Iron Binding Capacity Research Articles

Dose-dependent relationship between iron metabolism and perioperative myocardial injury in cardiac surgery with cardiopulmonary bypass: A retrospective analysis.

We sought to comprehensively explore the potential linear and nonlinear relationship between preoperative iron metabolism and perioperative myocardial injury (PMI) following cardiac surgery with cardiopulmonary bypass (CPB). Patients who underwent cardiac surgery with CPB between December 2018 and April 2021 were retrospectively collected. The measurements of iron metabolism included serum iron (SI), serum ferritin (SF), transferrin (TRF), transferrin saturation (TS), and total iron binding capacity (TIBC). Logistic regression and restricted cubic spline (RCS) models were used for linear and nonlinear analysis. The primary outcome was PMI with a 100x upper reference limit (URL). Of 2420 patients screened,744 eligible patients were enrolled for the final analysis. The incidence of PMI was 25.7%. No significant linear relationship was observed. In the RCS models adjusted with age (median:56), female, and history of diabetes, a statistically significant difference was detected between TRF (p for nonlinear 0.0152) or TIBC (p for nonlinear 0.0477) and PMI. The gentle U-shaped relationship observed between TRF, TIBC, and PMI suggests that when TRF and TIBC increase, the risk decreases, reaching its lowest point when TRF=2.4 and TIBC=54. Nevertheless, as TRF and TIBC continue to increase, the risk starts to rise again. Subgroup analyses yielded consistent findings, with a notable emphasis on older patients who were more susceptible to variations in iron metabolism. Iron metabolism, including TRF, and TIBC, exhibited a nonlinear relationship with PMI by the RCS model adjusted by age, gender, and history of diabetes.

Do dynamic changes in haematological and biochemical parameters predict mortality in critically ill COVID-19 patients?

BACKGROUND: Critically ill COVID-19 patients are usually subjected to clinical, laboratory, and radiological diagnostic procedures resulting in numerous findings. Utilizing these findings as indicators for disease progression or outcome prediction is particularly intriguing. OBJECTIVES: Exploring the significance of dynamic changes in haematological and biochemical parameters in predicting the mortality of critically ill COVID-19 patients. METHODS: The present study was a prospective and observational study involving mechanically ventilated 75 critically ill adult COVID-19 patients with hypoxemic respiratory failure. The collected data included baseline patient characteristics, treatment options, outcome, and laboratory findings at admission and 7 days after. The dynamics of the obtained findings were compared between survivors and non-survivors. RESULTS: The 28-day survival rate was 61.3%. In the group of non-survivors significant dynamic changes were found for C-reactive protein (p= 0.001), interleukin-6 (p< 0.001), lymphocyte (p= 0.003), neutrophil-lymphocyte ratio (p= 0.003), platelets (p< 0.001), haemoglobin (p< 0.001), iron (p= 0.012), and total iron-binding capacity (p< 0.001). Statistically significant changes over time were found for ferritin (p= 0.010), D-dimer (p< 0.001), hs-troponin T (p< 0.002), lactate dehydrogenase (p= 0.001), glucose (p= 0.023), unsaturated iron-binding capacity (p= 0.008), and vitamin D (p< 0.001). CONCLUSION: The dynamic changes in inflammatory, haematological and biochemical parameters can predict disease severity, and outcome.

Overweight and vitamin D deficiency are common in patients with irritable bowel syndrome - a cross-sectional study

BackgroundIrritable bowel syndrome (IBS) is a common disease with unknown etiology. Poor dietary intake with nutritional deficiency and overweight have been described to increase the risk of IBS. The aim of the present study was to compare weight and circulating levels of micronutrients in IBS compared with healthy controls.DesignCross-sectional study.MethodsPatients diagnosed with IBS and healthy volunteers were recruited. Participants had to complete a dietary diary book and the questionnaires Rome IV, IBS-severity scoring system (IBS-SSS), and visual analog scale for IBS (VAS-IBS). Weight and height were measured, and blood samples were drawn. C-reactive protein (CRP), cobalamin, folate, iron, total iron-binding capacity (TIBC), and 25-hydroxy (25-OH) vitamin D were analyzed. Differences were calculated between groups and generalized linear model for regressions was adjusted for false discovery rate (FDR).ResultsIBS patients (n = 260) were elder than controls (n = 50) (44.00 (33.25-56.00) vs. 37.85 (30.18–45.48) years; p = 0.012). After adjustment for age, both weight (β: 5.880; 95% CI: 1.433–10.327; p = 0.010, FDR = 0.020) and body mass index (BMI) (β: 2.02; 95% CI: 0.68–3.36; p = 0.003, FDR = 0.012) were higher in patients. Among IBS participants, 48.1% were overweight/obese compared with 26.0% in controls (p = 0.007). Diarrhea-predominated IBS had highest weight (p < 0.001) and BMI (p = 0.077). CRP and cobalamin were higher in patients than controls (p = 0.010 vs. p = 0.007), whereas folate was highest in controls (p = 0.001). IBS patients had lower intake of vegetables (p = 0.026), dairy products (p = 0.004), and cereals (p = 0.010) compared with controls. Despite 21.5% of IBS patients were taking vitamin D supplements, 23.65% of them had vitamin D levels below 50 nmol/L, compared with 26.0% observed in the control group (p = 0.720). Vitamin D levels were lower in overweight than in normal weight IBS patients (60 (48–73) nmol/L vs. 65 (53–78) nmol/L, p = 0.022). Vitamin D correlated with cobalamin and folate but correlated inversely with TIBC and BMI. IBS patients had a high degree of gastrointestinal and extraintestinal symptoms, which were inversely associated with iron levels. Extraintestinal symptoms were associated with increased BMI.ConclusionIBS patients were often overweight or obese, with low vitamin D levels. High burden of extraintestinal symptoms were associated with overweight and lower iron levels.RegistrationClinicalTrials.gov, NCT05192603 (Date of registration 11/29/2021) and NCT03306381 (Date of registration 09/18/2017), respectively.

Enhancement of polyphenols and haematological profile of rats fed with traditional African soups

Nigeria is a multi-ethnic and multicultural country where several traditional soups are indigenous to the various social groups. When soups are prepared with the right spices, it can be truly healthy with multiple biochemical/nutritional benefits. The objective of the study is to determine some blood parameters, total iron binding capacity (TIBC), polyphenols and flavonoid content of rats fed with indigenous soups in Delta State, Nigeria. A total of twenty-five mature male albino Wistar rats were divided into five groups of five rats each. Group 1 rats served as control, rats in Group 2 were given Igbagba soup (okro pepper soup), rats in Group 3 were administered Oghwo ameidi (palm nut soup; soup made from African palm fruit; Elaeis guineensis). Group 4 and Group 5 rats were given Offe ikere (pepper soup) and aqueous tween 80 respectively. The rats in each group were allowed free access to clean drinking water and feed for 28 days experimental period. The results indicated that rats given soup extracts (Group 2, 3 and 4) their serum total polyphenol content was 20.75, 12.24 and 9.83 mg/g, respectively, while the control value was 2.81 mg/g. Significant increases in TIBC, total flavonoids, packed cell volume (PCV), haemoglobin (Hb), red blood cells (RBC), and white blood cells (WBC), were observed in rats given the soup extracts when compared with control. The study has shown that African indigenous soups may improve haematological indices owing to their polyphenol and flavonoids content.

Association of FGF23 Levels and Development of Anemia in Patients with Non Dialysis Chronic Kidney Disease

Background: Anemia is one of the common complication of Chronic Kidney Disease that intensifies in grade and severity as eGFR decline which also increases the risks for cardiovascular mortality. The development of anemia and elevated fibroblast growth factor 23 levels are the earliest changes observed in chronic kidney disease. Objective: This study aims to understand the association of FGF23 levels development of anemia in chronic kidney disease patients prior to renal replacement therapy. Methods: This is an analytical type of cross sectional study carried out among 95 respondent'1ged between 18 and 75 years with CKD stage 1-5 before dialysis, divided into two groups- Group I­ comprised of 68 patients and Group 11- included 27 age and sex matched respondents not having CKD, enrolled from two te1tiary-care hospitals, namely- Sir Salimullah Medical College &amp; Mitford Hospital and National Institute of Kidney Diseases &amp; Urology (NIKDU). Socio-demographic status, disease profile and laboratory findings including serum iron, iron binding capacity, ferritin, transferrin saturation, calcium, phosphorus, intact parathormone, vitamin D, eGFR and FGF-23 levels were studied. Result: Mean age of the respondents was 50.1±10.74 (SD) years, mean estimated glomerular filtration rate was 35.92± 22.61 in group I and 91.66± 14.2 in group II. The mean FGF23 level in group I and II were 85.76± 207.54, 21.99± 12.12 pg/mL respectively, serum iron level was 81.61± 39.24 mcg/dL and 95.0± 32.38 mcg/dL in group I and II respectively, serum ferritin level was 225.59± 2 I 2.5 ng/mL and 157.85± 220.89 ng/ml. TIBC was 312.65± 95.83 mcg/dL and 418.85± 118.25 mcg/dL in group I and II respectively. In Group I and II, iron deficiency was found in 23% and 25%respectively when stratified according to serum ferritin level and 26.5% and 22.22% respectively, when stratified according to serum transferrin saturation level. This difference was significant among the group. Serum iron, ferritin, TIBC and TSAT were significantly associated with serum FGF23 levels. Conclusion: Disrupted iron metabolism and high FGF23 levels is commonly found in chronic kidney disease. Clinical laboratory findings have revealed the relation between FGF23 and anemia in no dialysis chronic kidney disease patients.

Iron Deficiency Anemia among Sanitation Workers in a Tertiary Care Hospital: A Cross-sectional Study

ABSTRACT Background: Iron deficiency anemia (IDA) has been the main cause of the health burden in India over the past decade. The aim of the present study was to examine the iron status and prevalence of iron deficiency anemia using biochemical markers among sanitation workers working at a tertiary healthcare center. Methodology: This hospital-based cross-sectional observational study was conducted on 80 sanitation workers for a period of 18 months (age 31–40 years). Dietary intake patterns were collected through the structured questionnaires. Blood samples were analyzed for complete blood count, serum iron level and unsaturated iron binding capacity, and ferritin. Total iron binding capacity and percentage transferrin saturation were calculated. Stool samples were screened for intestinal helminthic ova and cysts of intestinal protozoa. Results: Of the 80 sanitation workers, IDA was found in 38.7%; out of this, mild anemia was found in 16 (20%) participants, while 11.3% and 7.5% participants had moderate and severe anemia, respectively. Higher plasma sTfR levels were observed in women with severe iron depletion than in those with iron sufficiency (median 17.6 versus 15.5 nmol/L; P = 0.001). A statistically significant positive correlation between hemoglobin and serum iron, serum ferritin, and transferrin saturation was found. Hemoglobin was positively correlated with white blood cells, red blood cells, hematocrit, and mean corpuscular hemoglobin. Conclusion: This study highlights the presence of mild IDA among sanitary workers and lower levels of iron intake than the recommended dietary allowance.

Iron saturation and binding capacity of lactoferrin - development and validation of a colorimetric protocol for quality control

Among the numerous biofunctional properties of lactoferrin, its ability to bind iron ions can be considered a core function. The saturation level with ferric iron affects the stability and functionality of the protein. To reliably quantify the iron saturation, an assay based on the color reagent Ferrozine was developed and validated concerning the lower detection (0.023 μg mL−1) and quantification limits (0.069 μg mL−1), as well as precision, recovery and accuracy values.The established assay was used to monitor iron uptake, comparing two commercially available bovine lactoferrin powders. Significant differences between the samples were observed. One sample exhibited nearly ideal binding behavior with a high affinity for ferric iron (saturation > 98 %), while the comparison sample did not exceed saturation values >80 %. This finding underscores the importance of assessing the iron status and binding capacity for the quality evaluation of lactoferrin products.

Serum chemistry, thyroxine concentration, and blood cell morphology of wild, young Blackchin Guitarfish Glaucostegus cemiculus sampled on the eastern Mediterranean coastline.

The Blackchin Guitarfish Glaucostegus cemiculus is endemic to the Mediterranean Sea and is critically endangered, but relevant routine laboratory data are unavailable. Our objectives were to determine the packed cell volume (PCV), comprehensive serum chemistry analytes, and serum total thyroxine (sTT4) concentration; compare serum albumin and serum globulin concentrations as measured by two different methods; and describe the blood cell morphology of healthy, free-ranging Blackchin Guitarfish. Wild Blackchin Guitarfish were captured using a seine net. Blood samples for serum chemistry and hematological analyses were obtained and measured using routine laboratory methods. The fish were tagged and released. This study included 43 Blackchin Guitarfish (17 males and 26 females) that were younger than 6 months as estimated based on total length and body weight. The median PCV (n = 23) was 22% (minimum-maximum [min-max] = 15-25%). Median sTT4 (n = 10) measured by chemiluminescence immunoassay was 7.86 nmol/L (min-max = 7.52-9.57 nmol/L). The study included a comprehensive, 25-analyte serum chemistry analysis (e.g., serum iron and unbound and total iron-binding capacity) and a morphological description of all blood cells. Serum electrophoresis (SEP; n = 13) yielded a consistent serum albumin-migrating protein fraction and four globulin fractions. Serum electrophoretograms corroborating these results are presented. In Blackchin Guitarfish, the serum albumin-migrating fraction measured by SEP combined with serum total protein concentration yields a much higher albumin concentration compared to that measured by bromocresol green spectrophotometry. The true identity of this albumin-migrating fraction remains to be identified. The analytes' calculated 2.5-97.5% interpercentile intervals should be considered as reference intervals applying to Blackchin Guitarfish of similar age but should be applied cautiously to adult fish.

Iron Dysregulation: Unveiling Predictive Biomarkers for Severity in COVID-19 Patients

Objective: This study aimed to elucidate the association between iron dysregulation and the severity of COVID-19, examining serum levels of iron-related biomarkers in hospitalized patients. The primary objective was to identify reliable predictors for disease severity, specifically focusing on the role of ferritin, Hemoglobin (Hb), Total Iron-binding Capacity (TIBC), and iron. Materials and Methods: The study enrolled 117 consecutive COVID-19 patients, classified into mild, severe, and critical groups. Serum levels of Hb, TIBC, iron, and ferritin were measured using standardized methods. Data were analyzed using ROC analysis, logistic regression models, and correlation assessments. The study adhered to ethical guidelines, obtaining informed consent from all participants. Results: Results revealed a consistent elevation in iron and ferritin levels as disease severity increased, accompanied by a reciprocal decline in Hb and TIBC. Ferritin emerged as a robust predictor for disease prognosis, with an AUC of 0.808, providing a sensitivity of 62.50% and a specificity of 91.74%. Age and education were identified as exacerbating factors influencing patient outcomes. The findings have been found to align with previous studies linking higher ferritin levels to adverse outcomes, supporting ferritin’s utility as a prognostic marker. Conclusion: The intricate relationship between iron metabolism and COVID-19 severity has been highlighted in this study, emphasizing elevated ferritin levels as potential predictors for severe outcomes and indicators of inflammation-induced cellular damage. These findings may contribute valuable insights into personalized patient management strategies and the potential for targeted interventions in severe COVID-19 cases. Further research involving larger populations is essential to validate these observations and enhance our understanding of the complex host response to SARS-CoV-2.

Iron Homeostasis-Related Parameters and Hepcidin/Ferritin Ratio: Emerging Sex-Specific Predictive Markers for Metabolic Syndrome

Metabolic syndrome (MetS) is a worldwide public health challenge. Accumulating evidence implicates elevated serum ferritin and disruptions in iron metabolism as potential elements linked to an increased risk of MetS. This study investigates the relationship between iron homeostasis—including hepcidin levels, serum iron concentration, unsaturated iron-binding capacity (UIBC), and the hepcidin/ferritin (H/F) ratio—and MetS. In this descriptive cross-sectional study, 209 participants aged 24–70 were categorized into two groups: 103 with MetS and 106 without MetS. All participants underwent medical assessment, including anthropometric measures, indices of glycemic control, lipid profiles, and iron-related parameters. Participants were further stratified by the Homeostasis Model Assessment—Insulin Resistance index into three subgroups: insulin-sensitive (IS) (&lt;1.9), early insulin resistance (EIR) (&gt;1.9 to &lt;2.9), and significant insulin resistance (SIR) (&gt;2.9). Notable increments in serum ferritin and hepcidin were observed in the SIR group relative to the IS and EIR groups, with a significant association between metabolic parameters. The UIBC and serum ferritin emerged as significant predictors of MetS, particularly in men, with an area under the curve (AUC) of 0.753 and 0.792, respectively (p ≤ 0.001). In contrast, hepcidin was notably correlated with MetS in women, with an AUC of 0.655 (p = 0.007). The H/F ratio showed superior predictive capability for MetS across both sexes (at cutoff level = 0.67). Among women, this ratio had an AUC of 0.639 (p = 0.015), and for men, it had an AUC of 0.792 (p &lt; 0.001). Hypertension proved an independent risk factor for MetS, affirming its role in metabolic dysregulation. The findings highlight a significant interconnection between iron homeostasis parameters and MetS, with sex-specific variations underscoring the importance of personalized diagnostic criteria. The crucial role of the H/F ratio and the UIBC as emerging predictive markers for MetS indicates their potential utility in identifying at-risk individuals. Further longitudinal research is essential to establish causality and explore the interplay between these biomarkers and MetS.

Association of urinary glyphosate levels with iron homeostasis among a representative sample of US adults: NHANES 2013–2018

PurposeGlyphosate and glyphosate-based herbicides (GBH), widely used globally, were initially considered harmless to humans. Experimental studies have suggested that these substances can disrupt iron homeostasis by interfering with iron uptake or triggering inflammatory responses. However, their potential impact on human iron homeostasis remains underexplored. Approach and resultsWe analyzed data from 5812 participants aged three and older from the 2013 to 2018 NHANES. We investigated the relationships between urinary glyphosate levels, oral iron intake, and markers of iron homeostasis, including serum iron, unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), transferrin saturation, ferritin, and transferrin receptor. Higher urinary glyphosate levels were positively associated with oral iron intake (β = 1.310, S.E. = 0.382, P = 0.001). A one-unit increase in the natural logarithm (ln)-glyphosate was associated with lower serum iron (β = − 4.236, 95 % CI = − 6.432 to − 2.039, P < 0.001) and ferritin (β = − 9.994, 95 % CI = − 17.342 to − 2.647, P = 0.009), and higher UIBC (β = 5.431, 95 % CI = 1.061–9.800, P = 0.018) and transferrin receptor levels (β = 0.139, 95 % CI = 0.015–0.263, P = 0.029). Increasing glyphosate exposure was associated with significant decreases in serum iron and ferritin across exposure quintiles (trend P-values = 0.003 and 0.018, respectively). ConclusionsHigher glyphosate exposure is associated with reduced iron availability, suggesting potential disruptions in iron absorption. These findings underscore the need for further research into the health implications of glyphosate exposure on iron homeostasis.

Association of Serum Iron Profile among Patients with Type 2 Diabetes Mellitus with or without Diabetic Nephropathy

Background: Diabetes mellitus (DM) is the most significant public health challenges in both developed and developing countries. Diabetic nephropathy (DN) is one of the major causes of morbidity and mortality among patients with DM worldwide. Iron modify glucose metabolism and glucose metabolism impinges on iron. Objective: To evaluate serum iron profile in type 2 diabetic patients with or without diabetic nephropathy. Methods: This cross-sectional study was conducted at Department of Biochemistry and Molecular Biology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorder (BIRDEM), Dhaka, Bangladesh from January 2019 to December 2019. Total 150 participants were enrolled according to the selection criteria and were divided into three groups, 50 patients were with type 2 diabetes mellitus (T2DM), 50 patients were with DN and another 50 respondents were healthy controls. All relevant data were recorded and their serum iron profile was estimated accordingly. Data were analyzed and compared by statistical tests. Results: Male and female were 41.3% and 58.7% respectively and majority (31.3%) was in 51-60 years. The mean value of HbA1C of DN patients was significantly higher among groups (p&lt;0.001). It was found that serum iron and serum ferritin were significantly (p&lt;0.001) higher and total iron binding capacity (TIBC) was significantly (p&lt;0.001) lower in T2DM and DN patients compare with healthy controls. The mean serum creatinine level was significantly (p&lt;0.001) higher and mean value of estimated glomerular filtration rate (eGFR) was significantly (p&lt;0.001) lower in DN patients. There were significant negative correlation of serum iron and significant positive correlation of TIBC with eGFR in patients with DN; but a negative correlation of serum ferritin with eGFR in patients with DN. Conclusion: It was observed that, serum iron, serum ferritin levels were significantly increased and TIBC was significantly decreased ........

The potency of Thymus vulgaris seed extract in alleviating obesity complications and iron overload in obese rats

Natural products have long been recognized as valuable sources of bioactive compounds in therapeutic agents. Thymus vulgaris, commonly known as thyme and belonging to the Lamiaceae family, is widely distributed and extensively used in Egyptian folk medicine for its antibroncholitic, antispasmodic, carminative, and diuretic properties. However, there is a lack of research on the effects of T. vulgaris seed extract in mitigating obesity-induced iron overload in rats. Given its potent bioactive constituents, this study aimed to investigate the impact of T. vulgaris seed extract on iron overload associated with obesity by evaluating lipid profiles, iron status parameters—including plasma ferritin, total iron-binding capacity (TIBC), plasma transferrin, transferrin saturation percentage (TS%), and hepcidin gene expression in adipose tissue. About 30 flavonoids were identified in T. vulgaris seed extract using LC-MS. Among these, methoxyflavonoids were the most abundant metabolites. The administration of T. vulgaris seed extract to obese rats resulted in significant reductions in anthropometric features, hepcidin gene expression, cholesterol, triglycerides, low-density lipoprotein (LDL), TIBC, plasma ferritin, leptin, and iron and copper content in adipose tissue. Moreover, treatment with T. vulgaris extract led to a notable decrease in interleukin-6 (IL-6) levels (76.33 ± 4.31 ng/L and 40.83 ± 1.82 ng/L for low and high doses, respectively) compared to the obese control group (110.83 ± 5.82 ng/L). Conversely, plasma adiponectin levels were significantly increased with T. vulgaris supplementation (123.6 ± 7.9 µg/L and 217.4 ± 6.1 µg/L for low and high doses, respectively) compared to the obese group (54.6 ± 4.9 µg/L). Additionally, adipose tissue zinc levels were significantly elevated in response to T. vulgaris supplementation (2.54 ± 0.20 µg/g and 3.75 ± 0.14 µg/g for low and high doses, respectively) compared to the obese group (1.45 ± 0.23 µg/g). Our findings suggest that T. vulgaris could be a promising novel therapeutic agent for managing obesity-induced iron overload.

Indicators of iron metabolism in regular donors of blood platelets and plasma

Introduction. The high frequency of medical withdrawals from donatio ns due to a decrease in hemoglobin levels and the negative impact on the motivation and return to donation of temporarily withdrawn individuals dictates the need to study the effect of exfusion of blood and its components on iron metabolism.Aim: to evaluate the iron metabolism indicators in regular donors of platelets and plasma.Materials and methods. 99 platelet donors and 90 blood plasma donors who regularly participated in donations were examined. The comparison group consisted of 158 healthy individuals who had not previously donated blood and its components. Hemoglobin concentration, hematocrit, erythrocyte count and erythrocyte indices were assessed. The concentration levels of ferritin, iron, transferrin in blood serum as well as the values of total and unsaturated iron-binding capacity of se rum were studied, and the saturation coefficient of transferrin was calculated.Results. In men who donated platelets, a statistically significant decrease in the red blood cells count (p = 0.001), hematocrit (p = 0.014) and ferritin concentration (p &lt; 0.001) were found relative to those in the comparison group: 4.8×1012/l, 42.0 %, 28.9 ng/ml versus 5.0×1012/l, 44.0 %, 74.2 ng/ml respectively. In regular donors a significant increase in the medium of hemoglobin of red blood cells was noted: 30.8 pg (p = 0.008) and 31.4 pg (p &lt; 0.001) in men and 30.2 pg (p = 0.030) and 31.0 pg (p &lt; 0.001) in women with platelet and plasma exfusions respectively compared to 29.4 pg in men and 29.6 pg in women who participated in donation for the first time. In plasma donors of both sexes, the values of hemoglobin and its average concentration in the erythrocyte were significantly higher than in first-time donors: 154.0 g/l (p = 0.008), 35.7 g/dl (p &lt; 0.001) and 138.0 g/l (p &lt; 0.001), 35.2 g/dl (p &lt; 0.001) versus 146.0 g/l, 33.6 g/dl and 129.0 g/l, 33.8 g/dl in men and women, respectively.Conclusion. To prevent the development of iron deficiency in donors of blood components it is necessary to monitor the con-centration of serum ferritin and correct its reduced values by changing the donation regimen or prescribing iron-containing drugs. When selecting donors, attention should be paid to the frequency of apheresis, especially in men who regularly donate platelets.

Intravenous ferric carboxymaltose versus oral ferrous sulphate for the treatment of moderate to severe postpartum anaemia in Nigerian women (IVON-PP): protocol for an open-label randomised controlled type 1 hybrid effectiveness-implementation trial

IntroductionPostpartum anaemia is often caused by iron deficiency with onset during the antepartum period and can be exacerbated by excessive blood loss at birth. Its prevalence is estimated as 50–80%...

The clinical efficacy of combined ESA and Roxadustat treatment for renal anemia in hemodialysis patients with secondary hyperparathyroidism: A case series.

Pharmacological mechanism of Roxadustat in the treatment of renal anemia. To investigate the efficacy and safety of combined Roxadustat and erythropoiesis stimulator (ESA) treatment of renal anemia in hemodialysis patients with secondary hyperparathyroidism. A retrospective analysis was conducted on hemodialysis patients with renal anemia and secondary hyperparathyroidism treated with ESAs alone, who were admitted to our hospital from March 2022 to December 2022. The patients were treated with Roxadustat combined with ESAs for 3 months, during which oral iron supplementation was given, and the changes in Hb levels and laboratory-related indicators before and after the combined treatment were analyzed. The results showed that a total of 13 patients received combination therapy, with a significant increase in Hb compared to ESAs alone (t = -3.955, P = .002). The Hb qualification rate was 38.46%, and the ∆Hb response rate was 76.92%. The parathyroid hormone significantly decreased with a statistically significant difference (Z = -2.062b, P = .039). Hemoglobin (RBC), total iron binding capacity, and serum ferritin (male) were significantly increased compared to ESAs alone. Total cholesterol and low-density lipoprotein were significantly lower than ESAs alone. The differences in the changes in the above indicators were statistically significant (P < .05). There was no statistically significant difference in changes in other laboratory-related indicators (P > .05). No adverse reactions were observed during the combined treatment of 13 patients. The combination of Roxadustat and ESAs can effectively improve renal anemia in hemodialysis patients with secondary hyperparathyroidism, as well as improve indicators of hyperparathyroidism and blood lipid levels with high levels of safety. This combined treatment thus provides a new and safe treatment method for these patients.

Ferrous ascorbate non-effervescent floating mini-caplets as an oral iron supplement.

This research aimed to develop non-effervescent floating mini-caplets of Ferrous Ascorbate (FA) using low-density polymers to overcome the problems of poor bioavailability associated with immediate-release iron products.Methods:The excipients and method (melt granulation) were selected based on pre-and post-compression parameters in trial batches. The formulation was optimized by a full factorial 32 experimental design. An optimized formulation was evaluated for drug release kinetic, accelerated stability study, and in vivo study in healthy adult New Zealand female rabbits.Results:The optimized formulation F6 mini-caplets (42.5% FA, 45% Glyceryl palmitostearate asPrecirol, 10% polyvinyl pyrrolidone K-30, and 2.5% lactose) were found to have instant floating and 12h floating duration in 0.1N Hydrochloric acid (HCl) dissolution medium. In vitro drug release (diffusion mechanism) at 1h and 5h was 30-35% and 65-70%, respectively. It was found stable for three months under an accelerated stability study. In vivo study showed significantly increased serum iron levels and decreased unsaturated iron binding capacity (UIBC) in the test group (optimized formulation) compared to control and standard (immediate-release iron).Conclusion:Based on the in vitro and in vivo results, we conclude that non-effervescent floating FA mini-caplets have higher bioavailability compared to immediate release FA, which may be attributed to prolonged iron release at its absorption site due to their retention in the gastric region. Hence, non-effervescent floating FA mini-caplets may act as a potential approach for iron deficiency.

The Diagnostic Performance of Serum Glycosylated Ferritin in Patients Undergoing Regular Blood Transfusion: An Indicator of Iron Overload to Initiate Iron Chelation Therapy.

Background and objective Serum ferritin concentration and transferrin saturation are commonly employed to estimate body iron but are non-specific to iron overload. Glycosylated ferritin may be primarily elevated in cases of iron overload in patients undergoing regular blood transfusions. In this study, we aimed to estimate glycosylated ferritin and determine its cutoff values for iron overload in patients receiving blood transfusions regularly. We also endeavored to the examine correlation between serum ferritin and glycosylated ferritin in patients receiving regular blood transfusions. Methods We conducted a cross-sectional study involving 17 patients undergoing regular blood transfusions in the Department of Medical Oncology/Hematology, who had already received ≥10 transfusions without any iron chelation therapy or acute inflammation. All participants were evaluated based on a questionnaire to gather relevant medical details. Serum iron, ferritin, glycosylated ferritin, and unsaturated iron-binding capacity (UIBC) were estimated. Total iron-binding capacity (TIBC) and transferrin saturation were also calculated. Results Participants were divided into two groups based on transferrin saturation (≥50% as a reference for iron overload). The group with transferrin saturation ≥50% had significantly higher levels of serum ferritin, glycosylated ferritin, and iron, compared to the group with transferrin saturation <50%. Glycosylated ferritin showed a positive correlation with ferritin (rho=0.80) and transferrin saturation (rho=0.64), which was statistically significant. UIBCand TIBCshowed a negative association with glycosylated ferritin. The correlation of glycosylated ferritin with units of blood transfusion (Spearman's rho=0.60) was found to be better than that of serum ferritin (Spearman's rho=0.52). Conclusions Based on our findings, glycosylated ferritin could be a potential marker for transfusion-related iron overload. The optimal cutoff value for iron overload using serum glycosylated ferritin level was >587.55 ng/mL. Further extensive studies withlarger sample sizes will substantiate the role of glycosylated ferritin in predicting post-transfusion iron overload.

Valpalf®: A New Nutraceutical Formulation Containing Bovine Lactoferrin That Exhibits Potentiated Biological Activity.

As a nutraceutical, bovine lactoferrin (bLf), an iron-binding glycoprotein involved in innate immunity, is gaining elevated attention for its ability to exert pleiotropic functions and to be exceptionally tolerated even at high dosages. Some of bLf's activities, including its anti-inflammatory and antioxidant, are tightly linked to its ability to both chelate iron and enter inside the cell nucleus. Here, we present data about Valpalf®, a new formulation containing bLf, sodium citrate, and sodium bicarbonate at a molar ratio of 10-3. In the present study, Valpalf® exhibits superior iron-binding capacity, resistance to tryptic digestion, and a greater capacity to accumulate into the nucleus over time when compared to the native bLf alone. In agreement, Valpalf® effectively reduces interleukin(IL)-6 levels in lipopolysaccharide-stimulated macrophages and modulates the expression of antioxidant enzymes, such as superoxide dismutase 1 and 2, in phorbol-12-myristate-13-acetate-stimulated monocytes. Of note, this potentiated bioactivity was corroborated in a retrospective study on the treatment of anemia of inflammation in hereditary thrombophilic pregnant and non-pregnant women, demonstrating that Valpalf® improves hematological parameters and reduces serum IL-6 levels to a higher extent than bLf alone.

Effects of Oral Iron Supplements in Pregnancy with IDA in Association with Oxidative Stress

Background: Iron deficiency anemia (IDA) is associated with adverse outcomes related to hemoglobin (Hb) and red cell indices and is now recognized as a major contributor to oxidative stress (OS). Maternal IDA during pregnancy is one of the most common nutritional deficiencies worldwide, exposing both the mother and developing fetus to the risk of OS. This study aims to identify the effects of IDA and oral iron supplements on oxidative stress during pregnancy. Methodology: The IDA group comprised 90 pregnant women between 16 to 20 weeks of gestation. The study lasted 12 weeks with follow-up visits every 4 weeks. Two antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), were studied as OS parameters. Hemoglobin (Hb), serum ferritin concentration (SFC), and total iron binding capacity (TIBC) were also measured. Results: The study found decreased levels of SOD, Hb, and SFC in the anemic group, which showed significant improvement after iron supplementation. GSH-Px and TIBC values were significantly lower compared to the control group. There was a direct relationship between SOD and Hb levels, with the highest SOD levels observed in conjunction with the highest Hb values. Conclusion: Oral iron administration to treat IDA during pregnancy not only improves hematological parameters but also decreases oxidative stress by improving SOD levels. However, other micronutrient deficiencies might be responsible for the alterations in GSH-Px levels.