Iron Binding Research Articles

The role of unsaturated iron binding capacity (UIBC) in the diagnosis of anemia

The role of unsaturated iron binding capacity (UIBC) in the diagnosis of anemia

Is the Bioimpedance Method Sufficient in Evaluating the Nutritional Status of Patients Receiving Hemodialysis Treatment?

Aim: The purpose of this study was to test validity of bioelectrical impedance (BIA) analysis in the nutritional assessment among patients with receiving hemodialysis. Method: This study which was cross-sectional was conducted with 166 patients with hemodialysis at the hemodialysis units in two state hospital and a private hospital. The data were collected by means of patient information form, Malnutrition Inflammation Score (MIS) and Body Composition Analyzer. Descriptive, t test, Mann-Whitney U, chi-square, Wilcoxon, ROC analysis and logistic regresyon analysis were used in statistical analysis. Results: The average ages of patients were 51.57±13.01 (21-66) years. Of the patients, 53.6% were male. Mean body mass index (BMI) was 24.4±4.98 kg/m2 of whom (%54.8) were well-nourished. Male patients had higher albumin, muscule mass, and BMI than female patients and these values were statistical difference in according to gender. A significant difference was found to hemoglobin, albümin, iron binding, tanita fat ratio, fat mass, and BMI between the well-nourished and malnourished patients. The findings of logistic regretion analysis among MIS and BIA parameters shown that performance of BIA was statistical significantly. Conclusion: The results of study indicated that bioelectrical impedance analysis was shown to identify the most suitable BIA parameters for predicting presence of malnutrition. It could be suggested that BIA method may use for assess to nutritional status among patients receiving hemodialysis.

Verification of analytical performance of Unsaturated iron binding capacity (UIBC) assay on the Abbott Alinity ci®: Experience of the central laboratory of Mohammed VI University Hospital of Oujda

The verification of analytical methods is a requirement outlined by the International Organization for Standardization (ISO). This process involves evaluating the performance of an analytical method according to a well-defined protocol and subsequently comparing it with pre-established analytical objectives. In our study, we conducted an evaluation of the analytical performance of the unsaturated iron binding capacity assay using the Abbott kit on the Alinity CI analyzer in the biochemistry laboratory of Mohammed VI University Hospital in Oujda. The methodology employed adheres to the recommendations of the French accreditation committee (COFRAC) accreditation technical guide SH GTA 04, focusing on the assessment of reproducibility and repeatability. Overall, the results obtained from the study are considered satisfactory and align with the acceptability criteria recommended by the supplier. It's important to note that the accuracy and reliability of examination results are influenced not only by laboratory personnel, equipment, and environmental conditions, but also by the methods utilized and their eventual validation or verification.

Amino Acid Chelated Iron Versus Ferric Ammonium Citrate on Iron Status in Egyptian Children with Iron Deficiency Anemia: A Randomized Controlled Study

AbstractFew studies have compared the relative effectiveness of different iron compounds on iron status in school-age children with iron deficiency anemia. The objective of this study was to compare the effect of iron amino acid chelated (AACI) preparation versus ferric ammonium citrate (FAC) in treatment of iron deficiency anemia. Patients and methods: A randomized, clinical study was conducted on one hundred and sixty children aged 5–13 years old proved to have iron deficiency according to guide lines of WHO, 2001. All included children were subjected to the following laboratory investigations: CBC, reticulocytic count, CRP, serum iron, total iron binding capacity (TIBC), serum ferritin (SF), and serum hepcidin. Patients were assigned to two treatment regimens on randomized base 1:1 either to supplement with (AACI) or (FAC) once daily at bedtime. The subjects were followed up for eight weeks. Results: At the end of the study, group 1 who received AACI had increase in: Hb from 9.9 ± 1.1to 11.5 ± 0.3 gm/l(p = 0.01), MCV(fl) from 63.57.7 ± to 69 ± 6.3 (p = 0.05), serum iron from 49.5 ± 5.8 to 87 ± 12.7ug/dl(p = 0.001), serum ferritin from26.2 ± 10.5to 116.4 ± 19.7ng/ml(p = 0.001) while in group 2 who received FAC, there was increase in: HB from10.1 ± 1.7 to 11.2 ± 0.8, (p = 0.1), MCV from 64.5 ± 8.02 to 73.2 ± 8.9 (p = 0.01), serum iron from 48.2 ± 3.5to74 .3 ± 15 ug/dl (p = 0.01) and serum ferritin from 28.1 ± 9.3 to 84.3 ± 15.2 ng/ml (p = 0.006). Conclusion: Our study showed much improvement in iron status indices in AACI preparation with no significant statistically difference between it and FAC.

The Administration of Intradialytic Parenteral Nutrition Does Not Affect the Anemia Status of Chronic Kidney Disease Patients Undergoing Hemodialysis

Background: Hemodialysis (HD) patients are susceptible to malnutrition, and there is a close relationship between malnutrition and the incidence of anemia. Parenteral nutrition plays a role in treating malnutrition. Objective: This study aims to determine the effect of parenteral nutrition on anemia in HD patients. Methods: Quasi-experimental research which is part of the nutritional research tree at the Hemodialysis Unit of RSUP Dr. Soetomo Surabaya for 3 months. A total of 45 malnourished CKD patients (SGA B & C) undergoing routine HD were included in this study (n=26 received regular diet & education, n=17 received regular diet, education and intradialytic parenteral nutrition, and n=2 dropped out of school due to blood transfusion). Measurements of body mass index (BMI), hemoglobin (Hb), serum iron (SI), and total iron binding capacity (TIBC) were carried out before and 8 weeks after therapy. Between groups used the Mann-Whitney test, while pre and post used the Wilcoxon matched-pairs sign rank test. Results: The treatment group was older than the control group. There was no difference in duration of HD between groups. Intradialytic parenteral nutrition had no effect on BMI (24.71±3.939 vs 24.71±4.026; p=0.3802), Hb (9.746±1.309 vs 9.162±1.960; p= 0.3525), SI (62.33±34.74 vs. 53.78±24.89; p=0.3594), and TIBC (242.8±119.0 vs. 197.3±43, 65; p=0.4258). Conclusion: In HD patients, intradialytic parenteral nutrition for 8 weeks did not affect Hb, SI and TIBC levels. Long-term observations with larger samples are needed to confirm these findings.

Role of blood hepcidin alteration as a biomarker in β-thalassemia patients’ diagnosis

The objective of this research was to determine the change in hepcidin levels and other biochemical markers, including total iron binding capacity (TIBC), serum iron, testosterone, and specific vitamins in the blood of individuals with β-Thalassemia. Here, 140 participants were involved in the study, of whom 110 were affected by β-thalassemia and 30 were healthy. The samples were obtained from Baqubah Teaching Hospital, the blood bank and blood donation center. The study was carried out from May 2022 to August 2022, and the patients were housed in Diyala Provence, Baquba City and its suburbs. The participants in this investigation were split into three groups: A: 55 male patients with β-thalassemia; B: 55 female patients with β-thalassemia; and C: 30 healthy individuals that were set as a control group. The findings of the study showed that the levels of HbA1 in males and females were 93.44 ± 0.71 and 93.53 ± 0.91, respectively, while the levels of HbA2 in males and females were 4.99 ± 0.59 and 5.29 ± 0.72, respectively. In contrast, the control group had HbA1 levels of 97.33 ± 0.40 in males and 97.66 ± 0.46 in females, but HbA2 levels were 2.32 ± 0.33 in males and 2.24 ± 0.24 in females. The study revealed remarkable differences (P < 0.05) between these variables. Hematological measures, such as hemoglobin concentration and percentages of mean corpuscular volume (MCV), packed cell volume (PCV), and mean corpuscular hemoglobin (MCH) were substantially reduced (P < 0.05) in β-thalassemia patients when compared to the controls. Serum iron and TIBC were significantly increased (P < 0.05), while Hepcidin levels were markedly decreased (P < 0.05) in the serum of β-thalassemia patients compared to controls. Therefore, as a conclusion the reduction of hepcidin levels and increase in iron levels are correlated with β-thalassemia and can be used as a biomarkers in monitoring β-thalassemia disease.

Effect of dual modifications with ultrasonication and succinylation on Cicer arietinum protein-iron complexes: Characterization, digestibility, in-vitro cellular mineral uptake and preparation of fortified smoothie

The research aimed to evaluate the effect of ultrasonication and succinylation on the functional, iron binding, physiochemical, and cellular mineral uptake efficacy of chickpea protein concentrate. Succinylation resulted in significant improvements in the water-holding capacity (WHC) (25.47 %), oil-holding capacity (OHC) (31.38 %), and solubility (5.80 %) of the chickpea protein-iron complex. Mineral bioavailability significantly increased by 4.41 %, and there was a significant increase in cellular mineral uptake (64.64 %), retention (36.68 %), and transport (27.96 %). The ferritin content of the succinylated chickpea protein-iron complex showed a substantial increase of 66.31%. Furthermore, the dual modification approach combining ultrasonication and succinylation reduced the particle size of the protein-iron complex with a substantial reduction of 83.25 %. It also resulted in a significant enhancement of 51.5 % in the SH (sulfhydryl) content and 48.92 % in the surface hydrophobicity. Mineral bioavailability and cellular mineral uptake, retention, and transport were further enhanced through dual modification. In terms of application, the addition of single and dual-modified chickpea protein-iron complex to a fruit-based smoothie demonstrated positive acceptance in sensory attributes. Overall, the combined approach of succinylation and ultrasonication to the chickpea protein-iron complex shows a promising strategy for enhancing the physiochemical and techno-functional characteristics, cellular mineral uptake, and the development of vegan food products.

How does maternal anemia affect the levels of umbilical cord brain-derived neurotrophic factor?

ObjectiveIn this study, we aimed to evaluate the effect of maternal iron deficiency anemia on the umbilical cord level of brain-derived neurotrophic factor (BDNF), which plays a very important role in the central nervous system. MethodsOur research was planned as a quantitative, prospective, and analytical type of study. A total of 90 volunteers, term, singleton pregnant hospitalized in the Health Sciences University Ümraniye Training and Research Hospital Gynecology and Obstetrics Clinic between September 2021 and August 2022 were included in this study. While 45 of these pregnants were pregnant women with iron deficiency anemia (hemoglobin ≤ 110 g/L and serum ferritin level ≤ 12 μg/L), 45 cases were in the control group without iron deficiency anemia (hemoglobin > 110 g/L, serum ferritin > 12 μg/L). When pregnant were admitted to the hospital, blood samples were taken to analyze hemoglobin, mean cell volume (MCV), iron, unsaturated iron binding capacity, total iron binding capacity, serum ferritin, transferrin, and CRP levels. Also, we noted the maternal age, gravida, parity, birth weight, head circumference, type of birth, 1. minute Apgar score, and 5. minute Apgar score. During the delivery; after the umbilical cord had been clamped and cut, we took 5 cc of umbilical cord blood. Then, we put it in the serum-separating laboratory tubes. After we centrifuged these blood samples, we put the serum parts in the Eppendorf tubes to be stored at −80 degrees Celsius. At the end of the study, we calculated the level of BDNF using special human brain-derived neurotrophic factor ELISA kits. The umbilical cord BDNF levels of the maternal iron deficiency anemia group and the control group were compared statistically. ResultsWhen we evaluated the fetal umbilical cord BDNF values of 90 participants, the median value BDNF in the babies of 45 anemic mothers was 3.16 (IQR 0.73), and the median BDNF value of the babies of 45 healthy mothers was 5.37 (IQR 1.02). We found a statistical difference between BDNF and hemoglobin, hematocrit, MCV, and iron values between these two groups. ConclusionIn conclusion, the BDNF value of the babies of healthy individuals is higher than that of anemic individuals. Our study showed that the amount of BDNF in the umbilical cord blood was significantly affected by maternal iron deficiency anemia.

A chromosome-level genome assembly of the soybean pod borer: insights into larval transcriptional response to transgenic soybean expressing the pesticidal Cry1Ac protein

BackgroundGenetically modified (GM) crop plants with transgenic expression of Bacillus thuringiensis (Bt) pesticidal proteins are used to manage feeding damage by pest insects. The durability of this technology is threatened by the selection for resistance in pest populations. The molecular mechanism(s) involved in insect physiological response or evolution of resistance to Bt is not fully understood.ResultsTo investigate the response of a susceptible target insect to Bt, the soybean pod borer, Leguminivora glycinivorella (Lepidoptera: Tortricidae), was exposed to soybean, Glycine max, expressing Cry1Ac pesticidal protein or the non-transgenic parental cultivar. Assessment of larval changes in gene expression was facilitated by a third-generation sequenced and scaffolded chromosome-level assembly of the L. glycinivorella genome (657.4 Mb; 27 autosomes + Z chromosome), and subsequent structural annotation of 18,197 RefSeq gene models encoding 23,735 putative mRNA transcripts. Exposure of L. glycinivorella larvae to transgenic Cry1Ac G. max resulted in prediction of significant differential gene expression for 204 gene models (64 up- and 140 down-regulated) and differential splicing among isoforms for 10 genes compared to unexposed cohorts. Differentially expressed genes (DEGs) included putative peritrophic membrane constituents, orthologs of Bt receptor-encoding genes previously linked or associated with Bt resistance, and those involved in stress responses. Putative functional Gene Ontology (GO) annotations assigned to DEGs were significantly enriched for 36 categories at GO level 2, respectively. Most significantly enriched cellular component (CC), biological process (BP), and molecular function (MF) categories corresponded to vacuolar and microbody, transport and metabolic processes, and binding and reductase activities. The DEGs in enriched GO categories were biased for those that were down-regulated (≥ 0.783), with only MF categories GTPase and iron binding activities were bias for up-regulation genes.ConclusionsThis study provides insights into pathways and processes involved larval response to Bt intoxication, which may inform future unbiased investigations into mechanisms of resistance that show no evidence of alteration in midgut receptors.

Effects of the ferroptosis inducer erastin on osteogenic differentiation and biological pathways of primary osteoblasts

ABSTRACT Background Periodontitis is a chronic destructive inflammatory disease exacerbated by osteoblast dysfunction. Ferroptosis has emerged as a significant factor that could contribute to the pathological changes observed in periodontitis. However, the impact of ferroptosis on osteogenic differentiation and gene expression patterns of primary osteoblasts remain elusive. Methods In this study, osteoblasts were osteogenically induced for specific durations with and without the ferroptosis inducer erastin. Subsequently, cell proliferation, ferroptosis-related molecules, and osteogenic differentiation capacity were assessed. Furthermore, the differences in transcriptome expression following erastin treatment were analyzed by RNA sequencing. Results The results demonstrated that erastin treatment induced ferroptosis, resulting in suppressed cell proliferation and impaired osteogenic differentiation. Transcriptomic analysis revealed significant alterations in processes such as hydrogen peroxide catabolism, response to lipid peroxidation, and metal iron binding, as well as BMP receptor activity and collagen type XI trimer. Conclusion The ferroptosis inducer erastin inhibited osteoblast proliferation and differentiation. Our study provides novel insights into the effect of ferroptosis on osteogenesis, suggesting that targeting ferroptosis may present a promising approach in the treatment of periodontitis.

Ferrous gluconate triggers ferroptosis in Escherichia coli: Implications of lipid peroxidation and DNA damage

Microbial ferroptosis has been proved to combat drug-resistant pathogens, but whether this pattern can be applied to the prevention and control of Escherichia coli remains to be further explored. In this study, ferrous gluconate (FeGlu) showed remarkable efficacy in killing E. coli MG1655 with a mortality rate exceeding 99.9%, as well as enterotoxigenic E. coli H10407 (ETEC H10407) and enterohemorrhagic E. coli O157:H7 (EHEC O157:H7). Bacteria death was instigated by the infiltration of Fe2+, accompanied by a burst of intracellular reactive oxygen species (ROS) and lipid peroxidation. Notably, mitigating lipid peroxidation failed to alleviate death of E. coli. Further findings confirmed that FeGlu induced DNA damage, and ΔrecA mutant showed more sensitive, implicating that DNA damage was involved in the death of E. coli. The direct interaction of Fe2+ with DNA was demonstrated by fluorescent staining, gel electrophoresis, and circular dichroism (CD). Moreover, proteomic analysis unveiled 50 differentially expressed proteins (DEPs), including 18 significantly down-regulated proteins and 32 significantly up-regulated proteins. Among them, the down-regulation of SOS-responsive transcriptional suppressor LexA indicated DNA damage induced severely by FeGlu. Furthermore, FeGlu influenced pathways such as fatty acid metabolism (FadB, FadE), iron-sulfur cluster assembly (IscA, IscU, YadR), iron binding, and DNA-binding transcription, along with α-linolenic acid metabolism, fatty acid degradation, and pyruvate metabolism. These pathways were related to FeGlu stress, including lipid peroxidation and DNA damage. In summary, FeGlu facilitated ferroptosis in E. coli through mechanisms involving lipid peroxidation and DNA damage, which presents a new strategy for the development of innovative antimicrobial strategies targeting E. coli infections.

Intravenous iron infusions in pediatric patients: A retrospective review of efficacy and safety.

Pediatric iron deficiency anemia (IDA) is often treated with oral iron supplementation as the first-line therapy despite poor adherence. This single-institution retrospective chart review of pediatric patients was conducted to assess the safety, efficacy, and adherence of intravenous (IV) iron infusions compared to oral iron therapy in patients who had failed a trial of oral iron supplementation. We reviewed medical records of patients aged 1-21 with IDA who received at least one IV iron infusion at Cooper University Hospital between 2016 and 2021. Paired t-tests compared pre-infusion and post-infusion hematologic indices of hemoglobin (Hgb), mean corpuscular volume, red blood cell count, red cell distribution width, ferritin, total iron binding capacity, iron stores, and iron saturation. We compared adherence and adverse reactions to both oral iron supplementation and IV iron infusions using McNemar's test. A total of 107 subjects were included (mean age of 12.7 years). Hgb, ferritin, iron, and iron saturation between pre-infusion and post-final infusion significantly improved (p < 0.001). Hgb, ferritin, and iron improved when subcategorizing by race and etiology of IDA. Adherence to IV iron infusions (70.1%) was significantly greater than adherence to oral iron therapy (43.0%). There were also significantly fewer adverse effects with IV iron infusions (3.7%) compared to oral iron (77.9%). We demonstrated the safety, efficacy, and improved adherence of IV iron infusions compared to oral iron supplementation for treatment of pediatric IDA in patients who were unable to tolerate oral iron supplementation. Future studies could compare adherence to multiple doses of IV iron infusions in contrast with other single-dosing IV iron formulations.

Erythroferrone and hepcidin levels in children with iron deficiency anemia.

Iron deficiency anemia remains a significant public health issue in developing countries. The regulation of iron metabolism is primarily controlled by hepcidin, a key regulatory protein. During erythropoiesis, erythroferrone (ERFE), a hormone produced by erythroblasts in response to erythropoietin (EPO) synthesis, mediates the suppression of hepcidin. In this study, it was aimed to determine the correlation between erythroferrone (ERFE) and hepcidin levels in children with iron deficiency anemia. This is a case-control study conducted at Kırşehir Ahi Evran University Training and Research Hospital Pediatrics Clinic between 1 and 31 September 2020. The study included 26 healthy children and 26 children with iron deficiency anemia. In order to evaluate iron status,whole blood count, serum iron, total iron binding capacity (TIBC), and ferritin levels were analyzed. The study measured the levels of hepcidin and erythroferrone in the serum of children diagnosed with iron deficiency before and after one month of iron treatment, as well as in a control group, using the ELISA method. Correlation between whole blood count, initial ferritin, hepcidin, ERFE and ferritin in the iron deficiency group was evaluated. Compared with healthy controls, the iron-deficient group had significantly lower haemoglobin (p < 0.001), MCV (p = 0.001), MCH (p < 0.001), MCHC (p < 0.001), iron (p < 0.001), ferritin (p < 0.001) and hepcidin (p = 0.001). Ferritin and hepcidin levels increased while erythroferrone levels remained unchanged after iron deficiency treatment. There was no correlation between hepcidin and ferritin levels in treatment group. The study found a strong and positive correlation between ferritin and hepcidin levels in iron-deficient children, but not between ERFE levels, suggesting that hepcidin is largely regulated by iron deposition levels. In addition, there was an increase in ferritin and hepcidin levels after iron treatment. The study found no significant difference in erythroferrone levels between the iron-deficient group and the control group. It is thought that this may be due to the short duration of iron treatment given to the patients with iron deficiency anemia included in the study.

Association of single nucleotide polymorphism at BMP2 gene with iron deficiency status among anaemic patients in Hospital Universiti Sains Malaysia

BackgroundIron deficiency contributes for over half of all anaemia cases, especially among women and children. Iron deficiency anaemia remains a serious public health concern worldwide. The aim of this study is to determine the association between the single nucleotide polymorphism rs235756 in the bone morphogenetic protein 2 (BMP2) gene and iron deficiency status.Results104 total anaemic samples were selected from Hospital Universiti Sains Malaysia. ARMS-PCR was performed to genotype the rs235756 SNP in the 104 samples. The genotype distribution of BMP2 rs235756 showed that AG genotypes had the highest frequency 51(86.4%) followed by GG 6(10.2%) and AA 2(3.4%) in IDA group, whereas AG 42(93.3%), AA 2(4.4%) and GG 1(2.2%) were found in the other anaemia group. The minor allele frequency in BMP 2 rs235756 from this study (0.514) was not similar to the East Asian (EAS) population (0.135); however, the allelic frequency showed significant association between these two. The mean of total iron binding capacity level differed significantly between homozygous-dominant AA and AG + GG genotypes (P < 0.05) but no significant difference for the mean of haematological parameter, ferritin and serum iron.ConclusionsIn future clinical settings, this finding can potentially be as a guide in the early prediction for IDA patients through the genetic testing.

Effect of Iron Deficiency Anemia on HbA1c Levels Among Diabetic and Nondiabetic Patients

Abstract Background and Aims: Hemoglobin A1c (HbA1c) is widely used for assessment of glycemic status and diagnosis of diabetes. HbA1c levels are influenced by age, ethnicity, and conditions that alter the red cell turnover or survival. We aimed to assess the effect of iron deficiency anemia (IDA) on HbA1c levels among adult diabetic and nondiabetic patients and correlate HbA1c with iron profile. Materials and Methods: A cross-sectional study was carried out among 150 patients, of whom 50 were diagnosed diabetics with IDA, 50 were nondiabetics with IDA, and 50 were controls. They were investigated for hemogram, renal function test, HbA1c, and iron profile. Results: Mean HbA1c value among controls was 5.03 ± 0.34%, among diabetics with IDA was 8.69 ± 0.92%, and among nondiabetics with IDA was 5.87 ± 0.76% and this difference was statistically significant. Total iron binding capacity (TIBC) was 332.54 ± 58.32 µg/dL among controls, 420.63 ± 119.03 µg/dL among nondiabetics with IDA, and 495.88 ± 126.79 µg/dL among diabetics with IDA. Pearson’s correlation coefficient of HbA1c with serum ferritin was -0.444, with serum iron was -0.357, and with TIBC was 0.476. Conclusion: HbA1c levels are elevated in diabetes with IDA. HBA1c is negatively correlated with serum iron and ferritin and positively correlated with TIBC.

Genetically predicted biomarkers of iron homeostasis and risk of non-ischemic cardiomyopathy: A mendelian randomization study

Background and aimsBoth iron overload and iron deficiency have been associated with cardiovascular diseases in observational studies. Previous Mendelian Randomization (MR) studies discovered a protective effect of higher iron status on coronary atrial disease, while a neutral effect on all-cause heart failure. Using two-sample MR, we evaluated how genetically predicted systemic iron status affects the risk of non-ischemic cardiomyopathy and different phenotypes. Methods and resultsTwo-sample MR analyses were performed to estimate the causal effect of four biomarkers of systemic iron status on diagnosed cardiomyopathy and its subtypes in 242,607 participants from the FinnGen research project. The level of transferrin saturation was significantly associated with an increased risk of cardiomyopathy (OR, 1.17; 95% CI, 1.13–1.38) when using nine separately selected genetic instruments. An increase in genetically determined serum iron (odds ratio [OR] per standard deviation [SD], 1.25; 95% confidence interval [CI], 1.13–1.38) and ferritin (OR, 1.49; 95% CI, 1.02–2.18) were associated with an increased risk of cardiomyopathy. Total iron binding capacity, a marker of reduced iron status, was inversely linked with cardiomyopathy (OR, 0.80; 95% CI, 0.65–0.98). The risk effect of iron status was more evident in hypertrophic cardiomyopathy and related heart failure. ConclusionsThese analyses support the causal effect of increased systemic iron status on a higher risk of non-ischemic cardiomyopathy. A screening test for cardiomyopathy should be considered in patients with evidence of iron overload. Future study is needed for exploring the mechanism of these causal variants on cardiomyopathy.

Prevalence of iron deficiency in type 2 diabetes mellitus patients and its association with altered lipid profile

Abstract Background: The escalation of diabetes mellitus poses a significant public health challenge in India. This condition impacts iron metabolism, potentially causing variations in the iron profile. This study aimed to ascertain the prevalence of iron deficiency in individuals with type 2 diabetes mellitus and explore its associated factors. Materials and Methods: A cross-sectional study was conducted on adult patients with type 2 diabetes mellitus at a tertiary care center in Eastern India. Biochemical assessments encompassed fasting plasma glucose, post-prandial glucose, glycosylated hemoglobin (HbA1c), lipid profile, renal function tests, complete hemogram, and iron profile. Anthropometric measurements were conducted using standardized procedures. Results: This study revealed that among the 203 participants, the prevalence of iron deficiency was 63.5% (95% confidence interval: 56.5–70.2). Anemia was observed in 34% of patients (men &lt;13 g/dL, women &lt;12 g/dL). The mean levels of serum iron, ferritin, total iron binding capacity, and transferrin saturation were 62.9 ± 26.1 μg/dL, 100.6 ± 103.2 ng/mL, 392.3 ± 72 μg/dL, and 16.6 ± 7.5%, respectively. The mean fasting blood sugar, post-prandial blood sugar, and HbA1c values were 154.2 ± 63 mg/dL, 229.3 ± 92.1 mg/dL, and 7.7 ± 1.5%, respectively. There were no significant differences in iron levels between genders or between poorly controlled and well-controlled diabetics. However, significant associations were observed between iron deficiency and lower total cholesterol levels, low-density lipoprotein, and triglycerides. Conclusion: This study concludes that iron deficiency is highly prevalent among diabetic patients in India and is associated with lipid profile alterations.

No genetic causal association between iron status and pulmonary artery hypertension: Insights from a two‐sample Mendelian randomization

AbstractTo explore the genetic causal association between pulmonary artery hypertension (PAH) and iron status through Mendelian randomization (MR), we conducted MR analysis using publicly available genome‐wide association study (GWAS) summary data. Five indicators related to iron status (serum iron, ferritin, total iron binding capacity (TIBC), soluble transferrin receptor (sTfR), and transferrin saturation) served as exposures, while PAH was the outcome. The genetic causal association between these iron status indicators and PAH was assessed using the inverse variance weighted (IVW) method. Cochran's Q statistic was employed to evaluate heterogeneity. We assessed pleiotropy using MR‐Egger regression and MR‐Presso test. Additionally, we validated our results using the Weighted median, Simple mode, and Weighted mode methods. Based on the IVW method, we found no causal association between iron status (serum iron, ferritin, TIBC, sTfR, and transferrin saturation) and PAH (pβ &gt; 0.05). The Weighted median, Simple mode, and Weighted mode methods showed no potential genetic causal association (pβ &gt; 0.05 in the three analyses). Additionally, no heterogeneity or horizontal pleiotropy was detected in any of the analyses. Our results show that there are no genetic causal association between iron status and PAH.

Impact of Oral Nutritional Supplementation in Chronic Kidney Disease Patients on Maintenance Hemodialysis: An Open-label, Single-arm Study among Indian Patients.

Protein-energy wasting (PEW) affects about 50-75% of patients with chronic kidney disease (CKD), particularly those who are on maintenance hemodialysis (MHD). This study evaluated the efficacy and tolerability of an oral nutritional supplement in Indian patients receiving MHD. This was a 3-month, prospective, open-label, and single-centered study. Eligible participants supplemented their regular diet with one sachet (40 gm) of oral nutritional supplement powder twice daily for 90 days. The study efficacy endpoints were mean change in acute phase proteins (albumin and prealbumin), anthropometric measurements [weight, body mass index (BMI), and triceps skin fold thickness], handgrip strength, hemoglobin, total iron binding capacity (TIBC), potassium, and phosphorus levels, malnutrition score (MS)-modified subjective global assessment (modified SGA), malnutrition inflammation score (MIS), and nutritional status. The study population comprised 36 (42.9%) men and 48 (57.1%) women with a mean age of 54.85 ± 15.50 years. A paired sample t-test was used to compare the baseline with end-of-study values for continuous variables. Serum albumin, prealbumin, hemoglobin, and phosphorus levels remained stable throughout the study period. The mean change in weight, BMI, triceps skin fold thickness, handgrip strength, and TIBC for the overall study population was 1.11 kg (1.82%, p < 0.0001), 0.46 kg/m2 (1.98%, p < 0.0001), 3.47 mm (30.78%, p < 0.0001), 6.05 kg (44.98%, p < 0.0001) and 11.80 µg/dL (6.06%, p < 0.0001), respectively. At the end of the study period, there was a significant (p < 0.0001) improvement in the SGA and MIS scores. Further, there was a significant improvement in nutritional status as demonstrated by the overall intake of calories (p < 0.001), proteins (p < 0.0001), carbohydrates (p = 0.003, and fats (p < 0.0001). Protein-energy malnutrition is a strong predictor of morbidity, mortality, and poor outcomes in CKD patients. A scientifically designed formula in accordance with KDOQI standards was able to improve the nutritional status, overall body composition, sarcopenia, and quality of life in CKD patients on MHD.

Introduction: Women are considered to be vulnerable with regards to immunothrombotic conditions. Exploring this bidirectional susceptibility across the different female reproductive phases is important for effective maternal healthcare delivery. This study assessed selected indicators of immunothrombosis between premenopausal and postmenopausal women. Methods: Equal numbers of premenopausal and postmenopausal women totaling one hundred were recruited for this comparative study. Blood sample

Introduction: Maternal healthcare takes into consideration the immediate state of an individual woman with regards to health status and subsequent management. Anaemia is a common maternal health challenge that is affected by hormonal shifts in women. Thus, this study focused on prevalence of anaemia and iron requirement across women of premenopausal and postmenopausal phases. Methods: This study enrolled apparently healthy 100 females with equal numbers of premenopausal and postmenopausal subjects. Blood sample was appropriately obtained from each subject for assessment of red cell and iron parameters. Microhaematocrit and cyanmethaemoglobin methods were employed for the measurement of packed cell volume and haemoglobin concentration respectively, while the iron parameters were assayed by colorimetric methods. Transferrin saturation was mathematically derived. Results are expressed as Frequencies and Mean ±SD, while student t-test was used for analysis of data on SPSS version 22.0. Statistical significance was drawn at a p≤ 0.05. Results: Postmenopausal women had significantly higher values of packed cell volume (0.38 ± 0.03 l/l), haemoglobin concentration (125.50 ± 9.30 g/l), serum iron (23.17 ± 0.93 µmol/l) and transferrin saturation (36.88 ± 2.00 %) than the premenopausal women (0.37 ± 0.02 l/l, 121.44 ± 7.83 g/l, 15.53 ± 2.60 µmol/l and 20.70 ± 3.60 % respectively) while the premenopausal women had significantly higher values in total iron binding capacity (75.24 ± 3.32 µmol/l) than the postmenopausal women (62.97 ± 1.88 µmol/l. Whereas 30% of the premenopausal women were anaemic and 10% had low transferrin saturation, anaemia in postmenopausal women occurred at a prevalence of 18% and the indicators of iron need were adequate. Conclusion: This study has shown that among apparently healthy individuals, prevalence of anaemia and iron requirement are lower in postmenopausal women than premenopausal women.