Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).

Features of acute decompensation of heart failure in patients with type 2 diabetes mellitus with anemia and latent iron deficiency

Objective: to assess the contribution of anemia and latent iron deficiency (LID) to the formation of acute decompensation of chronic heart failure (ADHF) in patients with diabetes mellitus (DM) type 2 in history.Materials and methods: a one‑time screening clinical non‑randomized study was conducted. 98 patients with ADHF were examined according to the criteria for inclusion and non‑inclusion, among which 47 (48%) patients suffered from type 2 DM. Among patients with impaired carbohydrate metabolism, 14 (29.8%) patients had an anemic syndrome verified.Results: the prevalence of anemia among hospitalized patients with ADHF against the background of type 2 DM was 29.8%, LID without anemia – 51.5%. Anemic syndrome in patients with ADHF and type 2 DM was represented by iron deficiency anemia in 85.7% and anemia of chronic conditions in 14.3% of cases. In 2/3 of the patients, anemia corresponded to moderate severity. The relative risk (RR) of the development of ADHF against the background of type 2 DM and anemia increases by 2.4 times, in the presence of LID – by 2.9 times. The presence of coronary artery disease, myocardial infarction in history, atrial fibrillation with a heart rate of more than 110 beats per minute, renal dysfunction, high activity of nonspecific inflammation were risk factors for the formation of ADHF in patients with type 2 DM and anemia. The presence of left ventricular hypertrophy in patients with anemia increased the RR of the development of ADHF by 1.8 times, the presence of chronic kidney disease – by 1.7 times, with an increase in the excretion of albumin/protein in the urine >30 mg/g – by 5.7 times, with tubular dysfunction – by 2.4 times, with an increase in aortic stiffness – by 3.5 times.Conclusion: the prevalence of anemia and LID among patients with ADHF and type 2 DM is high. These conditions were risk factors for the development of ADHF and its progression. ADHF in patients with type 2 DM against the background of anemia and LID was characterized by a more severe course, a more pronounced lesion of the target organs.

Iron deficiency anemia in the practice of a gastroenterologist (according to AGA recommendations)

Iron deficiency anemia (IDA) is the most common type of anemic disorder, accounting for 41.5% of cases. According to the WHO, the clear lack of iron is fixed at 30% of the world’s population, but 2 times more likely to observe a latent iron deficiency. The article discusses the diagnosis of iron deficiency anemia in the practice of a gastroenterologist. A list of diseases of the gastrointestinal tract and algorithms for detecting iron deficiency anemia in them are presented.

INFLUENCE OF NITRIC OXIDE, HYDROGEN SULFIDE, MARKERS OF ANTIOXIDANT HOMEOSTASIS AND BONE METABOLISM OF ORAL FLUID ON THE DENTAL HEALTH OF CHILDREN WITH MILD IODINE DEFICIENCY, LATENT IRON DEFICIENCY AND ASSOCIATED MICROELEMENTOSIS

The article analyzes the metabolism of nitric oxide (NO), hydrogen sulfide (H2S), markers of antioxidant protection, bone metabolism of oral fluid and features of dental status in children with mild iodine deficiency (МІD), latent iron deficiency and combined (LID); a combination of trace elements was examined. As a result of the study (age group from 6 to 11 years) under the conditions of МІD in boys there was an increase in the level of NO2, NO2- + NO3-, and in girls - peroxynitrite in the oral fluid. In schoolchildren with LІD changes in the studied parameters were less pronounced (in the oral fluid increased NO2 concentration regardless of gender and increased peroxynitrite content only in girls). Under conditions of combined micronutrient imbalance in the oral fluid levels of NO2 increased, the amount of NO2- and NO3-, peroxynitrite, regardless of gender, and girls, in addition, levels of arginase decreased. Such changes were observed against the background of weakening of antioxidant protection of oral fluid. In particular, acid phosphatase (АсР) was activated under the conditions of LD in boys against the background of alkaline phosphatase (АР) inhibition and reduction of total calcium levels in oral fluid. The same tendency was observed in girls of this group, in addition, they found inhibition of superoxide dismutase (SOD) activity of oral fluid. Under the conditions of LІD, regardless of gender, KF activation was observed against the background of АсР suppression (in boys), decrease in SOD activity (in girls). The most pronounced changes were observed in the oral fluid of children with combined iodine and iron deficiency: increased activity of АР regardless of gender, glutathione peroxidase (GP), LF in girls, inhibition of АсР activity in boys, decreased total calcium regardless of gender. The level of ionized calcium in the oral fluid increased only in girls. In children aged 12 to 18 years under the conditions of МІD, an increase in the concentration of peroxynitrite in the oral fluid regardless of gender and a decrease in arginase levels were found only in girls. In the oral fluid of boys with LІD found a decrease in L-arginine, in girls - and an increase in L-arginine, NO2 concentration on the background of a decrease in arginase and peroxynitrite. In high school students with combined microelements, regardless of gender, the content of peroxynitrite in the oral fluid and a decrease in the level of L-arginine in boys and an increase in arginase in girls. In this group, a significant increase in the concentration of H2S in schoolgirls, which can perform a protective function in oxidative stress or impaired blood supply, attracts attention. The results of the level of total, ionized calcium and phosphatase activity indicate an increase in the resorptive process in periodontal tissues in all experimental groups. During the dental examination, a high level of caries prevalence, a decrease in the level of hygiene, and a higher PMA index were found in older schoolchildren with a combination of microelements. The poorer level of dental health among boys concerning girls attracts attention, which can be explained by the better level of care and daily rehabilitation of the oral cavity in girls. Thus, under the conditions of preclinical microelements the indicators of NO metabolism change, the antioxidant reserve of oral fluid decreases, and markers of bone metabolism are disturbed. Such biochemical changes in the composition of oral fluid are compared with indicators of dental status.

Incidence of iron deficiency and its pathogenesis in patients with H. pylori infection

606 patients (405 men and 201 women) with HP infection were examined, 121 (m 67; f 54) found clinical or clinical and laboratory signs of iron deficiency, the frequency of iron deficiency in the examined group of patients with HP was 19.9% (16.8-23.3; CI 95%). 25 (20.7%) were diagnosed with anaemia, 66 (54.5%) patients had a latent deficit of iron, 30 patients (24.8%) showed only a decrease in TS, which is typical for pre-latent iron deficiency. 38 (31.4%) patients had a «true» iron deficiency, 44 (36.4%) patients had a combined variant of iron deficiency, and 39 (32.2%) iron deficiency developed as a result of chronic inflammation. There was a significant difference in the level of hepcidin in patients with different options for iron deficiency. In patients with “isolated” iron deficiency, it was 12.4 ± 2.3 ng/ml, vs 48.2-± 20.2 ng/ml vs 189.7 ± 31.1 ng / ml in patients with a combined pathogenic variant of iron deficiency and in patients with iron deficiency of chronic inflammation, respectively.

Latent iron deficiency and iron deficiency anemia in pregnancy: effects on maternal and fetal health, possible ways to solve the problem

Iron deficiency with or without anemia in pregnant women is quite common today. In fact, anemia affects nearly 30% of women of reproductive age, and its prevalence among pregnant women is estimated to be 38% worldwide. Although iron deficiency (IR) is not the only cause of anemia, it is the most prevalent one. Anemia-reduction strategies among pregnant women are often ineffective, and severe anemia can greatly increase the risk of maternal mortality, as reported by WHO. Now therefore, the current guidelines for screening and treatment of ID-anemia (IDA) in pregnant women and new-borns require change. Severe anemia can greatly increase the risk of maternal death and adversely affect a developing fetus and new-born. In this review, we analyse the available data on the epidemiology and the effects of iron deficiency on mothers and infants, current treatment strategies and screening recommendations, as well as examine the treatment of IDA in pregnant women and newborns and the problem of poor compliance in patients with latent iron deficiency. A continuous long-term course of administration of oral iron supplements is one of the components of success in the treatment of IDA, and particularly latent forms of iron deficiency in pregnant women. It is often the case that poor patients’ compliance with therapy leads to poor treatment outcomes and misleading conclusions about the ineffectiveness of oral iron dosage forms in the battle against IDA. The data we have analysed suggest the possibility of increasing compliance with IDA treatment in pregnant women.

ANEMIA AND LATENT IRON DEFICIENCY IN FREQUENT PLASMA DONORS

A lot of works have been devoted to the development of iron deficiency in blood donors. However, this issue has not been sufficiently disclosed in plasma donors. The aim of this paper was to study the development of latent iron deficiency and iron deficiency anemia in active plasma donors. Materials and Methods. The authors carried out a prospective study on the basis of the Ulyanovsk Regional Blood Transfusion Station from 2016 to 2019. The study included 259 plasma donors, who were divided into 2 groups: frequent plasma donors (n=127), and rare plasma donors (n=132). Before donating plasma, blood was collected from all donors for complete blood count and serum iron test. The results of the test were considered as baseline parameters. Similar bloodwork results obtained one year from the starting point served as the final results of the trial. Statistica v. 8.0 (StatSoft Inc., USA) was used for statistical analysis. Results. There were no significant differences in total blood counts between the groups one year after the first donation. Anemia was found in 10 frequent donors (7.9 %), and in 5 rare donors (3.8 %) (χ2=1.981, p=0.159). Latent iron deficiency was found in 22 frequent donors (17.3 %) and 15 rare donors (11.4 %) (χ2=1.877, p=0.171). There was an increase in anemia and latent iron deficiency in frequent donors, while only increased anemia was observed in rare donors. Conclusion. Thus, frequent plasma donations can lead to the development of latent iron deficiency and anemia. Keywords: anemia, latent iron deficiency, plasma donors, blood donors, serum iron. Изучению развития железодефицитных состояний у доноров крови посвящено немало работ, в то время как в отношении доноров плазмы этот вопрос раскрыт недостаточно. Целью работы явилось исследование особенностей развития латентного дефицита железа (ЛДЖ) и железодефицитной анемии у активных доноров плазмы. Материалы и методы. В период с 2016 по 2019 г. на базе ГУЗ «Ульяновская областная станция переливания крови» проведено проспективное исследование, в которое вошли 259 доноров плазмы, поделенные на 2 группы: часто сдающие плазму доноры – 127 чел., редко сдающие плазму – 132 чел. У всех доноров перед сдачей плазмы была взята кровь для общего анализа и анализа на содержание сывороточного железа. Результаты этих анализов приняты нами за исходные. В качестве конечных взяты результаты аналогичного лабораторного обследования по прошествии 1 года от исходной точки. Статистический анализ проводили с применением программы Statistica v. 8.0 (StatSoft Inc., США). Результаты. Через год после первой донации достоверных различий в показателях общего анализа крови между группами не появилось. Доля лиц с анемией среди часто сдающих плазму составила 7,9 % (10 чел.), в группе редко сдающих – 3,8 % (5 чел.) (χ2=1,981, р=0,159). ЛДЖ обнаружен у 22 чел. (17,3 %) в основной группе и 15 чел. (11,4 %) в группе сравнения (χ2=1,877, р=0,171). Отмечен рост распространенности анемии и ЛДЖ у доноров, часто сдающих плазму, в то время как у редко сдающих отмечается только увеличение распространенности анемии. Выводы. Частые донации плазмы могут стать причиной развития латентного дефицита железа и анемии. Ключевые слова: анемия, латентный дефицит железа, доноры плазмы, доноры крови, сывороточное железо.

SYNDROME OF INTRACRANIAL HYPERTENSION AND IRON DEFICIENCY IN INFANTS WITH CEREBRAL ISCHEMIA IN THE NEONATAL PERIOD

Objective of the research: to study the relationship between severity of clinical manifestations of intracranial hypertension (ICH) syndrome of perinatal genesis and red blood counts in infants who underwent cerebral ischemia (CI) at birth. Materials and methods: 94 children with ICH syndrome of perinatal posthypoxic genesis at the age of 6 months of corrected age were examined: 1st group – with normal hemoglobin (Hb) level, 32 children (34%); 2nd group – with reduced Hb level, 62 children (66%). Researchers used anamnestic, clinico-neurological (assessment of the somatic and neurological status with objectification of ICH severity using a specially developed 60-point «Assessment of intracranial hypertension severity» (AIHS) scale in children aged 1 month to 1 year), laboratory study of Hb level on an automated hematological analyzer Sysmex XE2100, Sysmex, Germany, and ferritin level on a modular analytical system Сobas8000, Roche, Denmark) and statistical methods of research. Results: 77% of children (72 children) were diagnosed with mild ICH, 22% (21 children) had moderate severity, and one child (1%) had severe ICH. A strong negative relationship was obtained between the severity of ICH syndrome (the number of points on AIHS scale) and the Hb level (R=–0,72): the lower the Hb level, the more pronounced the clinical manifestations of the ICH syndrome. The ferritin content turned out to be reduced in 83% (78 children), an average negative correlation was found between the severity of the ICH syndrome (the number of points on AIHS scale and ferritin values (R=–0,55): the lower the ferritin content in the blood, the more severe the clinical manifestations of ICH syndrome. Conclusion: in infants with ICH syndrome in the residual period of neonatal IC, a relationship was found between the severity of clinical and instrumental manifestations of ICH syndrome with red blood parameters (Hb and serum ferritin). In this regard, the participation of latent iron deficiency in the pathophysiological processes of the formation and course of ICH syndrome in infants is not excluded.