Hemoglobin In Subjects Research Articles

Ischemic stroke subtypes in subjects with and without diabetes: data from two hospitals in Mongolia

According to the World Health Organization report in 2020, the number of stroke deaths in Mongolia has reached 4,401, accounting for 19.84% of the total deaths, ranking as the second leading cause of death in Mongolia. Furthermore, the prevalence of diabetes has been steadily increasing for the last 20 years. In this case-control study (80 diabetic and 160 non-diabetic subjects), we analyzed data from two tertiary stroke centers over the past six months (June-December 2022). Inclusion criteria included patients over 18 years who presented to the emergency department with an acute ischemic stroke (I63 according to ICD 10). We reviewed and compared the data on clinical assessments such as the National Institutes of Health The Stroke Scale (NIHTSS), Glasgow Coma Scale and Modified Rankin Score, laboratory parameters, and TOAST classification of ischemic stroke between diabetic and non-diabetic patients in Mongolia. The mean age was 39.2±15.2, and 33.2% (n = 392) were male. The duration of diabetes in patients ranged from 0 to 23 years, and the median was 5.0. Mean glycated haemoglobin in subjects was 9.75±2.49%, and only 27.5% (n = 22) had HbA1c below 7.5%. Only BMI was significantly different in patients with diabetes compared to patients without diabetes (27.2±4.4 vs. 28.6±5.2). However, for other parameters, no significant difference was observed, but the NIHTSS at discharge was significantly higher in patients with diabetes. According to the TOAST classification, the risk of ischemic stroke caused by microangiopathy (18% vs 33.8%, p=0.142) and macroangiopathy (44.4% vs 57.5%, p=0.192) was 13-15% higher in people with diabetes than in people without diabetes. In regression analysis, patients with diabetes had a six times greater risk of ischemic stroke caused by atherosclerosis than non-diabetic patients. Most subtypes of stroke that occur in people with diabetes are caused by atherosclerosis, both large and small vessels.

Evaluation of a Potential Association between Head Lice (Pediculus capitis) Infestation and Anemia among Female Primary School Students in Holy Makkah, Saudi Arabia

Aims: This study aimed to determine if there was an association between head lice infestation and anemia among female primary schools students.
 Study Design: Case-control study.
 Place and Duration of Study: Holy Makkah, Saudi Arabia between August 2020 and November 2020.
 Methodology: We conducted a case-control study by comparing hemoglobin levels among study subjects with and without head lice infestation. Female students at 6 randomly selected primary schools were examined for the presence of head lice. Hemoglobin levels were obtained from each study subject; both those with and without head lice. Selected characteristics of study subjects were recorded and examined to determine associations between those factors and anemia.
 Results: A total of 82 subjects were included in the study; 44 subjects with head lice. The average (± standard deviation) age of subjects was 11 (± 2) (range: 6-11) years. We found a significant (p<0.028) association between the presence of head lice and hemoglobin level, the OR= 2.036 at 95% confidence interval 0.23 to 18.009. The mean of hemoglobin in subjects with lice was 13(±2) while the level in subjects without lice was 14.8(±2). Other factors significantly associated with the level of hemoglobin were being aged 10-11 years (p<0.05) and having a non-working mother (p<0.05).
 Conclusion: In our study we found a significant association between head lice and level of hemoglobin among study subjects. Further studies are needed to determine the reason of this association in order to determine the appropriate management and prevention of this problem.

Glycosylated Hemoglobin in Subjects Affected by Iron-Deficiency Anemia.

Previous studies have suggested that iron-deficiency anemia affects glycosylated hemoglobin (HbA1c) measurements, but the results were contradictory. We conducted a retrospective case-control study to determine the effects of iron deficiency on HbA1c levels. Starting with the large computerized database of the Italian Hospital of Desio, including data from 2000 to 2016, all non-pregnant individuals older than 12 years of age with at least one measurement of HbA1c, cell blood count, ferritin, and fasting blood glucose on the same date of blood collection were enrolled. A total of 2,831 patients met the study criteria. Eighty-six individuals were diagnosed with iron-deficiency anemia, while 2,745 had a normal iron state. The adjusted means of HbA1c were significantly higher in anemic subjects (5.59% [37.37 mmol/mol]), than those measured in individuals without anemia (5.34% [34.81 mmol/mol]) (P<0.0001). These results suggest that clinicians should be cautious about diagnosing prediabetes and diabetes in individuals with anemia.

Ertugliflozin: a sodium-glucose cotransporter-2 (SGLT-2) inhibitor for glycemic control in type 2 diabetes.

Recently, a new class of anti-diabetic drugs has found its way into the market: sodium-glucose cotransporters (SGLT) inhibitors. Two major SGLT isoforms have been identified: SGLT-2, mainly expressed in proximal renal tubules, and SGLT-1, mainly expressed in the small intestine, the proximal renal tubule, and the myocardium. SGLT-2 inhibitors increase urinary glucose excretion, lowering glycemia without inducing excessive insulin secretion. Marketed SGLT-2 inhibitors actually include dapagliflozin, canagliflozin, and empagliflozin; a new SGLT-2 inhibitor is being studied: ertugliflozin. Ertugliflozin is a potent inhibitor of SGLT-2 and possesses a high selectivity over glucose transport via SGLT-1 and several other glucose transporters GLUT-1–4. Ertugliflozin inhibits renal glucose reabsorption resulting in urinary glucose excretion and thereby reduces plasma glucose and glycated hemoglobin in subjects with type 2 diabetes mellitus. Ertugliflozin is being developed as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. The aim of this review is to evaluate the preliminary published data about this new molecule.

Determinants of Glycated Hemoglobin in Subjects With Impaired Glucose Tolerance: Subanalysis of the Japan Diabetes Prevention Program.

BackgroundLimited evidence is available about the relationship of lifestyle factors with glycated hemoglobin (HbA1c) in subjects with impaired glucose tolerance. The aim of study was to identify such determinant factors of HbA1c in subjects with impaired glucose tolerance.MethodsThis cross-sectional study included 121 men and 124 women with impaired glucose tolerance, who were diagnosed based on a 75-g oral glucose tolerance test. Demographic and biochemical parameters, including the body mass index (BMI), fasting plasma glucose (FPG), 2-h post-load glucose (2-h PG), and HbA1c, were measured. The pancreatic β-cell function and insulin resistance were assessed using homeostasis model assessment (HOMA-β). Dietary intake was assessed by a food frequency questionnaire.ResultsThe levels of FPG, 2-h PG, and carbohydrate intake were correlated with the HbA1c level in men, while the FPG and 2-h PG levels were correlated with the HbA1c level in women. In multiple regression analyses, BMI, FPG, 2-h PG, and white rice intake were associated with HbA1c levels in men, while BMI, FPG, HOMA-β, and bread intake were associated with HbA1c levels in women.ConclusionsThe present findings suggest that a substantial portion of HbA1c may be composed of not only glycemic but also several lifestyle factors in men with impaired glucose tolerance. These factors can be taken into consideration as modifiable determinants in assessing the HbA1c level for the diagnosis and therapeutic monitoring of the disease course.

Apolipoprotein B and non-HDL cholesterol are more powerful predictors for incident type 2 diabetes than fasting glucose or glycated hemoglobin in subjects with normal glucose tolerance: a 3.3-year retrospective longitudinal study.

The association between atherogenic dyslipidemia (AD) and incident type 2 diabetes (T2D) in the low-risk group for T2D has not yet been determined. The aims of this study were to investigate whether AD, characterized by increased serum apoB and non-HDL cholesterol, could predict the development of T2D in subjects with normal glucose tolerance (NGT). A total of 84,394 subjects with NGT (48,906 men and 35,488 women), aged 20-89 years (mean age 38.4 years), were enrolled in this study and were followed for a mean duration of 3.3 years. ApoB and non-HDL cholesterol levels showed stronger associations with the development of T2D compared with conventional lipid measurements and their ratios (HR per 1-SD (95 % CI) 1.27 (1.23-1.30) and 1.27 (1.24-1.29), respectively, both P < 0.001). In multivariate Cox regression models, both apoB and non-HDL cholesterol were associated with the development of T2D, independent of other risk factors for T2D, fasting serum glucose, HbA1c, and conventional lipid measurements such as triglycerides and HDL cholesterol (HR per 1-SD (95 % CI) 1.16 (1.11-1.21) and 1.15 (1.11-1.19), respectively, both P < 0.001). However, fasting serum glucose was not associated with the development of T2D in these models. In conclusion, AD was more closely associated with the development of T2D than fasting glucose or glycated hemoglobin in subjects with NGT.

The effects of Spirulina on anemia and immune function in senior citizens

Anemia and immunological dysfunction (i.e. immunosenescence) are commonly found in older subjects and nutritional approaches are sought to counteract these phenomena. Spirulina is a filamentous and multicellular bule-green alga capable of reducing inflammation and also manifesting antioxidant effects. We hypothesized that Spirulina may ameliorate anemia and immunosenescence in senior citizens with a history of anemia. We enrolled 40 volunteers of both sexes with an age of 50 years or older who had no history of major chronic diseases. Participants took a Spirulina supplementation for 12 weeks and were administered comprehensive dietary questionnaires to determine their nutritional regimen during the study. Complete cell count (CCC) and indoleamine 2,3-dioxygenase (IDO) enzyme activity, as a sign of immune function, were determined at baseline and weeks 6 and 12 of supplementation. Thirty study participants completed the entire study and the data obtained were analyzed. Over the 12-week study period, there was a steady increase in average values of mean corpuscular hemoglobin in subjects of both sexes. In addition, mean corpuscular volume and mean corpuscular hemoglobin concentration also increased in male participants. Older women appeared to benefit more rapidly from Spirulina supplements. Similarly, the majority of subjects manifested increased IDO activity and white blood cell count at 6 and 12 weeks of Spirulina supplementation. Spirulina may ameliorate anemia and immunosenescence in older subjects. We encourage large human studies to determine whether this safe supplement could prove beneficial in randomized clinical trials.

Update on Rice Fortification in the Philippines

Rice, the staple in all regions in the Philippines, is an excellent vehicle for fortification. The Food and Nutrition Research Institute developed the technology for the fortification of rice with iron, using ferrous sulphate as the fortificant. A prototype machine was manufactured for the production of iron-fortified premix with a capacity of 200 kg per batch. A study on iron bioavailability showed a significant increase in the amount of iron absorbed with iron-fortified rice. A clinical trial conducted with 173 schoolchildren for six months showed a greater increase in haemoglobin in subjects who received iron-fortified rice than in those who did not. The problems and constraints that arise with rice fortification include the added cost of fortification (estimated at 2.5% of the cost of rice), which would probably be passed on to the consumer, and the presence of numerous rice mills throughout the country, which may pose difficulties in enforcement. Nevertheless, when carried out in large rice mills, fortification of rice with iron could reach a significant portion of the population.

Oxygen transport impairment induced by three major cardiovascular risk factors.

This paper is a report on examinations of the oxygen affinity of hemoglobin in subjects with diabetes mellitus, with hyperlipoproteinemia and in smokers, indicating the presence of a fluctuating disorder in the oxygen unloading from the erythrocytes in these conditions known as cardiovascular risk factors. Since these states may also be associated with an impairment in microcirculatory flow, the synergistic effects of these factors may lead to serious consequences for the oxygenation of tissues, particularly in those with a poor microcirculation as in the arterial walls.

Oxygen Binding to Haemoglobin in Subjects with Hypoproliferative Anaemia, with and without Chronic Renal Disease: Role of pH

Summary. The relationships of haenioglobin concentration and blood pH to red cell 2,3‐dipliosphoglycerate and oxygen binding by haenioglobin have been studicd in healthy subjects and subjects with hypoproliferative anaemia with or without severe chronic renal disease. Red cell 2,3‐DPG was inversely correlated with haemoglobin deficit and directly and equally strongly associated with blood pH in anaemic subjects without chronic renal disease. In subjects with chronic renal disease receiving regular haemodialysis, predialysis pH was not increased despite severe anaemia, and red cell 2,3‐DPG was not significantly elevated, except in subjects who had a sustained alkalosis due to the use of sodium bicarbonate.In hypoproliferative anaemia, the incrcmcnt in pH was associated with the decrease in haenioglobin concentration such that 80% of the increase in p50 measured at standard conditions which occurred with anaemia was explicable by the relationship of (a) pH with haemoglobin concentration, (b) red cell 2,3‐DPG with pH, and (c) pso std with red cell 2,3‐DPG. However, p50 at the pH and base excess present in vivo was similar in all anaemic subjects whether an increase in red cell 2,3‐DPG occurred or not. Blood alkalosis and the accumulation of 2,3‐DPG cancelled each other's effect on oxygen binding by haemoglobin. Hence, increased red cell 2,3‐DPG and p50 compensated for the alkalosis of hypoproliferative anaemia, not for the deficit in haemoglobin concentration.

Chemical heterogeneity of fetal hemoglobin in subjects with sickle cell anemia, homozygous hb-c disease, sc-disease, and various combinations of hemoglobin variants

This study has determined the ratio of G γ to A γ chains in the fetal hemoglobin of individuals with various combinations of abnormal β chain variants. Hemoglobin F was quantitated in all samples and also hemoglobin A 2 when hemoglobin C was absent. The following combinations have been examined: mainly SS, but also CC, SC, AS, AC, A Lepore, A Sabine, A Richmond, and traits for two unidentified unstable hemoglobins. The level of Hb-F in 58 subjects with sickle cell anemia appears to decrease with age during the first 20 years of life and then be greater in older female patients and to a lesser extent in male patients of a similar age group. Hb-A 2 levels are slightly higher than those of normal adults and do not change with age. No relation is evident between the Hb-A 2 percentage and the level of Hb-F. The Hb-F of the SS, SC, and AS patients shows a wide spread in the ratio of the G γ to A γ chains. The data are inadequate to decide whether or not there is a bimodal distribution into groups with the ratio of about 2:3 as in normal adults and 3:1 as in the newborn. Some indication of a familial occurrence of these specific ratios was obtained. However, whether this phenomenon has a genetic basis or is controlled by other (perhaps, hormonal) factors cannot be deduced from the data. In the remaining classes, relatively few examples are available, but G γ and A γ chains usually have the ratio of about 2:3, which is the non-specific ratio in the Hb-F of normal adults.

Experience with an Extended Methemoglobin Reduction Test: Factors Influencing Hemoglobin Destruction

AbstractExperiments have been designed to elucidate the varying degrees of destruction of intact hemoglobin (methemoglobin plus oxyhemoglobin) observed on application of the methemoglobin reduction test to normal and abnormal subjects. Surprisingly, the degree of intact hemoglobin destruction was found to vary directly with the rates of methemoglobin reduction, particularly via the pentose phosphate pathway in the presence of methylene blue, and inversely with cell age. In addition, confirmation was obtained of increased susceptibility to destruction of intact hemoglobin in subjects with such congenital or acquired defects of hemoglobin stability as might result from hemoglobin H, acute lead poisoning, or prior exposure to aromatic drugs.Further evidence was presented that accumulation of methemoglobin militates against intact hemoglobin destruction. It was suggested that the methemoglobin content of samples of blood after application of the methemoglobin reduction test should be assessed in relation to the simultaneous changes in the intact hemoglobin concentrations of the incubation mixtures.