Blood Iron Indices Research Articles

Effect of Haemoglobin and Iron Status of the Antenatal Mothers on their Newborns at Birth: A Cross-sectional Study

Introduction: Iron deficiency (ID) anaemia in pregnant mothers can affect the iron reserves of their newborns and lead to anaemia later. The haematological indices and iron status of pregnant women and its correlation with their neonates is still unclear. Aim: To assess the correlation between maternal and cord blood Hb and iron status. Materials and Methods: The present cross-sectional study included 134 antenatal mothers, at term gestation without any significant antenatal complications. Complete haemogram, serum iron, ferritin, and iron binding capacity were assessed for these mothers before delivery and also from the cord blood samples of their newborns at birth. Statistical difference and correlation were observed using Chi-square test and Pearson’s correlation coefficient. Results: Maternal anaemia Hb <11 gm/dL) was observed in 62 (46.3%). The mean Hb and ferritin of the mothers were 11.06±1.02 gm/dL and 113.3±7.1 μg/L, respectively. The mean Hb and ferritin levels of the cord blood samples were 12.24±0.17 gm/dL and 214.3±20.1 μg/L, respectively. In univariate analysis, maternal Hb showed a significant correlation with cord blood Hb with Odds Ratio (OR) 0.508 and 95% Confidence Interval (CI): 0.428-0.603. The Pearson’s correlation showed a moderate correlation between mother and cord blood Packed Cell Volume (PCV) (r=0.344, p<0.001) and weak correlation between other maternal and cord blood iron indices and serum ferritin (r=0.191, p=0.027 and r=0.203, p=0.019). Conclusion: There is a significant correlation between maternal and cord blood Hb in term neonates. The study indicates that the haematological indices of pregnant women determine the neonatal Hb in term babies.

Cord Blood-Derived Exosomal CNTN2 and BDNF: Potential Molecular Markers for Brain Health of Neonates at Risk for Iron Deficiency

Maternal iron deficiency anemia, obesity, and diabetes are prevalent during pregnancy. All are associated with neonatal brain iron deficiency (ID) and neurodevelopmental impairment. Exosomes are extracellular vesicles involved in cell–cell communication. Contactin-2 (CNTN2), a neural-specific glycoprotein, and brain-derived neurotrophic factor (BDNF) are important in neurodevelopment and found in exosomes. We hypothesized that exosomal CNTN2 and BDNF identify infants at risk for brain ID. Umbilical cord blood samples were measured for iron status. Maternal anemia, diabetes, and body mass index (BMI) were recorded. Cord blood exosomes were isolated and validated for the exosomal marker CD81 and the neural-specific exosomal marker CNTN2. Exosomal CNTN2 and BDNF levels were quantified by ELISA. Analysis of CNTN2 and BDNF levels as predictors of cord blood iron indices showed a direct correlation between CNTN2 and ferritin in all neonates (n = 79, β = 1.75, p = 0.02). In contrast, BDNF levels inversely correlated with ferritin (β = −1.20, p = 0.03), with stronger association in female neonates (n = 37, β = −1.35, p = 0.06), although there is no evidence of a sex-specific effect. Analysis of maternal risk factors for neonatal brain ID as predictors of exosomal CNTN2 and BDNF levels showed sex-specific relationships between infants of diabetic mothers (IDMs) and CNTN2 levels (Interaction p = 0.0005). While male IDMs exhibited a negative correlation (n = 42, β = −0.69, p = 0.02), female IDMs showed a positive correlation (n = 37, β = 0.92, p = 0.01) with CNTN2. A negative correlation between BNDF and maternal BMI was found with stronger association in female neonates (per 10 units BMI, β = −0.60, p = 0.04). These findings suggest CNTN2 and BNDF are respective molecular markers for male and female neonates at risk for brain ID. This study supports the potential of exosomal markers to assess neonatal brain status in at-risk infants.

Effects of Manganese Exposure on Blood Iron Indices in Miners of Iran Manganese Mines Co. (Qom)

Background: In present study, chronic exposure to manganese (Mn) and its effect on blood iron (Fe) indices in miners of Iran manganese mines-Qom have been investigated. Methods: In this cross-sectional study, fifty six miners and 5 control persons were studied cross sectionally. Prior to beginning of daily work, miners filed questionnaire and then their blood, urine and saliva samples were collected. Mn concentrations in samples were analyzed by atomic absorption spectroscopy (AAS). CBC analysis was performed by auto-analyzer system and blood Fe, transferrin (Tf), ferritin (Fr), total iron binding capacity (TIBC) and hemoglobin (Hb) were determined by respected commercial kits. Results processed by using software SPSS 16. Results: Between measured indices, only blood Mn, Fe and TIBC had significant difference in miners and controls (P < 0.05). The results showed that although Mn and Fe level increased in serum of miners but did not cause anemia. Result even the maximum manganese of blood, 1580 μg/L has not had undesired effects on miners iron homeostasis. Conclusions: Therefore Mn mining and Mn accumulation in blood did not increase the risk of impaired iron homeostasis. This may be due to co-exposure to Fe (in braunite (Mn mineral)) and/or compensatory mechanisms that don’t allow to wide range changes in blood parameters. Also personal discrepancy, social status, life style and place may influence the results of present study.

Impact of Growth Restriction and Other Prenatal Risk Factors on Cord Blood Iron Status in Prematurity.

To determine whether prenatal risk factors (RFs) that predict cord blood iron status in term newborns also predict iron status of premature newborns. Cord blood iron indices from 80 preterm newborns were compared with historical and demographic RFs for developing iron deficiency if born at term. The presence of multiple RFs did not incrementally interfere with cord iron status in preterm newborns. Poorer iron status accompanied being small for gestational age in prematurity, but other RFs, including diabetes, had relatively little impact. Growth-restricted preterm newborns are at risk for poor iron endowment, likely due to uteroplacental insufficiency. Other RFs were less impactful on iron status of premature newborns than in term newborns, likely reflecting that disruptive effects of RFs are more impactful in the third trimester. Understanding RFs for poor iron endowment is important for clinical recognition and treatment of premature babies.

English

This study aimed to evaluate the therapeutic yield of levonorgestrel-releasing intrauterine device (LNG-IUD) for management of tamoxifen induced menorrhagia in women who had mastectomy for treatment of breast cancer. This study included 34 patients who had breast cancer, underwent mastectomy, were maintained on tamoxifen post-operatively for at least 6 months, and had also newly developed menorrhagia throughout their follow-up period. All the patients underwent clinical examination for determination of duration and heaviness of menstrual blood loss (MBL), transvaginal ultrasonography (TVU) and endometrial biopsy for exclusion of abnormal pathology, estimation of blood iron indices and quality of life (QoL) scoring. Baseline endometrial biopsy detected simple endometrial hyperplasia (EH) in 4 patients and 30 patients had proliferative endometrium. Three patients were excluded and 31 patients completed the follow-up period without the need for shift to hysterectomy. Both mean duration and heaviness of MBL showed significant progressive decrease throughout the observation period as compared to baseline data. At the end of follow-up period, 5 women became amenorrheic, 2 women had moderate MBL and 24 women had mild MBL. Iron indices studies showed significant improvement at the end of follow-up as compared to baseline indices and total QoL scoring recorded at 6 and 12 months after enrollment were significantly higher as compared to baseline scores with significantly higher scores at 12 months.&nbsp; LNG-IUD could be considered as an appropriate therapeutic modality for tamoxifen-induced menorrhagia in patients who had mastectomy for breast cancer with significant reduction of duration and severity of MBL and improved QoL and iron indices. Key words: Levonorgestrel-releasing intrauterine device, mastectomy, menstrual blood loss, transvaginal ultrasonography.

Iron status at birth and at 4 weeks in preterm-SGA infants in comparison with preterm and term-AGA infants

Objective: To determine the iron status at birth in preterm small for gestational age (SGA) in comparison with preterm appropriate for gestation (AGA) and term-AGA infants. Methods: Mother–infant pairs with gestation of < 37 weeks, both SGA, and preterm-AGA and term-AGA as control were enrolled. Maternal, cord blood and infant blood samples at 4 weeks were obtained for various iron indices – cord serum ferritin, proportion of infants with “low” serum ferritin, serum ferritin at 4 weeks and correlation among maternal and neonatal iron indices – hemoglobin,serum ferritin and total iron-binding capacity. Results: There were 50 mother–infant pairs in each group. Cord serum ferritin levels were less in preterm-SGA group as compared to preterm-AGA group (median [interquartile range]: 68 [30 113] vs. 120 [73 127], p = 0.002) and preterm-AGA had less cord ferritin than term-AGA (141 [63 259], p = 0.006). The proportion of the infants with “low” serum ferritin was more in preterm-SGA than in preterm-AGA (16 [32%] vs. 5 [10%], p = 0.01). The serum ferritin levels at follow-up were also less in preterm-SGA as compared to preterm-AGA (143.5 ± 101 vs. 235.1 ± 160, p = 0.004). Other cord blood iron indices and follow-up serum ferritin levels were similar. There was no correlation among various maternal and neonatal cord iron parameters. Conclusions: Preterm-SGA infants have lesser total iron stores as compared to gestation-matched AGA infants, which is again lesser than term infants. Future studies can be planned to look at iron status at 12 months as well as their neurodevelopmental outcome.

An Epidemiologic Study on the Incidence and Significance of HFE Mutations in a Korean Cohort With Nonalcoholic Fatty Liver Disease

The incidence and significance of HFE mutations (C282Y, H63D, and S65C) in nonalcoholic fatty liver disease (NAFLD) has not been investigated in Korea. Mutation analysis of HFE gene and measurement of blood iron indices were carried out in 125 NAFLD patients and 221 controls. Neither C282Y nor S65C gene mutations were detected. The prevalence of the H63D mutation was higher in the NAFLD group (14.4%) than in the controls (7.2%) (P=0.032). The estimated odds ratio (OR) of NAFLD for H63D mutations was 3.09 (P=0.008) by multivariate analysis, and age, gender, obesity, diabetes mellitus, and hypercholesterolemia were independent variables associated with NAFLD. However, in the multivariate analysis containing interaction of the types of HFE mutations and gender, the prevalence of the H63D mutation was significantly higher in the male NAFLD group than in the male control group (OR=5.51, P=0.007); the difference of the prevalence between the NAFLD and the control group in females was not significant. The NAFLD patients with H63D mutations had higher levels of TS than those with the wild type (OR=3.14, P=0.048) by the multivariate analysis. A higher TS was significantly associated with the lower body mass index only in the male NAFLD group by multivariate analysis (OR=0.67, P=0.002). The presence of H63D mutations was an independent factor associated with NAFLD and elevated TS. Therefore, the H63D mutation may increase susceptibility to NAFLD probably associated with peripheral iron overload, especially in males.

Serum prohepcidin levels in chronic hepatitis C, alcoholic liver disease, and nonalcoholic fatty liver disease

Background/AimsPatients with various chronic liver diseases frequently have increased body iron stores. Prohepcidin is an easily measurable precursor of hepcidin, which is a key regulator of iron homeostasis. This study investigated the serum prohepcidin levels in patients with various chronic liver diseases with various etiologies.MethodsSerum prohepcidin levels were measured in patients with chronic hepatitis C (CH-C) (n=28), nonalcoholic fatty liver disease (NAFLD) (n=24), and alcoholic liver disease (ALD) (n=22), and in healthy controls (n=25) using commercial ELISA. Serum interleukin 6 (IL-6) levels and blood iron indices were also measured.ResultsThe serum levels of both prohepcidin and IL-6 were significantly higher in CH-C patients than in healthy controls, and there was a positive correlation between the IL-6 and prohepcidin levels (r=0.505, p=0.020). The prohepcidin levels in ALD patients did not differ from those in controls, despite their significantly elevated IL-6 levels. There was a tendency for a negative correlation between serum prohepcidin levels and transferrin saturation in ALD patients (r=-0.420, p=0.051). Neither prohepcidin nor IL-6 was significantly elevated in the NAFLD group, despite the presence of elevated serum iron and ferritin levels.ConclusionsThe role of prohepcidin may differ in different human liver diseases. In the setting of CH-C, both the serum prohepcidin and IL-6 levels were significantly elevated and were positively correlated with each other.

Hepatic Iron, Serum Ferritin, HFE Mutation, and Hepatic Fibrosis in Chronic Hepatitis C

Objectives: We studied the status of hepatic iron deposition and its relationship with blood iron indices, liver histology, and HFE gene mutations in Korean patients with chronic hepatitis C (CH-C). Methods: 105 patients with CH-C who underwent pretreatment liver biopsy were consecutively enrolled. The hepatic iron deposition, histological activity and fibrosis were assessed by appropriate pathological scoring systems, clinical data including serum iron indices, and HFE gene mutation. Results: Hepatic iron deposition was found in 37 patients (35%), which was not significantly associated with degree of hepatic fibrosis or steatosis. The serum ferritin level was elevated in 27% of the patients and was an independent factor associated with hepatic iron deposition by logistic regression; however, it was not significantly associated with hepatic fibrosis either. Only H63D heterozygote was found in 6 out of 48 patients (12.5%), which was not different from the prevalence of H63D mutation in the Korean population (8.5%). Conclusions: Hepatic iron deposition was uncommon and mild in Korean CH-C. Neither hepatic iron deposition nor serum ferritin were significantly related to the severity of hepatic fibrosis, which does not support the significant role of iron in the progression of hepatic fibrosis.

HFE Gene Mutations, Serum Ferritin Level, Transferrin Saturation, and Their Clinical Correlates in a Korean Population

The aim of this study was to investigate HFE gene mutations, blood iron indices, and their clinical correlates in a Korean population. In 484 prospectively enrolled health-check examinees, HFE gene mutations and iron indices with clinical and laboratory variables were analyzed. Although neither the C282Y nor S65C gene mutation were found, the H63D heterozygote was detected in 41 subjects (8.5%). The mean serum ferritin and transferrin saturation (TS) were 136.2 +/- 129.8 microg/dl and 39.2 +/- 15.7%, respectively. The H63D genotype was not significantly associated with iron indices. High serum ferritin was associated with old age, the male gender, high body mass index (BMI), and the presence of nonalcoholic fatty liver disease (NAFLD). High TS was associated with the male gender and alcohol drinking. HFE gene mutation is rare; however, TS seems to be higher in Koreans compared to Caucasians or other ethnic groups. Serum ferritin reflects iron store as well as the presence of NAFLD.

Iron Supplementation and Running Performance in Female Cross-Country Runners

The purpose of this study was to determine the effects of two weeks of high dosage iron supplementation on various blood iron indices and metabolic parameters in non-anemic, iron-depleted competitive female cross-country runners. The subjects were highly trained members of the Colorado State University cross-country team and were completing 40 to 50 miles of training weekly. A pretest, post-test single-blind crossover design was employed. Upon collection of baseline exercise blood and metabolic data, five subjects were randomly assigned to iron supplementation (650 mg ferrous sulfate; 130 mg elemental iron) and five subjects to placebo treatment. At two weeks the treatments were reversed. Exercise blood and metabolic data were collected at two-week intervals. Dietary iron intake was assessed using a three-day dietary survey. Dietary analysis revealed deficiencies in vitamin B-6, iron, magnesium, and zinc according to USRDA standards. Baseline blood samples revealed no deficiencies in iron storage or transport proteins. Two weeks of iron supplementation resulted in no significant increases in blood iron indices. Metabolic parameters related to running performance were also unchanged after iron supplementation. High dosage, short-term iron supplementation appears to have no effect on blood or metabolic parameters in iron-depleted but non-anemic female cross-country runners.