Anemia In Man Research Articles

Anaemia among men in India: a nationally representative cross-sectional study

Population-based studies on anaemia in India have mostly focused on women and children, with men with anaemia receiving much less attention despite anaemia's adverse effect on health, wellbeing, and economic productivity. This study aimed to determine the national prevalence of anaemia among men in India; how the prevalence of anaemia in men varies across India among states and districts and by sociodemographic characteristics; and whether the geographical and sociodemographic variation in the prevalence of anaemia among men is similar to that among women to inform whether anaemia reduction efforts for men should be coupled with existing efforts for women. In this cross-sectional study, we analysed data from a nationally representative household survey carried out from January, 2015, to December, 2016, among men aged 15-54 years and women aged 15-49 years in all 29 states and seven Union Territories of India. Haemoglobin concentration was measured using the portable HemoCue Hb 201+ (HemoCue AB, Ängelholm, Sweden) and a capillary blood sample. In addition to disaggregating anaemia prevalence (separately in men and women) by state and age group, we used mixed-effects Poisson regression to determine individual-level and district-level predictors of anaemia. 106 298 men and 633 305 women were included in our analysis. In men, the prevalence of any anaemia was 23·2% (95% CI 22·7-23·7), moderate or severe anaemia was 5·1% (4·9-5·4), and severe anaemia was 0·5% (0·5-0·6). An estimated 21·7% (20·9-22·5) of men with any degree of anaemia had moderate or severe anaemia compared with 53·2% (52·9-53·5) of women with any anaemia. Men aged 20-34 years had the lowest probability of having anaemia whereas anaemia prevalence among women was similar across age groups. State-level prevalence of any anaemia in men varied from 9·2% (7·7-10·9) in Manipur to 32·9% (31·0-34·7) in Bihar. The individual-level predictors of less household wealth, lower education, living in a rural area, smoking, consuming smokeless tobacco, and being underweight and the district-level predictors of living in a district with a lower rate of primary school completion, level of urbanisation, and household wealth were all associated with a higher probability of anaemia in men. Although some important exceptions were noted, district-level and state-level prevalence of anaemia among men correlated strongly with that among women. Anaemia among men in India is an important public health problem. Because of the similarities in the patterns of geographical and sociodemographic variation of anaemia between men and women, future efforts to reduce anaemia among men could target similar population groups as those targeted in existing efforts to reduce anaemia among women. Alexander von Humboldt Foundation.

Clarias anguillaris as a biological indicator of metal contamination of selected aquatic habitats of North-Western Nigeria

Abstract Fish is a natural source of vitamins and mineral elements that are important in growth and immune system. Because of its habitat, Clarias anguillaris was used as a biological indicator of metal contamination in pollution prone aquatic environment. Gills, muscles, and bones from Clarias anguillaris were digested, and selected metals were quantified by atomic absorption spectrophotometry. Values were compared with WHO acceptable limits for sea foods. Generally, lead and cadmium concentrations were higher in season I samples of Rivers Bunsuru and Rima while same metals were higher in concentrations in season II samples of River Gagare and Goronyo Dam. For other metals and mineral elements, season I samples had higher concentrations while in other cases season II samples had higher concentrations. Tissue samples of season II from Goronyo Dam had highest lead contents than other samples from other rivers. Bioaccumulation of lead in fish tissues had occurred in the study sites due to uncontrolled mining activities. Lead replaces ∞-aminolevulenic acid in haem biosynthesis and can cause anaemia in man being at the high trophic level of food chain.

Unexplained anaemia in men: Remember to screen for hypogonadism

Unexplained anaemia in men: Remember to screen for hypogonadism

Anemia in men and increased Parkinson's disease risk: A population-based large scale cohort study

ObjectiveTo evaluate the association between anemia and Parkinson's disease risk (PD) in men and women. MethodsA population-based cohort of 474,129 individuals (aged 40–79 years at date of first Hb test, 47.4% men) with repeated Hb levels was derived from a large Healthcare Maintenance Organization that serves 2 million citizens in Israel (study-period 1.1.1999–31.12.2012). An annual anemia indicator [Hb levels (g/dL) for men <13; for women <12.0] was assessed for each individual and they were followed from first Hb test until the date of PD incidence, death or end of the study. Cox-proportional hazards models, stratified by sex and age, with time-dependent anemia covariate were used to estimate adjusted Hazard Ratio with 95% of confidence intervals (HR, 95%CI) for PD. ResultsDuring a mean follow up of 8.8 ± 3.9 years (7.0 ± 3.6 for men and 7.9 ± 4.1 for women), 2427 incident PD cases were detected. Cumulative PD incidence at ages over 65 years was 3.3%. The mean levels of Hb at baseline was 14.8 ± 1.1 g/dL among men; 12.8 ± 1.1 g/dL among women. Anemia was associated with significant PD risk among men, age-pooled HR = 1.19 (95%CI: 1.04–1.37), with the highest risk between ages 60–64 years [HR = 1.41 (95%CI: 1.03–1.93)]. Anemia was not associated with PD risk among women across all age-groups. The age-pooled HR for women was 1.02 (95%CI 0.95–1.09). ConclusionsThe finding that anemia was associated with PD risk in men, especially in middle age, warrants further investigations on common pathophysiologic processes between Hb abnormalities and brain dysfunction.

The Importance of RET-He in the Diagnosis of Iron Deficiency and Iron Deficiency Anemia and the Evaluation of Response to Oral Iron Therapy.

SummaryBackgroundThe purpose of this study is to investigate whether or not reticulocyte hemoglobin equivalent (RET-He) is a superior indicator of blood count and other iron parameters in terms of diagnosing iron deficiency (ID) and iron deficiency anemia (IDA), and thus evaluating a patient’s response to oral iron treatment.MethodsThe research population consisted of 217 participants in total: 54 control, 53 ID, 58 non-ID anemia, and 52 IDA patients. A hemoglobin (Hb) value of < 130.0 g/L was defined as indicating anemia for men, while an Hb value of < 120.0 g/L was defined as indicating anemia for women. All patients were administered 270 mg oral elemental iron sulphate daily.ResultsThe RET-He was significantly lower in the IDA group, compared to other groups (IDA: 21.0 ± 4.1, ID: 26.0 ± 4.9, non-ID anemia: 32.1 ± 6.8, control: 36.6 ± 7.0; < 0.001). The ID group had a lower RET-He compared to the non-ID anemia group and the control group. On the 5th day of treatment, the ID and IDA group showed no significant differences in terms of Hb while the RET-He level demonstrated a significant increase. The increase in the RET-He level observed in the IDA group on the 5th day was significantly higher compared to the increase observed in the ID group. A RET-He value of 25.4 pg and below predicted ID diagnosis with 90.4% sensitivity and 49.1% specificity in IDA patients, compared to the ID group.ConclusionsThe results of our study, therefore, suggest that RET-He may be a clinically useful marker in the diagnosis of ID and IDA.

The Risk of Inflammatory Bowel Disease in Subjects Presenting With Perianal Abscess: Findings From the THIN Database.

Perianal abscess [PA] is associated with inflammatory bowel disease [IBD]. The incidence of IBD after a diagnosis of PA and potential predictors of a future diagnosis of IBD are unknown. The Health Improvement Network [THIN] is a primary care database representative of the UK population. Incident cases of PA were identified between 1995 and 2017. Subjects with PA were matched to controls within the same general practice. The primary outcome was a subsequent diagnosis of Crohn's Disease [CD] or ulcerative colitis [UC]. A Cox regression model was used to assess potential predictors of a new diagnosis of CD or UC following PA. The risk of CD was higher in the PA cohort compared with controls; adjusted hazard ratio [HR] 7.51 (95% confidence interval [CI] 4.86-11.62), p < 0.0001. The risk of UC was also higher in the PA cohort compared with controls; adjusted HR 2.03 [1.38-2.99], p < 0.0001. Anaemia in men (HR 2.82 [1.34-5.92], p = 0.002), and use of antidiarrhoeal medications (HR 2.70 [1.71-4.25], p < 0.0001) were associated with an increased risk of CD following PA. Anaemia in men (HR 2.58 [1.09-6.07], p = 0.03), diarrhoea (HR 2.18 [1.23-3.85], p = 0.007), and use of anti-diarrhoeal medication (HR 2.27 [1.19-4.30], p = 0.012) were associated with an increased risk of UC following PA. Subjects with PA are at an increased risk of subsequent diagnosis of CD and UC. Clinicians should strongly consider investigation for IBD in young patients presenting with diarrhoea and anaemia [in males] following PA. Future research should discern appropriate screening strategies for this high-risk cohort.

Association of anemia with health-related quality of life and survival: a large population-based cohort study.

Anemia is highly prevalent, especially in older individuals. In selected populations, anemia has been reported to be associated with impaired survival and health-related quality of life. However, data on this impact in the general population are rare. Furthermore, discussions on the optimal definition of anemia have not been conclusive. We investigated these issues using survival data, scores from a health-related quality of life questionnaire (RAND-36), and hemoglobin concentration from 138670 subjects, aged 18-93 years, participating in the Lifelines cohort. Anemia was defined according to World Health Organization criteria and was further subclassified in participants over 60 years old. Anemia was present in 5510 (4.0%) of all 138670 subjects and 516 (2.8%) in the 18667 individuals older than 60 years. Anemia had no impact on overall survival and limited impact on health-related quality of life in individuals less than 60 years old. In contrast, in individuals over 60 years old anemia significantly impaired overall survival and health-related quality of life. The lower health-related quality of life was mainly observed in subscales representing physical functioning. Although consensus on the subclassification of anemia is lacking, our data suggest that particularly anemia of chronic inflammation was associated with worse overall survival and decreased health-related quality of life. Multivariate models confirmed that anemia was an independent risk factor for decreased health-related quality of life in older individuals. Finally, women with a hemoglobin concentration between 12.0-13.0 g/dL (considered anemia in men, but not in women) experienced a significantly lower health-related quality of life. This large, prospective, population-based study indicates that anemia is associated with worse overall survival and health-related quality of life in older individuals, but not in younger individuals. The findings of this study challenge the definition of anemia in women over 60 years old, and suggest that the optimal definition of anemia, in the perspective of health-related quality of life, in women over 60 years old should be altered to a hemoglobin concentration below 13.0 g/dL (8.0 mmol/L), which is comparable to that in men.

Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

BackgroundTransfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland.MethodsIn this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed.Results560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin <130 g/L for men and by 57% at <120 g/L in non-pregnant women). 62% and 43% respectively, did not define anemia in men and in women according to the World Health Organization. Fifty percent reported not to transfuse RBC according to international guidelines. Following factors were indicated to influence the decision to transfuse: educational background of the physicians, geographical region of employment, severity of anemia, and presence of known coronary artery disease. 60% indicated that their knowledge on Transfusion-related Acute Lung Injury (TRALI) did not influence transfusion practice. 50% of physicians stated that no local transfusion guidelines exist and 84% supported the development of national recommendations on transfusion in non-acutely bleeding, anemic patients.ConclusionThis study highlights the lack of adherence to current transfusion guidelines in Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

Androgen Deprivation Therapy and the Risk of Anemia in Men with Prostate Cancer.

The use of androgen deprivation therapy in prostate cancer may be associated with an increased risk of anemia, but the evidence remains limited. This study aimed to determine if androgen deprivation is associated with increased risk of anemia in patients newly diagnosed with prostate cancer. This was a population-based cohort study using the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episode Statistics repository. The cohort consisted of 10,364 men newly diagnosed with nonmetastatic prostate cancer between 1 April 1998 and 30 September 2015. We used time-dependent Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for anemia (hemoglobin <130 g/L) associated with current and past use of androgen deprivation therapy, compared with nonuse. There were 3,651 incident anemia events during 31,574 person-years of follow-up (rate: 11.6/100 person-years). Current androgen deprivation therapy use was associated with a nearly three-fold increased hazard of anemia, compared with nonuse (23.5 vs. 5.9 per 100 person-years, respectively; HR: 2.90, 95% CI: 2.67, 3.16). The HR was elevated in the first 6 months of use (HR: 2.20, 95% CI: 1.95, 2.48) and continued to be elevated with longer durations of use. Past androgen deprivation therapy use was associated with a lower estimate (HR: 1.27, 95% CI: 1.12, 1.43), which returned closer to the null ≥25 months after treatment discontinuation (HR: 0.95, 95% CI: 0.79, 1.15). The use of androgen deprivation therapy is associated with increased risk of anemia, which reverses upon treatment discontinuation.

Gender Differences in Anemia and Survival in Patients Hospitalized for Acute Decompensated Heart Failure With Preserved or Reduced Ejection Fraction

In patients with acute decompensated heart failure (HF), the influence of gender on anemia, left ventricular ejection fraction (EF), and outcomes is unclear. We evaluated the association of anemia and left ventricular EF with survival in men or women hospitalized for acute decompensated HF. Of the 4,842 patients enrolled in the Acute Decompensated Heart Failure Syndromes registry, 4,215 patients (2,450 men and 1,765 women) discharged alive after hospitalization for acute decompensated HF were enrolled to evaluate the association of gender, anemia (hemoglobin <13.0g/dl for men and <12.0g/dl for women) at discharge, and a preserved or reduced EF with all-cause death or cardiac death after discharge. Men or women were divided into 4 groups based on left ventricular EF (preserved or reduced EF) and anemia status at discharge. The median follow-up period after discharge was 524 days (384 to 791). After adjustment for multiple co-morbidities, there was no adverse influence of anemia in men with a preserved EF, whereas anemia was an independent predictor of all-cause death in men with a reduced EF. Conversely, anemia was an independent predictor of all-cause death in women with a preserved EF but not in women with a reduced EF. With respect to cardiac death, multivariable analyses revealed highly similar trends as those for all-cause death in patients of both genders. In conclusion, in acute decompensated patients with HF with a preserved or reduced EF, there were marked differences between men and women with respect to the association of anemia andleftventricular EF with survival.

Low level arsenite exposures suppress the development of bone marrow erythroid progenitors and result in anemia in adult male mice

Epidemiological studies report an association between chronic arsenic (As) exposure and anemia in men, and women who are predisposed to anemia. The purpose of these studies was to determine whether a 60 d drinking water exposure of adult male C57BL/6J mice to 0, 100, and 500ppb arsenite (As+3) results in anemia due to alterations in erythroid progenitor cell development in the bone marrow. Exposure to 500ppb As+3 for 60 d resulted in a reduction of mean corpuscular hemoglobin (MCH) levels, but did not significantly alter red blood cell (RBC) counts, hemoglobin (Hgb) levels, mean corpuscular Hgb concentrations (MCHC), or mean corpuscular volumes (MCV). Attenuation of burst-forming unit-erythroid (BFU-E) colony formation was observed in bone marrow cells of mice exposed to 500ppb As+3. The differentiation of late-stage bone marrow erythroblasts as defined by CD71 and Ter119 surface marker expression was reduced with the 500ppb As+3 exposure. Mice exposed to 500ppb As+3 also had elevated serum levels of erythropoietin (EPO). Collectively, these results show that exposure to low levels of As+3 attenuate the development of early BFU-E cells and reduce the differentiation of late-stage erythroblasts. This suppression of bone marrow erythropoiesis may be a contributing factor to the mild hypochromic anemia observed in 500ppb As+3 exposed mice.

High Serum Adiponectin Level Is a Risk Factor for Anemia in Japanese Men: A Prospective Observational Study of 1,029 Japanese Subjects.

Erythroid abnormalities including anemia and polycythemia are often observed in the general clinical setting. Because recent studies reported that adiponectin negatively affects hematopoiesis, we performed a prospective observational study to assess the relationship between anemia and adiponectin, as well as other parameters, in 1029 Japanese subjects (477 men and 552 women) 40 years of age and older. Body measurements, blood tests, and nutrition intake studies were performed at baseline, and 5 to 7 years later (follow-up). Hemoglobin (Hb) and hematocrit (Hct) levels in men with high serum adiponectin levels were lower at follow-up than at baseline. Multiple regression analysis showed that age, body mass index, adiponectin, and glutamic-pyruvic transaminase were significantly associated with erythroid-related variables (red blood cells, Hb, and Hct) in both men and women (P <0.05). In a logistic regression analysis, adiponectin, fasting blood glucose, and β-natriuretic peptide were significant risk factors for anemia in men, and blood urea nitrogen and amylase were significant risk factors in women. Physical features and nutrient intake were not risk factors for anemia. Our study demonstrates, both clinically and epidemiologically, that a high serum adiponectin level decreases the amounts of erythroid-related variables and is a risk factor for anemia in Japanese men.

The Prevalence of Anemia and Moderate-Severe Anemia in the US Population (NHANES 2003-2012).

Since anemia is associated with poor health outcomes, the prevalence of anemia is a significant public health indicator. Even though anemia is primarily caused by iron deficiency, low oxygen-carrying capacity may result from other conditions such as chronic diseases, which remain a relevant health concern in the United States. However, studies examining current rates of anemia in the total US population and in more specific subgroups are limited. Data from five National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2012 were analyzed to assess two outcomes: anemia and moderate-severe anemia, which were based upon serum hemoglobin levels (Hb) as per World Health Organization (WHO) definitions. Statistical analysis using SAS examined temporal trends and the prevalence of anemia among sexes, age groups, and races/ethnicities. The study estimated that an average of 5.6% of the U.S. population met the criteria for anemia and 1.5% for moderate-severe anemia during this 10-year period. High-risk groups such as pregnant women, elderly persons, women of reproductive age, non-Hispanic blacks, and Hispanics were identified, and relationships between multiple risk factors were examined. Rates of anemia in men increased monotonically with age, while that of women increased bimodally with peaks in age group 40–49 years and 80–85 years. The effect of risk factors was observed to compound. For instance, the prevalence of anemia in black women aged 80–85 years was 35.6%, 6.4 times higher than the population average. Moreover, anemia is a growing problem because of the increased prevalence of anemia (4.0% to 7.1%) and moderate-severe anemia (1.0% to 1.9%), which nearly doubled from 2003–2004 to 2011–2012. Thus, these results augment the current knowledge on anemia prevalence, severity, and distribution among subgroups in the US and raised anemia as an issue that requires urgent public health intervention.

Vitamin D, sex hormones and anaemia in men – is there an influence of cholecalciferol supplementation on haemoglobin concentrations or regulation of sex hormones in male haemodialysis patients? A pilot study

Introduction. Active metabolites of vitamin D, as well as androgens, may play a substantial role in the correction of anaemia caused by chronic kidney disease. Aim. Aim of the study was to analyze the association among vitamin D metabolite – 25(OH)D, sex hormones and anaemia and assess the influence of vitamin D supplementation on haemoglobin concentrations, and sex hormones levels in male haemodialysis patients. Material and methods. The study was performed in male patients on haemodialysis at the Diaverum Dialysis Unit at Ceglowska Street in Warsaw. In 18 eligible patients aged 35-65 who gave informed consent, out of the total of 81, concentrations of 25(OH)D were measured. All patients had vitamin D deficiency. Thus, in all patients included in the study cholecalciferol was supplemented for three months in the dose adjusted to the vitamin D deficiency. During the study the complete blood count, parameters of iron, calcium and phosphate homeostasis, and concentrations of sex hormones were measured. Results. Normalization of 25(OH)D concentration was achieved in 11out of 16 patients who completed the study (68.75%). In 8 patients (50%) a significant increase in haemoglobin concentration was observed (P = 0.001). Baseline concentrations of 25(OH)D correlated strongly with total testosterone levels and weakly with haemoglobin concentrations. Moreover, free testosterone index (FTI) moderately correlated with haemoglobin concentrations. Substantial increase in androstenedione concentrations and a decrease in LH, but no significant changes in testosterone concentrations or FTI values were observed during cholecalciferol supplementation. Conclusions. Cholecalciferol supplementation in vitamin D deficient men on haemodialysis effectively normalized its serum concentration. Strong correlation between 25(OH)D and testosterone concentrations may suggest pathophysiologic association, however, the influence of vitamin D supplementation on testosterone and haemoglobin levels seems clinically negligible.

Clozapine and anemia: a 2-year follow-up study.

Clozapine's association with agranulocytosis led to the implementation of stringent and mandatory hematologic monitoring guidelines in most countries. Although other hematologic aberrations such as eosinophilia and neutropenia have been previously described, clozapine's impact on the erythroid lineage has not been studied. There is a suspicion that a higher rate of anemia is observed in patients receiving clozapine; therefore, we hypothesized that there would be a higher rate of anemia in patients receiving clozapine therapy. All individuals initiated on clozapine at our center from 2009 to 2010 were recruited. Information on age, gender, medical comorbidities, and smoking status was extracted from the medical records. Data from complete blood counts over a 2-year follow-up period were extracted, with anemia defined as a hemoglobin value below 120 g/L for women and 130 g/L for men. Time to anemia event was calculated and Cox regression was employed to identify predictors of anemia. We found a high incidence of anemia in the first 2 years following clozapine initiation; of the 94 individuals (68 men, 26 women) recruited, 23 (24.5%) developed anemia. Higher baseline hemoglobin level (hazard ratio [HR] = 0.86, P = .002) and smoking status (HR = 0.21, P = .021) were identified as significant protective factors against anemia in men but not in women (HR = 0.92, P = .184, and HR = 0.52, P = .467 for baseline hemoglobin and smoking, respectively). Although smoking appears to lower the risk of anemia, we believe this is due to smoking's up-regulation of hemoglobin levels. Further studies are warranted in light of the present findings; for example, we cannot exclude the possibility that anemia was an epiphenomenon, characterizing instead a population with severe mental illness.

PREVALENCE OF ANEMIA, ITS SOCIO-DEMOGRAPHIC DETERMINANTS AND POTENTIAL ASSOCIATION WITH METABOLIC SYNDROME IN RESIDENTS OF TURKESTAN, SOUTHERN KAZAKHSTAN

We have studied the prevalence and socio-demographic determinants of anemia and also have investigated associations between anemia and metabolic syndrome in Turkestan, Southern Kazakhstan region, Kazakhstan. Southern Kazakhstan is one of the regions with the lowest level of incomes. The sample consisted of 839 patients from the polyclinic of the International Kazakh-Turkish University. The overall prevalence of anemia was 26.4 %. The highest prevalence of anemia was observed among women (30.4 %) and in the age group 30-39 years (39,0 %). A multiple logistic regression was performed to study independent associations between the studied factors and development of anemia with and without adjustment to other socio-demographic factors. The odds of anemia in persons from the oldest age category is 5 times lower than in the younger age categories. Odds of anemia in men by 2.4 times less compared to women. A multiple linear regression was used to study associations between hemoglobin levels and socio-demographic factors. There were statistically significant relationship between hemoglobin levels and age (β = 5.85; 95 % CI: 1.63; 10.06), between hemoglobin level and gender (β = 21.50; 95 % CI: 19.12 ; 23.89). Also, was found statistically significant interaction between the presence of metabolic syndrome and the level of hemoglobin after adjustment for all socio-demographic factors ((β = 3.12; 95 % CI: 0.53; 1.32).

Elevated Hepcidin Is Part of a Complex Relation That Links Mortality with Iron Homeostasis and Anemia in Men and Women with HIV Infection1–3

Background: Early and chronic inflammation is a hallmark of HIV infection, and inflammation is known to increase hepcidin expression. Consequently, hepcidin may be a key determinant of the iron homeostasis and anemia associated with poorer HIV prognoses.Objective: The objective of this study was to understand how hepcidin is related to anemia, iron homeostasis, and inflammation at HIV diagnosis and to investigate associations between hepcidin and all-cause mortality in HIV infection.Methods: In a retrospective cohort, baseline plasma hepcidin was measured by competitive enzyme immunoassay within 3 mo of HIV diagnosis in 196 antiretroviral-naive Gambians. Iron homeostasis [hemoglobin, plasma transferrin, ferritin, iron, soluble transferrin receptor (sTfR)] and inflammation [α1-antichymotrypsin (ACT)] from the same plasma sample were available, as were absolute CD4 cell counts, age, gender, body mass index (BMI), and HIV type.Results: Anemia was common across the spectrum of immunosuppression [CD4 cell counts (prevalence of anemia): >500 cells/μL (68%), 200–500 cells/μL (73%), and <200 cells/μL (89%); P = 0.032] and in men (81%) and women (76%). Increasing hepcidin was associated with iron homeostasis biomarkers (higher ferritin and lower transferrin, hemoglobin, and sTfR), inflammation (higher ACT), and key health indicators (lower CD4 or BMI, advancing age, and male gender; P < 0.001 except for hemoglobin, P = 0.021). Elevated hepcidin was associated with greater all-cause mortality in a dose-dependent manner [intermediate vs. lowest tertile: unadjusted HR (95% CI), 1.95 (1.22, 3.10); upper vs. lowest tertile: 3.02 (1.91, 4.78)]. Principal components analysis identified 2 patterns composed of hepcidin-ferritin-transferrin, with or without ACT, and iron-sTfR-hemoglobin that may distinguish inflammation and erythropoiesis iron functions.Conclusions: Elevated hepcidin is independently associated with greater mortality in men and women with HIV infection, and hepcidin is also part of a complex relation linking iron homeostasis, anemia, and HIV. Understanding the mechanisms and role of hepcidin modulation may further guide evidence-based interventions needed to counter detrimental iron homeostasis and anemia in HIV infection.

Demir eksikliği anemisi olan hastalarda alt ve üst gastrointestinal endoskopik inceleme sonuçları

Giriş ve Amaç:Gastrointestinal sistem kaynaklı kronik kan kaybı, erkek ve postmenapozal kadınlarda demir eksikliği anemisinin en sık nedenidir. Bu çalışmada, demir eksikliği anemisi nedeni ile endoskopi uygulanan hastaları, endoskopik yaklaşım ve etyolojik tanı yönünden inceledik. Gereç ve Yöntem:Ocak 2012 ve Haziran 2013 tarihleri arasında endoskopik inceleme yapılan 181 (K=121, E=60) olgu retrospektif olarak değerlendirildi. Çalışmaya hemoglobin düzeyi kadınlarda

Evaluation of the Relationship between Selected Reticulocyte Parameters and Inflammation determined by Plasma C-reactive Protein in Dogs

Anaemia secondary to inflammatory disease is one of the main causes of anaemia in veterinary and human medicine and impairment of iron homeostasis due to the release of pro-inflammatory cytokines is one of the aetiological mechanisms involved. Because reticulocytes are recently produced cells, reticulocyte indices are early indicators of iron deficiency anaemia in man and dogs and reticulocyte indices may be affected during the course of inflammatory processes earlier than indices related to mature red blood cells. The aim of this study was to evaluate the possible influence of inflammation on reticulocyte parameters including concentration, mean reticulocyte volume, volume distribution width, percentage of microcytic reticulocytes, percentage of macrocytic reticulocytes, mean reticulocyte haemoglobin content (CHr), haemoglobin distribution width, cell haemoglobin concentration, mean percentage of hypochromic reticulocytes, percentage of reticulocytes with low CHr and immature reticulocyte factor medium and high, and on white blood cell concentration by using C-reactive protein (CRP) as an inflammatory biomarker. Samples from 175 diseased dogs and 16 healthy dogs were included in the study. The diseased dogs were grouped according to plasma CRP and ferritin concentrations, the presence and type of anaemia and different aetiopathological categories. Dogs with high plasma CRP concentrations had lower CHr (median 23.3 pg) and percentage of reticulocytes with high CHr (median 35.5%) and higher percentage of reticulocytes with low CHr (median 14.6%) compared with dogs without inflammation (median 24.9 pg, median 50.9% and median 7.8%, respectively) and healthy dogs (median 25.1 pg, median 50.0% and median 6.1%, respectively), with no differences between the last two groups. Reticulocyte parameters, particularly those related to haemoglobin concentration, are therefore affected by inflammatory conditions in anaemic and in non-anaemic dogs.

High prevalence of iron deficiency in patients with acute decompensated heart failure.

Limited data are available on iron parameters in patients hospitalized for decompensation of chronic heart failure. Iron parameters of patients hospitalized for decompensation of chronic heart failure were prospectively assessed during the 72 h after hospital admission. Iron deficiency was defined according to the 2012 European Society of Cardiology Guidelines. Overall, 411 men (75 ± 12 years; 75% NYHA functional classes III/IV) and 421 women (81 ± 11 years; 71% NYHA classes III/IV) were evaluated. The prevalence of iron deficiency was 69% in men and 75% in women (including 41% and 49% with absolute iron deficiency, respectively). The prevalence of anaemia in men (<13 g/dL) was 68% and in women (<12 g/dL) it was 52%. Among non-anaemic patients, the prevalence of iron deficiency was 57% in men and 79% in women. Only 9% of patients received iron supplementation at the time of admission (oral, 9%; intravenous, 0.2%). Multivariate analysis showed that anaemia and antiplatelet treatment in men, and diabetes and low C-reactive protein in women, were independently associated with iron deficiency. Iron deficiency is very common in patients admitted for acute decompensated heart failure, even among non-anaemic patients. Given the benefit of iron therapy in chronic heart failure, our results emphasize the need to assess iron status not only in chronic heart failure patients, but even more so in those admitted for worsening heart failure, regardless of gender, heart failure severity, or haemoglobin level. Initiating iron therapy in hospitalized heart failure patients needs to be investigated.