Association Of Iron Deficiency Research Articles

The association of TMPRSS6 gene polymorphism with iron status in Egyptian children (a pilot study)

Several studies have shown association of single nucleotide polymorphisms (SNPs) of hepcidin regulatory pathways genes with impaired iron status. The most common is in the TMPRSS6 gene. In Africa, very few studies have been reported. We aimed to investigate the correlation between the common SNPs in the transmembrane protease, serine 6 (TMPRSS6) gene and iron indicators in a sample of Egyptian children for identifying the suitable candidate for iron supplementation.Patients and methods One hundred and sixty children aged 5–13 years were included & classified into iron deficient, iron deficient anemia and normal healthy controls. All were subjected to assessment of serum iron, serum ferritin, total iron binding capacity, complete blood count, reticulocyte count, serum soluble transferrin receptor and serum hepcidin. Molecular study of TMPRSS6 genotyping polymorphisms (rs4820268, rs855791 and rs11704654) were also evaluated.Results There was an association of iron deficiency with AG of rs855791 SNP, (P = 0.01). The minor allele frequency for included children were 0.43, 0.45 & 0.17 for rs4820268, rs855791 & rs11704654 respectively. Genotype GG of rs4820268 expressed the highest hepcidin gene expression fold, the lowest serum ferroportin & iron store compared to AA and AG genotypes (p = 0.05, p = 0.05, p = 0.03 respectively). GG of rs855791 had lower serum ferritin than AA (p = 0.04), lowest iron store & highest serum hepcidin compared to AA and AG genotypes (p = 0.04, p = 0.01 respectively). Children having CC of rs11704654 had lower level of hemoglobin, serum ferritin and serum hepcidin compared with CT genotype (p = 0.01, p = 0.01, p = 0.02) respectively.Conclusion Possible contribution of SNPs (rs855791, rs4820268 and rs11704654) to low iron status.

Association of iron deficiency with chronic suppurative otitis media in adults

Background Chronic suppurative otitis media (CSOM) is a prevalent chronic inflammatory disease globally. Current research suggests a possible association between anaemia and the development of CSOM. Objectives The objective of this trial was to investigate the relationship between iron metabolism and chronic suppurative otitis media (CSOM) in adults aged 20–60 years. Materials and methods A consecutive sampling case-control study was used. The study participants were divided into a case group (42 children diagnosed with CSOM) and a control group (42 children with normal ears). Haemoglobin (Hb), Hematocrit (Hct), mean corpuscular volume of erythrocytes (MCV), serum iron level (SI), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), transferrin (TF), ferritin (Fer) were tested in all the participants, and the results were compared with the normal ranges of the World Health Organization (WHO). The comparative analysis of cases and controls was performed using the Fisher extract test, independence t-test, or Mann–Whitney U test. p-value <.05 was considered statistically significant for correlation. Results There were 61 patients with CSOM and 61 controls included in the study. In the case group, 16 out of 61 patients (26.2%) had low ferritin levels and in the control group, 1 out of 61 patients (1.6%) had low ferritin levels (p < .001). In the case group, 6 (9.8%) of 61 patients had IDA, and in the control group, there were no patients with IDA among 61 patients (p = .027). There were significant differences in SI, UIBC, and Fer parameters between the groups. Conclusions In adult patients, the incidence of iron deficiency was higher in CSOM patients than in controls. Iron deficiency may be considered a potential risk factor for chronic suppurative otitis media, and serum iron parameters should be evaluated in these CSOM patients and further studies should be conducted to better understand the potential link between iron deficiency and CSOM.

Abstract 12590: Association of Iron Deficiency With the Recurrence of Atrial Fibrillation After Pharmacological Cardioversion

Introduction: Anemia and iron deficiency (ID) are common conditions in patients with atrial fibrillation (AF). The presence of anemia may be associated with worse outcome in patients with AF. The potential role of ID in the development of AF has been discussed recently, however the issue is considered only in the context of anemia. Thus, information on the direct impact of ID on AF development and on the sinus rhythm maintenance remains limited. Methods: The purpose of this article is to study the effects of ID on the frequency of recurrence of AF within 12 months in patients with paroxysmal AF after pharmacological cardioversion with amiodarone.198 patients (120 men) with nonvalvular paroxysmal AF with successful pharmacological cardioversion were included in the study between 2019-2021 years. The Me of the patients age is 71 (63,2–77) year. ID is assumed to be present when serum ferritin &lt;100 ng/mL or 100 ng/mL ≤ serum ferritin ≤299 ng/mL with transferrin saturation (TSAT) &lt;20%. The primary outcome was AF recurrence within 12 months after pharmacological cardioversion. AF recurrence is statistically tested by the Kaplan-Meier test. Results: The patients were divided into 2 groups: group 1 - 116 patients with ID, group 2 - 82 patients without ID. The groups did not differ in the main clinical parameters, comorbidities and medications. After cardioversion, all patients received treatment according to the current guidelines. The significant difference in AF recurrence was observed between groups. Within 12 months of observation, AF recurrence was developed in 49 (42.2%) patients in group 1 and in 16 (19.5%) patients in group 2 (p=0.0008). The RR of the recurrence of AF in patients with ID is 2.64 [95% CI: 1.5-4.65] (p=0.0003). Conclusion: ID is associated with the higher chances of AF recurrence within 12 months after pharmacological cardioversion. ID increases the risk of AF recurrence by 2,64 times within 12 months after pharmacological cardioversion.

A Study of Serum Ferritin and Thyroid-Stimulating Hormone Levels in Male Patients with Androgenetic Alopecia

ABSTRACT Background: Androgenetic alopecia (AGA) is a multifactorial disorder expressed by several genes and various environmental factors apart from nutritional and endocrinological factors. Although association of iron deficiency (ID) as well as thyroid disorder has been evaluated in females, this is still an untouched topic as far as male pattern hair loss (MPHL) is concerned. This study tries to establish if any association of MPHL with ID and thyroid dysfunction. Materials and Methods: This case–control study comprised 30 consecutive cases of MPHL and equal numbers of age-matched healthy controls attending dermatology outdoor department at a tertiary care hospital. Cases as well as controls were evaluated and screened for the levels of serum ferritin (SF) and thyroid-stimulating hormone (TSH). Value of SF (8–388 ng/mL) and TSH (0.358–3.7 uIU/mL) was used as standardized reference. Results: In cases of AGA, SF level varied from 6.00 to 212.09 ng/mL (mean - 88.30 ng/mL). Whereas controls showed SF levels ranging between 23.67 and 185.05 ng/mL (mean 78.69 ng/mL). The range of TSH level in the case group was 0.379–5.078 uIU/L (mean 2.25 uIU/L), respectively, whereas control group showed serum TSH levels ranging between 0.30 and 4.30 uIU/L (mean - 1.78 uIU/L). Statistically considering two samples of equal variance P (2-tailed) for SF level was found to be 0.424, whereas 0.085 in case of TSH level depicting insignificant association. Spearman’s correlations (P = 0.244) between alopecia grade and SF level were found to be statistically insignificant (P = 0.193). Similarly, the P value calculated for the alopecia grade and serum TSH was 0.784, making the correlation between alopecia and serum TSH as insignificant. Conclusion: The study found no statistically significant difference in the SF level and TSH level of the cases as compared to controls.

Association of iron deficiency with atrial fibrillation recurrence after pharmacological cardioversion

Aim. This study aims to assess the association between iron deficiency (ID) and recurrences of atrial fibrillation (AF) in patients after pharmacological cardioversion with amiodarone within 12 months.Material and methods. The open-label, prospective, single-center study included 198 patients with non-valvular paroxysmal AF after successful pharmacological cardioversion with amiodarone. Group I included 116 patients with ID, and group II — 82 patients with normal iron status. The primary end-point of the study was the development of symptomatic AF recurrences within 12 months after the cardioversion which was estimated by the Kaplan-Meier method. The differences were considered statistically significant if p-value was &lt;0,05.Results. Absolute ID was found in patients of group I; anemia was revealed in 85,3% of the patients. The groups did not differ in basic clinical and demographical parameters, concomitant diseases and drug therapy. Along with that, the I group patients were older (the median was 73 (64,8-79) years old and 69 (63-75) years old, respectively, р=0,008), and their left ventricular mass was larger (the median was 145 (115-176) g and 132,5 (118,2-145) g, respectively, р=0,004). The sinus rhythm restoration in group I required less dose of amiodarone (the median was 450 (300-600) mg and 1000 (600-1200) mg, respectively, р&lt;0,001) and less time from the start of the drug administration to the rhythm restoration (the median was 7 (3-10) and 12 (9-18) hours, respectively, р&lt;0,001). During the 12-month follow-up period, 49 (42,2%) patients in group I and 16 (19,5%) patients in group II developed AF recurrences (р=0,0008), hazard ratio 2,64 (95% confidence interval: 1,5-4,65) (р=0,0003).Conclusion. ID is associated with the increase of the number of symptomatic AF recurrences in patients after pharmacological cardioversion with amiodarone within 12 months.

Association of Iron Deficiency with Electronic Gaming Addiction and Low Health Influencing School Performance

Association of Iron Deficiency with Electronic Gaming Addiction and Low Health Influencing School Performance

Iron deficiency and common neurodevelopmental disorders-A scoping review.

A wealth of human and experimental studies document a causal and aggravating role of iron deficiency in neurodevelopmental disorders. While pre-, peri-, and early postnatal iron deficiency sets the stage for the risk of developing neurodevelopmental disorders, iron deficiency acquired at later ages aggravates pre-existing neurodevelopmental disorders. Yet, the association of iron deficiency and neurodevelopmental disorders in childhood and adolescence has not yet been explored comprehensively. In this scoping review, we investigate 1) the association of iron deficiency in children and adolescents with the most frequent neurodevelopmental disorders, ADHD, ASD, and FASD, and 2) whether iron supplementation improves outcomes in these disorders. Scoping review of studies published between 1994 and 2021 using "iron deficiency / iron deficiency anemia" AND "ADHD" OR "autism" OR "FASD" in four biomedical databases. The main inclusion criterion was that articles needed to have quantitative determination of iron status at any postnatal age with primary iron markers such as serum ferritin being reported in association with ADHD, ASD, or FASD. For ADHD, 22/30 studies and 4/4 systematic reviews showed an association of ADHD occurrence or severity with iron deficiency; 6/6 treatment studies including 2 randomized controlled trials demonstrated positive effects of iron supplementation. For ASD, 3/6 studies showed an association with iron deficiency, while 3/6 and 1/1 systematic literature review did not; 4 studies showed a variety of prevalence rates of iron deficiency in ASD populations; 1 randomized controlled trial found no positive effect of iron supplementation on behavioural symptoms of ASD. For FASD, 2/2 studies showed an association of iron deficiency with growth retardation in infants and children with prenatal alcohol exposure. Evidence in favor of screening for iron deficiency and using iron supplementation for pediatric neurodevelopmental disorders comes primarily from ADHD studies and needs to be further investigated for ASD and FASD. Further analysis of study methodologies employed and populations investigated is needed to compare studies against each other and further substantiate the evidence created.

A study on association of iron deficiency and gall stones in cholelithiasis patients

A study on association of iron deficiency and gall stones in cholelithiasis patients

Association of iron deficiency with incident cardiovascular diseases and mortality in the general population.

AimsAlthough absolute (AID) and functional iron deficiency (FID) are known risk factors for patients with cardiovascular (CV) disease, their relevance for the general population is unknown. The aim was to assess the association between AID/FID with incident CV disease and mortality in the general population.Methods and resultsIn 12 164 individuals from three European population‐based cohorts, AID was defined as ferritin < 100 μg/L or as ferritin < 30 μg/L (severe AID), and FID was defined as ferritin < 100 μg/L or ferritin 100–299 μg/L and transferrin saturation < 20%. The association between iron deficiency and incident coronary heart disease (CHD), CV mortality, and all‐cause mortality was evaluated by Cox regression models. Population attributable fraction (PAF) was estimated. Median age was 59 (45–68) years; 45.2% were male. AID, severe AID, and FID were prevalent in 60.0%, 16.4%, and 64.3% of individuals. AID was associated with CHD [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.04–1.39, P = 0.01], but not with mortality. Severe AID was associated with all‐cause mortality (HR 1.28, 95% CI 1.12–1.46, P < 0.01), but not with CV mortality/CHD. FID was associated with CHD (HR 1.24, 95% CI 1.07–1.43, P < 0.01), CV mortality (HR 1.26, 95% CI 1.03–1.54, P = 0.03), and all‐cause mortality (HR 1.12, 95% CI 1.01–1.24, P = 0.03). Overall, 5.4% of all deaths, 11.7% of all CV deaths, and 10.7% of CHD were attributable to FID.ConclusionsIn the general population, FID was highly prevalent, was associated with incident CHD, CV death, and all‐cause death, and had the highest PAF for these events, whereas AID was only associated with CHD and severe AID only with all‐cause mortality. This indicates that FID is a relevant risk factor for CV diseases in the general population.

"Plummer -Vinson Syndrome: Diagnosis by Barium Esophagogram Studies May Still Be Important in the Shortage of Endoscopic Sources"

Plummer-Vinson syndrome (PVS), association of iron deficiency with dysphagia due to proximal esophageal web, is still a relevant cause of dysphagia in Western societies as well as developing countries...

Prevalence and association of iron deficiency with anemia among patients with heart failure in the USA: NHANES 2017-2018

ABSTRACT Background: Heart failure (HF) is a major debilitating disease. HF patients with iron deficiency(ID) have poorer outcomes and treatment significantly improves outcomes. We set out to update the national prevalence of ID in the USA and its association with anemia using data from NHANES 2017–2018. Methods: Diagnosis of HF was self-reported. ID was defined as serum ferritin levels <100 ng/mL or a ferritin level between 100 and 299 ng/mL with transferrin saturation <20%. Anemia was defined as a hemoglobin level of <13 g/dl and <12 g/dl for men and women, respectively. Differences in prevalence of ID across various groups were assessed using Chi-squared test for categorical variables and equality of means for continuous variables with p-values <0.05 considered statistically significant. Results: A total of 187 persons ≥20 years, corresponding to a 5.57million had HF. The prevalence of ID was 48.17% (95% CI 36.84–59.69) and the prevalence of anemia was 12.08%(95% CI 8.16–17.53). Diabetics (61.03%) were more likely to have ID compared to nondiabetics (35.38%), p 0.022. The prevalence of ID was similar in persons with anemia (47.45%) and persons without anemia (48.27%), p-value 0.983. The prevalence of ID has been constant for at least the past 20 years, making ID in HF an underdiagnose and/or undertreated condition among patients with HF and should be addressed. Conclusions: One in every two persons with HF has ID. Also, prevalence of ID was similar in patients with anemia and without anemia. Anemia should not be considered a prerequisite for screening for ID in patients with HF.

Restless Leg Syndrome and Sleep Disorders in Patients with Rheumatoid Arthritis and Its Relation with Anemia Parameters.

We aimed to investigate the prevalence of restless legs syndrome (RLS) and sleep disorders in patients with rheumatoid arthritis (RA), and the association of iron deficiency with them. The study included 72 patients with RA (59 females, 13 males), and 50 healthy control subjects (57 females, 15 males). Assessments were made using the International RLS Rating Scale, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Fatigue Severity Scale (FSS), Beck anxiety and depression index and the SF-36 quality of life scores. We found that the frequency of RLS in RA patients was 29.1% and 13.8% in healthy control (p = 0.021). RA patients had 44.4% iron deficiency and 5.5% anemia of chronic disease. We found that 52.3% of patients with iron deficiency had RLS. There was an independent relationship between present of RLS and FSS (Beta [β] = 0.317, p = 0.005) and total iron binding capacity (TIBC) (β = 0.244, p = 0.031). There was an independent relationship between RLS severity score and PSQI (β = 0.264, p = 0.025) and social functionality (β = 0.302, p = 0.009). The prevalence of iron deficiency is high in RA in the developing countries. Analysis obtained in patients with RA is suggestive of an association between iron deficiency and increased frequency of RLS. The presence of RLS in patients with RA negatively affects sleep quality, psychiatric status, and quality of life of patients with RA. TIBC value may be a predictive marker for early detection of RLS in patients with RA.

Iron status, anemia and functional capacity in adults with congenital heart disease: a single center analysis

Abstract Background Iron is essential to the mitochondrial energy production in cardiomyocytes and its depletion is negatively associated with symptoms, functional capacity, quality of life and outcomes in patients with heart failure – independent of anemia. The relevance of iron deficiency in adults with congenital heart disease however has not been evaluated to date, and we thus aimed to evaluate it in an all-comer cohort of patients with congenital heart disease in correlation with symptoms and functional capacity. Methods and results 527 patient cases from one referral center over 2 years were evaluated concerning their iron status, anemia, functional capacity and ejection fraction of their systemic ventricle. 264 were female, 94 had a shunt lesion, 96 had left-sided obstructive lesions, 181 right-sided lesions, while 108 were considered to have complex lesions and 28 were cyanotic. The median age was 34 years, the mean BMI was 25.2±5 kg/m2, 429 patients had a normal ejection fraction and 34 moderately and severely depressed. 35 patients were classified as NYHA III, and 56 as NYHA II, while their functional capacity was evaluated via cardiopulmonary testing with a mean VO2max/kg of 22.6±6.5 and mean 69±17% of the expected. The mean serum iron concentration was 99.4±42.3 mcg/dL, their mean transferrin saturation was 27.36±13%, the mean ferritin concentration was 130.8±185 ng/mL, the mean soluble transfer factor was 1.3±0.66 mg/l and their mean Hemoglobin 14.8±2 mg/dL, while the mean MCV was 88±5.3 and the mean MCHC 33.7±1.4. 40 patients were anemic according to the WHO definition for anemia, in 28 of those patients that was already known. Iron deficiency according to stratified according to ferritin was present in 53 patients. However, when stratified according to the heart failure guidelines definition for iron deficiency 299 patients were found affected. Using the soluble transferrin receptor (sTfR) and sTfR-ferritin index iron deficiency was suspected in 10 additional individuals. Iron deficiency was associated with the ejection fraction (p=0.0001) - patients with moderately or severely depressed systemic ventricular function more often were diagnosed with iron deficiency (p=0.007)-, while it did not correlate with functional NYHA classification (p=0.622) or functional capacity (p=0.1 and 0.057). Iron deficiency was also not found significantly different amongst congenital defects but did correlate with all laboratory iron studies. Conclusions In this ambulatory population of adults with congenital heart disease we found an association of ejection fraction with iron deficiency, however no association of iron deficiency with functional capacity. The question arising is if a new definition of iron deficiency anemia in congenital heart disease similar to heart failure would be of clinical value. Funding Acknowledgement Type of funding source: None

Iron deficiency is a possible risk factor causing right heart failure in Tibetan children living in high altitude area.

The aim of the study is to discuss the risk factor of right heart failure (RHF) especially the association of iron deficiency with RHF in Tibetan children who live in high altitude area. In this retrospective study, we collected the data of Tibetan children from January 2011 to December 2018 in our hospital. The patients included in the study had the following data: age, gender, ferritin, echocardiography, hemoglobin, C-reaction protein, and altitude of residence. According to whether RHF was diagnosed, the patients were divided into RHF group and non-RHF group. Totally 133 patients were included with 59 in RHF group and 74 in non-RHF group. In single factor analysis, age (P = .008), altitude of residence (P < .001), ferritin (P < .001), and pulmonary arterial systolic pressure (P < .001) showed significant difference between the 2 groups. Binary logistic regression was performed to further identify the association of the clinical factors with RHF. Higher pulmonary arterial systolic pressure (odds ratio: 29.303, 95% confidence interval: 5.249-163.589, P < .001) and lower ferritin level (odds ratio: 5.849, 95% confidence interval: 1.585-21.593, P = .008) were independent risk factors associated with RHF. In receiver-operating characteristic curve, the optimal cutoff value of ferritin level was 14.6 μg/L with the sensitivity of 81.4% and specificity of 89.2%. As continuous variable, the correlation between ferritin and RHF was not certain (P = .281). Due to the possibility that iron deficiency be a risk factor of RHF in Tibetan children, prevention and treatment of iron deficiency might be a potential way in reducing the incidence of RHF in this high altitude area.

Association of iron deficiency, anaemia, and functional outcomes in patients undergoing edge-to-edge mitral valve repair.

AimsPatients undergoing percutaneous mitral valve repair (PMVR) show a substantial heterogeneity of prognostic and symptomatic benefit. Iron deficiency and anaemia are associated with worse outcomes in heart failure patients. We investigated the impact of these comorbidities on functional and clinical outcome after PMVR.Methods and resultsIron deficiency and anaemia were prospectively assessed in 130 patients undergoing PMVR with MitraClip. Associations with functional outcomes at 6 weeks [6 min walking distance (6MWD), Short‐Form‐36 physical component score, and Minnesota Living with Heart Failure Questionnaire score, New York Heart Association class] and long‐term clinical outcome were examined. Iron deficiency and anaemia were frequent with 52% and 50%, respectively. Patients with anaemia showed significant worse baseline functional measures, whereas patients with iron deficiency showed only a trend for lower baseline 6MWD. The benefit in functional outcomes after PMVR was notable and did not differ significantly by iron deficiency or anaemia status (range of median changes in 6MWD 35 to 45 m, physical component score 5.6 to 7.2, Minnesota Living with Heart Failure Questionnaire −8.0 to −10.5; improvement of ≥1 New York Heart Association class 69% to 80%). Anaemia was associated with higher risk for the combined endpoint of mortality and heart failure hospitalization (hazard ratio: 2.51; 95% confidence interval: 1.24–5.1; P = 0.01), whereas iron deficiency showed a trend towards more heart failure hospitalizations (hazard ratio: 2.94; 95% confidence interval: 0.94–9.03; P = 0.09).ConclusionsThe prevalence of iron deficiency and anaemia is high in patients undergoing MitraClip. Clinical baseline status and long‐term outcome were worse particularly in patients with anaemia. However, the functional benefit of PMVR was equal in patients with and without iron deficiency and anaemia.

A study on association of iron deficiency with attention deficit hyperactivity disorder in a tertiary care center.

Background:Iron is important for brain development and cognitive function. Iron deficiency may cause alteration of neurotransmitters and may be manifested by different central nervous system disorders including attention deficit hyperactivity disorder (ADHD).Aims:As studies are scarce in the Indian context, we had undertaken this study to find out the association between iron deficiency and ADHD.Settings and Design:Hospital-based cross-sectional study.Materials and Methods:Hematological parameters indicating iron status (hemoglobin [Hb], ferritin, Iron, total iron binding capacity [TIBC], mean corpuscular volume [MCV], and mean corpuscular Hb [MCH]) were measured among 119 ADHD patients selected by complete enumeration method and 119 controls.Statistical Analysis:Shapiro–Wilk test, Mann–Whitney U-test, Spearman's correlation, and binary logistic regression were used. P < 0.01 was taken as statistically significant.Results:Hb, iron, ferritin, MCV, and MCH were lower among cases and negatively correlated to ADHD, while reverse is true for TIBC and ADHD. Iron deficiency anemia makes one 3.82 times more prone for ADHD.Conclusion:Iron deficiency was associated with ADHD.

ROLE OF SERUM IRON AND ITS ASSOCIATION WITH ANEMIC PREVALANCE AMONG PATIENTS WITH DIFFERENT TYPE OF CANCER

Cancer is a group of diseases in which cells are aggressive, invasive and sometimes metastatic. Nutritional status an important factor that contributes to immune competence for which trace minerals plays a crucial role in the biochemical and physiological activity of the system. Trace element a category of minerals essential for the biological system and plays an active role in immune effector mechanism. Normal range of iron essential for body metabolism, iron deficiencies leads to anemia which might complicate the event of tumor genesis.&#x0D; Study involved 50 volunteers (36 females, 14 males) of cancer patients of Mohan Nursing Home Madurai. Serum was collected in the informed consent of the patients. Serum iron level was quantified using Atomic Absorption Spectrophotometer.&#x0D; Study documented percentage deviation of serum iron concentration (85%) with severe anemic prevalence from the control individual (without cancer) and also establish an association of iron deficiency with anemic prevalence.&#x0D; Study documented the existence of Iron deficiency which is the most common cause of anemia worldwide. Iron plays a role in oxygen transfer in cytochromes, protein molecules involved in the production of energy in cells and also exhibit certain properties to facilitate antitumor status. Study concludes that serum iron modulations need to be emphasized to minimize the burdenization of the host with Clinical associated complications of Iron deficiency among patients with cancer.

The Association of Iron Deficiency and Fatigue in Non-Anemic Females of Childbearing Age: An Nhanes Analysis

Introduction:Iron deficiency (ID) is the most common nutritional deficiency in the world and remains relatively common in at-risk groups in the United States. The development of (ID) is dependent upon the individual's iron stores which is a balance between iron absorption and loss. Commonly associated with (ID) is iron deficiency anemia (IDA) which has a well known association with fatigue. Fatigue is a common complaint in general, with a prevalence in population-based surveys in Great Britain and the United States of 6.0 and 7.5 % respectively. However it is not uncommon to have (ID) without subsequent anemia in females childbearing age group. Our study aims to evaluate the prevalence of ID in non anemic females of childbearing age and its association with fatigue.Methods:Data was obtained from continuous NHANES database, a nationally representative health survey conducted from 2005-2010. The data including age, race, complete blood count (CBC), ferritin and fatigue was obtianed from laboratory and questionnaire datasets, respectively. Subjects were further divided based on ferritin levels into two groups, Group A; ferritin ≤20 ng/mL and Group B; ferritin >20 ng/mL. The question regarding fatigue- "feeling tired or having little energy for past two weeks" was obtained from PHQ-9 scale. Univariate analysis was done comparing Group A and Group B using chi-square test and t-test for categorical and numerical variables, respectively. The effect of iron deficiency on fatigue was obtained using logistic regression to calculate odds ratio (OR) after adjusting for age and race.Results:Of 3230 female subjects( age 18yrs -49yrs), there were 809 with ID with no anemia. The weighted prevalence of iron deficiency in non-anemic women of childbearing age was 22.5% (95% CI 20.76-24.22). The weighted prevalence of fatigue in Group A and Group B was 61.8% (95% CI 56.4-67.2) and 59.7 % (95%CI 57-62.4) respectively (p=0.45)(table 1). In multivariate analysis, after adjusting for age and race, the odds ratio (OR) for fatigue with iron deficiency was 1.1 ( 95% CI 0.8-1.4).Conclusion:The prevalence of ID in non anemic females of childbearing age in the United States was 22.5 % .The percentage of subjects who reported fatigue was significantly high in both iron deficient and non-iron deficient subjects in this age group. There was no statistical difference in self-reported fatigue in both iron deficient and non-iron deficient women of childbearing age. Further studies are needed to validate our findings.Table 1Comparision of GpA and GpBVariablesFerritin≤ 20 ng/mL (GpA)Ferritin > 20 ng/mLFatigue - Yes5121452Fatigue - No297986Total8092421 DisclosuresNo relevant conflicts of interest to declare.

Soluble Transferrin Receptor Discriminates Iron Deficiency Anemia from Anemia of Chronic Disease in Leukemic and Breast Cancer Patients

Anemia is a global public health problem, affecting about 30% of the world’s population. Association of iron deficiency with some chronic diseases is inevitable, hence the necessity to differentiate between anemia of chronic disease and iron deficiency anaemia (IDA). The present study was conducted to discriminate iron deficiency anemia from that due to leukemia and breast cancer as this would help to avoid unnecessary and invasive investigative procedures and also treatment outcomes. Sixty patients drawn from each condition of chronic leukaemia, female breast cancer, other anemic conditions as well as apparently healthy subjects who served as controls were included in the study totalling two hundred and twenty four participants from various clinics of Ladoke Akintola University Teaching Hospital, Osogbo and Abake medical centre Osogbo. Soluble serum transferrin receptor (sTfR) level was determined using Enzyme Linked Immunosorbent Assay (ELISA) with kit from R&D, Biosystems, UK with the hematocrit determined using the automated method by Sysmex 2006 facility. Serum transferrin receptor level in anemic patients is significantly higher than in control subjects (p 0.05) in sTfR was obtained between breast cancer and control subjects. Leukemia subjects however had a significantly lower sTfR level compared to the control subjects. All the test groups had hematocrit level significantly lower (p<0.05) than the control group. This study indicates that the anemias observed in breast cancer and leukemia patients are due to anemia of chronic disease (ACD), while anemia in the other anemic

Iron Deficiency: Beyond Anemia

Iron deficiency is the most common nutritional disorder affecting at least one third of world's population. Though anemia is common manifestation of iron deficiency, other effects of iron deficiency on various tissues, organs and systems are usually under recognized. Impaired brain development and cognitive, behavioural and psychomotor impairment are most worrisome manifestations of iron deficiency. Studies have demonstrated that some of these changes occurring during period of brain growth spurt (<2 years age) may be irreversible. Association of iron deficiency with febrile seizures, pica, breath holding spells, restless leg syndrome and thrombosis is increasingly being recognized. Impaired cell-mediated immunity and bactericidal function are generally noted in iron-deficient persons; however, the findings are inconsistent. Despite proven reversible functional immunological defects in vitro studies, a clinically important relationship between states of iron deficiency and susceptibility to infections remains controversial. Studies from malaria endemic regions have reported increased incidence of malaria in association with iron supplementation. These and some other aspects of iron deficiency are reviewed in this article.