Iron Deficiency Research Articles

Genetic Variants Affecting Iron Metabolism in Healthy Adults: A Systematic Review to Support Personalized Nutrition Strategies

Background/Objectives: Increased interest in personalized nutrition has led to a growing focus on exploring genetic variants and their impact on nutritional uptake (nutrigenomics). Nevertheless, no systematic review to date has compiled scientific evidence on genetic variants (such as single-nucleotide polymorphisms (SNPs)) affecting mineral metabolism in humans. This review aims to fill this gap and enable optimized personalized nutrition recommendations in health care. Methods: Cochrane, Embase and MEDLINE databases were systematically searched for English and German studies published between 2007 and 2023, focusing on genetic variants linked to nutrition. Studies on overweight, diseased, or underage individuals were excluded. Papers with verified findings were assessed for methodological quality using the Joanna Briggs Institute critical appraisal tool. Results: Twenty-one scientific papers on SNPs associated with mineral metabolism were included. The majority were observational studies (n = 19) conducted on Caucasian populations. Women outnumbered men (37.4%) women, 18.9% men, 43.7% sex not reported. All identified SNPs linked to minerals influenced iron parameters, with the TMPRSS6 gene showing the strongest correlation. Two HFE SNPs (rs1800562 and rs1799945) and one TF SNP (rs1799852) exhibited protective effects, while the other 11 SNPs were linked to increased risk of iron deficiency, suggesting potential benefits from iron supplementation for individuals with those genetic variants. Conclusions: This review provides comprehensive insights into the association between genetic variants and mineral metabolism, and the findings highlight the relevance of genetic makeup in optimizing health through nutritional interventions. The generalizability of the findings may be limited to Caucasians, warranting future research with diverse populations. This review was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 12 July 2022, under INPLASY202270068 and funded by the University Centre for Prevention and Sports Medicine at Balgrist University Hospital Zurich and the Swiss Innovation Agency Innosuisse, Switzerland.

Analysis of Iron Status in Sickle Cell Disease Patients During Steady State at the Center de Recherche et de Lutte contre la Drépanocytose (CRLD) Bamako.

Sickle cell disease (SCD) is a prevalent inherited blood disorder arising from a single point mutation that results in substitution of valine with glutamic acid in the Beta hemoglobin chain, making red blood cells assume a banana shape under low oxygen state. It is most prevalent in sub-Saharan Africa, affecting approximately 2% of the population in Mali. This study aimed to evaluate the iron status and associated hematological parameters in SCD patients at steady state in an environment with a high prevalence of iron deficiency. A cross-sectional study was conducted at the Center de Recherche et de Lutte contre la Drépanocytose (CRLD) in Bamako, Mali, involving 757 SCD patients aged 10 to 29 years. Iron deficiency was defined as serum ferritin < 20 ng/mL, while iron overload was associated with serum ferritin > 500 ng/mL. The study population consisted of 171 (22.6%) hemolytic phenotypes (SS and Sβ0) and 586 (77.4%) viscous phenotypes (SC and Sβ+). Iron deficiency was found in 19 SCD patients (2.5%), with a higher prevalence in the SC phenotype (68.4%). All iron-deficient subjects exhibited microcytosis (MCV < 80 fL) and hypochromia (MCH < 26 pg). Hemoglobin levels < 12 g/dL were observed only in homozygous SCD patients. Low reticulocyte counts were noted in iron-deficient subjects with SC and Sβ+ phenotypes, but not in iron-deficient SS subjects. Serum C-reactive protein (CRP) was normal (< 10 mg/L) in all iron-deficient subjects, excluding iron deficiency due to chronic inflammation. Iron deficiency was observed among 2.5% of the study population, with a predominant occurrence among those with SC phenotype. All iron deficient subjects had microcytosis and hypochromia. Hemoglobin levels below 12 g/dL were only found in homozygous SCD patients. Additionally, low reticulocyte counts were noted in iron deficient patients with SC and Sβ+ phenotypes, though not in those with the SS phenotype. These findings contribute to the understanding of iron status in SCD patients in an African context and highlights the importance of monitoring iron levels in these population to prevent complications associated with iron deficiency or overload.

High Protein Milk Affected the Increase of the Hb Levels of Third-trimester of Pregnancy with Anemia

Anemia is a risk factor that contributes to 50% of all maternal deaths. The main factors causing anemia are low iron intake and infection. Protein intake, especially animal protein intake, helps increase iron absorption. This study aims to determine the effect of providing high protein milk intake on increasing hemoglobin levels in pregnant women in the third trimester with iron deficiency. This type of research is Pre-Experimental with One Group Pretest-Posttest Design. The population in this study was all third-trimester of pregnant women with pale faces in the of the Gondanglegi Public Health Center Kabupaten Malang. The sample was 33 people taken by using the total sampling technique. The measuring test was the Wilcoxon Marked Rank Test. The examination results showed that the average hemoglobin level before treatment was 10.1 gr/dl, and after treatment was 11.1 gr/dl. The results showed that there was an effect of giving high-protein milk on increasing hemoglobin levels in third-trimester pregnant women with pale skin in Gondanglegi Health Center (p-value = 0.000). This study concludes that milk protein consumption basically affects the increase in hemoglobin levels in pregnant women. It is recommended for pregnant women who get anemia to focus on their food intake, especially protein consumption.

Comparative analysis of ferric carboxymaltose and iron sucrose in treating iron deficiency anemia in perimenopausal women with heavy menstrual bleeding: a randomized controlled trial.

To evaluate the impact of intravenous ferric carboxymaltose (FCM) compared to iron sucrose (ISC) in perimenopausal women with heavy menstrual bleeding (HMB) and anemia. This prospective, open-label, randomized controlled trial enrolled perimenopausal women (40-50 years) with HMB and hemoglobin levels between 6-10 g/dL, intolerant or non-compliant to oral iron therapy. The study compared FCM and ISC by assessing hematological parameters, including hemoglobin, ferritin, and iron levels, over a 12-week period. The patients were followed up at 3, 6, and 12 weeks after initiation. The adverse effects were also evaluated. The study included 60 perimenopausal women, with 30 in each group. The baseline patient characteristics were comparable. FCM demonstrated a statistically significant higher mean increase in hemoglobin (4.97 g/dL) than ISC (4.63 g/dL) over 12 weeks. The proportion of patients achieving correction of anemia (Hb ≥12%) was higher in the FCM group (75.9% vs. 65.5%). Serum ferritin levels were significantly higher in the FCM group after 3 weeks. Adverse effects were minimal and comparable between the groups. Although the direct cost of FCM is high, its ability to be administered in larger doses may result in lower total costs. In perimenopausal women with heavy menstrual bleeding and iron deficiency anemia, FCM and ISC show comparable efficacy in increasing hemoglobin levels with similar side effect profiles. This study highlights the potential benefits of FCM and calls for further exploration of these therapies in diverse patient populations.

Prevention of iron deficiency conditions in obese children

Background. Due to the progressive increase in childhood obesity, the effect of iron levels in the body on carbohydrate and lipid metabolism disorders and the relationship between these conditions are actively studied. It is proven that obesity in children is often associated with dysregulation of iron metabolism. The correlation between the body mass index and iron deficiency (ID) in children and adolescents was reported. Therefore, implementing preventive measures to correct the iron deficiency state (IDS), including the enrichment of the diet with foods containing easily digestible iron, is relevant and can be considered as one of the principles of an integrated approach to the treatment of obesity in childhood. Aim. To evaluate the effectiveness of dietary supplements "Kidz Tasty iron" for IDS prevention in obese children. Materials and methods. Thirty children aged 7–14 with exogenous constitutional obesity were followed up, 14 (47%) females and 16 (53%) males. All patients received a dietary supplement (DS), "Kidz Tasty iron," 10 mL once daily with meals according to the label for 1 month. The follow-up included data on signs and symptoms, medical history, evaluation of anthropometric data, evaluation of current nutrition status with the software "Optimal Nutrition 5.0", bioimpedance analysis of body composition, questionnaire on the assessment of ID symptoms and quality of life, general hematology and blood chemistry tests, validated for childhood. Results. The diets of obese children in the study had low iron content (33.3% of patients), which justifies the need for additional iron supplementation. While taking the dietary supplement "Kidz Tasty Iron," there was a positive clinical trend: decreased symptoms related to ID and clinical signs of ID, improved overall well-being, and increased quality of life. The improvement of the body composition of the studied children was represented by preservation and an increase (20% of patients) in the active cell mass in the studied children. Laboratory tests of iron metabolism improved in 9 children (30%). Most children reported the good organoleptic properties of the product. Adherence to the DS was 96.7%. Conclusion. The study results show the "Kidz Tasty iron" dietary supplement to be tolerable, safe, and effective, supporting its use in the complex therapy of children and adolescents with obesity, including for IDS prevention.

Relationship Between Early Childhood Caries And Iron Levels In Children: A Systematic Review

Background: Early childhood caries (ECC) is one of the most common diseases in early years of life. It is considered a serious public health problem. Though preventable, globally over 530 million children have decay in their primary teeth, and the condition is highly prevalent in both developed and developing countries. It has also been reported to have a close relationship with other systemic deficiencies. Materials and Methods: A systematic review on ECC and iron deficiency was done based on published articles in PubMed and Google scholar databases. The search profiles included ECC/risk factor, ECC/anemia, ECC/ferritin, and ECC/iron. Inclusion criteria comprised of all studies that focused on ECC and iron. Results: A significant relationship was observed between iron deficiency (ID) and occurrence of ECC. Several theories have been laid down in this regard. Our listed studies states that children with ECC appear to be at greater odds of having low iron and haemoglobin levels depicting iron deficiency anemia as compared to the control groups. Conclusions: Based on our findings, it is concluded that the incidence of ECC in young children appears to be associated with iron deficiency even in its mildest form. It is one of the risk factors for ID in children. More research needs to be done to examine lifestyle and socioeconomic risk factors that are associated with malnourishment.

Ferric carboxymaltose reduces the burden of arrhythmic events in heart failure with reduced ejection fraction: the role of the non-invasive arrhythmic biomarkers

BackgroundTreating iron deficiency (ID) with ferric carboxymaltose (FCM) in patients with heart failure with reduced ejection fraction (HFrEF) enhances morbidity, quality of life (QoL), and exercise capacity. MethodsThis single center, prospective follow-up study aims to assess FCM's impact on arrhythmic events and non-invasive markers in HFrEF patients with cardiac implantable electronic devices (CIEDs) and ID. Symptomatic HFrEF patients with ID and CIEDs scheduled for IV FCM were followed for 12-months. Arrhythmic activity was evaluated from CIEDs and non-invasive markers from Holter recordings pre- and post-FCM. Ventricular tachycardia/ventricular fibrillation (VT/VF) episodes, non-sustained VT (nsVT), late potentials (LPs), Microvolt T-wave alternans (MTWA), heart rate variability, turbulence (HRT) QTc, and premature ventricular contractions (PVCs, number and Lown and Wolf classification) were assessed. Left ventricular EF (LVEF), global longitudinal strain (LV GLS), QoL (KCCQ, EQ-5D-5L), six-minute walking distance (6MWD), peak oxygen consumption, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels were also recorded. ResultsNinety-six patients in optimal medical treatment participated (median age 71.9 [12.3] years, 83% male). Post-FCM treatment, VT/VF (P=0.043) and nsVT (P<0.001) frequency decreased significantly. The Lown and Wolf classification improved (P=0.002) and predicted VT/VF episodes better than other markers (AUC 0.737, P=.001). MTWA, LPs and HRT improved statistically significantly post-FCM. Hospitalization rates and NT-proBNP levels decreased, while LVEF, LV GLS, 6MWD, QoL and peak VO2 improved statistically significantly (P<0.001). ConclusionsOur study provides real-world evidence that IV FCM led to statistically significant reduction in ventricular arrhythmic episodes, as well as an improvement in non-invasive arrhythmic markers.

Association between dietary iron intake and hyperuricemia in U.S. adults: a cross-sectional study

BackgroundElevating blood iron levels may increase the risk of hyperuricemia. However, the association between dietary iron intake and hyperuricemia remains unclear. This study examines the association between dietary iron and hyperuricemia.MethodsThe data for this cross-sectional study came from the 2011–2020 National Health and Nutrition Examination Survey (NHANES), which included adults aged 20 and above in the United States. Detailed information on their demographics, dietary iron intake, serum uric acid, and other variables were gathered. This study employs a multifactorial logistic regression method to assess the relationship between dietary iron intake and hyperuricemia. Additionally, it utilizes Restricted Cubic Spline analysis to determine whether there is a non-linear relationship between dietary iron and hyperuricemia. Furthermore, sub-group analyses are conducted to further validate the robustness of this correlation.ResultsThis study included 11,441 patients, with a prevalence of hyperuricemia at 14.96%. Regardless of whether confounding factors were adjusted for, there was a positive correlation between dietary iron intake and hyperuricemia. In Model III, after adjusting for age, gender, race, educational background, body mass index, hypertension, carbohydrate intake, dietary fiber intake, total saturated fatty acid intake, vitamin K intake, vitamin C intake, marital status, poverty income ratio, smoking status, drinking status, work activity, diabetes, sodium intake, energy intake, protein intake, zinc intake, copper intake, selenium intake and total sugars intake, we found that compared to the lowest quintile of dietary iron intake (Q1, ≤ 8.03 mg/day), the odds ratios (ORs) for hyperuricemia in the second (Q2, 8.04–11.07 mg/day), third (Q3, 11.08–14.27 mg/day), fourth (Q4, 14.28–19.33 mg/day), and fifth quintiles (Q5, ≥ 19.34 mg/day) were 1.05 (95% confidence interval: 0.79–1.40), 1.30 (95% confidence interval: 0.99–1.73), 1.39 (95% confidence interval: 1.02–1.89), and 1.36 (95% confidence interval: 0.95–1.97), respectively. The study results indicate that a higher dietary iron intake is significantly positively associated with the likelihood of hyperuricemia.ConclusionIn the adult population of the United States, there is a positive correlation between dietary iron intake and hyperuricemia, with higher dietary iron intake associated with an increased likelihood of hyperuricemia.

Genotype-phenotype correlation analysis of patients with thalassemia in Quanzhou city, Southeast of China

BackgroundThe carrying rate of thalassemia is high in Quanzhou city. However, there are few large-scale studies on the correlation analysis between genotype and phenotype of thalassemia in Quanzhou. In this study, the genotype and phenotype data of 1076 individuals with thalassemia in Quanzhou city were analyzed to provide reference data for screening and diagnosis of thalassemia in this region. Material and MethodsReverse dot blot hybridization (RDB-PCR), Gap-PCR and nested PCR were used to detect the thalassemia genotype. Clinical and hematological parameters of 1076 individuals of thalassemia were collected to analyze the correlation between genotype and phenotype. ResultsAmong 2997 subjects, 1076 cases diagnosed as thalassemia gene carrier or patients, with detection rate 35.9%, among which Southeast Asian deletion (--SEA) / αα was the most common α-thalassemia genotype (48.4%) and one rare genotype was detected: HKαα/--SEA (0.1%). Subjects with thalassemia alone showed the least severe symptoms of anemia with higher red blood cell count (RBC) and hemoglobin (Hb), lower red blood cell distribution width (RDW) than those with iron deficiency (ID) or iron overload (IO) (p<0.05). The Hb, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) levels in gene carriers of α-thalassemia were higher than those of β-thalassemia, while RBC, RDW and serum ferritin (SF) levels were lower than the later(p<0.05). Among individuals with --SEA/αα, the Hb, MCV, MCH, mean corpuscular hemoglobin concentration (MCHC) and SF levels of subjects≥19 years old were higher than those of ≤18 years old. For cases ≥19 years old, the RBC, Hb and SF levels in male were higher than that in female, while MCHC level was lower than female(p<0.05). ConclusionThe difference of hematological phenotypes in patients with thalassemia is not only affected by their genotype, but also the influence of gender and age.

Iron deficiency and its impact on post-vaccination immunity: a review

Iron deficiency and its impact on post-vaccination immunity: a review

Effect of dietary protein on serum hepcidin and iron in adults with obesity and insulin resistance: A randomized single blind clinical trial.

Background and AimsBoth obesity and iron deficiency are public health problems. The association between the two problems could be explained by chronic low-grade inflammation in obesity, which could stimulate hepcidin expression and modify iron concentration that the consumption of high-protein diets could prevent. Thus, this study aimed to compare the effects of high-protein diets with a predominance of animal or vegetable protein on serum hepcidin and iron concentrations in adults with obesity. Methods and ResultsThis randomized clinical trial involved adults with obesity and insulin resistance, who were assigned to either a high animal protein (AP) group or a high vegetable protein (VP) group for a one-month intervention. Both groups followed a calorie-restricted diet, reducing energy intake by 750 kcal/day. Baseline and final measurements included serum concentrations of hepcidin and iron, biochemical parameters, anthropometric data, and body composition. A total of 33 participants (63% female) were included in the study. Significant weight loss was observed in both groups after the intervention. Adjusted for weight loss percentage, the AP group showed a significant increase in hepcidin concentration (from 22.3 ± 14.7 to 27.5 ± 19.5 ng/mL) compared to the VP group (from 17.9 ± 15.1 to 17.2 ± 10.1 ng/mL) (p < 0.01), with no changes in serum iron concentration. Additionally, the VP diet significantly reduced serum adiponectin (p = 0.04) and C-reactive protein (p = 0.03) levels. ConclusionsIn adults with obesity following the AP diet for one month, hepcidin levels increased without affecting serum iron concentrations. Trial registrationNCT03627104

Prospects of iron solubilizing Bacillus species for improving growth and iron in maize (Zea mays L.) under axenic conditions

Iron (Fe) deficiency in calcareous soils is a significant agricultural challenge, affecting crop productivity and nutritional quality. This study aimed to isolate, characterize, and evaluate Fe solubilizing rhizobacterial isolates from maize rhizosphere in calcareous soils as potential biofertilizers. Forty bacterial isolates coded as SG1, SG2, …, SG40 were isolated and screened for siderophore production, with ten showing significant Fe solubilizing capabilities. These isolates were further assessed for phosphate solubilization and exopolysaccharides production. The selected bacterial isolates were also screened under axenic conditions for their ability to improve maize growth. The isolates SG8, SG13, SG24, SG30 and SG33 significantly enhanced growth parameters of maize. Notably, SG30 showed highest increment in shoot length (58%), root length (54%), root fresh and dry biomass (67% and 76%), SPAD value (67%), relative water contents (69%), root surface area (61%), and Fe concentration in shoots (79%) as compared to control. The biochemical characterization of these strains showed that all these strains have capability to solubilize insoluble phosphorus, produce indole-3-acetic acid (IAA), and ammonia with catalase, urease and protease activity. Molecular identification through 16s rRNA gene sequencing confirmed high similarity (99.7–100%) of the selected isolates to various Bacillus species, including B. pyramidoids, B. firmicutes, and B. cereus. The study provides a strong base for developing eco-friendly, cost-effective biofertilizers to address Fe deficiency in crops and promote sustainable agriculture.

Exploration of Iron deficiency Anemia and its associated factors among pregnant women seeking antenatal care in public health facilities of southwestern Ethiopia. A mixed study.

Background: Anemia is a major problem in Ethiopia, affecting a large part of the population. Despite the importance of the problem, the causes of anemia, especially iron deficiency anemia, among pregnant women attending antenatal care (ANC) in the study area have been little studied. Therefore, the aim of this study was to investigate iron deficiency anemia and its associated factors in pregnant women seeking antenatal care in public health facilities in Southwest Ethiopia in 2023. Methods and Materialsa mixed facility-based cross-sectional study was conducted involving 364 pregnant women from selected health facilities in Ilubabor and Buno Bedele zones. Backward multiple logistic regression was used to analyze the relationship between dependent and independent variables, with statistical significance set at a P value less than 0.05. ResultsIn this study, the prevalence of iron deficiency anemia was found to be 21.4%. Several factors have been significantly associated with iron deficiency anemia including; presence of malaria parasite [AOR= 15.8, CI = 5.1–48.4], presence of Helminthes [AOR= 8.1, CI=2.8–23.9], consumption of leafy vegetables less than once a day [AOR = 3.4, CI = 1.5-13.3] and not taking iron supplements/consumption [AOR= 2.2, CI = 1.1 to 4.4]. Conclusion and RecommendationsThe overall prevalence of iron deficiency anemia in the study area suggests that, it is a moderate public health problem. In order to improve the nutritional status of women, routine and consistent nutritional advice, the establishment of regular preventive systems and the implementation of feedback mechanisms are recommended.

OA13 Trust your gut: it has the answer

Abstract Introduction We report the case of a 51-year-old man who presented over seven years to multiple specialities, including rheumatology on several occasions, with arthralgia, fevers and weight loss. He was found to have raised inflammatory markers, lymphadenopathy and pericardial and pleural effusions but despite extensive investigation over this time, the cause for his presentation remained elusive. After many years, he developed gastrointestinal symptoms, which led us to the unifying diagnosis of Whipple’s disease. Case description This patient initially presented to rheumatology in 2017 with left ankle pain. His only medical history was renal calculi. He was diagnosed with gout and osteoarthritis and was discharged. Two years later, he presented with fevers. Investigations revealed raised inflammatory markers, small pericardial and pleural effusions and small-volume upper abdominal lymphadenopathy. He was treated with colchicine for pericarditis with some improvement. He presented again in 2021 with chest and flank pain and breathlessness. CTPA revealed an ongoing small pericardial effusion and small-volume intrathoracic and intra-abdominal lymphadenopathy. Inflammatory markers remained raised (CRP 30-50, ESR 20-30). He had now begun to lose weight. He was referred to the cancer of unknown primary service, who monitored his lymphadenopathy. In January 2022, he underwent an open biopsy of a mesenteric lymph node, which revealed non-caseating granulomas and no evidence of malignancy. He was referred again to rheumatology due to ongoing migratory joint pains in his wrists, ankles and knees. Rheumatoid factor, anti-CCP, antinuclear antibody and serum ACE had been negative on several occasions. He underwent a PET scan that revealed persistent lymphadenopathy with low to moderate avidity, borderline splenomegaly and a slightly prominent marrow signal. He then had a bone marrow biopsy that showed no significant abnormality. In December 2023, we settled on a probable diagnosis of sarcoidosis. He was treated with a trial of steroid without much symptomatic improvement and there was a plan to initiate Methotrexate. However, he then developed nausea and vomiting and was noted to have a new iron deficiency anaemia. He was referred to gastroenterology and underwent an upper endoscopy, which was macroscopically normal, but microscopically showed findings in keeping with Whipple’s disease (WD) with PAS-positive staining. Duodenal biopsy PCR confirmed this. He is now awaiting input from the infectious diseases team and long-term antibiotic treatment. Discussion WD is caused by the bacterium Tropheryma whipplei. There are four commonly recognised manifestations of T. whipplei infections: 1) classic WD, 2) localised chronic infections, 3) acute infections and 4) asymptomatic carriage. Our patient has classic WD, and his case exemplifies the disease course and diagnostic challenges. Classic WD is a rare, chronic, multisystem infectious disease. It is reported as most often affecting middle-aged white males of European ancestry. It can be divided into an early phase with intermittent arthralgias or arthritis and fever, a middle phase with gastrointestinal symptoms and weight loss, and a late phase with predominant neurological symptoms. Arthritis is the presenting symptom in 60-70% of cases and occurs in 90% of all cases. Given this, around half of patients are initially misdiagnosed as having an inflammatory rheumatic disease. As in the case of our patient, joint manifestations do not correlate with intestinal symptoms and can precede intestinal manifestations by a mean interval of six years. Joint involvement in WD is typically a migratory oligo- or polyarthritis or arthralgia primarily involving large and medium joints, most commonly the knees, ankles and wrists. Less commonly affected joints are elbows, hips and shoulders. WD should be considered in all patients with the four cardinal symptoms of arthralgias, diarrhoea, abdominal pain, and weight loss after more common differentials have been excluded. In patients without gastrointestinal symptoms, having suspicion of the disease is more difficult; however, consideration should be made in patients with seronegative arthritis, who do not respond to immunosuppressive treatment. Other clinical syndromes in which WD should be considered include fever of unknown origin, chronic serositis, generalised lymphadenopathy, progressive central nervous system disease or early onset cognitive deficits. Although histology revealing non-caseating granulomas is the hallmark of sarcoidosis, they are non-specific and can be found in many other diseases. Key learning points • WD has a reputation as a great mimicker of many diseases and there is still often a considerable delay to diagnosis, even in typical cases, given the natural history of the disease and its rarity. WD should be considered in patients with seronegative arthritis not following a typical disease course, particularly if they develop gastrointestinal symptoms. WD is also a pertinent differential in patients with persistent constitutional upset with unexplained lymphadenopathy or serositis. It should be remembered that non-caseating granulomas can be found in many diseases and that sarcoidosis remains a diagnosis of exclusion among granulomatous disorders.

Correction of iron deficiency and iron deficiency anemia in women of reproductive age: choice of a drug within framework of concept of patient blood management

The article presents a review of the literature and our own data on the problem of prevention, diagnosis and treatment of iron deficiency and iron deficiency anemia in patients of reproductive age with a burdened somatic status with the development of a chronic inflammatory process. In the concept of patient blood management (PBM), the diagnosis and treatment of anemia in patients with gynecological diseases requiring subsequent surgical treatment is given paramount importance, since anemia and iron deficiency are considered risk factors for worse treatment outcomes for patients. Women with gynecological pathology often have diseases that are accompanied by the development of a systemic inflammatory response, which leads to activation of hepcidin protein synthesis and the development of so-called anemia of inflammatory diseases. Data are presented indicating the effectiveness and safety of the sucrosomial iron drug (SiderAL® Forte) in obstetric and gynecological patients with increased levels of C-reactive protein in combination with iron deficiency and iron deficiency anemia. The increase in ferrokinetic parameters in patients receiving sucrosomial iron is due to the unique physicochemical and pharmacokinetic characteristics of sucrosome, which provides protection of sucrosomial iron from the effects of gastric juice, excluding contact with the mucous membrane of the gastrointestinal tract and its absorption through special M-cells of the small intestinal mucosa followed by the release of iron in liver cells. Sucrosomial iron is novel, convenient, effective, and well tolerated compared with traditional oral iron supplements.

Burden and causes of anemia in Vietnam: insights from the global burden of disease data

BackgroundAnemia is a significant global health issue, impacting 1.92 billion people and ranking as a leading cause of disability. It is marked by low hemoglobin levels, which hinder oxygen delivery to vital organs and result from causes such as nutritional deficiencies and chronic diseases. Despite some progress, anemia remains a major concern in Southeast Asia, including Vietnam. Although the country has reduced its anemia rates, the progress is insufficient to achieve the WHO’s 2030 targets for anemia reduction among women of reproductive age. This study explores anemia trends and socio-economic determinants in Vietnam, with a focus on age and gender differences, to inform targeted interventions and policy development.MethodsThis study used the Global Burden of Diseases, Injuries, and Risk Factors (GBD) dataset to explore the burden of anemia and its causes in Vietnam from 1990 to 2021. The GBD study provides data on anemia prevalence and years lived with disability (YLD) by age, sex, and 37 causes across 204 countries and territories. Further, this study employed a regression model to examine how the anemia burden (i.e., prevalence rate and YLD rate) relates to socio-economic factors such as the Human Development Index (HDI), gender disparities in human development achievement, and gender-based inequalities in reproductive health, empowerment, and economic status in Vietnam over this period.ResultsIn 1990, there were 16.30 million anemia cases in Vietnam, decreasing slightly to 16.05 million by 2021. Male prevalence dropped from 34.90 to 26.58%, while female prevalence increased from 65.10 to 73.42%. Iron deficiency was the main cause, affecting 68.35% of cases in 1990 and 68.84% in 2021, with 24.96% in males and 75.04% in females in 2021. While anemia has decreased among infants, young children, and adolescents due to improved healthcare, it has increased among middle-aged and older adults, especially females. Regression analysis shows that higher human development and gender equality reduce anemia prevalence and disability, whereas gender inequality worsens the issue.ConclusionsThe study underscores that anemia remains a major health concern in Vietnam, marked by significant gender and age disparities. Despite a decrease in overall anemia rates and the effectiveness of specific interventions like iron-folic acid supplementation, females, particularly those of reproductive age and older adults, continue to face higher rates. Socio-economic improvements, including higher income and better human development, are linked to lower anemia rates, though the impact differs by gender. The persistent gender disparity and the shift in burden to older adults highlight the need for more comprehensive, gender-sensitive interventions. Future efforts should integrate nutritional support with broader socio-economic enhancements to effectively address anemia and improve public health in Vietnam.

ORAL IRON-HYDROXIDE POLYMALTOSE COMPLEX VERSUS SUCROSOMIAL IRON FOR CHILDREN WITH IRON DEFICIENCY WITH OR WITHOUT ANEMIA: A CLINICAL TRIAL WITH EMPHASIS ON INTESTINAL INFLAMMATION

Background: Iron deficiency anemia (IDA) is a major public health problem among children worldwide. Iron deficiency without anemia (IDWA) is at least twice as common as IDA. Some studies propose that oral iron fortification can modify the infant’s gut microbiome leading to intestinal inflammation. Objectives: To determine whether oral iron therapy can lead to intestinal inflammation in children with IDA or IDWA. Patients and methods: Fifty-six patients aged 6 months to 16 years (median age 7.6 years) with IDA or IDWA were randomly assigned to receive either iron (III)-hydroxide polymaltose complex (IPC) 5mg/kg once daily (maximum dose 100 mg) or sucrosomial iron (SI) 1.4 mg/kg once daily (maximum dose 29.4 mg). Safety and efficacy were studied after 30 and 90 days of treatment. In addition, fecal calprotectin as a marker of intestinal inflammation was measured simultaneously and compared to results obtained before therapy. Results: A significant increase in serum ferritin was noted in both groups as the median ferritin level at baseline was 6.7 μg/L in the IPC group and 6.6 μg/L in the SI group, increasing to 15.9 μg/L and 12.1μg/L respectively, after 90 days of treatment. However, there was no significant change in fecal calprotectin in either group. In addition, no differences in the trend over time were observed between the two groups regarding fecal calprotectin, serum ferritin, and hemoglobin. Conclusions: IPC and SI were equally effective in treating IDA and IDWA. At the recommended doses, oral iron therapy does not seem to induce intestinal inflammation.

Iron Deficiency Anemia Among Women in Skardu, Gilgit-Baltistan

ABSTRACT Objective: To determine the frequency of iron deficiency anemia among women in Skardu, Gligit-Baltistan. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Skardu, Pakistan, from Dec 2021 to May 2022. Methodology: A total of 202 women were selected through consecutive sampling from General Medical OPD of Combined Military Hospital, Skardu, Pakistan. Hemoglobin globin levels (Hb gram/deciliter), mean corpuscular volume (MCV fL) and red cell distribution width (RDW%) were determined for all enrolled patients. Results: Mean age of participants in this study was 34.46±10.93 years. Reduced Hb was observed in 62(30.69%) women with a mean hemoglobin level of 9.48±1.59 gl/deciliter and mean corpuscular volume of 79.97±10.7d fL. Among these women, 5(2.47%) were severely anemic (6.56±0.39 gl/deciliter), 28(13.86%) moderately anemic (8.51±0.83 gl/deciliter) while 29(14.35%) were mildly anemic (10.92±0.48 gl/deciliter). Women of younger age group, between18-35 years, were found to suffer more from iron deficiency anemia (39.14%) with mean hemoglobin levels of 11.31±1.80 and mean corpuscular volume of 79.34±10.86 fL. Conclusion: Iron Deficiency Anemia is present in female population of Gilgit-Baltistan in general and woman of childbearing age in particular. Emergency measures for awareness and fortification of basic food items with iron should be undertaken at large scale.

Construction of iron oxide nanoparticles modified with Angelica sinensis polysaccharide for the treatment of iron deficiency anemia

Construction of iron oxide nanoparticles modified with Angelica sinensis polysaccharide for the treatment of iron deficiency anemia

Intervention on Anemia prevention among adolescent girls: A quasi-experimental study on providing meatballs chips modified to increase hemoglobin levels

Adolescent girls are at higher risk of anemia due to menstrual cycle, with iron deficiency from daily food intake being the most common cause. Therefore, this study aimed to determine the effect of fried meatballs modified with a combination of local ingredients, such as chicken liver flour, moringa oleifera leaves, soybean tempeh flour, and mackerel fish, abbreviated as Tioek chips, on changes in haemoglobin levels on adolescent girls in Kupang City and Kupang Regency. The results show that foods modified with nutritious local ingredients such as Tioek chips can be classified as an affordable and delicious alternative to healthy snacks to prevent anemia.