Iron Deficiency Research Articles

Hypertension and iron deficiency anemia: Exploring genetic associations and causal inference

Background and aimObservational studies have suggested a potential association between hypertension and Iron deficiency anemia (IDA). However, it is unclear whether there is a genetic and causal link between hypertension and IDA. Methods and resultsGenome-Wide Association Studies (GWAS) data for hypertension were sourced from the UK Biobank and FinnGen. Genetic variants data for IDA were extracted from FinnGen and the IEU Open GWAS project, all derived from European populations. The genetic association between hypertension and IDA was assessed using Linkage Disequilibrium Score Regression (LDSC), with MR employed to determine causality. Inverse variance weighted (IVW) as a major analytical method for MR. Sensitivity and heterogeneity analyses were conducted to ensure result reliability. Furthermore, validation analysis was performed to further strengthen the robustness of the findings. A genetic association between hypertension and IDA was observed (rg = 0.121, P = 0.002). Our findings suggest that hypertension increases the risk of developing IDA (OR = 2.493,P = 0.038), and IDA maybe serve as a risk factor for hypertension (OR = 1.006,P < 0.001). Validation analysis yielded consistent results. Importantly, our findings demonstrated no heterogeneity or horizontal pleiotropy. ConclusionRegular testing of iron ions and anemia-related markers in hypertensive patients is crucial for early identification of IDA. If necessary, oral iron supplementation can be prescribed to prevent IDA for hypertensive patients. Furthermore, it is imperative to closely monitor the blood pressure of patients with IDA to promptly identify and diagnose hypertension. The implementation of these integrated health strategies is vital for global efforts to tackle the dual challenges of hypertension and IDA.

Microalbuminuria and Functional Iron Deficiency are Risk Factors for Hearing Loss in Adolescents.

Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10-19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high-frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL (p = 0.003) and HFHL (p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL (p = 0.002) or HFHL (p = 0.001). And, HFHL was associated with lower ferritin levels (p = 0.017). HL and HFHL were related to MIA (p = 0.004 and p = 0.022, respectively) and TSAT (p = 0.005 and p = 0.011, respectively) after controlling other factors. MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. 3 (individual cross-sectional study) Laryngoscope, 134:3329-3334, 2024.

Assessing the Efficacy of Bovine Lactoferrin to Correct Iron Deficiency Anaemia in Women of Reproductive Age: A Double Blind Randomized Controlled Trial in Mirpur, Dhaka

Assessing the Efficacy of Bovine Lactoferrin to Correct Iron Deficiency Anaemia in Women of Reproductive Age: A Double Blind Randomized Controlled Trial in Mirpur, Dhaka

Diagnostic value and method of soluble transferrin receptor for suspected coronary artery disease: a case-control study.

Many studies have pointed out that iron overload in the body is a risk factor for coronary atherosclerosis (AS), while there are also studies that show that iron deficiency is associated with coronary AS. There is still no consensus on how iron metabolism affects coronary artery disease (CAD). This study aimed to analyze the relationship between iron metabolism indexes and CAD, investigate the diagnostic value of soluble transferrin receptor (sTfR) in suspected CAD, and establish a diagnostic model. This was a retrospective study. A total of 268 people with CAD-like symptoms who underwent coronary angiography in the Department of Cardiovascular Medicine, The Second Affiliated Hospital of Anhui Medical University from September 2022 to May 2023 without other chronic diseases or related medication history were included in the study and formed a continuous series including 188 CAD patients and 80 control subjects. Each iron metabolism index was divided into a grade variable according to tertile. The comparison of CAD morbidity between the tertiles and nonlinear correlation test was conducted to investigate the relationship between iron metabolism indexes and CAD risk. We used restricted cubic spline (RCS) to plot the relationship curve between sTfR and CAD risk and to determine the sTfR value corresponding to the minimal odds, according to which we divided the total sample into the "sTfR low level" subgroup and the "sTfR high level" subgroup. Logistic regression analyses were used to establish diagnostic models in both subgroups. The diagnostic efficiency of the indexes and models was compared by receiver operating characteristic (ROC) analysis. There is a "J" shape correlation between sTfR and CAD risk. Age/sTfR ratio [area under the curve (AUC) =0.690, 95% confidence interval (CI): 0.598-0.782, specificity 0.488 and sensitivity 0.842] has the best diagnostic efficiency in the "sTfR low level" subgroup. The diagnostic efficiency of sTfR (AUC =0.701, 95% CI: 0.598-0.803, specificity 0.541 and sensitivity 0.797) in the "sTfR high level" subgroup was higher than that of cardiac troponin I (cTnI) (AUC =0.674, 95% CI: 0.564-0.784, specificity 0.719 and sensitivity 0.653). The specific diagnostic methods were as follows: (I) When sTfR ≤1.087 mg/L, calculate the age/sTfR ratio, which indicates the diagnosis of CAD when the result is >58.595; (II) We can directly make a preliminary clinical diagnosis of CAD when sTfR >1.205 mg/L. Except for the above 2 cases, we can initially rule out a diagnosis of CAD. The iron metabolism index sTfR correlates with CAD morbidity in a "J" shape. With superior diagnostic efficacy than cTnI, sTfR can assist in diagnosing CAD in patients with CAD-like symptoms. In addition, sTfR can provide guidance for the management of body iron levels in CAD patients.

ЛЕЧЕНИЕ ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИИ И ДЕФИЦИТА ФОЛАТОВ У ДЕТЕЙ РАННЕГО ВОЗРАСТА

Anemia is a global health problem worldwide associated with high morbidity and mortality rates and an increase in the number of hospitalizations. The article reflects the prevalence of grade 1 iron deficiency anemia and folate deficiency in children from 0 to 36 months of age, presents the latest data on the clinical efficacy of a drug containing iron protein succinylate and calcium folinate pentahydrate in this category of children in the treatment of grade 1 iron deficiency anemia and folate deficiency. The study monitored blood changes in children from 0 to 36 with grade 1 iron deficiency anemia and folate deficiency before and after treatment with a drug containing iron protein succinylate and calcium folinate pentagiomrate, and justified the pharmacoeconomical expediency of prescribing this drug from the point of view of the patient and the doctor.

МАТЕМАТИЧЕСКОЕ МОДЕЛИРОВАНИЕ В ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКЕ АНЕМИИ ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЙ И ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИИ У ПАЦИЕНТОВ С ВОСПАЛИТЕЛЬНЫМИ ЗАБОЛЕВАНИЯМИ СУСТАВОВ

Aim. To develop based on the indicators of clinical blood tests, some biochemical markers, iron metabolism and cytokines a mathematical model that allows with high sensitivity and specificity to conduct differential diagnosis of anemia of chronic diseases (AHD) and iron deficiency anemia (IDA) in patients with inflammatory joint diseases (rheumatoid arthritis (RA), psoriatic arthritis (PSA), ankylosing spondylitis (AS)). Material and methods. The study included 104 patients with inflammatory joint diseases and anemic syndrome (37 males/67 females, age 48.4±5.42 years old), of which 54 patients with RA, 27 patients with PSA and 23 patients with AS. The control group consisted of 22 patients with inflammatory diseases of the joints without anemia (13 males/9 females, age 47.8±3.55 years old), of which 7 patients with RA, 10 with PSA, 5 with AS. For all patients, in addition to hemogram parameters, the concentrations of interleukin-6, interleukin-10, interleukin-1β, interferon-gamma, tumor necrosis factor alpha, ferritin, C-reactive protein, hepcidin, transferrin, soluble transferrin receptor were determined. For quantitative indicators, the median, standard error of the mean, and interquartile range was calculated. The significance of differences between several unrelated groups was determined using the Kruskal-Wallis test. The calculation of a mathematical model for the differential diagnosis of ACD and IDA was carried out using discriminant analysis. Results. As a result of the study, a canonical linear discriminant function (CLDF) was obtained: CLDF = 1.612171-0.002725× Hepcidin -0.005429× Ferritin The coordinates of the centroids are calculated, for ACD it is -1.44222008, and for IDA it is 1.52705656. A patient whose CLDF value is determined based on ferritin and hepcidin concentrations should be classified into the ACD or IDA group based on the minimum distance to the corresponding centroid. The resulting mathematical model has 100% sensitivity and 80% specificity. Conclusions. The equation based on hepcidin and ferritin (obtained from the results of discriminant analysis) allows, with high sensitivity, specificity and information ability, to carry out differential diagnosis of ACD and IDA in patients with inflammatory joints diseases instantly at the stage of initial contact with the doctor. Using of the equation will make it possible to more effectively diagnose and correct these types of anemia in this pathology, including for the purpose of more effective treatment.

The Effects of Maternal Iron and Folate Supplementation on Pregnancy and Infant Outcomes in Africa: A Systematic Review

Background: Iron and folate deficiency are prevalent in pregnant women in Africa. However, limited research exists on the differential effect of oral iron-only, folate-only, or Iron Folic Acid (IFA) supplementation on adverse pregnancy and infant outcomes. This systematic review addresses this gap, focusing on studies conducted in Africa with limited healthcare access. Understanding these differential effects could lead to more targeted and potentially cost-effective interventions to improve maternal and child health in these settings. Methods: A systematic review was conducted following PRISMA guidelines. The primary exposures were oral iron-only, folate-only, or IFA oral supplementation during pregnancy, while the outcomes were adverse pregnancy and infant outcomes. A qualitative synthesis guided by methods without meta-analysis was performed. Results: Our qualitative synthesis analysed 10 articles reporting adverse pregnancy (adverse birth outcomes, stillbirths, and perinatal mortality) and infant outcomes (neonatal mortality). Consistently, iron-only supplementation demonstrated a reduction in perinatal death. However, evidence is insufficient to assess the relationship between iron-only and IFA supplementation with adverse birth outcomes, stillbirths, and neonatal mortality. Conclusion: Findings suggested that iron-only supplementation during pregnancy may reduce perinatal mortality in African women. However, evidence remains limited regarding the effectiveness of both iron-only and IFA supplementation in reducing stillbirths, and neonatal mortality. Moreover, additional primary studies are necessary to comprehend the effects of iron-only, folate-only, and IFA supplementation on pregnancy outcomes and infant health in the African region, considering rurality and income level as effect modifiers.

Synergistic effects of microbial inoculation, different forms of iron application, and phosphorus on wheat growth and nutrient uptake in alkaline soil

Iron and phosphorus deficiencies in alkaline soils threaten wheat by limiting nutrient availability due to their antagonistic relationship. This study tested if combining microbial incubation with foliar iron could synergistically improve wheat productivity and nutrition and mitigate deficiencies. A field experiment using a split plot design tested different iron and phosphate fertilization techniques. The main plots consisted of three iron application methods: foliar-applied iron (FL) at 2.5 kg ha−1, soil-applied iron (FS) at 5 kg ha−1, and no iron (F0). The subplots comprised four phosphate fertilizers: PSB + TSP (inoculation with phosphate-solubilizing bacteria + 100 kg ha−1 of triple superphosphate fertilizer), AMF + TSP (inoculation with arbuscular mycorrhizal fungi + triple superphosphate), TSP alone, and no phosphorus (P0). Foliar iron application with AMF + TSP increased seed potassium and root length density by 16.3-17.9% and 22.1-25.8% more than PSB + TSP, respectively. Under FS conditions, AMF + TSP exhibited 28.5-29.1% lower magnesium and 23.9-28.4% higher zinc seed concentrations compared to PSB + TSP, as well as higher levels of soluble proteins and lower concentrations of chlorophyll. There was no difference in grain yield between PSB + TSP and AMF + TSP for any of the iron treatments. Combining AMF + TSP and foliar iron application resulted in the highest grain yield, desirable seed nutrient content (particularly zinc, iron (>100 mg kg−1), and magnesium (>18 mg kg−1), improved root biomass, chlorophyll, and soluble proteins compared to PSB + TSP and TSP alone. This combination of microbial inoculation with foliar iron application is an effective strategy for mitigating the antagonism between iron and phosphorus and improving both crop productivity and nutrition.

Aging limits stemness and tumorigenesis in the lung by reprogramming iron homeostasis.

Aging is associated with a decline in the number and fitness of adult stem cells 1-4 . Aging-associated loss of stemness is posited to suppress tumorigenesis 5,6 , but this hypothesis has not been tested in vivo . Here, using physiologically aged autochthonous genetically engineered mouse models and primary cells 7,8 , we demonstrate aging suppresses lung cancer initiation and progression by degrading stemness of the alveolar cell of origin. This phenotype is underpinned by aging-associated induction of the transcription factor NUPR1 and its downstream target lipocalin-2 in the cell of origin in mice and humans, leading to a functional iron insufficiency in the aged cells. Genetic inactivation of the NUPR1-lipocalin-2 axis or iron supplementation rescue stemness and promote tumorigenic potential of aged alveolar cells. Conversely, targeting the NUPR1- lipocalin-2 axis is detrimental to young alveolar cells via induction of ferroptosis. We find that aging-associated DNA hypomethylation at specific enhancer sites associates with elevated NUPR1 expression, which is recapitulated in young alveolar cells by inhibition of DNA methylation. We uncover that aging drives a functional iron insufficiency, which leads to loss of stemness and tumorigenesis, but promotes resistance to ferroptosis. These findings have significant implications for the therapeutic modulation of cellular iron homeostasis in regenerative medicine and in cancer prevention. Furthermore, our findings are consistent with a model whereby most human cancers initiate in young individuals, revealing a critical window for such cancer prevention efforts.

Continuous training in young athletes decreases hepcidin secretion and is positively correlated with serum 25(OH)D and ferritin

Continuous training in young athletes decreases hepcidin secretion and is positively correlated with serum 25(OH)D and ferritin

A systematic review on the impact of nutrition and possible supplementation on the deficiency of vitamin complexes, iron, omega-3-fatty acids, and lycopene in relation to increased morbidity in women after menopause.

The objective of this study was to conduct a systematic review of studies that analyzed the impact of vitamin and nutrient deficiencies in postmenopausal women in relation to increased morbidities and chronic conditions. Observational studies were searched in the databases PubMed, UpToDate, and Google Scholar. We searched 122 studies, of which 90 were included in our analysis. The meta-analysis of the data could not be performed because of the heterogeneity of the statistical methodsin the included studies. In our study, we focused on the aspects of vitamin B6, vitamin B12, vitamin D, iron, omega-3-fatty acids, and lycopene, belonging to the family of carotenoids. Postmenopausal women with deficiencies of these nutrients are more vulnerable to comorbidities such as cardiovascular and cerebrovascular events, metabolic diseases, osteoporosis, obesity, cancer and neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease, depression, cognitive decline, dementia, and stroke. We concluded that women after menopause tend to have a greater probability of suffering from deficiencies in various vitamins and nutrients, and consequently have an increased risk of developing morbidities and chronic diseases. In conclusion, maintaining optimum serum levels of nutrients and vitamins, either through a balanced and healthy diet consuming fresh fruits, vegetables, and fats or by taking appropriate supplementation, is essential in maintaining optimal health-related quality of life and reducing the risk for women during the menopausal transition and after menopause. Nevertheless, more recent studies need to be assessed to formulate adequate recommendations to achieve positive clinical outcomes.

The microbiota and the host organism switch between cooperation and competition based on dietary iron levels

The microbiota and the host organism switch between cooperation and competition based on dietary iron levels

Iron and ferritin deficiency in women with hypothyroidism and chronic lymphocytic thyroiditis - systematic review.

Iron is one of the essential microelements necessary for maintaining the body's homeostasis. It serves various roles, including being a crucial component in the proper structure of many enzymes and supporting the transport of oxygen and electrons. Its deficiency can lead to anaemia, which is a common clinical condition often associated with thyroid diseases. Iron deficiency is one of the most common nutritional deficiencies, and its prevalence is strongly associated with socioeconomic status. It is the primary cause of anaemia in 42% of children and 50% of women. Importantly, iron deficiency is placed among the top 5 causes of disability in women. Thyroid peroxidase (TPO) is an enzyme essential for the production of thyroid hormones, and iron is a key factor in its proper functioning. Therefore, in the case of iron deficiency, the activity of this enzyme is also reduced. Iron is also a factor that is important in epigenetic modification processes, and its deficiency may contribute to genomic changes potentially promoting the development of autoimmune thyroid diseases. Adequate supplementation in patients with Hashimoto's disease is one of the crucial elements of effective therapy. In addition to iodine, selenium, and magnesium supplementation, attention should be paid to proper iron intake. Iron is an element that is a component of the heme enzyme- thyroid peroxidase, which owes its activity to the binding of haem, and its function is the production of thyroid hormones. Iron can be delivered to the body in haem and non-haem forms. The haem form is found particularly in haemoglobin-rich red meat, but also in eggs, fish, and poultry. On the other hand, non-haem iron can be found in legumes, grains, fruits, and vegetables. Our study aimed to gather and summarise knowledge from scientific literature regarding iron deficiency anaemia and its association with hypothyroidism in women, as well as the possible mechanisms and pathogenesis of these conditions. The paper also aims to highlight that considering the high risk of iron deficiency, assessing iron status along with ferritin should be an integral part of additional diagnostic measures in cases of hypothyroidism, particularly Hashimoto's disease.

Assessment and Mapping of Nutrients in Soils of Babain and Ladwa Blocks of Kurukshetra using GIS

The study was conducted in 2021-22 to evaluate the soil fertility status and create geospatial thematic mapping of available macro and micronutrients using GIS, and their correlation with physico-chemical properties of the soils of the Babain and Ladwa blocks of Kurukshetra, India. A composite of 204 georeferenced soil samples was collected from different villages of both blocks and samples were analysed using standard procedures. The average pH of the soils of Babain and Ladwa had a mean value of 8.10 and 8.18. Among the total soil samples, 92 and 80 samples were found to be saline in Babain and Ladwa, respectively. The nitrogen, phosphorous, potassium and sulphur content in the soils of the Babain block ranged from 105-280, 6-32, 80-500 and 34-298 kg ha-1, while in the Ladwa block nitrogen, phosphorous, potassium and sulphur content in the soils ranged from 89-287, 7-27, 65-510 and 45-430 kg ha-1, respectively. The soil samples exhibited varying levels of zinc, iron, and copper, with some falling into the sufficient category and others into the deficient category. However, all samples had sufficient manganese and boron content. The observed deficiency of zinc, iron and copper can be replenished with the application of manures and fertilizers to improve soil fertility and crop productivity.

Comparative efficacy and safety of Chinese patent medicines of iron deficiency anemia during pregnancy: A network meta-analysis.

Iron deficiency anemia (IDA) is a prevalent nutritional disorder during pregnancy. Clinical studies indicate that incorporating Chinese patent medicines (CPMs) with oral iron (OI) in treating IDA in pregnancy can reduce adverse effects and improve clinical outcomes. Nonetheless, the comparative efficacy of different CPMs remains unclear. To assess the safety and effectiveness of different CPMs for treating IDA during pregnancy using network meta-analysis. We conducted a search for randomized controlled trials (RCTs) that combined CPM and OI for IDA treatment in pregnancy, spanning from 2013 to the present. Data analysis was performed using Rev Man 5.3 and Stata 14.0 on literature that satisfied the quality criteria. The analysis included 45 RCTs, encompassing 4422 pregnant patients with IDA. Six CPMs were examined, including Shengxuebao Mixture, Shengxuening Tablets (SXN), Yiqi Weixue CPMs (YQWX), Jianpi Shengxue CPMs (JPSX), Yiqi Buxue Tablets, and Compound Hongyi Buxue Oral Liquid (FFHY). Findings indicated that FFHY + OI significantly improved the clinical effective rate. SXN + OI was most effective in boosting red blood cells counts and hemoglobin levels. YQWX + OI showed superior results in improving serum ferritin, and SXN + OI was most effective in increasing serum iron levels. JPSX + OI was optimal in reducing adverse pregnancy outcomes, while YQBX + OI effectively minimized adverse events. A cluster analysis suggested that SXN + OI could be the potentially optimal therapeutic regimen for IDA in pregnancy. This study demonstrates that the combination of OI with CPMs offers better outcomes than OI alone. Based on clinical efficacy and other measured outcomes, SXN + OI emerges as the most effective treatment modality for improving the health of pregnant patients with IDA.

Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study

ObjectiveTo estimate the strength of association between exposure to selected classes of prescribed medications and the risk of developing iron deficiency anaemia (IDA), specifically considering oral anticoagulants (OACs), antidepressants, antiplatelet...

A Comparison between Serum 25-Hydroxyvitamin D3 Levels and Serum Ferritin in Children and Adolescents with Iron Deficiency Anemia, Thalassemia Minor, Thalassemia Major and Healthy People

Background: We aimed to determine the level of serum vitamin D and serum ferritin in four groups’ children and adolescents. Methods: This descriptive/analytical study was conducted in 2019 on children and adolescents with thalassemia aged 7-18 years in Ahvaz, Iran. Overall, 160 patients with the target inclusion and exclusion criteria were assigned into four groups (n=40) of people with thalassemia minor, thalassemia major, iron deficiency anemia and healthy individuals. The level of ferritin and vitamin D was assessed. Mann-Whitney test, Wilcoxon test and Spearman's correlation test were used as well as SPSS Statistics V21. Results: The mean age of the participants was 13.07 ± 3.82 yr and 100 people (62.5%) were male. In terms of vitamin D deficiency, 16 people (40%) had severe deficiency in iron deficiency group. The highest level of ferritin was found in thalassemia major group and the lowest in iron deficiency group. Regarding the level of vitamin D and ferritin in the healthy group, there was a statistically significant difference between mean vitamin D and serum ferritin levels (P=0.027). In iron deficiency group, this level of ferritin was observed with mild deficiency (P=0.017). In thalassemia major group, the increase in ferritin was associated with severe vitamin D deficiency (P=0.05. Conclusion: Severe vitamin D is seen in thalassemia major due to the increase in ferritin, but moderate deficiency of this vitamin in healthy people and mild deficiency in iron deficiency anemia group was observed considering the normal levels of ferritin.

Development and validation of a faecal immunochemical test-based model in the work-up of patients with iron deficiency anaemia.

In patients with iron deficiency anaemia (IDA), the diagnostic yield of gastroscopy and colonoscopy (bidirectional endoscopy) in detecting neoplastic lesions is low. This study aimed to develop and validate a faecal immunochemical test (FIT)-based model to optimise the work-up of patients with IDA. Outpatients with IDA were enrolled in a prospective, multicentre study from April 2016 to October 2019. One FIT was performed before bidirectional endoscopy. Significant gastrointestinal lesions were recorded and a combined model developed with variables that were independently associated with significant colorectal lesions in the multivariate analysis. The model cut-off was selected to provide a sensitivity of at least 95% for colorectal cancer (CRC) detection, and its performance was compared to different FIT cut-offs. The data set was randomly split into two groups (developed and validation cohorts). An online calculator was developed for clinical application. The development and validation cohorts included 373 and 160 patients, respectively. The developed model included FIT value, age, and sex. In the development and validation cohorts, a model cut-off of 0.1375 provided a negative predictive value of 98.1 and 96.7% for CRC and 90.7 and 88.3% for significant colorectal lesions, respectively. This combined model reduced the rate of missed significant colorectal lesions compared to FIT alone and could have avoided more than one-fourth of colonoscopies. The FIT-based combined model developed in this study may serve as a useful diagnostic tool to triage IDA patients for early endoscopic referral, resulting in considerable reduction of unnecessary colonoscopies.

The Intersection of Hepcidin and Polycystic Ovary Syndrome: A Review of Current Understanding

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting up to 13% of reproductive-age women. It is characterized by a constellation of symptoms including menstrual irregularities, hyperandrogenism, and polycystic ovaries, often intertwined with metabolic disturbances such as insulin resistance and dyslipidemia. Hepcidin is a liver-produced peptide hormone that regulates iron homeostasis, with a significant role in the pathophysiology of PCOS. Hepcidin controls iron absorption and storage by binding to ferroportin, leading to its degradation and reducing iron export from enterocytes and macrophages. In PCOS patients, hepcidin dysregulation is linked to underlying hormonal and metabolic abnormalities, including insulin resistance and hyperandrogenism. Studies consistently demonstrate decreased hepcidin levels in PCOS patients, resulting in altered iron metabolism parameters, such as increased serum iron and ferritin concentrations, leading to iron overload. This iron overload can exacerbate complications like anemia. The relationship between hepcidin, anemia, and PCOS is influenced by several mechanisms. Hyperandrogenism in PCOS inhibits hepcidin synthesis, reducing iron sequestration and increasing serum iron levels, contributing to erythropoiesis and potentially mitigating anemia, while also posing a risk of iron overload. Hyperinsulinemia associated with insulin resistance further decreases hepcidin levels, enhancing dietary iron absorption and increasing serum iron levels. Despite the chronic low-grade inflammation typical in PCOS, which usually increases hepcidin levels, the inflammation may not be sufficient to override the suppressive effects of hyperandrogenism and hyperinsulinemia on hepcidin expression. Oligomenorrhea or amenorrhea in PCOS leads to reduced menstrual blood loss, contributing to iron retention and further influencing hepcidin regulation. Genetic and epigenetic factors also significantly impact hepcidin expression and iron metabolism in PCOS.

Brain iron deficiency and periodic limb movement disorder with parasomnias

Brain iron deficiency and periodic limb movement disorder with parasomnias