Iron Binding Capacity Research Articles

Intravenous Iron Therapy in Severe Anemia at 28-34 Weeks of Gestation and it’s Feto-Maternal Outcome- A Prospective Study from A Developing Country

Introduction: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Anemia results in poor pregnancy outcome and also affects fetal outcome. This study was undertaken to evaluate the response of intravenous iron given to pregnant women with severe IDA and their feto-maternal outcome.
 Methodology: A prospective study was conducted in the department of Obstetrics & Gynaecology, at a tertiary care centre of Northern India. Fifty-two pregnant women with haemoglobin between 5-7 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron complex Follow-up after 4 weeks was done and IDA specific blood profile was done at baseline and at follow-up. Feto-maternal outcomes were seen at delivery.
 Results: The mean age of study population was 25.5 ± 3.96 yrs. Improvement at 4 week follow-up from baseline in hemoglobin (p value-0.001) and iron profiles (S. Iron, Total Iron Binding Capacity (TIBC), S. Ferritin) (p value -0.0001) were highly significant. On comparing the Hb levels at delivery after intravenous infusion at 28-34 weeks gestation, 17 patients were still below 8 gm%, whereas 35 were above 8 gm%. Distribution of IUGR, preterm labor and blood transfusion in postpartum period were statistically significant amongst both group (p value<0.05). Fetal outcomes were also evaluated amongst the 2 groups. Distribution of Preterm birth, birth weight and NICU admission was also statistically significant (p value<0.05).
 Conclusion: The intravascular iron therapy definitely has a rapid increase in haemoglobin which can prevent the complications due to severe anaemia in pregnancy and blood transfusion can also be prevented, but iron stores are not replenished to the optimum level, so there is a need to give replacement therapy (by oral route) post transfusion for long term benefits. The rise of hemoglobin affects feto-maternal outcomes even in the last trimester.contrast agents. This is a first case report of AHCM portrayed by this ingenious technology.
 Keywords: AMCH, IUGR, TIBC

Intravenous Iron Technique Evaluation in Chronic Heart Failure With Iron Deficiency Anemia.

This study aimed to investigate and assess whether IV iron improves symptoms of chronic heart failure (CHF) in patients with iron deficiency anemia (IDA). A total of 66 subjects with heart failure (HF) seeking therapy in the Department of Medicine's Inpatient Department (IPD) and Outpatient Department (OPD) were included. The data were collected during an outpatient or inpatient visit, documented in a predesigned and pretested proformaand then evaluated. All subjects received history-taking, examinationsand regular laboratory tests after being informed and signing an agreement. On admission, the following data was collected: name, age, genderand comorbidities. The examination of subjects included a general examination and a systematic examination. Hematological parameters includinghemoglobin (Haemometer, Top Tech Bio Medicals Mumbai), serum iron (Roche Cobas c501, USA), total iron binding capacity (TIBC, Beckman Coulter AU480, India), transferrin saturation percentage (TSAT% = (serum iron/TIBC) × 100), left ventricular ejection fraction (LVEF, 2D echocardiography, Nivan Healthcare Solutions, India) and ferritin (Abbott Architect Ferritin Assay, Delhi) are also important. Other blood tests like liver and renal function tests include an electrocardiogram (12-lead ECG) and two-dimensional echocardiography on admission and follow-up. In our study, 66 patients in total received IV iron as a treatment option to improve the symptoms of CHF with IDA; the New York Heart Association (NYHA) classification showed significant improvement (p-value <0.001). Before the intervention, 57.58% of patients had NYHA class II and 42.4% of patients had NYHA class III. After treatment, 33.33% of patients showed NYHA class II and 19.70% of patients showed NYHA class III. After iron therapy treatment, out of 29 cases of NYHA class III, nine (31.03%) cases converted to NYHA class I, seven (24.14%) cases converted to NYHA class II, and 13 (44.83%) cases belonged to the same NYHA class. Out of 37 cases of NYHA class II, 22 (59.45%) cases converted to NYHA class I, and 15 (40.54%) cases belong to the same NYHA class. Thus, we come to the conclusion that the NYHA classification has exhibited notable enhancement subsequent to the administration of parenteral iron therapy. Sufficient evidence exists to substantiate the advantageous effects of intravenous iron therapy in the treatment of iron deficiency anemia.The administration of iron therapy has been observed to yield favorable outcomes in the mitigation of symptoms among individuals afflicted with cardiac insufficiency.

Multivariate linear mixture models for the prediction of febrile seizure risk and recurrence: a prospective case–control study

Our goal was to identify highly accurate empirical models for the prediction of the risk of febrile seizure (FS) and FS recurrence. In a prospective, three-arm, case–control study, we enrolled 162 children (age 25.8 ± 17.1 months old, 71 females). Participants formed one case group (patients with FS) and two control groups (febrile patients without seizures and healthy controls). The impact of blood iron status, peak body temperature, and participants’ demographics on FS risk and recurrence was investigated with univariate and multivariate statistics. Serum iron concentration, iron saturation, and unsaturated iron-binding capacity differed between the three investigated groups (pFWE < 0.05). These serum analytes were key variables in the design of novel multivariate linear mixture models. The models classified FS risk with higher accuracy than univariate approaches. The designed bi-linear classifier achieved a sensitivity/specificity of 82%/89% and was closest to the gold-standard classifier. A multivariate model assessing FS recurrence provided a difference (pFWE < 0.05) with a separating sensitivity/specificity of 72%/69%. Iron deficiency, height percentile, and age were significant FS risk factors. In addition, height percentile and hemoglobin concentration were linked to FS recurrence. Novel multivariate models utilizing blood iron status and demographic variables predicted FS risk and recurrence among infants and young children with fever.

The Relation of the Iron Metabolism Index to the Vulnerability Index of Carotid Plaque with Different Degrees of Stenosis.

To investigate the differences in serum iron index and iron metabolizing protein expression in plaques in patients with different degrees of carotid artery stenosis and the relationship with plaque traits. A total of 100 patients eligible for carotid endarterectomy (CEA) from August 2021 to February 2022 were included. Patients completed a computed tomography (CTA) scan for patient grouping and a magnetic resonance imaging (MRI) for precise quantification of carotid plaque traits within 1 week prior to surgery. Clinical indicators associated with the progression of carotid stenosis to occlusion were analyzed using ordered logistic regression. Twenty carotid plaques were analyzed immunohistochemically to investigate the relationship between plaque traits and the iron metabolism indexes. No significant correlation between high serum ferritin (SF), unsaturated iron binding capacity (UIBC) and progression of carotid stenosis (OR 1.100, 95% CI 0.004-0.165, p = 0.039; OR 1.050, 95% CI 0.005-0.094, p = 0.031). SF and serum transferrin receptor (sTfR) were correlated with normalized wall index (NWI) (R = 0.470, p = 0.036; R = 0.449, p = 0.046), and the results of multiple linear regression suggested that SF and sTfR remained associated with NWI (R = 0.630, R2 = 0.397, Adjusted R2 = 0.326, p = 0.014). In plaques, H-type ferritin (H-FT) was correlated with NWI and lipid-rich necrotic core (LRNC) volume (R = 0.502, p = 0.028; R = 0.468, p = 0.043). Transferrin receptor 1 (TfR1) was correlated with LRNC volume and intraplaque hemorrhage (IPH) volume (R = 0.538, p = 0.017; R = 0.707, p = 0.001). There were statistical differences in the expression of iron metabolism proteins in carotid plaques with different degrees of stenosis. Serum iron metabolism index (SF and sTfR) and expression of iron metabolizing proteins (H-FT and TfR1) in plaques were positively correlated with carotid plaque vulnerability index (NWI, LRNC volume).

Grape seed extract in combination with deferasirox ameliorates iron overload, oxidative stress, inflammation, and liver dysfunction in beta thalassemia children

Background and purposeIron overload in the body is associated with serious and irreversible tissue damage. This study aimed to investigate the iron‐chelating, antioxidant, anti-inflammatory, and hepatoprotective activities of grape seed extract (GSE) supplement as well as its safety in β‐thalassemia major (β‐TM) pediatric patients receiving deferasirox as a standard iron‐chelation therapy. Materials and methodsThe children were randomly allocated to either GSE group (n = 30) or control group (n = 30) to receive GSE (100 mg/day) or placebo capsules, respectively, for 4 weeks. The serum levels of iron, ferritin, total iron-binding capacity (TIBC), alanine transaminase (ALT), aspartate aminotransferase (AST), tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), and glutathione (GSH) as well as superoxide dismutase (SOD) activity and hemoglobin (Hb) concentration were measured pre-and post-intervention. ResultsGSE supplement significantly attenuated the serum levels of iron (p = 0.030), ferritin (p = 0.017), ALT (p = 0.000), AST (p = 0.000), TNF-α (p = 0.000), and hs-CRP (p = 0.001). The TIBC level (p = 0.020) significantly enhanced in the GSE group compared with the placebo group. Moreover, GSE supplement remarkably improved the oxidative stress markers, MDA (p = 0.000) and GSH (p = 0.001). The changes in the SOD activity (p = 0.590) and Hb concentration (p = 0.670) were not statistically different between the groups. ConclusionGSE supplement possesses several health beneficial influences on children with β‐TM by alleviating iron burden, oxidative stress, inflammation, and liver dysfunction.

Serological Screening for Celiac Disease and Gastrointestinal Absorption Disorders in Patients with Autoimmune Endocrine Diseases.

Celiac disease (CD) accompanying autoimmune endocrine diseases (AED) is generally asymptomatic. This study aimed to evaluate the frequency of clinically overt or silent CD in patients diagnosed with autoimmune endocrinopathy and the clinical effects of silent CD in these endocrinopathies. The study included 166 patients with known or newly diagnosed mono-/polyglandular AED and 90 age- and gender-matched healthy controls. The patients were classified into four groups: type 1 diabetes mellitus (DM) (n=44), Hashimoto's thyroiditis (HT) (n=68), Addison's disease (AD) (n=17), and autoimmune polyglandular syndrome (APS) (n=37). All subjects were serologically screened for tissue transglutaminase antibody (tTG) IgA and IgG. In addition, to evaluate the possible systemic consequences of CD, serum parathormone (PTH), 25-hydroxicholecalsiferol (25-OH-Vit D), vitamin B12, folic acid, iron, iron-binding capacity (IBC), and ferritin levels were measured. In the total series, 193 (75.4%) individuals were females, and 63 (24.6%) were males. TTG IgA antibody positivity was found in 23 among 166 patients, while no positivity was encountered in the healthy control group. The highest rates of positive tTg IgA frequency were detected in AD, with 29.4% (5/17). Serum 25-OH-Vit D, vitamin B12, folic acid, iron, and ferritin levels were significantly lower in AEDs compared to controls (p<0.001), and the lowest these parameters were detected in patients with AD. The serologic CD prevalence is higher in autoimmune mono-/and polyglandular endocrine diseases than in the control group. The data support recommends regular screening for CD in all patients with AEDs.

Relationship between Iron Metabolic Parameters and Platelet Counts in Blood Donors

To investigate the correlation of iron metabolic parameters with platelet counts in blood donors. A total of 400 blood donors who met requirements of apheresis platelet donation were collected, and their hematological parameters were analyzed. The donors were divided into low ferritin group and normal group, the differences of hematological parameters between the two groups were compared, and the correlation of iron metabolic parameters and routine hematology parameters with platelet counts were analyzed. Whether male or female, low ferritin group had higher platelet counts than normal group (P < 0.01). Among the iron metabolic parameters, the platelet counts was negatively correlated with serum ferritin (SF), serum iron (SI), and transferrin saturation (TSAT) (r =-0.162, r =-0.153, r =-0.256), and positively correlated with total iron binding capacity (TIBC) and unsaturated iron binding capacity (UIBC) (r =0.219, r =0.294) in female blood donors. Platelet counts was also negatively correlated with SF, SI and TSAT (r =-0.188, r =-0.148, r =-0.224) and positively correlated with UIBC (r =0.220) in male blood donors. Among the routine hematology parameters, platelet counts was negatively correlated with mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and reticulocyte hemoglobin equivalent (Ret-He) in female blood donors (r =-0.236, r =-0.267, r =-0.213, r =-0.284). Platelet counts was also negatively correlated with MCH, MCHC and Ret-He in male blood donors (r =-0.184, r =-0.221, r =-0.209). In blood donors with low C-reactive protein level, the lower the iron store capacity, the lower the iron utilization, and the platelet counts tends to rise.

Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes

ObjectivesDisordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its...

Sonneratia apetala (Buch.-Ham.) Fruit Extracts Ameliorate Iron Overload and Iron-Induced Oxidative Stress in Mice.

Iron overload results in oxidative damage to various biomolecules including DNA, proteins and lipids which ultimately leads to cell death. The Sonneratia apetala fruit contains a high content of antioxidants and displays several bioactive properties. Therefore, the powder of the S. apetala fruit was successively fractionated into n-hexane (Hex), chloroform (Chl), and methanol (Met) fractions to evaluate their efficiency in ameliorating iron overload. In vitro, a colorimetric method was used to assess the Fe-chelating activity of the fractions using ferrozine. The fractions were also used in vivo to examine their efficacy in ameliorating iron overload and iron-induced oxidative stress in mice induced by intraperitoneal injection of ferric carboxymaltose at 100 mg/kg body weight (bw). Among the fractions, Met showed the highest Fe-chelation ability with an inhibitory concentration 50 of 165 μg/mL followed by Hex (270 μg/mL), and Chl (418 μg/mL). In vivo, the results showed a significantly (P<0.05) lower iron profile (iron and ferritin concentrations in serum and liver tissue and total iron-binding capacity of serum) in the Met and the Hex treated mice groups than in the iron-overloaded group. Met at 1,000 μg/kg bw completely ameliorated iron overload in the blood and the liver tissue of mice. At this concentration, Met also prevented iron-induced oxidative stress in the liver tissue of iron-overloaded mice by restoring reducing power, total antioxidant capacity, and total protein. Thus, the S. apetala fruit, especially its Met fraction can be used in treating iron overload and associated toxicity.

Exploring the Roles of Arbuscular Mycorrhizal Fungi in Plant–Iron Homeostasis

Arbuscular mycorrhizal fungi (AMF) form a vital symbiotic relationship with plants. Through their extensive hyphal networks, AMF extend the absorptive capacity of plant roots, thereby allowing plants to reach otherwise inaccessible micronutrient sources. Iron, a critical micronutrient involved in photosynthesis and other metabolic processes, often becomes inaccessible owing to its tendency to form insoluble complexes in soil. AMF symbiosis significantly ameliorates this challenge by enhancing iron uptake and homeostasis in plants, altering root architecture, and producing root exudates that improve iron solubility. Moreover, the interaction with diverse soil bacteria, particularly plant growth-promoting rhizobacteria, can potentiate the benefits of AMF symbiosis. Siderophores are low-molecular-weight chelators with iron-binding capacities produced by various microorganisms and plant roots. They play pivotal roles in regulating intracellular iron and have been identified in different mycorrhizal associations, including AMF. While molecular mechanisms behind AMF-mediated iron uptake have been partially explored, the intricate networks involving AMF, plants, siderophores, and other soil microbiota are largely unknown. This review focuses on the multifaceted roles of AMF in plant–iron homeostasis, interactions with soil bacteria, and the potential of siderophores in these processes, emphasizing the possibilities for harnessing these relationships for sustainable agriculture and enhancing plant productivity.

Postoperative micronutrient changes in bariatric surgery patients compliant with nutritional supplementation.

Bariatric surgery is commonly used in patients with body mass indexes over 35kg/m and obesity-related comorbidities. Despite the significant clinical benefits of bariatric surgery, nutritional deficiencies post-surgery remain a challenge for both patient and healthcare provider [Toninello et al. in Nutrients 13:1565, 2021, Gasmi et al. in Eur J Nutr 61:55-67, 2022]. Nutritional supplementation is a way of reducing the likelihood of postoperative deficiencies; however, prior studies have shown varying degrees of mostly poor to moderate patient adherence [Spetz et al. in Obes Res Clin Pract 16:407-412, 2022, Mahawar et al. in Obes Surg 29:1551-1556, 2019, Santonicola et al. in J Am Nutr Assoc 41:11-19, 2022, Sherf Dagan et al. in Obes Surg 27:2258-2271, 2017]. Our present study aims to provide insights into the micronutrient biochemical profile in patients previously found to be compliant with supplementation following roux-en-y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG). An 11-point outpatient survey was administered to consecutive patients ≥ 18years who had undergone either RYGB or VSG to determine adherence with nutritional supplementation. Medical records were retrospectively reviewed to determine preoperative and postoperative lab values, including vitamins A, B1, B12, and D, thyroid stimulating hormone (TSH), iron binding capacity, transferrin, ferritin, folate, iron, albumin, hemoglobin A1C, zinc, glomerular filtration rate (GFR, and liver function values. Values were classified as "abnormal" or "normal." Preoperative and postoperative values were compared for differences. Postoperative values were also compared between RYGB and VSG. There were no significant differences between preoperative and postoperative values for any nutritional marker aside from vitamin B12. A total of 51/60 patients (85.0%) had normal preoperative B12 measurements, compared with 40/65 (61.5%) patients postoperatively (P = 0.03). Notably, of 25 "abnormal" postoperative measurements, 20 (80%) were elevated values. There were no differences in postoperative deficiencies between RYGB and VSG. Patients in our sample did not have worsened micronutrient deficiencies following bariatric surgery, and there were no differences in micronutrient deficiencies between surgical technique.

Vitamin D Levels in Children Presenting with Breath-Holding Spells: An Example of A University Hospital

Aim: This study aimed to examine the vitamin D levels in children who experience breath-holding spells (BHS) and to compare these levels with those of a healthy control group. The goal was to establish a connection between BHS and vitamin D levels.&#x0D; Method: The records of 98 patients, who presented to the Pediatric Neurology and Pediatric Cardiology polyclinics of Adıyaman University Training and Research Hospital between December 2019 and October 2022, were retrospectively reviewed. Fifty-two patients who did not meet the inclusion criteria were excluded. The study included forty-six patients with BHS whose laboratory results were assessed and a healthy control group of fifty-three individuals. Fe, serum iron binding capacity, ferritin, vitamin B12, and vitamin D levels were measured in all patients.&#x0D; Results: The study group comprised 46 patients (female/male ratio = 1.4), consisting of 27 girls (58.6%) and 19 boys (41.3%). Within our patient cohort, 39 individuals (84.8%) were diagnosed with cyanotic-type spells, three (6.5%) with pallid-type spells, and four (8.7%) with mixed-type spells. For patients experiencing BHS, a comprehensive analysis was conducted on parameters including complete blood count, iron levels, iron-binding capacity, ferritin levels, vitamin B12, and vitamin D levels. Although no significant correlation was identified with vitamin D levels in this study, noteworthy connections were established with lower hemoglobin levels, decreased vitamin B12 levels, and reduced ferritin levels. Moreover, upon exclusion of patients exhibiting low vitamin B12 values from the analysis, a statistically significant relationship emerged between iron deficiency anemia and the occurrence of BHS (p

A-128 Analytical Performance Evaluation of Assays Used for Iron Studies on the Atellica® CI 1900 Analyzer

Abstract Background The Atellica® CI 1900 Analyzer is an automated, mid-throughput, integrated chemistry and immunoassay analyzer employing both Atellica CH and Atellica IM assays. This study was designed to evaluate the analytical performance of the Atellica CH Iron_2 (Iron_2), Total Iron Binding Capacity (TIBC), and Transferrin (Trf) assays* and the Atellica IM Ferritin (Fer) assay on the Atellica CI 1900 Analyzer. Methods The Atellica CI 1900 Iron_2, TIBC, and Trf assays use the same reagents and calibrators as the comparable Atellica chemistry assays. The Atellica CI 1900 Fer assay uses the same reagents and calibrators as the Atellica immunoassay. Precision and method comparison (MC) were used as performance indicators for the Atellica CI 1900 Analyzer. Precision studies were performed according to CLSI EP05-A3 using native and contrived human serum samples. MC studies were performed according to CLSI EP09-A3. Native and contrived human samples were analyzed using the Atellica CH Iron_2, TIBC, and Trf assays on both the Atellica® CH 930 and Atellica CI 1900 Analyzers. For Fer, native and contrived human samples were analyzed using the Atellica IM Fer assay on both the Atellica® IM 1600 and Atellica CI 1900 Analyzers. Results Representative precision and MC results for each assay are listed in the table. For the four assays tested, repeatability and within-lab %CVs were &amp;lt;3.5% and &amp;lt;4.5%, respectively. Slopes determined by the Deming linear regression model were approximately equal to 1. Conclusion Evaluation of the Atellica CH Iron_2, TIBC, and Trf and Atellica IM Fer assays using the Atellica CI 1900 Analyzer demonstrated good precision and equivalent performance compared to the same assays on their respective Atellica CH 930 and Atellica IM 1600 Analyzers. *The products mentioned are not commercially available in all countries. Their future availability cannot be guaranteed.

A-139 Investigating the Utility of Reticulocyte Hemoglobin Equivalent for Diagnosis of Iron Deficiency Anemia

Abstract Background Iron deficiency anemia (IDA) is one of the most common leading global health problems, which could cause extreme fatigue, chest pain, headache, and even neurodevelopment deterioration in children. Traditionally, assessing serum ferritin, transferrin, and iron are the tools to diagnose IDA. However, a high false-positive rate of these conventional biomarkers might be observed due to inflammation, infection, or malignancy. Reticulocyte hemoglobin equivalent (RET-He) is a new parameter that reflects the recent functional availability of iron for erythropoiesis, with the advantage of real-time results as part of automated reticulocyte analysis. The present study, therefore, aimed to investigate the utility of RET-He for the diagnosis of patients with IDA. Methods This retrospective study collected laboratory data from patients with both serum ferritin and reticulocyte results from January 2022 through December 2022, and excluded the high white blood cell count (WBC &amp;gt; 9380 cells/μL) and high C-reaction protein (CRP &amp;gt; 0.5 mg/dL). RET-He was measured by Sysmex XN-10 or XN-20 automated hematology analyzer (Sysmex, Kobe, Japan). Serum ferritin was measured by Roche Cobas e801 (Roche Diagnostics, Mannheim, Germany). Iron and total iron binding capacity (TIBC) were measured by Roche Cobas c702 (Roche Diagnostics, Mannheim, Germany). Anemia was defined as hemoglobin concentration &amp;lt;13 g/dL for men and &amp;lt; 12 g/dL for women. Iron deficiency was defined as serum ferritin &amp;lt;15 μg/L. Student T-tests and Pearson correlation were performed, and P-values less than 0.05 were considered statistically significant. Statistical analyses were performed with SPSS software (Version 22.0). Results A total of 2208 patient data were enrolled in this study and were classified into the IDA, iron deficiency, anemia, and control groups according to ferritin level and hemoglobin concentration. The RET-He were 20.6, 27.7, 30.4, and 32.3 pg in the IDA, iron deficiency, anemia, and control groups, respectively. The IDA group showed significantly lower RET-He levels than the control group (P &amp;lt; 0.001). By Pearson correlation analysis, the RET-He showed a weak positive correlation with ferritin and hemoglobin (r = 0.236, 0.274), moderate positive correlation with iron (r = 0.354), and moderate negative correlation with TIBC (r = −0.369). In addition, the average turn-around time (received-reported) of RET-He was 16.4 min, which was shorter than other biochemical markers such as ferritin, iron, and TIBC (57.7, 34.2, 34.4 min). Conclusion The RET-He could be an assessment of the iron actually used for the biosynthesis of hemoglobin and as a useful and rapid tool for diagnosing and monitoring iron deficiency anemia.

B-014 Impact of Centrifugation Time Reduction in Laboratory Automation System

Abstract Background The centrifugation of specimens is an important preanalytical process which will be impact the most on turnaround time of the laboratory results. To verify the automation systems, we tested different combinations of tube and centrifugation settings to determine the most efficient for routine chemistry procedure. The outcomes of each combination were then compared to the benchmark to find out the best setting to reduce turnaround time for laboratory results. Methods In this study, we evaluated a total of 40 leftover blood samples that were collected on 4 mL plastic Vacutainer® (Becton Dickinson) lithium heparin tubes and 2 mL plastic Vacuette® (Greiner bio-one) lithium heparin tubes. All tubes were centrifuged on Abbott Automation GLP systems. The first set of samples was centrifuged according to the manufacturer’s guideline (10 min at 1300 × g, room temperature for Vacutainer® tubes and 10 min at 2200 × g, room temperature for Vacuette® tubes). The second set was centrifuged 7 min at 2700 × g, room temperature. And the third set was centrifuged 5 min at 2700 × g, room temperature. Then, analyzed all samples with 22 routine chemistry parameters on Alinity ci analyzers. The allowable total error and correlation coefficient (R) were used to determine the significance of the differences between 3 protocols of the centrifugation time. Results The study showed that the centrifugation times of 7 min and 5 min were not significantly different from the manufacturer’s protocol (10 min) after testing with 22 routine chemistry parameters (albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, direct bilirubin, total bilirubin, calcium, chloride, cholesterol, creatinine, low-density lipoprotein-cholesterol, iron, potassium, lactate dehydrogenase, sodium, phosphorus, total protein, triglycerides, unsaturated iron-binding capacity, high-density lipoprotein-cholesterol, urea nitrogen and uric acid) in both 4 mL plastic Vacutainer® lithium heparin tubes and 2 mL plastic Vacuette® lithium heparin tubes. Overall, the results of the study indicate that shorter centrifugation times of 7 min and 5 min at 2700 × g able to use for routine chemistry. Conclusion The study concluded that the centrifugation time did not affect the analytical results of 22 routine chemistry parameters. This suggests that shorter centrifugation times able to use with no impact on accuracy or reliability. The results of the study will support laboratory to have efficiency improvements by shorten the turnaround time on the results release.

Assessment of erythroferrone levels in children with chronic kidney disease on regular hemodialysis

Anemia is a common comorbidity in children with chronic kidney disease (CKD) and is associated with adverse outcomes. Erythroferrone (ERFE) is a hepcidin inhibitor whose synthesis is stimulated by erythropoietin, which increases iron absorption and mobilization. Aim of the study: to assess the levels of ERFE hormone in children with CKD on regular hemodialysis. This case–control study was carried out at Menoufia University Hospital and included 70 subjects: 38 healthy individuals (controls) and 32 children with CKD on regular dialysis (cases). The study was approved by the Faculty of Medicine Ethics Committee at Menoufia University. All children were subjected to full history taking, complete clinical examination, blood tests such as complete blood count, reticulocyte count, serum iron, ferritin, and total iron binding capacity, liver and renal function tests, and an immunoassay to measure human ERFE. There was a statistically significant difference in the levels of ERFE between the cases and controls (p &lt; 0.001). There was a significant, strong correlation between the levels of hemoglobin and serum iron and the level of ERFE (r = –0.655, p &lt; 0.001). There was no significant correlation between the administered dose of exogenous erythropoietin and the level of ERFE (p = 0.460). Serum ERFE levels in the children with CKD on regular hemodialysis were significantly higher than in the controls and were negatively correlated with hemoglobin and iron levels. There was no significant correlation between ERFE levels and both serum ferritin and total iron binding capacity levels.

Blood biomarker profiles and exceptional longevity: comparison of centenarians and non-centenarians in a 35-year follow-up of the Swedish AMORIS cohort

Comparing biomarker profiles measured at similar ages, but earlier in life, among exceptionally long-lived individuals and their shorter-lived peers can improve our understanding of aging processes. This study aimed to (i) describe and compare biomarker profiles at similar ages between 64 and 99 among individuals eventually becoming centenarians and their shorter-lived peers, (ii) investigate the association between specific biomarker values and the chance of reaching age 100, and (iii) examine to what extent centenarians have homogenous biomarker profiles earlier in life. Participants in the population-based AMORIS cohort with information on blood-based biomarkers measured during 1985–1996 were followed in Swedish register data for up to 35 years. We examined biomarkers of metabolism, inflammation, liver, renal, anemia, and nutritional status using descriptive statistics, logistic regression, and cluster analysis. In total, 1224 participants (84.6% females) lived to their 100th birthday. Higher levels of total cholesterol and iron and lower levels of glucose, creatinine, uric acid, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, lactate dehydrogenase, and total iron-binding capacity were associated with reaching 100 years. Centenarians overall displayed rather homogenous biomarker profiles. Already from age 65 and onwards, centenarians displayed more favorable biomarker values in commonly available biomarkers than individuals dying before age 100. The differences in biomarker values between centenarians and non-centenarians more than one decade prior death suggest that genetic and/or possibly modifiable lifestyle factors reflected in these biomarker levels may play an important role for exceptional longevity.

The effects of a single dialysis session on serum hepcidin levels

Abstract Objectives Hepcidin plays an important role in regulating iron metabolism. Elevated levels of hepcidin in renal failure contribute to the development of anemia. We aimed to evaluate the association between hepcidin and inflammation in hemodialysis patients and how dialysis affects hepcidin levels. Methods Hepcidin clearance with hemodialysis was investigated by measuring hepcidin concentrations by enzyme-linked immunosorbent assay (ELISA) method before and after hemodialysis of 40 patients in a single dialysis session. Hemogram parameters and ferritin, iron, total iron binding capacity (TIBC), and C-reactive protein (CRP) were measured and evaluated their relations with predialysis hepcidin levels. Results Hepcidin levels decreased significantly with dialysis treatment (p=0.009). Median hepcidin concentration before dialysis was measured as 330 ng/mL (83–459) and post-dialysis median hepcidin concentration was 250 ng/mL (94–384). There was a significant correlation between predialysis hepcidin levels and ferritin (r=0.858, p&lt;0.001), TIBC (r=−0.451, p=0.004), and MCV (r=0.384, p=0.016). It was found that increases in ferritin levels in time were positively correlated with hepcidin before dialysis. Conclusions We think that understanding the removal of the hepcidin by dialysis, which causes a decrease in the amount of iron available in the anemia, is important in managing future therapy.

Correlation of Plasma Iron Profile and Intradialytic Hypotension in Hemodialysis Patients

Abstract: Intradialytic hypotension (IDH) has been a common complication which should be aware of, in hemodialysis procedure. Its pathogenesis is multifactorial, and severe anemia is considered as one of the most notable risk factors on IDH. This study aimed to evaluate the correlation between plasma iron profile and intradialytic hypotension in hemodialysis patients. This was an analytical and retrospective study using medical records of hemodialysis patients at Prof. Dr. R. D. Kandou Hospital, Manado from January to May 2022. Sampling was conducted through consecutive sampling method, on available records. Patients with CKD grade 5 which undergoes routine HD twice a week for &gt;3 weeks, aged 18-60 years old were included, while subjects with sepsis, malignancy, autoimmune disease, crisis hypertension, and unstable congestive heart failure were excluded for further studies. The details on iron profile and blood pressure measurement were then extracted, which then analyzed with descriptive analysis and Pearson correlation using IBM SPSS Statistics 26.0. The results obtained a total of 35 patients; 57.1% were male. The Pearson correlation analysis on all variables reported several notable significant results, with a correlation between iron profile and blood pressure measurement were seen in TIBC and systole pre- and post-procedure (-.496 and -.611 respectively) with strong negative relationship; and serum ferritin value with systole post-procedure (.373) implying moderate positive relationship. The results suggested that the increase of ferritin value and decrease of TIBC value were correlated with the increase of systole blood pressure. Meanwhile, the TIBC had a strong positive correlation with systolic changes (.473) meanwhile serum iron had a moderate negative correlation with diastolic changes (-.365). In conclusion, there is a significant correlation between iron profile and changes in blood pressure, with higher iron profile value (lower TIBC) is positively correlated with the increase of both systole and diastole measurement; also negatively correlated with the reduction of blood pressure in hemodialysis patients Keywords: iron; ferritin; intradialytic hypotension; hemodialysis; transferrin; total iron binding capacity

Prevalence and pattern of iron deficiency and its correlation with different hematological parameters in a segment of patients coming to a tertiary care hospital in Lahore

Background: Iron is an essential micronutrient, abundantly present in nature. Very low quantities of iron are required in our daily diet to prevent its deficiency. But paradoxically, its deficiency is very common all around the world. In keeping with its wide and varied functions in the body, the deficiency of iron also has multiple manifestations. This study aimed to study the prevalence and pattern of iron deficiency in a segment of our population. The effect on various hematological parameters was also studied.&#x0D; Materials and Methods: Fifty cases including both genders and all ages were included in the study. The parameters analyzed were iron status and hematological indices. The status of serum iron levels was compared with total iron binding capacity (TIBC). Blood examination included total leukocyte count, differential leukocyte count, hemoglobin level, total RBC count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and platelet count. The correlation of serum iron levels with the different hematological indices was analyzed.&#x0D; Results: Iron deficiency was even more prevalent than previously reported (70%). It was seen in both genders and all age groups. Only the elderly male group showed a mean that was in the normal range. Females were affected more severely than males in all age groups. Red cell indices showed expected correlation with serum iron levels. Platelet counts showed an increase with falling iron levels.&#x0D; Discussion: Iron deficiency continues to be rampant despite decades of public health measures to correct it. Iron deficiency anemia impacts multiple body functions with a myriad of health consequences. The ensuing symptoms are those classically related to anemia as well as some that are both unexpected and hard to explain. Increase in platelet count seen in iron deficiency carries the risk of creation of a thrombogenic state. The factors contributing to iron deficiency need to be identified and addressed.&#x0D; Key words: Serum iron levels, Complete Blood Count, iron deficiency, platelet count.