Effect Of Iron Deficiency Anemia Research Articles

A study on influence of iron deficiency anaemia over HbA1c levels

Background: Haemoglobin A1c (HbA1c) is a glycated form of haemoglobin reflects average plasma glucose over the previous 8 to 12 weeks. HbA1c can be affected by multiple non-glycaemic parameters. Iron deficiency anaemia (IDA) is one among them which is the most common type of anaemia in India. However, reports on the effects of iron deficiency anaemia on HbA1c levels are inconsistent. Hence we conducted a study to find out the influence of iron deficiency anaemia over HbA1c levels. Methods: 120 patients confirmed to have iron deficiency anaemia were enrolled in this study. HbA1c levels were measured at baseline and 3 months after treatment, and these values were compared with those in the control population.Results: The mean baseline HbA1c level in anaemic patients (4.62%) was significantly lower than that in the control group (5.45%, P<0.001). A significant increase was observed in the patients HbA1c levels at 3 months after treatment (5.82%, P<0.001). There was a significant correlation observed between haemoglobin and HbA1c level (Coefficient of correlation=0.26, P<0.01) in the study group before correction.Conclusions: In contrast to the observations of previous studies, ours showed that HbA1c levels increased with treatment of iron deficiency anaemia. This could be attributable to nutritional deficiency, racial-ethnic variations and/or certain unknown variables. Further studies are warranted.

Studying the Auditory Effect of Maternal Iron Deficiency Anemia on Neonates Using Otoacoustic Emissions (Oaes)

Background: The adverse effects of iron deficiency anemia on auditory nerve (AN) development have been showed a significant functional consequence on auditory brainstem response (ABR). Aim of the work was to study the effect of maternal iron deficiency anemia on auditory system of newborn infant using otoacoustic emissions (OAEs). Subjects and Methods: 60 full term neonates were divided into 2 groups: Group 1: 30 newborn infants as a control group with maternal blood Hb >10.5 g/dL. Group 2: study group: 30 newborn infants with maternal blood Hb ≤ 10.5 g/dL and diagnosed as maternal iron deficiency anemia (IDA). Results: In transient-evoked otoacoustic emissions (TEOAE) there was significant difference between the studied groups at frequency of 4000 Hz in both right and left ears. There was also significant difference between right and left ears as regard signal to noise ratio (SNR) and overall amplitude TEOAE at frequency of 2000Hz in control group and at 4000 Hz in study group. There was significant difference in study group between right and left ears as regard signal to noise ratio (SNR) distortion-product otoacoustic emissions (DPOAE) at frequencies 1409 with right ears showing a higher mean SNR than left ears. Conclusion: The peripheral auditory function, as tested by TEOAEs test, is affected in high frequency region of the cochlea in low ferritin babies while DPOAEs test was less sensitive in these patients for assessment of their cochlear function.

The effect of iron deficiency anemia on experimental dental caries in mice

ObjectiveThe objective of this study was to examine the relationship between iron deficiency and caries susceptibility in a mouse model. Materials and methodsThree-week-old C57BL/J6 mice were fed a cariogenic diet containing either standard iron (48 ppm Fe) or low iron (4 ppm Fe) levels. Concurrently, groups of mice with both diets were orally inoculated with Streptococcus mutans (1 × 108) cells on three consecutive days. At the end of the 5th week after infection, mice were sacrificed and jaws were collected for caries scoring, rating the number and severity of lesions using a modified Keyes method applicable to mice. ResultsBlood analysis by the end of the 5th week revealed marked reduction in the hemoglobin and hematocrit levels of the mice fed the iron deficient diet (IDA and IDA-S. mutans). Anemic mice in both groups lacked the incisor enamel pigmentation observed in mice fed an iron deficient diet. Anemic infected mice had the highest caries severity scores reflecting extensive deep lesions (P < 0.05). S. mutans infected mice fed a standard iron diet had similar numbers of lesions and severity scores as un-infected IDA animals (p < 0.05). IDA did not alter S. mutans CFU counts in infected animals (P < 0.05). ConclusionThese results demonstrated that IDA mice are at a higher risk of developing deep dental caries compared to non-anemic mice; highlighting the protective role of iron against dental caries.

Health and educational achievement of school-aged children: The impact of anaemia and iron status on learning.

BackgroundAnaemia is a common blood disorder in children and is known to cause complications such as lethargy and stress on bodily organs. Children from disadvantaged communities often fail to achieve their age-related potential with iron deficiency anaemia stated as a risk factor through causing inattentiveness and learning problems. Limited evidence exists for the adverse effects of iron deficiency anaemia on the developing child’s brain from South African studies.AimThe objective of this study was to determine the local prevalence of anaemia and iron deficiency and to examine their association with psychomotor development and school performance in school-aged children.SettingThis study was conducted in a peri-urban disadvantaged community from KwaZulu-Natal, South Africa.MethodsChildren aged 6 to 8 years from KwaZulu-Natal were enrolled (n = 184). Three parameters of assessment were used: clinical data, biochemical data (haemoglobin levels and iron studies) and school performance (interviews with caregivers, teachers and the children). Anaemia presence and iron deficiency were the hypothesised mediating variables through which growth, development and school performance were influenced.ResultsA high point prevalence of anaemia (23.4%), iron deficiency anaemia (4.9%) and helminth infection (27.1%) was identified. Impaired cognitive assessment scores (20.7%) were prevalent in the children sampled. Behavioural problems (4.3%), poor memory function (4.3%) and impaired attention (1.1%) were of low prevalence. Anaemia and iron deficiency were both associated with impaired fine motor skills (p < 0.05). Anaemia was significantly associated with low cognitive scores (p = 0.01). Neither anaemia, iron status nor helminth infection significantly predicted school performance in the children sampled.ConclusionsThe point prevalence of anaemia and iron deficiency among the sampled children was higher than the national prevalence. The sample size was however inadequate for drawing statistical conclusions about psychomotor development and school performance because of the low prevalence of the different outcomes that were examined. Practical challenges faced in conducting this investigation in rural South African schools were discussed.

Effect of iron deficiency anemia on HbA1c in diabetic patients at Tikur Anbessa specialized teaching hospital, Addis Ababa Ethiopia

BackgroundHemoglobin A1C (HbA1c) is the predominant hemoglobin found in HbA1 fractions. A1c assay is the recommended assay for diagnosing diabetes and any condition that changes red cell turnover such as Iron deficiency Anemia (IDA), will lead to spurious A1C results. Therefore, the present study was aimed at determining the effect of IDA on HbA1c in diabetic patients attending Black Lion Specialized Teaching Hospital, Addis Ababa, Ethiopia.MethodsA facility based comparative cross sectional study was conducted on 174 diabetic patients (87 with IDA and 87 without IDA) from April to July 2016. Socio demographic data and clinical conditions were collected using structured questionnaire. Venous blood was collected for performing Complete blood count (CBC) using Cell dyn 1800 hematology analyzer; Serum ferritin, performed by COBAS INTEGRA 400/800 Chemistry analyzer and HbA1c tests, performed by COBAS C 111 analyzer. Data was analyzed using SPSS version 21 software. Pearson’s correlation, chi-square, and independent t-tests were calculated. The data was presented as mean ± SD. A P-value of < 0.05 was taken as statistically significant.ResultsMean hemoglobin (Hgb), hematocrit (HCT), Mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC) were lower in IDA group compared to non-IDA diabetic patients. HbA1c (%) level was significantly lower in IDA group (6.18 ± 1.57) compared with the non-IDA diabetic patients (7.74 ± 1.81) (p < 0.05).ConclusionHbA1c is significantly lower in diabetic patients with IDA compared to the non-IDA diabetic patients. Therefore, the authors believe that monitoring these patients using only HbA1c could be misleading, hence physicians and health care providers should take this into account before making any therapeutic decision. Detailed examination including large number of participants employing advanced laboratory techniques is recommended.

Buffered or impaired: Maternal anemia, inflammation and breast milk macronutrients in northern Kenya.

Maternal anemia has adverse consequences for the mother-infant dyad. To evaluate whether and how milk nutrient content may change in ways that could "buffer" infants against the conditions underlying maternal anemia, this study assessed associations between milk macronutrients and maternal iron-deficiency anemia (IDA), non-iron-deficiency anemia (NIDA), and inflammation. A secondary analysis of cross-sectional data and milk from northern Kenya was conducted (n = 204). The combination of hemoglobin and transferrin receptor defined IDA/NIDA. Elevated serum C-reactive protein defined acute inflammation. The effects of IDA, NIDA, and inflammation on milk macronutrients were evaluated in regression models. IDA (β = 0.077, p = .022) and NIDA (β = 0.083, p = .100) predicted higher total protein (ln). IDA (β = -0.293, p = .002), NIDA (β = -0.313, p = .047), and inflammation (β = -0.269, p = .007) each predicted lower fat (ln); however, anemia accompanying inflammation predicted higher fat (β = 0.655, p = .007 for IDA and β = 0.468, p = .092 for NIDA). NIDA predicted higher lactose (β = 1.020, p = .003). Milk macronutrient content both increases and decreases in the presence of maternal anemia and inflammation, suggesting a more complicated and dynamic change than simple impairment of nutrient delivery during maternal stress. Maternal fat delivery to milk may be impaired under anemia. Mothers may buffer infant nutrition against adverse conditions or poor maternal health by elevating milk protein (mothers with IDA/NIDA), lactose (mothers with NIDA), or fat (mothers with anemia and inflammation). This study demonstrates the foundational importance of maternal micronutrient health and inflammation or infection for advancing the ecological understanding of human milk nutrient variation.

Effect of Iron Deficiency Anemia on IGF-1 Level Among Sample of Children

Background and objectives:Iron-deficiency anemia is a worldwide nutritional problem and an important public health problem especially in developing countries. The aim of this study was to compare the mean insulin like growth factor-1 of anemic children with that of non-anemic children and to correlate the levels of insulin like growth factor-1 with the levels of serum ferritin. Methods:cross-sectional study included fifty children. Measurement of levels of insulin like growth factor-1 was done in 25 children with iron deficiency anemia and compared with twenty-five age- and sex- matched non anemic children. Results: The mean age + SD were 6.11 + 3.31 years, ranging. There was significant difference detected between the iron deficiency anemia and control group regarding the mean values of insulin like growth factor-1 level as there was more than one third of iron deficiency anemia group had insulin like growth factor-1 levels lower than that of the control group. There was a relatively strong, significant positive correlation between serum ferritin levels with insulin like growth factor-1 levels. Conclusions:A significant correlation was observed between serum ferritin and serum insulin growth factor-1 level, since less serum ferritin levels is associated with less insulin growth factor-1 levels among anemic group compared with control group, implying that the effect of IDA on insulin like growth factor-1 level may differ according to body iron status.

Longitudinal Effects of Iron Deficiency Anemia and Subsequent Repletion on Blood Parameters and the Rate and Composition of Growth in Pigs.

Iron deficiency is reported as the most common nutrient deficiency worldwide. Due to rapid growth, infants are at particular risk for developing iron deficiency, which can easily progress to iron deficiency anemia (IDA), if not treated. The aim of this study was to determine the lasting effects of an early-life iron deficiency after a period of dietary iron repletion. Forty-two intact male pigs were fed, ad libitum, either control (CONT, 21.3 mg Fe/L) or iron-deficient (ID 2.72 mg Fe/L) milk replacer from postnatal day (PND) 2 to 32 (phase 1). From PND 33 to 61 (phase 2), all pigs were transitioned onto a series of industry-standard, iron-adequate diets. Blood was collected weekly from PND 7 to 28, and again on PND 35 and 56, and tissues were collected at either PND 32 or PND 61. At the end of phase 1, ID pigs exhibited reduced hematocrit (Hct; p < 0.0001) and hemoglobin (Hb; p < 0.0001) compared with CONT pigs, but neither Hct (p = 0.5968) nor Hb (p = 0.6291) differed between treatment groups after dietary iron repletion at the end of phase 2. Body weight gain was reduced (p < 0.0001) 58% at PND 32 in ID pigs compared with CONT pigs during phase 1, and this effect remained significant at the end of phase 2 (p = 0.0001), with ID pigs weighing 34% less than CONT pigs at PND 61. Analysis of peripheral protein and messenger RNA (mRNA) gene expression biomarkers yielded inconclusive results, as would be expected based on previous biomarker analyses across multiple species. These findings suggest that early-life iron status negatively influences blood parameters and growth performance, with dietary iron repletion allowing for full recovery of hematological outcomes, but not growth performance.

Relation of Iron Deficiency Anemia and the Level of Glycosylated Hemoglobin (HbA1c) in Non-Diabetic Patients

Introduction: The major form of glycohemoglobin is hemoglobin A1c (HbA1c). The Hb A1c fraction is elevated in chronic hyperglycemic diabetic patients and correlates positively with glycemic control. Previous studies suggest that iron deficiency anemia (IDA) affects the level of HbA1c. The aim of the study: To determine the effect of IDA on HbA1c level in non-diabetic patients before and after treatment with iron. Material and methods: The study included 100 females from Al jmail General Hospital at the west of Tripoli, 50 were with IDA and 50 were not anemic (control group). Age ranged from (20-40) years. Fasting blood glucose, HbA1c, complete blood count, serum iron, total iron binding capacity and serum Ferritin were measured in all females before treatment and after treatment. Patients who had glucose tolerance abnormality (impaired glucose tolerance or diabetes mellitus), hemoglobinopathy, hemolytic anemia, chronic alcohol ingestion, chronic renal disease, chronic liver disease and rheumatoid arthritis were excluded from study. All patients with IDA were treated with ferrous sulfate as 325mg orally three times a day for 3 months. Results: The mean percentage of the HbA1c in non-anemic patients control group was 5.2%. The mean percentage of HbA1c in patients with mild anemia was (6%), moderate anemia (5.9 %). In patients with severe anemia HbA1c was (3.2%) which is significantly low in comparison to normal females. After treatment with iron, significant increase in HbA1c was observed in patients with severe anemia (5.2%) p < 0.001 and significant decrease in HbA1c in female with mild and moderate anemia 5.2%,5.3% respectively P<0.001. Conclusion: In patient with iron deficiency anemia, hemoglobin A1c in not reliable parameter for follow up of patients with diabetes mellitus.

Effects of iron-deficiency anemia on auditory function in school-aged children

Introduction Iron is important for proper myelination of spinal cord and white matter of cerebellar folds in brain and is a cofactor for a number of enzymes involved in neurotransmitter synthesis. Auditory brainstem evoked response (ABR) represents the progressive activation of different levels of the auditory pathway from the acoustic nerve (wave I) to the lateral lemniscuses (wave V). Otoacoustic emissions (OAEs) are sounds measured in the external ear canal that reflect movement of the outer hair cells in the cochlea. Patients and methods A total of 40 children, of both sexes, with age ranging from 6–12 years old, were selected for this study after a thorough clinical assessment to exclude any other pathological disorder other than anemia. They are compared with a control group that consisted of 20 normal children of the same age. After laboratory investigations, all children were examined by ABR and transient-evoked OAEs. The study group children were classified according to ABR results into study group 1, comprising anemic children with abnormal ABR results and study group 2, comprising anemic children with normal ABR results. Results ABR showed that absolute peak latencies of waves I, III, and V and interpeak latencies were prolonged; moreover, ABR waves I and V showed reduced amplitude in study group 1 than control group, and the difference is statistically significant. In contrast, there was no statistically significant difference between study group 2 and control group regarding ABR results. Transient-evoked OAEs results showed no statistically significant difference between anemic children and control group. Conclusion This study added to the evidences that iron-deficiency anemia is a risk factor for auditory function impairment. Further studies for the effect of timing, duration, and severity of iron deficiency on auditory functions are needed. Well-designed large-scale studies are needed to address the iron-deficiency anemia in health planning programs to put plans for control and prevention especially in developing countries.

Role of Iron Supplements on Pregnancy Outcomes

Background: Anemia is one of the most widely recognized nutritional deficiencies for the duration of pregnancy in underdeveloped countries. It is a risk factor for preterm delivery and consequent low birth weight new born, and subsequent ill effects on neonate and infant health. Further research and sufficient data in different setting is required for determining the extent to which maternal anemia might contribute to maternal morbidity, mortality and impact on pregnancy outcomes. Objective: To assess the effects of iron supplements on pregnancy outcomes. Study Design: Cross-sectional study in which women delivered in hospital were questioned for history of intake of iron supplements during ante-natal period and new born was examined for any adverse effects of iron deficiency anemia. Setting: Hilal-E-Ahmar Maternity Hospital Faisalabad. Results and Discussion: 400 respondents were included in study that was regular in attending ante-natal clinic in the hospital during different gestational period. No significant adverse effects/outcomes were seen in women and newborn irrespective of frequency of iron supplementation already taken during these gestational periods. Conclusion: Majority of the newborn delivered full term and without any complication of pregnancy in this study as well as most of them had normal birth weight. This finding is linked with intake of iron supplements taken by majority of pregnant women during antenatal care. Incidence of low birth weight new born, abortion (spontaneous & therapeutic) and fetal deaths were almost negligible.

Role of Iron Supplements on Pregnancy Outcomes

Background: Anemia is one of the most widely recognized nutritional deficiencies for the duration of pregnancy in underdeveloped countries. It is a risk factor for preterm delivery and consequent low birth weight new born, and subsequent ill effects on neonate and infant health. Further research and sufficient data in different setting is required for determining the extent to which maternal anemia might contribute to maternal morbidity, mortality and impact on pregnancy outcomes. Objective: To assess the effects of iron supplements on pregnancy outcomes. Study Design: Cross-sectional study in which women delivered in hospital were questioned for history of intake of iron supplements during ante-natal period and new born was examined for any adverse effects of iron deficiency anemia. Setting: Hilal-E-Ahmar Maternity Hospital Faisalabad. Results and Discussion: 400 respondents were included in study that was regular in attending ante-natal clinic in the hospital during different gestational period. No significant adverse effects/outcomes were seen in women and newborn irrespective of frequency of iron supplementation already taken during these gestational periods. Conclusion: Majority of the newborn delivered full term and without any complication of pregnancy in this study as well as most of them had normal birth weight. This finding is linked with intake of iron supplements taken by majority of pregnant women during antenatal care. Incidence of low birth weight new born, abortion (spontaneous & therapeutic) and fetal deaths were almost negligible.

Depression, anxiety, stress and cognition in females with Iron deficiency anemia

Introduction: Iron deficiency anemia (IDA) is characterized by defect in the synthesis of hemoglobin leading to the poor delivery of oxygen to the cells and tissues expressing the clinical symptoms like lethargy, dizziness, shortness of breath and pale conjunctiva. Objectives: The present study is taken up to learn the levels of depression, anxiety, stress with IDA in females. The effect of IDA on cognitive skills was also studied. Methods: The present cross sectional study included thirty female participants with diagnosed iron deficiency anemia and thirty age matched controls, after obtaining voluntary, written informed consent. DASS-42 was used to assess depression, anxiety and stress. Spatial and verbal memory test was used to assess spatial and verbal memory test. Results: We have observed higher levels of depression, anxiety and stress and decreased spatial memory scores in females with iron deficiency anemia. Conclusion: We recommend further detailed studies in this area to explore the association of iron status with stress and cognition for planning better treatment options for the benefit of the patients.

Impact of Iron Deficiency Anemia on Glycated Hemoglobin (HbA1c) Levels in Diabetics with Controlled Plasma Glucose Levels

BACKGROUND : Glycated hemoglobin (HbA 1 C) is used as a gold standard for monitoring glycemic control. American Diabetes Association (ADA) has certified HbA 1 C ≥ 6.5% as a diagnostic criterion for diabetes mellitus (DM). Recent studies suggest that conditions affecting erythrocyte turnover like Iron deficiency anemia (IDA) alters HbA 1 C levels but their results are conflicting. However the effect of IDA on HbA 1 C is rarely reported. To determine the impact of IDA on HbA 1 C levels among controlled diabetics [Fasting plasma glucose (FPG) <126mg/dl since last 6 months] independent of blood glucose concentration and its variation according to the degree of anemia. METHODS: This cross-sectional study carried out in SRM Medical College Hospital and Research Centre, Chennai includes totally 300 controlled diabetic patients –Type 2 DM (150 with IDA and 150 without IDA). Medical history recorded. HbA 1 C, complete hemogram and FPG were tested. RESULT: The mean HbA 1 C among controlled diabetics with IDA (7.86 ± 0.11%) was significantly higher than those without IDA (5.45 ± 0.038%) (P<0.05). HbA 1 C results were higher with the reduction of total hemoglobin (p< 0.05) CONCLUSION: IDA spuriously elevates HbA1C levels independent of blood glucose concentration in controlled-diabetics.HbA 1 C increases significantly as severity of anemia worsens. Thereby this study insists on the utter importance to exclude IDA and to correct it before any diagnostic or therapeutic decision is made based solely on HbA 1 C level.

A comparison of effect of Iron Deficiency Anemia on HbA1c levels in controlled diabetics and non-diabetics: A cross sectional analysis of 300 cases

BACKGROUND: Diabetes Mellitus (DM) has become a major health problem worldwide. American Diabetes Association has considered HbA 1 C levels ≤ 6.5 % as the prime target for glycemic control and as a diagnostic criterion for DM. Anemia is common in DM (8-66%).Studies on alteration of HbA 1 C in IDA have conflicting results. OBJECTIVES: To identify and compare the effect of IDA on HbA 1 C levels among controlled diabetics (Fasting plasma glucose (FPG) <126mg/dl since last 6 months) and non-diabetics and its variation according to the degree of anemia. METHODS: This cross-sectional study done in SRM Medical College Hospital and Research Centre, Chennai includes 150 Controlled diabetics (75 with IDA and 75 without IDA) and 150 non diabetics (75 with IDA and 75 without IDA). HbA 1 C, complete hemogram, iron profile and FPG were tested. Medical history was recorded. RESULTS: The mean HbA 1 C in controlled diabetics with and without IDA were 8.81±0.13 & 5.79±0.01 respectively (P<0.05) and in non-diabetics with and without IDA were 6.84±0.07 & 5.12±0.04 respectively (P<0.05). The difference between no, mild, moderate and severe anemia in both diabetics and non-diabetics was statistically significant (p< 0.05). Mean HbA 1 C% was highest in groups with severe anemia. CONCLUSION: IDA falsely elevates HbA 1 C level independent of blood glucose concentration in both controlled diabetics and non-diabetics. Hence prior to alteration of treatment regimen based on HbA 1 C for diabetes, IDA should be diagnosed and corrected. Concurrent evaluation for anemia is critical to correctly interpret glycemic status in Indian population with prevalent IDA. DOI: 10.21276/APALM.1276

The Effect of Iron Deficiency Anemia on Glycated Hemoglobin (HbA1c) in Non Diabetic Adults

The Effect of Iron Deficiency Anemia on Glycated Hemoglobin (HbA1c) in Non Diabetic Adults

Iron deficiency anemia and glucose metabolism.

Iron deficiency anemia (IDA) is a global public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. It occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children. IDA appears to be more common in diabetic patients compared to non-diabetic population. Iron deficiency (ID) and IDA can impair glucose homeostasis in animals and human and may negatively affect glycemic control and predispose to more complications in diabetic patients. On the other hand diabetes and its complications are associated with anemia and its correction improves diabetes control and may prevent or delay the occurrence of complications. Physicians treating this form of anemia should be aware of its negative effect on glycemic control in normal and diabetic patients (both type 1 and type 2). They should prevent ID and treat early all those with IDA. This brief review aims to enlighten the different effects of IDA on glucose metabolism in normal and diabetic patients. (www.actabiomedica.it)

Effect of iron deficiency anemia on glycosylated hemoglobin level (HbA1c) in non-diabetic patients in Riyadh region of Saudi Arabia

Effect of iron deficiency anemia on glycosylated hemoglobin level (HbA1c) in non-diabetic patients in Riyadh region of Saudi Arabia

Impact of iron deficiency anemia on the function of the immune system in children.

The importance of iron deficiency as a public health problem is based ultimately on the seriousness of its consequences on health. The most extensively investigated consequences of iron deficiency involve work performance and immune function. The significance of the effects on work performance is generally accepted. In contrast, data on the influence of iron deficiency on immune function are often perceived as being confusing and contradictory.We aimed to evaluate the effect of iron deficiency anemia on humoral, cellular, nonspecific immunity, and also the effect on the cytokines that are the key factors of many immunologic steps.Forty children with iron deficiency anemia and 20 age and sex-matched healthy children were included. All children were subjected to full medical history, thorough clinical examination, complete blood count, iron indices (serum iron, serum total iron-binding capacity, serum ferritin, and transferrin saturation), immunoglobulin assay (IgA, IgG, and IgM), interleukin (IL)-6 serum level, study of T-lymphocyte subsets, and evaluation of phagocytic function of macrophages and oxidative burst activity of neutrophils.Patients had significantly lower IgG levels, IL-6, phagocytic activity, and oxidative burst of neutrophils than controls, although there was no significant difference between patients and controls with regard to other immunoglobulins and CD4/CD8 ratio. There was significantly positive correlation between serum iron and IL-6 serum level.We concluded that humoral, nonspecific immunity (phagocytic activity and oxidative burst), and the IL-6 are influenced in patients with iron deficiency anemia. Study of these abnormalities after correction of iron deficiency is strongly needed.

Effect of iron deficiency anemia and iron supplementation on HbA1c levels - Implications for diagnosis of prediabetes and diabetes mellitus in Asian Indians

BackgroundWe investigated the effect of iron deficiency anemia (IDA) on levels of glycated hemoglobin (HbA1c) and to compare its levels before and after iron supplementations. MethodsAge and sex matched subjects were enrolled and clustered in 2 groups: IDA (n=62) and healthy controls (HC; n=60). HbA1c levels were estimated by HPLC. Hemogram were estimated by hematology analyser. Serum ferritin (ELISA) and other parameters of iron profile were measured by standard guidelines of ICSH. HbA1c values and iron studies were repeated after 3months of iron supplementation to determine the effect of iron therapy on HbA1c levels. ResultsSignificantly higher HbA1c levels were observed in IDA subjects compared to HC (5.51±0.696 v/s 4.85±0.461%, p<0.001). A significant negative correlation was observed between HbA1c and hemoglobin, hematocrit, RBC count, MCH, MCHC and serum ferritin in IDA subjects (r=−0.632, −0.652, −0.384, −0.236, −0.192 and −0.441). Significant decline was noticed in HbA1c levels in IDA subjects after iron supplementation (5.51±0.696 before treatment v/s 5.044±0.603 post-treatment; p<0.001). Post treatment, 70% subjects (14/20) with HbA1c in pre-diabetes range normalised to normal glucose tolerance (NGT) range and out of 6 patients with pre-treatment HbA1c in diabetes range, 5 reverted to pre-diabetes range while 1 of them reverted to the NGT range. ConclusionsCaution must be exercised in interpreting the results of HbA1c in patients of IDA and iron deficiency must be corrected before diagnosing diabetes and pre-diabetes solely on the basis of HbA1c criteria.