Decreased Serum Iron Levels Research Articles

Study of Nutritional Anemia in Children Admitted to Pediatric Department in Rural Teaching Hospital of Telangana

Abstract Background: Globally, around 600 million preschool and school aged children are affected by anemia. According to World Health Organization, 65.5% of preschool children in southeast asia are anemic. Nutritional anemia is the commonest cause of anemia resulting from deficiencies of nutrients essential for red blood cell formation. Iron deficiency anemia is the most common nutritional deficiency amounting to 50%, followed by vitamin B12 and folate deficiency. This study is conducted to study the incidence of nutritional anemia among hospitalised children in a territory care teaching hospital in rural Telangana, in the age group of 6 months to 18 years and to bring awareness regarding the diet requirements in children in order to prevent deficiencies thereby the consequences of nutritional deficiencies. Method: This was a prospective hospital-based study conducted to study the incidence of Nutritional anemia along with clinical and hematological profile of nutritional anemia amongst children admitted to the Department of pediatrics in the age group of 6 months to 18 years at Mediciti Institute of Medical Sciences, Ghanpur, Telangana, from January 1st 2020 to June 30th 2021. All the children who had satisfied the inclusion criteria after taking consent from their parents were included in the study. Result: The incidence of nutritional anemia in the present study was found to be 52.08%, with both males and females equally affected. The age group of 6–12 years was particularly impacted, accounting for 49.3% of the cases. A significant 94% of the cases were associated with inadequate protein intake as per ICMR guidelines. Children from socio-economic classes 2 and 3, as per the Kuppuswamy scale, were more frequently affected. Severe anemia was observed in 8.7% of the cases. Peripheral smear analysis revealed microcytic, hypochromic red blood cells in 64.4% of the cases, with 94% of the children showing decreased serum iron levels. Conclusion: Nutritional anemia is the major cause of anemia in hospitalised children affecting majorly children in the age group of 6-12 years. Inadequate protein intake is the major contributor accounting to 94%, which can be prevented with proper dietary measures

Association between ferritin, hemoglobin, and anemia response in jaktinib-treated patients with myelofibrosis: A post-hoc analysis of the ZGJAK006 study.

e18527 Background: Iron metabolism is disrupted in MF through the increased production of hepcidin, contributing to increased ferritin levels and iron-binding capacity, decreased serum iron levels and hemoglobin levels. Hepcidin production is upregulated by JAK/STAT pathway and BMP6/ACVR1/SMAD pathway. Jaktinib showed inhibition effects on JAK family and ACVR1 in preclinical studies. Anemia benefits with jaktinib treatment were observed in several clinical studies in MF pts. To explore the underlying mechanisms, we conducted a post-hoc analysis to investigate the change of ferritin levels during jaktinib treatment in MF pts with and without anemia response from a phase 2 study in pts who were intolerant to ruxolitinib (the ZGJAK006 study). Methods: Pts from the ZGJAK006 study were included if they were RBC transfusion dependent or with hemoglobin level ≤100 g/L at baseline. Transfusion dependence was assigned to pts with an average RBC transfusion of ≥2 U/month within 3 months prior to study drug administration. Pts without baseline ferritin results were excluded. Eligible pts were divided into 2 groups: anemia responders by week 24 and non-responders by week 24. Anemia response was defined as becoming RBC transfusion independent (defined by no transfusion in ≥12 consecutive weeks and hemoglobin ≥85 g/L) for transfusion-dependent pts or a ≥20 g/L increase in hemoglobin for non-transfusion-dependent pts with baseline hemoglobin ≤100 g/L. Results: A total of 39 pts were included in this post-hoc analysis, with 14 anemia responders and 25 non-responders. The baseline hemoglobin was similar in responders (median: 78.5 g/L) and non-responders (median: 78.0 g/L). The baseline levels of ferritin were higher than upper limit of normal in most pts (69.2%) with a median of 784.6 ng/mL in the overall population (697.5 ng/mL in responders and 785.0 ng/mL in non-responders). Ferritin decreased to 583.9 and 531.7 ng/mL at weeks 12 and 24, respectively. Notably, anemia responders had a fast reduction in ferritin and increase in hemoglobin compared to non-responders. In addition, the hemoglobin levels of those non-responders maintained were stable and eight non-responders had a ≥50% decrease in RBC infusion frequency or unit. Six (42.9%) of 14 responders and 10 (40.0%) of 25 non-responders achieved spleen volume reduction of ≥ 35% from baseline at week 24. Conclusions: In this post-hoc analysis of pts with anemic MF, jaktinib treatment led to improvement in iron metabolism and anemia. The results were in consistence with the known activities of jaktinib against JAK family and ACVR1. Moreover, similar spleen responses were observed for anemia responders and non-responders. Nevertheless, ferritin was the only marker of iron metabolism measured in this study, a translational biology study evaluating hepcidin may be needed to further support the clinical findings. Clinical trial information: NCT04217993 .

Analysis of related factors of CRA in lung cancer patients with different serum iron levels: A retrospective cohort study.

Serum iron, an essential component of hemoglobin (Hb) synthesis invivo, is a crucial parameter for evaluating the body's iron storage and metabolism capacity. Iron deficiency leads to reduced Hb synthesis in red blood cells and smaller red blood cell volume, ultimately resulting in iron-deficiency anemia. Although serum iron cannot independently evaluate iron storage or metabolism ability, it can reflect iron concentration invivo and serve as a good predictor of iron-deficiency anemia. Therefore, exploring the influence of different serum iron levels on anemia and diagnosing and treating iron deficiency in the early stages is of great significance for patients with lung cancer. This study aims to explore the related factors of cancer-related anemia (CRA) in lung cancer and construct a nomogram prediction model to evaluate the risk of CRA in patients with different serum iron levels. A single-center retrospective cohort study was conducted, including 1610 patients with lung cancer, of whom 1040 had CRA. The relationship between CRA and its influencing factors was analyzed using multiple linear regression models. Lung cancer patients were divided into two groups according to their serum iron levels: decreased serum iron and normal serum iron. Each group was randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The influencing factors were screened by univariate and multivariate logistic regression analyses, and nomogram models were constructed. The area under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the models. CRA in lung cancer is mainly related to surgery, chemotherapy, Karnofsky Performance Status (KPS) score, serum iron, C-reactive protein (CRP), albumin, and total cholesterol (p < 0.05). CRA in lung cancer patients with decreased serum iron is primarily associated with albumin, age, and cancer staging, while CRA in lung cancer patients with normal serum iron is mainly related to CRP, albumin, total cholesterol, and cancer staging. The area under the ROC curve of the training cohort and validation cohort for the prediction model of lung cancer patients with decreased serum iron was 0.758 and 0.760, respectively. Similarly, the area under the ROC curve of the training cohort and validation cohort for the prediction model of lung cancer patients with normal serum iron was 0.715 and 0.730, respectively. The calibration curves of both prediction models were around the ideal 45° line, suggesting good discrimination and calibration. DCA showed that the nomograms had good clinical utility. Both models have good reliability and validity and have significant clinical value. They can help doctors better assess the risk of developing CRA in lung cancer patients. CRP is a risk factor for CRA in lung cancer patients with normal serum iron but not in patients with decreased serum iron. Therefore, whether CRP and the inflammatory state represented by CRP will further aggravate the decrease in serum iron levels, thus contributing to anemia, warrants further study.

Assessing Nutritional Anemia Among University Students in Jazan, Saudi Arabia: A Public Health Perspective.

Nutritional anemia is a significant public health concern worldwide, particularly affecting young adults and children in Saudi Arabia, where inadequate nutrition is considered a primary contributing factor. This study aims to (i) examine the levels of serum iron, folate, and vitamin B12 in young adult students, with a focus on identifying any deficiencies and their association with anemia; (ii) explore the prevalence of mixed-deficiency anemia resulting from deficiencies in serum iron, folate, and vitamin B12 (iii) explore how sociodemographic characteristics and dietary habits influence serum iron, folate, and vitamin B12 levels. This cross-sectional study encompassed 158 young adult students at Jazan University, Saudi Arabia. Blood samples were collected following a comprehensive questionnaire addressing sociodemographic and health characteristics. These samples were analyzed for complete blood count, serum iron, folate, and vitamin B12 levels. The findings of this study revealed a significant decrease in serum iron levels, with 70.6% of males and 88% in females exhibiting reduced level. Additionally, low levels of folate were observed in 4% of the study population, while deficiency in vitamin B12 was found in 2.2% of the study population. However, the simultaneous presence of low serum iron levels along with deficiencies in folate or vitamin B12 was not observed in the study participants. The study indicates that there is a high incidence of low serum iron and ferritin levels among university students in Saudi Arabia, which poses a considerable public health concern. Conversely, the prevalence of folate and vitamin B12 deficiencies among the students was comparatively low, and notably, there were no cases where these deficiencies were observed alongside iron deficiency.

The effect of iron deficiency anemia on myocardial function in pediatrics

BackgroundIron deficiency is one of the most common types of anemia in children. Anemia leads to tissue hypoxia, which activates compensatory mechanisms such as increased cardiac output. Tissue Doppler imaging (TDI) is a useful echocardiographic technique for evaluation of regional and global myocardial systolic and diastolic function. ObjectivesThis study aimed to determine whether iron deficiency anemia (IDA) affects myocardial function in pediatric patients using conventional echocardiography and TDI. MethodsThis case-control study was conducted at an outpatient general pediatric clinic in cooperation with the Cardiology Unit of the Pediatric Department of Fayoum University Hospital from May 2021 to February 2022. The study included 30 cases with IDA and 30 apparently healthy children. The two study groups were matched for age and sex. ResultsThere was an increase in left ventricular end-diastolic diameter (LVEDD), while the control group showed increased ejection time (ET). There was a statistically significant lower mean E/A ratio among cases. There was a positive correlation between serum iron levels, ET, and isovolumetric contraction time (IVCT) among the cases. Additionally, there was a negative correlation between hemoglobin levels and LVEDD in the entire study group. No significant difference was found between the two study groups regarding the Tei index. ConclusionMinimal alterations in LV function parameters may occur due to IDA. A decrease in serum iron levels was significantly associated with further decreases in ET and IVCT. Additionally, there was a statistically significant lower mean E/A ratio among cases.

The role of serum ferritin, vitamin B12 and vitamin D levels in childhood primary headaches

Aim: In this study, it was aimed to investigate the relationship between headache components and serum ferritin, vitamin B12 and vitamin D levels in pediatric patients with migraine and tension-type headache (TTH).&#x0D; Methods: The data of patients aged 7-17 years who applied to the outpatient pediatric neurology clinic with a complaint of headache and were diagnosed with migraine and TTH based on the International Classification of Headache Disorder (ICHD)-3 beta criteria were evaluated retrospectively.&#x0D; Results: The mean age of the patients was 13.80 ± 3.89 years in the migraine group and 14.10± 4.17 years in the TTH group. In the migraine group, the duration of the attack was longer and the pain intensity was higher. Unilateral headache, throbbing character, nausea, vomiting, discomfort from light and sound were statistically significantly higher in the migraine group. In patients with migraine, low vitamin D and low ferritin levels were associated with a prolongation of the disease duration and an increase in the frequency of attacks. A decrease in serum iron level was associated with an increase in pain severity and a decrease in vitamin D levels was associated with an increase in attack duration. It was observed that there was an increase in the frequency of attacks with a decrease in serum ferritin levels in the TTH group. No statistically significant correlation was found between headache characteristics and vitamin B12.&#x0D; Conclusions: Our study shows the necessity of routine evaluation of vitamin D and ferritin levels in childhood primary headaches.

Lower Serum Iron Level Predicts Postoperative Global Cerebral Edema Following Aneurysmal Subarachnoid Hemorrhage.

Iron plays an important role in neuronal injury and edema formation after intracranial hemorrhage. However, the role of serum iron in aneurysmal subarachnoid hemorrhage (aSAH) is yet to be well-established. This study aims to identify whether serum iron could predict postoperative global cerebral edema (GCE) and poor outcome in aSAH. 847 patients' aSAH clinical data were retrospectively collected at the First Affiliated Hospital of Fujian Medical University. Data on demographics, clinical characteristics, and laboratory values were collected and analyzed through univariate and multivariate analyses. Propensity score matching (PSM) analysis was performed to balance the baseline differences between the groups. The incidence of high-grade global cerebral edema (H-GCE) following aSAH was 12.99% (110/847). Serum iron levels [odds ratio (OR) = 1.143; 95% confidence interval (CI), (1.097-1.191); p < 0.001] were associated with the occurrence of H-GCE following aSAH in the univariate analysis. This association remained statistically significant even after adjusting for other variables in the multivariate model, with serum iron having an OR of 1.091 (95% CI, 1.043-1.141; p < 0.001) for GCE. After 1:1 PSM, serum iron levels ≤ 10.7 µmol/L remained a significant independent predictor of GCE (p = 0.002). The receiver operating characteristic (ROC) curve analysis determined that a serum iron cut-off value of ≤ 10.7 µmol/L was optimal for predicting H-GCE [Areas under the ROC curves (AUC) = 0.701, 95% CI, (0.669-0.732), p < 0.001; sensitivity, 67.27%; specificity, 63.77%] in patients with aSAH. Additionally, a trend was observed in which higher Hunt-Hess grades (HH grade) were associated with lower serum iron levels, and higher modified Fisher grades (mFisher grade) were associated with lower serum iron levels. In addition, the serum iron level was also associated with a 3-month functional neurological outcome (p < 0.001). The results of this study indicate that a decreased serum iron level serves as a clinically significant biomarker for the prediction of postoperative GCE and a poor outcome at 3-months in patients with aSAH.

The iron deficiency anemia in association to Helicobacter pylori infection in Najran city, Saudi Arabia

Despite previous studies showing that Helicobacter pylori influences iron consumption, it is unknown what causes iron deficiency anemia in response to H. pylori infection. The goal of the study was to find out whether having an infection with H. pylori was linked to a drop-in serum iron level. Detection of H. pylori infection presented by serological test to detect titers of IgG and IgA in blood serum. The determination of iron serum level was performed by using biochemistry spectrophotometry test. Additionally, a full blood count was done to assess the haemoglobin concentration and establish whether the patient was anemic. Data analysis included descriptive statistics, Chi-square, and Mann–Whitney U test. Approximately 35% of the H. pylori group reported a low serum iron level against a 5% only in the control group. Also, the total bilirubin levels were 2.6-fold more among H. pylori positive cases than controls. H. pylori can cause a decrease in serum iron levels in infected individuals and eventually lead to iron deficiency anemia. Moreover, high total bilirubin levels are recorded among H. pylori-infected patients.

Glycochenodeoxycholate Affects Iron Homeostasis via Up-Regulating Hepcidin Expression.

Increasing hepcidin expression is a vital factor in iron homeostasis imbalance among patients with chronic kidney disease (CKD). Recent studies have elucidated that abnormal serum steroid levels might cause the elevation of hepcidin. Glycochenodeoxycholate (GCDCA), a steroid, is significantly elevated in patients with CKD. However, the correlation between GCDCA and hepcidin has not been elucidated. Decreased serum iron levels and increased hepcidin levels were both detected in patients with CKD in this study. Additionally, the concentrations of GCDCA in nephropathy patients were found to be higher than those in healthy subjects. HepG2 cells were used to investigate the effect of GCDCA on hepcidin in vitro. The results showed that hepcidin expression increased by nearly two-fold against control under 200 μM GCDCA treatment. The phosphorylation of SMAD1/5/8 increased remarkably, while STAT3 and CREBH remained unchanged. GCDCA triggered the expression of farnesoid X receptor (FXR), followed with the transcription and expression of both BMP6 and ALK3 (upward regulators of SMAD1/5/8). Thus, GCDCA is a potential regulator for hepcidin, which possibly acts by triggering FXR and the BMP6/ALK3-SMAD signaling pathway. Furthermore, 40 C57/BL6 mice were treated with 100 mg/kg/d, 200 mg/kg/d, and 300 mg/kg/d GCDCA to investigate its effect on hepcidin in vivo. The serum level of hepcidin increased in mice treated with 200 mg/kg/d and 300 mg/kg/d GCDCA, while hemoglobin and serum iron levels decreased. Similarly, the FXR-mediated SMAD signaling pathway was also responsible for activating hepcidin in liver. Overall, it was concluded that GCDCA could induce the expression of hepcidin and reduce serum iron level, in which FXR activation-related SMAD signaling was the main target for GCDCA. Thus, abnormal GCDCA level indicates a potential risk of iron homeostasis imbalance.

Этиопатогенетические аспекты влияния анемического синдрома на возникновение, течение и исход коронавирусной инфекции COVID-19

We consider relevant to modern realities coronavirus infection, which most of us, if not all of us, have encountered. And no less common among the population of the clinical and hematological syndrome is anemia. Anemia in coronavirus infection can be both a contributing factor to its development and a direct consequence of infection. We consider dyserythropoietic “deficiency” anemia – iron deficiency and anemia of chronic diseases characterized by a decrease in serum iron levels. In turn, iron is an active participant in tissue respiration and ensures the normal functioning of the immune system. Data were collected on the incidence of COVID-19 in patients with pre-existing anemia, we consider and analyze the incidence of anemia as a complication of coronavirus infection, and the overall impact of anemia on the severity of COVID-19 and its outcomes, the role of anemia in the necessity for artificial lung ventilation in patients, the development of complications associated with suppression of the immune system and oxygen starvation .The study revealed a significant negative impact of anemia on the course and outcome of coronavirus infection, as well as a its significant role in development of such severe conditions as hypoxic coma, acute respiratory distress syndrome and cytokine storm.

The relationship between hepcidin and anemia in controlled and uncontrolled Type-2 Diabetes Mellitus (T2DM) patients at Sanglah Hospital, Bali, Indonesia

Background: Anemia in patients with diabetes mellitus (DM) is often associated with anemia of chronic disease caused by inflammation or iron metabolism disorders. Hepcidin is known to function in initiating the internalization and degradation of ferroportin. It can inhibit the release of iron from cells where an increase in hepcidin levels will reduce iron absorption in the intestine, resulting in a decrease in serum iron levels. This study aims to determine the relationship between serum hepcidin levels and anemia in patients with Type-2 Diabetes Mellitus (T2DM).Methods: This cross-sectional study was conducted on 77 consecutive T2DM patients who met the inclusion and exclusion criteria and received health services at Sanglah Hospital, Bali, Indonesia, during the study period. The variables assessed in this study included T2DM status (controlled and uncontrolled), anemia, hemoglobin, HbA1c, erythrocyte sedimentation rate, and hepcidin. Data were analyzed with SPSS version 20 for Mac.Results: There was no significant difference in age, sex, disease duration, SGOT, SGPT, leukocytes, platelets, and ESR between controlled and uncontrolled T2DM groups (p&gt;0.05). However, there was a significant difference in eGFR and hemoglobin levels between controlled and uncontrolled T2DM groups (p&lt;0.05). Mann-Whitney U test found a significant difference in hepcidin levels between controlled and uncontrolled T2DM groups (MD=138.14; 95%CI=10.65-286.94; p=0.046). A weak significant negative correlation was found between hemoglobin and hepcidin levels by the Spearman correlation test (r=-0.259; p=0.043).Conclusion: There was a significant difference between the mean hemoglobin and hepcidin levels in the controlled T2DM group compared to uncontrolled T2DM group patients. A weak statistically significant negative correlation was found between hepcidin levels and anemia in T2DM patients.

Abnormal iron status is independently associated with reduced oscillometric lung function in schoolchildren.

Associations between anemia and allergic diseases have been reported, but the relationship of iron deficiency with airway dysfunction in children remains unclear. We aimed to investigate the relationship between abnormal iron parameters and lung function in schoolchildren. Four hundred and forty-five children (10-12years-old) from 11 elementary schools in were enrolled. The relationships of different iron parameters (hemoglobin, serum iron, transferrin saturation, and serum ferritin) with lung function evaluated by impulse oscillometry (airways resistanceat 5Hz [Rrs5], 10Hz [Rrs10], and the difference of Rrs5 and Rrs20 Hz [Rrs5-20]), and with exhaled nitric oxide (FeNO) were evaluated after adjustment for confounders including height, sex, and body mass index z-score, and for additional covariates that could affect airway function. Total airway dysfunction represented by Rrs5 was reduced in participants with low serum iron level (aβ: -0.13, 95% CI: -0.23 to -0.03, p=0.040) after adjustment for key confounders, but did not correlate with other iron profiles. Reduced oscillometric lung function recorded as Rrs5-20 was related with low serum iron and high serum ferritin, but the results were inconsistent after multiple comparisons. Associations were not observed with serum hemoglobin. Decreased serum iron level was related with airway dysfunction represented as oscillomteric Rrs5. Our results suggest a relationship of reduced lung function with abnormal iron status in children.

Hepcidin Signaling in Health and Disease: Ironing Out the Details.

Hepcidin, a peptide hormone produced by hepatocytes, is the central regulator of systemic iron homeostasis through its interaction with ferroportin, the major cellular iron export protein. Hepcidin binding to ferroportin results in reduced iron export from macrophages and intestinal absorptive cells, leading to decreased serum iron levels. Hepcidin expression is influenced by several factors that include serum and liver iron stores, erythropoiesis, hypoxia, inflammation, and infection. Erythropoietic drive and hypoxia suppress hepcidin expression and promote red cell production. In contrast, inflammation and infection are associated with increased hepcidin production to sequester iron intracellularly as a means of depriving microorganisms of iron. Chronic inflammation may up‐regulate hepcidin expression through the interleukin‐6 (IL‐6)–Janus kinase 2 (JAK2)–signal transducer and activator of transcription 3 (STAT3) pathway. The bone morphogenetic protein (BMP)–mothers against decapentaplegic homolog (SMAD) pathway is a major positive driver of hepcidin expression in response to either increased circulating iron in the form of transferrin or iron loading in organs. Hereditary hemochromatosis (HH) consists of several inherited disorders that cause inappropriately reduced hepcidin expression in response to body iron stores, leading to increased iron absorption from a normal diet. The most common form of HH is due to a mutation in the HFE gene, which causes a failure in the hepatocyte iron–sensing mechanism, leading to reduced hepcidin expression; the clinical manifestations of HFE‐HH include increased serum transferrin–iron saturation and progressive iron loading in the liver and other tissues over time among patients who express the disease phenotype. In this article, we review the physiologic mechanisms and cellular pathways by which hepcidin expression is regulated, and the different forms of HH resulting from various mutations that cause hepcidin deficiency. We also review other drivers of hepcidin expression and the associated pathophysiologic consequences.

Serum Hepcidin Levels in Diabetic and Non-diabetic Chronic Hepatitis C Patients and Its Relation with Serum Iron Levels

&lt;p&gt;&lt;strong&gt;Background and Objective:&lt;/strong&gt; Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver. Research shows that HCV infection leads to a marked reduction of serum&amp;nbsp; hepcidin levels which might be a factor in causing systemic iron overload. The present study was aimed to&amp;nbsp; determine the cause of iron overloadwhich might be due to reduced levels of serum hepcidin in chronic&amp;nbsp; hepatitis C patients.&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This cross-sectional study was conducted in Department of Physiology at University of Health Sciences, Lahorefrom January 2012 to January 2014. A total of 54 male patients of chronic hepatitis C were recruited for this study and divided into two groups, group A (CHC with diabetes) and group B (CHC without diabetes). Both groupswere tested for serum hepcidin, serum iron and serum ferritin levels. ELISA technique was used to measure serum hepcidin. Serum ferritin levels were measured via CODA analyzer. Serum iron levels were measured by colorimetric method. Frequencies and percentages were calculated for serum hepcidin, serum iron and serum ferritin levels in group. The data was analyzed using SPSS (Statistical Package for Social Sciences) version 20.0. Data was considered significant where P-value was &amp;le; 0.05.&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; Patients in both groups showed less serum hepcidin levelsalong with less serum iron levels in 93% cases of both groups. The patients in group A showed raisedferritin levels in 26% cases and normal ferritin levels in 63% cases. Whereas in group B 04% cases showed raisedferritin levels and 92% patients hadnormal ferritin levels; which could be a marker of ongoing chronic inflammation in CHC patients. Non-significant negative correlation was observed between serum iron and serum hepcidin inCHC population.&lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Hepatitis C virus and decreased serum iron levels in study population may be the reason of less serum hepcidin levels. Raised/normal ferritin reflects chronic inflammation in patients. Non-significant negative correlation between serum iron and serum hepcidin leads the focus towards increasing the sample size in further studies to see any significant negative correlation between studied parameters.&lt;/p&gt;

Serum Iron Level as a Potential Predictor of Coronavirus Disease 2019 Severity and Mortality: A Retrospective Study.

BackgroundVarious types of pulmonary diseases are associated with iron deficiency. However, information on iron status in coronavirus disease 2019 (COVID-19) is scarce.MethodsThis study included 50 hospitalized patients with confirmed COVID-19. The role of serum iron in predicting severity and mortality of COVID-19 was evaluated.ResultsThe most common symptoms of COVID-19 patients in this study were cough (82%), fever (64%), and chest distress (42%). Of the 50 patients, 45 (90%) patients had abnormally low serum iron levels (<7.8 μmol/L). The severity of COVID-19 was negatively correlated with serum iron levels before and after treatment and was positively correlated with C-reactive protein, serum amyloid A, D-dimer, lactate dehydrogenase, urea nitrogen, and myoglobin levels. Decreased serum iron level could predict the transition of COVID-19 from mild to severe and critical illness. Seven (53.8%) patients with a lower serum iron level after treatment in the critical group had died. There was a significant difference in posttreatment serum iron levels between COVID-19 survivors and nonsurvivors.ConclusionsSerum iron deficiency was detected in the patients with COVID-19. The severity and mortality of the disease was closely correlated with serum iron levels. Low serum iron concentration was an independent risk factor for death in COVID-19 patients.

Mu opioid receptor knockout mouse: Phenotypes with implications on restless legs syndrome.

Restless legs syndrome (RLS) is characterized by an irresistible need to move the legs while sitting or lying at night with insomnia as a frequent consequence. Human RLS has been associated with abnormalities in the endogenous opioid system, the dopaminergic system, the iron regulatory system, anemia, and inflammatory and auto-immune disorders. Our previous work indicates that mice lacking all three subtypes of opioid receptors have a phenotype similar to that of human RLS. To study the roles of each opioid receptor subtype in RLS, we first used mu opioid receptor knockout (MOR KO) mice based on our earlier studies using postmortem brain and cell culture. The KO mice showed decreased hemoglobin, hematocrit, and red blood cells (RBCs), with an appearance of microcytic RBCs indicating anemia. Together with decreased serum iron and transferrin, but increased ferritin levels, the anemia is similar to that seen with chronic inflammation in humans. A decreased serum iron level was also observed in the wildtype mice treated with an MOR antagonist. Iron was increased in the liver and spleen of the KO mice. Normal circadian variations in the dopaminergic and serotoninergic systems were absent in the KO mice. The KO mice showed hyperactivity and increased thermal sensitivity in wakefulness primarily during what would normally be the sleep phase similar to that seen in human RLS. Deficits in endogenous opioid system transmission could predispose to anemia of inflammation and loss of circadian variations in dopaminergic or serotonergic systems, thereby contributing to an RLS-like phenotype.

Comparative assessment of serum level of selenium and iron in 1st trimester of pregnancy with non-pregnant women

Introduction: Pregnancy is dynamic anabolic state in women’s life. During pregnancy women undergo profound hormonal, metabolic and physical changes. Aim of the present study was to compare the serum level of selenium and iron between pregnant and non-pregnant women. Materials and Methods: The present study was carried out in 50 first trimester pregnant women and 50 non pregnant women at tertiary care hospital in Surat, in age group of 30 years and in BMI groups of Blood was collected and serum was analyzed for selenium and iron concentration in atomic absorption spectrophotometry (AAS).We have also measured anthropological parameter like height, weight and based on this BMI calculated. SPSS software used for statistical analysis. Result: There was a significant lower level of serum selenium (p found in 1st trimester pregnant women compared to non-pregnant women. There was a significant decreased in selenium level in all BMI group in pregnant women except in 30 kg/m2 group and there was a decreased in serum iron level in all BMI group in pregnant women compared to non-pregnant women. Conclusion: There was a significant decrease in serum selenium and iron level in 1st trimester of pregnant women com pared to non- pregnant women, which indicate that during pregnancy requirement of trace elements increase to meet demand for fetus growth. A reduction in maternal selenium concentration during pregnancy can lead to various disorders such as miscarriage, premature birth, preeclampsia, pregnancy include hypertension, low birth weight, retinopathy of prematurity etc. Keywords: Selenium, Iron, Atomic absorption spectrophotometry.

Subclinical Iron Deficiency in Non-Anemic Individuals: A Retrospective Analysis of Korean Health Examinees

Objectives: Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed. Methods: This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%. Results: The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15–49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03–1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345–0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298–0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001–1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895–0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945–0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793–0.960 in males; 0.872, 95% CI 0.853–0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001). Conclusions: Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia.

Dietary iron restriction leads to a reduction in hepatic fibrosis in a rat model of non-alcoholic steatohepatitis.

ABSTRACTIron overload in the liver causes oxidative stress and inflammation, which result in organ dysfunction, making it a risk factor for non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma. We aimed to evaluate the effect of dietary iron restriction on disease progression in rats fed a choline-deficient L-amino acid-defined (CDAA) diet. Male F344 rats were fed a choline-sufficient amino acid-defined (control) diet, a CDAA diet or an iron-restricted CDAA diet for 4, 8 and 12 weeks. At each time point, hepatic iron levels, oxidative stress, inflammation and fibrosis were evaluated by immunohistochemistry. The iron-restricted CDAA diet significantly decreased serum iron levels for 12 weeks compared with the CDAA diet. Histological analysis confirmed that feeding with the CDAA diet induced hepatic iron overload and that this was associated with oxidative stress (number of 8-hydroxydeoxyguanosine-positive cells), inflammation (CD68 positive area) and fibrosis (Sirius Red positive area). Iron restriction with the CDAA diet significantly led to a reduction in the hepatic iron levels, oxidative stress, inflammation and fibrosis. Therefore, dietary iron restriction could be a useful therapeutic approach for NASH patients with hepatic iron overload.

Predictive value of laboratory parameters in childhood migraine.

Migraine is a neurovascular disease characterized by inflammation of the cerebral and extra cerebral vessels and appears in the form of attacks. Although the pathophysiology of migraine is not fully known, the data obtained because of long-term studies reliably support the presence of a potential relationship between migraine pathogenesis and platelet biology. The aim of this study was to investigate the effect of migraine on MPV and other blood parameters as well as the relationship between the hematologic parameters and characteristics of the headache and whether they possess diagnostic value as inflammation and platelet biology play a fundamental role in the disorder. The study group consisted of 56 patients who were followed up and treated with a diagnosis of migraine and 45 healthy patients. The median creatinine, CRP and TSH values of the children in the migraine group were found to be statistically significantly higher than the healthy control group. Serum iron levels of the migraine group were found to be statistically significantly lower than the control group. No statistically significant difference was found between the two groups in terms of MPV. However, when we examined only the patient group, we found MPV to be statistically significantly higher in girls. Increased MPV and decreased serum iron levels may be related to migraine. More comprehensive studies including a larger population are required to evaluate the specific parameters that may guide the follow-up and treatment of the disorder with simple tests to be used in routine practice and to elucidate the underlying pathophysiology.