Serum Iron Levels Research Articles

Hematological Assessments of Children with Oral Aphthous Ulcer in Diyala Governorate, Iraq

Abstract: BACKGROUND: Although the terms “aphthous ulcers” and “aphthous stomatitis” have been used interchangeably in the past, the latter is now preferable. It is a widespread illness that affects 20% of the general population and 9% of children, according to estimates. Due to the high prevalence, pediatric patients who complain of mouth ulcers frequently present to medical and dental specialists. OBJECTIVES: Hematological assessments of patients with oral aphthous ulcer and comparison with healthy control. MATERIALS AND METHODS: A case–control study of 120 kids was conducted. The study included 100 patients with oral aphthous ulcer (56 male and 44 female) and a group of 20 healthy controls (10 males and 10 females). Data were collected using questionnaires. The questionnaires had two sections. The first section involved personal information. The second section is related to hematological examinations, such as hemoglobin level, serum iron level, folic acid level, Vitamin B12 level, and mean corpuscular volume. Statistical analysis was carried out using the t-test, and the LSD was employed to significantly compare the means. RESULTS: The level of hemoglobin in the control group was statistically highly significantly increased when compared with patients with mean ± standard error (SE) (13.14 ± 0.20) versus mean ± SE (10.39 ± 0.19). Serum iron showed an increased level in the control group compared to patients with statistically showed highly significant correlation with mean ± SE (71.77 ± 5.14) versus mean ± SE (46.76 ± 2.79). A highly significant correlation existed when compared the control group and patients concerning Vitamin B12 levels with mean ± SE (517.02 ± 28.11) versus mean ± SE (367.32 ± 21.25). CONCLUSIONS: Hemoglobin, serum iron, and Vitamin B12 levels of patients are higher than that of controls. It is very important to observe the hemoglobin, folic acid, Vitamin B12, and serum iron levels in patients with oral ulcer before it starts to suggest treatments for oral ulcer.

Analysis of related factors of CRA in lung cancer patients with different serum iron levels: A retrospective cohort study.

Serum iron, an essential component of hemoglobin (Hb) synthesis invivo, is a crucial parameter for evaluating the body's iron storage and metabolism capacity. Iron deficiency leads to reduced Hb synthesis in red blood cells and smaller red blood cell volume, ultimately resulting in iron-deficiency anemia. Although serum iron cannot independently evaluate iron storage or metabolism ability, it can reflect iron concentration invivo and serve as a good predictor of iron-deficiency anemia. Therefore, exploring the influence of different serum iron levels on anemia and diagnosing and treating iron deficiency in the early stages is of great significance for patients with lung cancer. This study aims to explore the related factors of cancer-related anemia (CRA) in lung cancer and construct a nomogram prediction model to evaluate the risk of CRA in patients with different serum iron levels. A single-center retrospective cohort study was conducted, including 1610 patients with lung cancer, of whom 1040 had CRA. The relationship between CRA and its influencing factors was analyzed using multiple linear regression models. Lung cancer patients were divided into two groups according to their serum iron levels: decreased serum iron and normal serum iron. Each group was randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The influencing factors were screened by univariate and multivariate logistic regression analyses, and nomogram models were constructed. The area under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the models. CRA in lung cancer is mainly related to surgery, chemotherapy, Karnofsky Performance Status (KPS) score, serum iron, C-reactive protein (CRP), albumin, and total cholesterol (p < 0.05). CRA in lung cancer patients with decreased serum iron is primarily associated with albumin, age, and cancer staging, while CRA in lung cancer patients with normal serum iron is mainly related to CRP, albumin, total cholesterol, and cancer staging. The area under the ROC curve of the training cohort and validation cohort for the prediction model of lung cancer patients with decreased serum iron was 0.758 and 0.760, respectively. Similarly, the area under the ROC curve of the training cohort and validation cohort for the prediction model of lung cancer patients with normal serum iron was 0.715 and 0.730, respectively. The calibration curves of both prediction models were around the ideal 45° line, suggesting good discrimination and calibration. DCA showed that the nomograms had good clinical utility. Both models have good reliability and validity and have significant clinical value. They can help doctors better assess the risk of developing CRA in lung cancer patients. CRP is a risk factor for CRA in lung cancer patients with normal serum iron but not in patients with decreased serum iron. Therefore, whether CRP and the inflammatory state represented by CRP will further aggravate the decrease in serum iron levels, thus contributing to anemia, warrants further study.

Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis

IntroductionTraditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can coexist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A (VA) status...

Prevalence of iron deficiency in type 2 diabetes mellitus patients and its association with altered lipid profile

Abstract Background: The escalation of diabetes mellitus poses a significant public health challenge in India. This condition impacts iron metabolism, potentially causing variations in the iron profile. This study aimed to ascertain the prevalence of iron deficiency in individuals with type 2 diabetes mellitus and explore its associated factors. Materials and Methods: A cross-sectional study was conducted on adult patients with type 2 diabetes mellitus at a tertiary care center in Eastern India. Biochemical assessments encompassed fasting plasma glucose, post-prandial glucose, glycosylated hemoglobin (HbA1c), lipid profile, renal function tests, complete hemogram, and iron profile. Anthropometric measurements were conducted using standardized procedures. Results: This study revealed that among the 203 participants, the prevalence of iron deficiency was 63.5% (95% confidence interval: 56.5–70.2). Anemia was observed in 34% of patients (men &lt;13 g/dL, women &lt;12 g/dL). The mean levels of serum iron, ferritin, total iron binding capacity, and transferrin saturation were 62.9 ± 26.1 μg/dL, 100.6 ± 103.2 ng/mL, 392.3 ± 72 μg/dL, and 16.6 ± 7.5%, respectively. The mean fasting blood sugar, post-prandial blood sugar, and HbA1c values were 154.2 ± 63 mg/dL, 229.3 ± 92.1 mg/dL, and 7.7 ± 1.5%, respectively. There were no significant differences in iron levels between genders or between poorly controlled and well-controlled diabetics. However, significant associations were observed between iron deficiency and lower total cholesterol levels, low-density lipoprotein, and triglycerides. Conclusion: This study concludes that iron deficiency is highly prevalent among diabetic patients in India and is associated with lipid profile alterations.

Moyamoya Syndrome in a Child with Beta-Thalassemia Trait: A Case Report with Review of Literature

Background: The association of moyamoya angiopathy with hematological conditions such as sickle cell anemia and beta-thalassemia major or intermedia is well-known, but moyamoya syndrome (MMS) associated with thalassemia trait is hardly reported. We report such a rare association. Clinical Description: A 7-year-old boy presented with right-sided monoparesis with right-sided focal seizures, along with right-sided upper motor neuron type facial nerve palsy. He had a history of recurrent transient episodes of limb weakness, which were unevaluated. Examination revealed pallor and mild splenomegaly. Management and Outcome: Routine investigations revealed microcytic hypochromic anemia with normal serum iron levels. High-performance liquid chromatography was suggestive of beta-thalassemia trait. Contrast-enhanced computerized tomography of the head showed infarction in the territory of the left anterior cerebral artery (ACA) and middle cerebral artery (MCA). Magnetic resonance angiography revealed significantly attenuated bilateral internal carotid arteries in the supraclinoid region with attenuated bilateral ACA and bilateral MCA along with collateral formation suggestive of moyamoya angiopathy. The final diagnosis of MMS secondary to beta-thalassemia trait was made. The child improved with aspirin and supportive management. Conclusion: MMS can be rarely associated with the beta-thalassemia trait. Such an underlying, unsuspected heterozygous beta-thalassemia (trait) may be diagnosed only after the identification of moyamoya disease following a stroke.

Factors Impacting Outcome and Prognosis of Invasive Fungal Sinusitis: How Vital is Iron Metabolism?

Iron is an important micronutrient involved in cell biology through vital reactions. We examined the correlations between iron metabolism parameters and the course of invasive fungal sinusitis. Patients with invasive fungal sinusitis were enrolled. Serum iron and ferritin levels, total iron-binding capacity, and transferrin saturation were measured at the initiation of treatment. Patients were followed for 6months, and the clinical course was categorised as improvement or worsening/death. A total of 35 patients were enrolled. The average ferritin levels in mucormycosis patients was 944.9ng/ml, versus 110.7ng/ml for aspergillosis patients. Iron levels were significantly lower in mucormycosis than in aspergillosis (29.14µg/dl vs. 68.55µg/dl). Total iron-binding capacity was significantly different between the two groups (16.76µg/dl vs. 330.36µg/dl). After 6months, improvement, worsening, and death were noted for 18, 8, and 9 patients, respectively. Higher iron levels and lower ferritin levels were linked with improvement. Total iron-binding capacity was significantly higher in improved patients (2314 vs. 151). Iron metabolism parameters play significant roles in the preemptive judgment of the course of fungal sinusitis. Based on these findings, studies on drugs affecting iron metabolism should be conducted.

The causal effect of iron status on risk of anxiety disorders: A two-sample Mendelian randomization study.

Observational studies had investigated the association of iron metabolism with anxiety disorders. The conclusions were inconsistent and not available to reveal the causal or reverse-causal association due to the confounding. In this study we estimated the potential causal effect of iron homeostasis markers on anxiety disorders using two-sample Mendelian randomization (MR) analysis. Summary data of single nucleotide polymorphisms (SNPs) associated with four iron-related biomarkers were extracted from a recent report about analysis of three genome-wide association study (GWAS), the sample size of which ranged from 131471 to 246139 individuals. The corresponding data for anxiety disorders were from Finngen database (20992 cases and 197800 controls). The analyses were mainly based on inverse variance weighted (IVW) method. In addition, the heterogeneity and pleiotropy of the results were assessed by Cochran's Q test and MR-Egger regression. Basing on IVW method, genetically predicted serum iron level, ferritin and transferrin had negative effects on anxiety disorders. The odd ratios (OR) of anxiety disorders per 1 standard deviation (SD) unit increment in iron status biomarkers were 0.922 (95% confidence interval (CI) 0.862-0.986; p = 0.018) for serum iron level, 0.873 (95% CI 0.790-0.964; p = 0.008) for log-transformed ferritin and 0.917 (95% CI 0.867-0.969; p = 0.002) for transferrin saturation. But no statical significance was found in the association of 1 SD unit increased total iron-binding capacity (TIBC) with anxiety disorders (OR 1.080; 95% CI 0.988-1.180; p = 0.091). The analyses were supported by pleiotropy test which suggested no pleiotropic bias. Our results indicated that genetically determined iron status biomarkers causally linked to the risk of anxiety disorders, providing valuable insights into the genetic research and clinical intervention of anxiety disorders.

Demographic Characteristics and Low Iron Status Markers Are Associated with Hemoglobin Levels and Anemia among Children Living at High Elevation in Cusco, Peru.

Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3-16 years of age attending public schools were invited to participate. We enrolled children 3-16 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (±3.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35-3,497) meters. The mean hemoglobin level was 15 (±1.15) mg/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2-3.6], P <0.001) and serum transferrin saturation (OR 2.8 [95% CI 2-3.9], P <0.001). Younger age (OR 0.85 [95% CI 0.82-0.89], P <0.001), stunting (OR 0.68 [95% CI 0.59-0.79], P <0.001), education of the mother (OR 0.94 [95% CI 0.91-0.98], P <0.005), and low eosinophils (OR 0.49 [95% CI 0.26-0.9], P = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.

Serum Iron Levels, Dietary Iron Intake, and Supplement Use in Relation to Metabolic Syndrome in Adolescents: A Cross-Sectional Study.

The objective of this study was to investigate the potential associations between serum iron levels, dietary iron intake, and iron supplementation, and the prevalence of metabolic syndrome (MetS) in adolescents A cross-sectional analysis was conducted, utilizing data from adolescents participating in the 2003-2018 cycle of the National Health and Nutrition Examination Survey (NHANES). Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) pertaining to serum iron, dietary iron, and iron supplementation were derived through multivariate logistic regression models. Additionally, a restricted cubic spline (RCS) regression model was applied to explore the nonlinear relationship between dietary iron and serum iron concerning MetS. The study encompassed 4858 American adolescents aged 12 to 19, among whom 413 (8.5%) manifested MetS. The study cohort exhibited an average age of 15.52years, comprising 2551 males (52.51%) and 2307 females (47.49%). Relative to individuals in the lowest serum iron quartile, those in the highest quartile for serum iron (OR = 0.33, 95% CI 0.21-0.50), the highest quartile for dietary iron (OR = 0.53, 95% CI 0.32-0.89), and those utilizing iron supplements (OR = 0.61, 95% CI 0.37-0.99) evinced a diminished prevalence of MetS, even post adjustment for potential confounding variables. A non-linear relationship was discerned between serum iron and MetS, exhibiting a statistically significant negative correlation when serum iron concentrations exceeded the inflection point (serum iron = 8.66µmol/L, P for nonlinear < 0.001). This investigation reveals that higher levels of serum iron, increased dietary iron intake, and the use of iron supplements are linked to a lower prevalence of MetS in US adolescents. These findings suggest that dietary modifications could play a role in promoting the health of adolescents.

Effect of laparoscopic mini gastric bypass versus laparoscopic single anastomosis sleeve ileal bypass on serum iron and calcium levels

Background Although bariatric surgery techniques are very effective in the treatment of obesity, they are usually associated with evident nutritional deficiencies. Such operations require ongoing medical care along with vitamin (Vit) and nutrition supplements. Aim Is to determine and compare the effect of Laparoscopic mini gastric bypass (MGB) versus laparoscopic single anastomosis sleeve ileal bypass (SASI) on serum iron and calcium levels. Methodology The current prospective Randomized controlled study included 62 patients who were randomly allocated into one of two equal groups. Group A (n=31) underwent MGB while group B (n=31) underwent SASI. Follow-up was designed for 6 and 12 months in both groups for the serum iron profile, serum folate, Vit B12, Vit D, parathyroid hormone, and calcium level. Results There was a statistically significant decrease in Excess weight loss (EWL)% in both groups after 1, 6, and 12 months and a significant EWL % in group A more than group B (P=0.045*). There was a statistically significant drop in the Iron profile components’ levels in both groups after 1, 6, and 12 months in comparison with the corresponding baseline levels. There was a statistically significant decrease in the calcium level as well as Vit D3 within both groups at 1, 6, and 12 months follow-up with a significant increase in Parathyroid hormone in both groups at the same interval of follow-up. Conclusion Both MGB and SASI are effective methods for the treatment of morbid obesity. However, adherent follow-up for the Iron profile, Vit B12, Vit D3, parathyroid hormone, and calcium levels are mandatory.

Evidence for genetic causality between iron homeostasis and Parkinson's disease: A two-sample Mendelian randomization study

BackgroundParkinson's disease (PD) is a degenerative disease of the central nervous system, and its specific etiology is still unclear. At present, it is believed that the main pathological basis is the reduction of dopamine concentration in the brain striatum. Although many previous studies have believed that iron as an important nutrient element participates in the occurrence and development of PD, whether there is a causal correlation between total iron binding capacity(TIBC), transferring saturation(TSAT), ferritin and serum iron in iron homeostasis indicators and PD, there has been a lack of effective genetic evidence. MethodsWe used Mendelian randomization (MR) as an analytical method to effectively evaluate the genetic association between exposure and outcome, based on the largest genome-wide association study (GWAS) data to date. By using randomly assigned genetic instrumental variables (SNPs, Single Nucleotide Polymorphisms) that are not affected by any causal relationship, we effectively evaluated the causal relationship between iron homeostasis indicators and PD while controlling for confounding factors. ResultsBy coordinated analysis of 86 SNPs associated with iron homeostasis markers and 12,858,066 SNPs associated with PD, a total of 56 SNPs were finally screened for genome-wide significance of iron homeostasis associated with PD. The results of inverse variance weighting(IVW) analysis suggested that iron（ β = - 0.524; 95%cl=-0.046 to −0.002; P=0.032) was considered to have a genetic causal relationship with PD. Cochran's Q, Egger intercept and MR-PRESSO global tests did not detect the existence of heterogeneity and pleiotropy (P>0.05). Mr Steiger directionality test further confirmed our estimation of the potential causal direction of iron and PD (P=0.001). In addition, TIBC (β=-0.142; 95%Cl=-0.197–0.481; P=0.414), TSAT (β=-0.316; 95%Cl=-0.861–0.229; P=0.255), and ferritin (β=-0.387; 95%Cl=-1.179–0.405; P=0.338) did not have genetic causal relationships with PD, and the results were not heterogeneous and pleiotropic (P>0.05). In addition, TIBC (β=-0.142; 95%Cl=-0.197–0.481; P=0.414), TSAT (β=-0.316; 95%Cl=-0.861–0.229; P=0.255), and ferritin (β=-0.101; 95%Cl=--0.987 to −0.405; P=0.823) did not have genetic causal relationships with PD, and the results were not heterogeneous and pleiotropic (P>0.05). TIBC (P=0.008), TSAT (P=0.000) and ferritin (P=0.013) were all consistent with the estimation of MR Steiger directivity test. ConclusionOur study found that among the four iron homeostasis markers, there was a genetic causal association between serum iron and PD, and the serum iron level was negatively correlated with the risk of PD. In addition, TIBC, TSAT, ferritin had no genetic causal relationship with PD.

Childhood asthma biomarkers including zinc: An exploratory cross-sectional study.

Childhood bronchial asthma (BA) is a chronic inflammatory respiratory disease. Nutritional conditions, including zinc deficiency, can affect such allergic disorders. To outline the difference in serum zinc levels between asthmatic children and healthy controls. A cross-sectional study was carried out at Children's Hospital, Cairo University, investigating serum zinc levels in children with BA (n = 40) and healthy children (n = 21). Other markers included serum ferritin, iron, hemoglobin (Hb), and immunoglobulin E (IgE) levels. Independent t-tests and Mann-Whinny tests were used for comparisons. The Kruskal-Wallis test was applied to compare serum ferritin and IgE levels with regard to asthma severity. Spearman's rank correlation was performed to explore the relationship between serum ferritin levels and both iron and Hb levels in asthmatic children. Children with BA had higher levels of zinc, yet the difference was not significant (P = 0.115). Serum ferritin and IgE levels were significantly higher in asthmatic children (P = 0.006 and 0.001, respectively), yet their levels did not differ significantly by severity (P = 0.623 and 0.126, respectively). There was a nonsignificant weak correlation between serum ferritin levels and both serum iron and Hb levels. Serum zinc levels do not seem to differ between asthmatic children and healthy children. Serum ferritin levels may be a marker of asthma control. Serum IgE levels are not markers of asthma severity.

TO EVALUATE THE RELATIONSHIP BETWEEN THYROID PROFILE AND IRON STATUS AMONG HYPOTHYROID PATIENTS

Objective: Iron deficiency is very commonly seen among hypothyroidism patients. The study aimed to find out the relationship between thyroid profile and iron status among hypothyroidism patients, whether it is interdependent or not. Methods: This retrospective study was conducted among hypothyroidism patients at the Department of Biochemistry, Government Medical College, Amritsar. One hundred study participants were included in this study. The study participants were divided into two groups. Fifty hypothyroidism patients served as cases and 50 normal healthy individuals as control. Serum thyroid-stimulating hormone (TSH), T3, and T4 levels and serum ferritin, iron, and TIBC levels were estimated and then compared between the two groups. Results: In our findings, 70% of the females were hypothyroidism patients. Hypothyroidism patients’ mean age±SD value was 37±15.1 whereas the healthy control group was 39±12.5. Most of the middle-aged people suffer from this disease, i.e., 52%. In this study, the levels of ferritin, and iron were found to decrease whereas that of TIBC increased in patients suffering from hypothyroidism as compared to healthy controls. Serum TSH levels were inversely correlated with ferritin. The levels of ferritin were found to be significantly decreased in patients as compared to controls. Conclusion: Thyroid hormone insufficiency may lead to a deficiency of iron and vice versa. Other factors such as oxidative stress may also play a role. Thus, iron the estimation using the above parameters may be useful during diagnosing and treating hypothyroid patients.

Assessing Iron Deficiency Anemia in Obese Adolescents and Identifying Contributing Factors

Objective: Clinical outcomes can be significant for obesity and iron deficiency, two public health issues for which adolescents are especially vulnerable. The aim of this study was to assess the iron parameters and blood vitamin B12 levels in obese adolescents and identify the contributing variables to the development of anemia. Material and Method: The present study involved a retrospective evaluation of 260 children (130 obese-130 control) who were admitted to the Ankara Pediatrics Haematology Oncology Training and Research Hospital, Pediatric Outpatient Clinics, between March 2013 and May 2015. Body mass index (BMI) above the 95th percentile for age and gender was required for inclusion in the study group, which included children aged 12 to 18 years without acute or chronic illnesses. Data from patient files were used to collect information on physical examination findings, sociodemographic characteristics, daily dietary status, and level of physical activity. All patients had evaluations for CRP, iron parameters, vitamin B12, and complete blood count. Results: The study revealed that the obese group had significantly higher serum ferritin levels (p=0.002) and lower serum iron and vitamin B12 levels (p=0.036 and 0.047, respectively) as compared to the control group. In the obese population, elevated BMI has been demonstrated to be correlated with elevated CRP levels. Conclusion: In obese children, low serum iron and high ferritin levels can be regarded as typical reference values. Furthermore, it was discovered that low vitamin B12 levels were not associated with nutrition in obese children, although they were at risk for developing low levels

Serum and tissue metallome of pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) patients have late presentation at the time of diagnosis and a poor prognosis. Metal dyshomeostasis is known to play a role in cancer progression. However, the blood and tissue metallome of PDAC patients has not been assessed. This study aimed to determine the levels of essential and toxic metals in the serum and pancreatic tissue from PDAC patients. Serum samples were obtained from PDAC patients before surgical resection. Tissue (tumor and adjacent normal pancreas) were obtained from the surgically resected specimen. Inductively coupled plasma-mass spectrometry (ICP-MS) analysis was performed to quantify the levels of 10 essential and 3 toxic metals in these samples. Statistical analysis was performed to identify dysregulated metals in PDAC and their role as potential diagnostic and prognostic biomarkers. Significantly decreased serum levels of magnesium, potassium, calcium, iron, zinc, selenium, arsenic, and mercury and increased levels of molybdenum were shown to be associated with PDAC. There were significantly decreased levels of zinc, manganese and molybdenum, and increased levels of calcium and selenium in the pancreatic tumor tissue compared with the adjacent normal pancreas. Notably, lower serum levels of calcium, iron, and selenium, and higher levels of manganese, were significantly associated with a poor prognosis (i.e., overall survival) in PDAC patients. In conclusion, this is the first study to comprehensively assess the serum and tissue metallome of PDAC patients. It identified the association of metals with PDAC diagnosis and prognosis.

Sex differences in serum trace elements and minerals levels in unmedicated patients with major depressive episode: The role of suicidal ideation

BackgroundWe aimed to examine the influence of gender on serum trace elements and minerals levels in depression, as well as the impact of suicidal ideation (SI) on these gender dimorphisms. MethodsA total of 260 unmedicated patients with a current major depressive episode were enrolled. The Beck Scale for Suicide Ideation was utilized to evaluate SI. The serum levels of copper, zinc, iron, calcium, phosphorus, and magnesium were quantified. ResultsWithin the non-SI (NSI) group, females exhibited higher levels of copper (p = 0.001) and phosphorus (p = 0.008), and lower levels of zinc (p = 0.022) and calcium (p = 0.008) compared to males. Conversely, no discernible gender disparities were observed in the SI group (all p > 0.05). Also, no group differences in these trace elements/minerals were observed between the SI and NSI groups (all p > 0.05). Notably, serum iron levels exhibited a significant group-by-sex interaction effect (p = 0.024). Further analysis revealed that iron levels were higher in the SI group than in the NSI group among females (p = 0.048), but lower in females than in males within the NSI group (p < 0.001). Moreover, a positive association between the fourth quantile of serum iron and SI was detected in females (odds ratio [OR] = 2.88, 95 % confidence interval [CI]: 1.08–8.11). ConclusionsGender effects on serum trace element/mineral levels were different in depressed patients with and without SI. Female patients were susceptible to SI when serum iron was at the upper end of normal.

Point Shear Wave Elastography Detected Liver Stiffness Increased in Pediatric Patient With Thalassemia Major.

Transient elastography (TE) and point shear wave elastography (pSWE) are 2 elastographic ultrasound examinations used in liver stiffness (LS) measurement. It was shown that the LS value detected by TE in pediatric β-thalassemia major patients has increased, and there was no LS evaluation obtained with pSWE in literature. Thus, in this study, it was aimed to evaluate LS with pSWE examination in children with thalassemia major and to determine LS-related parameters in these patients. Sixty-three schoolchildren with a diagnosis of β-thalassemia major and 21 healthy controls between the ages of 7 and 18 years were included. In addition to routine anamnesis, physical examination, and laboratory examinations, renal and liver ultrasounds were performed. Liver stiffness values were measured by pSWE examination. Serum levels of urea, aspartate-aminotransferase, alanine-aminotransferase, iron, and ferritin were significantly higher in patients, and serum creatinine, iron binding capacity, and hemoglobin levels were found to be significantly lower (P < 0.05 for each). Liver stiffness values were significantly higher in patients compared with healthy controls. In linear regression analysis, serum iron and iron binding capacity values were found to be closely related with LS (P < 0.001 vs. β = 0.482 and P = 0.047 vs. β = 0.237, respectively). Liver stiffness values obtained by pSWE examination increase significantly in patients. According to the results of our study, in addition to the previously known TE method, we think that the LS evaluation obtained by pSWE, a new method that can make more accurate measurements, can be used in the possible early detection of target organ damage in children with thalassemia major.

Associations of iron metabolism and inflammation with all-cause and cardiovascular mortality in a large NHANES community sample: Moderating and mediating effects

Background and aimsThis study aimed to assess the associations between serum iron concentration, C-reactive protein (CRP) concentration and the risk of all-cause mortality and cardiovascular mortality in the general population and to explore potential mediating and moderating effects. Methods and resultsThis study analyzed data from the National Health and Nutrition Examination Survey spanning the years 1999–2010, encompassing 23,634 participants. Cox proportional hazards regression models were employed to investigate the independent associations of serum iron and CRP with all-cause and cardiovascular mortality. Moderation and mediation analyses explored the moderating effect of CRP on the association between the serum iron concentration and all-cause and cardiovascular mortality, and the mediating role of the serum iron concentration in the association between the CRP concentration and all-cause and cardiovascular mortality. After multivariate adjustments in the Cox model, serum iron and CRP levels were independently correlated with both all-cause and cardiovascular mortality risk. Moderation analyses revealed a more pronounced correlation between the serum iron concentration and both all-cause and cardiovascular mortality in participants with higher CRP levels. Mediation analysis indicated that the serum iron concentration partly mediated the impact of CRP on the risk of all-cause mortality (13.79%) and cardiovascular mortality (24.12%). ConclusionSerum iron and CRP are independently associated with all-cause and cardiovascular mortality. Moreover, the associations between serum iron concentrations and both all-cause and cardiovascular mortality are more pronounced in individuals with elevated CRP. Serum iron partially mediates the effect of CRP on all-cause and cardiovascular mortality.

Neutrophil-to-Lymphocyte Ratio as a Potential Biomarker to Managing Type 2 Diabetes Mellitus and Predicting Disease Progression.

Introduction Diabetes is a chronic disease that causes dysregulation of blood glucose. Type 2 diabetes mellitus (T2DM) could result in long-term inflammatory conditions that affect different organs of the body. Despite the availability of diagnostic markers like glycated hemoglobin (HbA1c) for T2DM, it is essential to find an appropriate marker that could predict long-term complications. This study evaluates the potential role of neutrophil-to-lymphocyte ratio (NLR) in predicting disease progression and treatment responses. Methods This case-control study was carried out among 160 T2DM patients and 132 non-diabetic persons. Blood samples were collected from each participant and were processed for hemoglobin, HbA1c, iron, ferritin, and complete blood picture (NLR). Results The study showed that there was a significant variation in the serum levels of ferritin (264.8±611.6ng/ml versus 168.3±364.7 ng/ml, p=0.392), iron (4.095±8.851 mcg/dl versus 55.20±37.62 mcg/dl, p=0.0111), and HbA1c (8.169±1.635% versus 5.668±0.5260% p<0.0001) among T2DM patients compared to non-diabetic persons. The NLR values (4.189±4.154 versus 4.095±8.851, p=0.009) among patients with T2DM significantly varied with that of non-diabetic persons. A significant negative correlation was noticed between the serum levels of iron and NLR (r=-0.17, p=0.014) and a positive correlation was noticed between HbA1c and NLR (r=0.19, p=0.014). The serum levels of iron revealed a significant positive correlation with the serum levels of ferritin (r=0.24, p=0.002) and hemoglobin percentage (r=0.41, p=0.008). HbA1c revealed a significant positive correlation with NLR (r=0.19, p=0.014). Additionally, a significant negative correlation was observed between iron with NLR (r=-0.17, p=0.029) and hemoglobin percentage with NLR (r=-0.30, p=0.005). However, no such correlation was demonstrated among non-diabetic persons. With an accuracy of 89.85% and high sensitivity and specificity, NLR showed diagnostic accuracy like HbA1c. Conclusions NLR demonstrated equivalent efficacy to HbA1c in predicting glycemic control. Since diabetes affects different organs of the body, evaluating NLR probably predicts inflammation. Therefore, NLR could be useful in the management of T2DM and in predicting long-term complications.

ASSESSING IRON DEFICIENCY AS RISK FACTOR FOR FEBRILE SEIZURES IN CHILDREN BETWEEN SIX MONTHS AND FIVE YEARS OF AGE

This case-control study was conducted from September 2023 to December 2023 at the Department of Pediatrics in Pak Emirates Military Hospital, Rawalpindi. The study aimed to determine the relationship between iron deficiency and the development of febrile seizures in children. A total of 150 patients aged between 1 and 6 years, with a history of febrile seizures and currently suffering from pyrexia, were included in the study. Children with a history of recent febrile seizures, structural/organic brain lesions, congenital metabolic/chromosomal anomalies, non-febrile seizures, delayed milestones, or those who were on medications that altered serum iron levels within the past six months were excluded. All participants were assessed for serum iron, ferritin, total iron binding capacity, magnesium, zinc, and calcium at enrollment. Patients were observed for the development of febrile seizures until they were afebrile for twenty-four continuous hours. Of the total sample, the mean age was 3.41 ± 1.51 years, and 83 (55.3%) were male. Patients with a transferrin saturation below 6.5% had a higher adjusted odds ratio (aOR) of 3.96 (CI 95% 1.29 – 12.18, p=0.016) for developing febrile seizures during a pyrexial illness. Similarly, patients with hypozincaemia, defined as a serum zinc level &lt;65 μg/dL, had an aOR of 2.54 (CI 95% 1.13 – 5.67, p=0.023). The study concluded that low serum levels of iron were associated with a higher risk of developing febrile seizures in pyrexial children with a history of the disorder.