced stages (3B,4 &5) of CKD patients in indoor of department of medicine of Mitford Hospital, Dhaka from July 2019 to January 2020. Convenience sampling was done. Data were analyzed with SPSS 26. Results: Total number of patients were 150. Male were 93 (62%) and female were 57 (38%). The mean (±SD) age was 55.22 (±10.30) years (range 33 - 75 years). Among the study subjects 38% had history of blood transfusion, 60% had history of iron supplementation and 12% subjects received erythropoietin. Mean (±SD) haemoglobin level was 7.61 (±2.54) g/dl. Seventy percent of the study subjects had haemoglobin level < 9 g/dl and rest had ³9 g/dl. Significant difference was found in between these two groups (p = 0.036). In the present study, mean (±SD) serum iron level was 15.59 (±07.39) μmol/l. In 46% of the study subjects, iron level was 7.3μ mol/l and 52% had iron level between 7.3 to 23.6 μmole/ lit. Mean (± SD) ferritin level of the study subjects was 155.22 (±92.32) ng/ ml. In 58% of the study subjects ferritin level was < 100ng/ ml and 42% had >100 ng/ml. Significant difference was found in between these two groups (p = 0.041) (Table-IV). Ferritin level had significant positive relationship with blood transfusion, iron and erythropoietin supplementation on logistic regression analysis. Haemoglobin and serum ferritin level was positively correlated with eGFR of the study subjects. Statistical analysis showed significant relationship between eGFR with haemoglobin and serum ferritin. Forty six percent of the study subjects had Transferrin saturation (TSAT) level below 20%. Fifty four percent subjects had a TSAT level above 20%. Significant difference was found in between these two groups (p = 0.001). In correlation analysis, haemoglobin, serum ferritin and TSAT level in the study subjects had negative relationship with duration of CKD in years. Relationship of haemoglobin and TSAT level with duration of CKD was statistically significant. In correlation analysis, serum TIBC level had negative relationship with haemoglobin level which was statistically significant. Serum iron, ferritin and TSAT level in the study subjects were positively correlated with haemoglobin level. Relationship of haemoglobin with serum iron level and TSAT level was statistically significant. Twenty percent of the study subjects had peripheral vascular disease, 111 (74%) of the study subjects had hypertension, 66 (44%) had ischaemic heart disease, 27 (18%) had a history of acute myocardial infarction, 24 (16%) had chronic heart failure, 93 (62%) had dyslipidemia and 27 (18%) patients had history of stroke. Conclusion: In this study it was observed that TSAT appears to be a more useful indicator for measuring the frequency of iron deficiency than serum iron, TIBC and serum ferritin. The cardiovascular comorbidities plagued significant number of patients with advanced CKD. Bangladesh J Medicine July 2022; 33(1) : 34-39

A low serum iron level is a potential predictor of poor renal function in patients following laparoscopic sleeve gastrectomy: a retrospective study

This study aimed to assess the association of serum iron level (Iron) with the estimated glomerular filtration rate (eGFR) after bariatric surgery (BS). We reviewed 210 patients with mean age of 39.1 ± 10.6 years (body mass index, 41.4 ± 5.5 kg/m2) undergoing BS. The primary outcome was the relationship between Iron and eGFR at 12-month after surgery. Multiple linear regression analyses were performed using postoperative eGFR as dependent variables and using Iron and other variables (i.e., age) as independent variables. At 12-month follow-up, 94 patients were analyzed. BMI significantly decreased, whereas serum iron level significantly increased. Although the percentage of patients with eGFR of < 90 mL/min/1.73 m2 increased during the study period, no significant difference was found in postoperative 12-month eGFR. No correlations were noted between Iron and eGFR at baseline and postoperative 1 and 6 months, whereas a significant relationship was observed between Iron and postoperative 12-month eGFR. Multiple linear regression analyses revealed that Iron and presence of diabetes were the independent predictors of postoperative 12-month eGFR. This pilot study showed a positive association of postoperative serum iron level with renal function in this patient population. Further large-scale trials are needed to confirm the findings.

A Novel Prognostic Model Based on the Serum Iron Level for Patients With Early-Stage Triple-Negative Breast Cancer

The dysregulation of iron homeostasis has been explored in malignancies. However, studies focusing on the association between the serum iron level and prognosis of patients with early-stage triple-negative breast cancer (TNBC) are scarce. Accordingly, in current study, 272 patients with early-stage TNBC treated at Sun Yat-sen University Cancer Center (SYSUCC) between September 2005 and October 2016 were included as a training cohort, another 86 patients from a previous randomized trial, SYSUCC-001, were analyzed as a validation cohort (SYSUCC-001 cohort). We retrospectively collected their clinicopathological data and tested the serum iron level using blood samples at the diagnosis. In the training cohort, patients were divided into low-iron and high-iron groups according to the serum iron level cut-off of 17.84 μmol/L determined by maximally selected rank statistics. After a median follow-up of 87.10 months, patients with a low iron had a significantly longer median disease-free survival (DFS) of 89.13 [interquartile range (IQR): 66.88–117.38] months and median overall survival (OS) of 92.85 (IQR: 68.83–117.38) months than those in the high-iron group (median DFS: 75.25, IQR: 39.76–105.70 months, P = 0.015; median OS: 77.17, IQR: 59.38–110.28 months, P = 0.015). Univariate and multivariate Cox analysis demonstrated the serum iron level to be an independent predictor for DFS and OS. Then, a prognostic nomogram incorporating the serum iron level, T stage and N stage was developed for individualized prognosis predictions. It had good discriminative ability with a C-index of DFS (0.729; 95% CI 0.666–0.792) and OS (0.739; 95% CI 0.666–0.812), respectively. Furtherly, we validated the predictive model in the SYSUCC-001 cohort, which also showed excellent predictive performance with a C-index of DFS (0.735; 95% CI 0.614–0.855) and OS (0.722; 95% CI 0.577–0.867), respectively. All these suggested that the serum iron level might be a potential prognostic biomarker for patients with early-stage TNBC, the predictive model based on it might be served as a practical tool for individualized survival predictions.

Neutrophils and Lymphocytes Can Help Distinguish Asymptomatic COVID-19 From Moderate COVID-19

IntroductionAsymptomatic coronavirus disease 2019 (COVID-19) and moderate COVID-19 may be the most common COVID-19 cases. This study was designed to develop a diagnostic model for patients with asymptomatic and moderate COVID-19 based on demographic, clinical, and laboratory variables.MethodsThis retrospective study divided the subjects into 2 groups: asymptomatic COVID-19 (without symptoms, n = 15) and moderate COVID-19 (with symptoms, n = 57). Demographic characteristics, clinical data, routine blood tests, other laboratory tests, and inpatient data were collected and analyzed to compare patients with asymptomatic COVID-19 and moderate COVID-19.ResultsComparison of the asymptomatic COVID-19 group with the moderate COVID-19 group yielded the following results: the patients were younger (P = 0.045); the cluster of differentiation (CD)8+ (cytotoxic) T cell level was higher (P = 0.017); the C-reactive protein (CRP) level was lower (P = 0.001); the white blood cell (WBC, P &lt; 0.001), neutrophil (NEU, P = 0.036), lymphocyte (LYM, P = 0.009), and eosinophil (EOS, P = 0.036) counts were higher; and the serum iron level (P = 0.049) was higher in the asymptomatic COVID-19 group. The multivariate analysis showed that the NEU count (odds ratio [OR] = 2.007, 95% confidence interval (CI): 1.162 - 3.715, P = 0.014) and LYM count (OR = 9.380, 95% CI: 2.382 - 36.934, P = 0.001) were independent factors for the presence of clinical symptoms after COVID-19 infection. The NEU count and LYM count were diagnostic predictors of asymptomatic COVID-19. This diagnostic prediction model showed high discriminatory power, consistency, and net clinical benefits.ConclusionsThe proposed model can distinguish asymptomatic COVID-19 from moderate COVID-19, thereby helping clinicians identify and distinguish patients with potential asymptomatic COVID-19 from those with moderate COVID-19.

EP.WE.548The prevalence iron deficiency anaemia in patients with oesophago-gastric cancer

Aims Blood loss from the gastrointestinal tract is the most common cause of iron deficiency anaemia (IDA) in adult men and post-menopausal women. Up to 10% of patients with IDA have underlying gastrointestinal cancer. The aim of this study was to investigate prevalence of IDA in patients with oesophago-gastric cancer. Methods A retrospective cohort study of all newly diagnosed oesophago-gastric cancers (adenocarcinoma and squamous cell carcinoma) and high grade dysplasia discussed at tertiary multi-disciplinary team meeting between October 2019 and September 2020. Electronic case notes and blood profile at presentation, including ferritin and serum iron level, were analysed. Patients who did not have blood profile within three months of presentation were excluded. Results A total of 349 patients were identified, 12 were excluded due to missing data. 226 (67.1%) were male and the mean age was 69.7 ± 11.7 years. 260 (77.2%) were referred from primary care. After initial investigations, 256 (76.0%) were oesophageal cancer, 248 (73.6%) were adenocarcinoma, and 134 (39.8%) were metastatic at presentation. 128 (38.0%) patients were anaemic: 30 (23.4%) microcytic, 88 (68.8%) normocytic and 10 (7.8%) macrocytic. 98 (76.6%) anaemic patients had ferritin and/or iron levels checked. Analysis of these identified 63 (49.2%) patients with bloods consistent with IDA: 22 (34.9%) microcytic, 40 (63.5%) normocytic, and 1 (1.6%) macrocytic. Conclusions This study confirms that while there is high prevalence of anaemia in patients presenting with oesophagi-gastric cancer, IDA was diagnosed in only half of these. The predominant form of anaemia identified in these patients is normocytic.

Determination of Level of Serum Iron among Routine Iron Supplemented Pregnant Women Attending Private Clinic in Sulaimani City, Kurdistan-Iraq

Iron deficiency, with or without anemia, is common in pregnant women and more than half of the anemia’s in the world are due to the deficiency of iron in the serum. The aims of this study were to determine the percentage and level of serum iron among iron supplemented pregnant women in different trimesters and in different age groups among supplemented pregnant women in Sulaimani city. This study was carried out in the private clinic in the Sulaimani city-Kurdistan Region of Iraq. The pregnant women were participated and enrolled between the first of December 2018 and first of December 2019. Two hundred and seventy-five healthy and iron supplemented pregnant women were selected randomly and the questionnaire form, which contains information about age of mothers and their gestational age, was filled and serum iron level was measured by COBAS C111 analyzer. The results of this study found that the percentage of iron deficiency among participants was high 33%, 45%, and 52.6 % in the first trimester in different age groups <25, 25–35, and above 35 years old, respectively. However, in the third trimesters decreased to 12.5%, 7.1%, and 3.7% in <25, 25–35, and above 35 years old, respectively. Regarding serum iron levels, the present study found that there were significant differences between ages 25 and 35 with age <25 years. However, there was no significant difference between first, second, and third trimesters. This study concludes that the percentage of iron deficiency among supplemented pregnant women was high compared to other cities or other countries. Pregnant women who their ages <25 are at risk of serum iron deficiency. On the other hand, pregnancy trimesters had no effects on the serum iron level among supplemented pregnant women.

Role of vitamin D, serum zinc, and serum iron deficiency in community-acquired pneumonia in children

Background Community-acquired pneumonia is a major cause of death among children. Inadequate nutrition disrupts the immune system and increases the susceptibility to infections. We aimed to evaluate the association between vitamin D, serum zinc, and iron, and pneumonia. A case-control study was conducted at the outpatient clinic and emergency room of Children’s Hospital. Thirty-one patients with community-acquired pneumonia and 36 healthy children (control group) underwent serum sampling for vitamin D, zinc, and iron. Results Most patients had mild form (n = 17, 54.8%). All patients survived and were discharged. The serum iron level showed a non-significant difference between pneumonia and control groups (p ˃ 0.05). TIBC, vitamin D, and serum zinc were significantly lower in the patient group than the control group (P value = 0.04, < 0.001, and 0.03, respectively). Vitamin D deficiency was highly associated with the severity of pneumonia (P value = 0.008). Conclusion Adequate serum zinc and vitamin D levels may be protective against infection with community-acquired pneumonia in children aged from 2 months to 5 years old, but not iron.

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

Coronavirus 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.