Risk Factors For Iron Deficiency Anemia Research Articles

Iron deficiency anemia in pediatric children at Kalmunai North Base Hospital, Sri Lanka

<b>Objective:</b> This study's aim was to estimate association between the iron deficiency anemia (IDA) and associated risk factors among children at Kalmunai north in Sri Lanka during COVID-19. <b>Material and Methods: </b>During the pandemic, 101 children aged between 1and 14 years were involved in the cross sectional study. Hemoglobin levels, serum ferritin and C-recactive protein (CRP) were measured to determine anemia. Additionally, dietary intake, socioeconomic status, and demographic information were collected through interviews with the caregivers. Chi-square tests and Pearson correlation were used to investigate connections between IDA and other factors such as demographic characteristics and eating habits. In addition, a multivariate regression analysis was performed to identify independent predictors of IDA. <b>Results:</b> 7.9% of children were found to be anemic at Kalmunai Base Hospital. Low dietary iron consumption was revealed as a significant risk factor for IDA. Meat, liver, fish, chicken, fresh milk, dark green leafy vegetables, and black tea were found to be independent predictors of IDA, explaining 57.7% of the variation in IDA frequency (R<sup>2</sup> value = 57.7%; P< 0.001). Consuming dark green leafy vegetables, poultry, liver, beef, and fish are linked to a lower incidence of IDA in children. On the other hand, a higher risk of IDA appears to be associated with increased consumption of fresh milk and black tea. In conclusion, this study focuses on Dietary factors, especially the consumption of particular foods, were found to be significant contributors of IDA, even if demographic parameters did not differ significantly from IDA. Strategies to increase iron intake and dietary diversity, particularly among young children, are critical in the fight against IDA.

Effect of Iron Polymaltose Complex Prophylaxis on Frequency of Iron Deficiency and Iron Deficiency Anemia.

To evaluate the effectiveness of national iron prophylaxis policy in 9-12 mo-old infants in Turkey. This study was planned as a cross-sectional study, and it included healthy infants aged 9 to 12 mo who presented to the pediatric outpatient clinic for routine check-ups. Parents were interviewed to identify risk factors for iron deficiency (ID) and gather information on Fe+3- iron polymaltose complex (IPC) prophylaxis usage. Blood samples were collected for hemogram and ferritin analysis. Multiple logistic regression analyses were conducted to determine risk factors for ID and iron deficiency anemia (IDA). The study included 317 infants. In the non-prophylaxis group, the frequency of IDA was 31.1%, compared to 13.4% in the regular prophylaxis group. Iron deficiency was detected in 25% of individuals receiving regular prophylaxis and 13.1% of those without prophylaxis. The risk factors for IDA were insufficient iron diets (OR 2.45, 95% CI: 1.35-4.45) and not receiving Fe+3 - IPC prophylaxis (OR 2.57, 95% CI: 1.24-5.31). The relationship between Fe+3-IPC prophylaxis and ID did not reach statistical significance (p = 0.253). Fe+3- IPC prophylaxis is associated with a lower risk of iron deficiency anemia, but not iron deficiency.

Is use of a long-term proton pump inhibitor or histamine-2 receptor antagonist a risk factor for iron-deficiency anaemia in Taiwan? A neglected clinical drug-drug interaction.

Proton pump inhibitors (PPIs) and histamine-2 receptor (H2) antagonists change the gastric pH and reduce the intestinal absorption of nonheme iron. Case reports and case-control studies have demonstrated that absorption of iron is affected by gastric acidity, but the clinical importance of these drug-drug interactions has remained uncertain. The present case-control study employed 2 million longitudinal claims in 2011-2018 in the Taiwan National Health Insurance Research Database to investigate the impact of PPIs/H2 antagonists on the occurrence of iron-deficiency anaemia (IDA). The present study retrospectively compared exposure to PPIs/H2 antagonists for 1 year among 5,326 cases with IDA and 21,304 matched controls. The postdiagnosis prescribing pattern was also calculated to understand current practice. Long-term (≥2 month) use of PPIs/H2 antagonists resulted in a higher risk of developing IDA than noncontinuous use/nonuse of those drugs (adjusted odds ratio [aOR] = 2.36, 95% confidence interval [CI] = 1.94-2.86, P < 0.001). There were significant changes in the postdiagnosis prescribing patterns of PPIs/H2 antagonists. The risk of developing IDA remained significant in the female subgroup (aOR = 2.16, 95% CI = 1.73-2.70, P < 0.001) and was even more prominent in those aged ≥ 50 years (aOR = 2.68, 95% CI = 1.94-3.70, P < 0.05). This study found that long-term use of PPIs/H2 antagonists increased the risk of developing IDA, and there was strong evidence of prescription pattern adjustments postdiagnosis. Physicians and pharmacists should be aware of this risk when patients are expected to take or have been taking PPIs/H2 antagonists for the long term.

Frequency of iron deficiency anemia in type 2 diabetes - Insights from tertiary diabetes care centres across India

AimTo study the frequency of iron deficiency anemia (IDA) in individuals with type 2 diabetes mellitus (T2DM) seen at tertiary diabetes care centres across India. MethodsThis is a retrospective study (January 1, 2017–December 31, 2019), which included 1137 individuals with T2DM, aged ≥18 years, for whom data on glycemic, lipid and haematological parameters were available. Anthropometric measurements were done using standardized techniques. Biochemical investigations included fasting plasma glucose[FPG], post prandial plasma glucose, HbA1c, lipids and serum ferritin and iron wherever feasible. ResultsOf the 1137 individuals included for the study, 117 (10.3%) were categorized as no ‘iron deficiency’ (ID) group [normal hemoglobin: male ≥13 g/dl, female ≥12 g/dl and normal serum ferritin ≥70 μg/L], 123 (10.8%) as ID group [normal hemoglobin and low serum ferritin <70 μg/L)], 447 (39.3%) as IDA group [low haemoglobin: male <13 g/dl, female <12 g/dl and low serum ferritin] and 450 (39.6%) as ‘anemia of chronic disease’ (ACD) group [low hemoglobin and normal serum ferritin]. The percentage of women having ID (57.7%) and IDA (65.3%) was significantly higher than their male counterparts. ID was most prevalent (61.7%) in the individuals with duration of diabetes <5 years whereas ACD was most prevalent (50.5%) in individuals with long standing diabetes (>10 years). Independent risk factors for IDA were female gender (OR 3.3,95% CI:1.75–6.23, p < 0.001), duration of diabetes (OR 1.05, 95% CI 1.01–1.11, p = 0.028) and FPG (OR 1.01, 95% CI 0.99–1.00, p = 0.018). ConclusionsThere is a need of identifying and monitoring iron status and anemia in patients with T2DM.

Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies.

Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0–5-year-old children and young women of childbearing age, especially during pregnancy. Iron deficiency can lead to life-threatening loss of red blood cells, muscle function, and energy production. Therefore, the pathogenic features associated with IDA are weakness and impaired growth, motor, and cognitive performance. IDA affects the well-being of the young generation and the economic advancement of developing countries, such as India. The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA. However, numerous strategic programs aimed to increase iron intake have shown that improvement of iron intake alone has not been sufficient to mitigate IDA. Emerging critical risk factors for IDA include a composition of cultural diets, infections, genetics, inflammatory conditions, metabolic diseases, dysbiosis, and socioeconomic parameters. In this review, we discuss numerous IDA mitigation programs in India and their limitations. The new multifactorial mechanism of IDA pathogenesis opens perspectives for the improvement of mitigation programs and relief of IDA in India and worldwide.

Risk factors for iron-deficiency anemia in infants aged 6-12month old

Background: Even though the frequency of iron deficient anemia has declined in the last years, It has been the most prevalent nutritional deficit in the world. Objective: To evaluate the prevalence and etiology due to iron shortage anemia in 6- to 12-month-old babies. Patients and method: This study is a hospitalized-based study performed in a central teaching hospital in Baghdad, from 1st March 2021 to 1st February 2022, to assess the incidence also underlying causes of IDA in infants between six months and 12m of age. full history was taken from the mothers, an assessment of nutritional status done to all cases. Infants (n=133) had their mean corpuscular volume, hemoglobin, Evaluation of serum ferritin, serum iron, also total iron-binding capability. Anemia was defined as hemoglobin levels below 10.5 g/L, serum ferritin levels below 12µg/L, then iron deficiency as ferritin levels also mean corpuscular volume below 74 fL, respectively, or serum iron below 9µmol/l and TIBC more than 50µmol/l. Results: Iron deficiency prevalence was 27,3 percent and iron deficiency anemia prevalence were 24,2 percent. Less than 3000 grams at birth was the most significant risk factor for iron insufficiency (P&lt;0.0001).

Prevalence and Associated Risk Factors of Iron Deficiency Anemia Among School Teenagers in Mbouda, Western Cameroon: A Cross Sectional Study

Teenagers are a particularly vulnerable age group to Iron Deficiency Anemia (IDA). This study aimed to determine the prevalence and associated risks factors of IDA among apparently healthy school teenagers in Mbouda, West-Cameroon. Blood samples, up to 778 were randomly collected from adolescents aged 10-19 years of four schools in Mbouda. For this cross-sectional study, participants collaborated to fill a questionnaire with us on socio-economic and demographic status. The methods of 24 hours recall, and dietary history were used to determine the dietary habits, the type of food and the consumed meal frequencies during a day. Appropriate indicators including hemoglobin and hematocrit, serum iron, ferritin, transferrin, and total iron binding capacity, transferrin saturation were determined using standard methods. Our findings showed that the prevalence of IDA was 82.4 % and 17.64 % in participants aged 13-19 years and 10-12 years respectively. High significant difference in the mean values of Serum Iron (p = 0.001), Serum ferritin (p&lt;0.001), TIBC (p&lt;0.001), CST (0.001) and Hemoglobin (p&lt;0.001, CI = 2) were observed in participants without IDA compared to those with IDA. The sociodemographic risk factors of IDA in school adolescents were sex [P = 0.001, OR = 0.39 (0.22–0.69)], residence areas [P = 0.001, OR = 3.30 (1.55–7.02)] and school sites [P = 0.002]. Consumption of vegetable [OR: 0.30 (0.17–0.54)], fruits, [OR: 0.26 (0.12–0.52)] and fats [OR: 0.33 (0.12–0.91)] significantly decreased the risk of IDA (p &lt;0.05), whereas the consumption of legumes [OR: 2.60 (1.57–4.32)] significantly increased the risk of IDA. This study suggested that IDA could be prevented by providing proper knowledge on the healthful diet including fats animal food sources, fruit and vegetables, improved lifestyle, and on the harmful effects of IDA to the teenager’s productivity.

Prevalence of Iron Deficiency Anemia among Adolescent School Children of Manipur, India

Background: Iron deficiency anemia (IDA), one of the most common types of nutritional anemia worldwide is considered a major public health problem in developing countries. Prevalence in India remains alarmingly high. Population of Manipur, a small state in the north-eastern part of India, is different with distinct race, culture, socio-demographic pattern and dietary habits. Therefore, this cross-sectional study was conducted to determine the prevalence and risk factors of IDA among apparently healthy school children of Manipur, India.&#x0D; Methods: Three hundred and seventy-nine blood samples (163 males and 216 females) were collected randomly from urban and rural school children in the age group of 13 to 19 years from Imphal west and Thoubal districts of Manipur respectively. Eligible participants were subjected to haemoglobin (Hb) estimation and serum ferritin (SF) assay. Moreover, a questionnaire was designed to collect demographics, food and drink habits, hygienic practices and socioeconomic status. BMI of the students were also recorded.&#x0D; Results: The overall prevalence of IDA was 23.2% (n = 88), of whom 81.81% were females (n = 72) and 18.18% were males (n = 16). Prevalence of IDA among the males and females was higher in the rural compared to urban schools but not statistically significant. Correlation between BMI and Hb was significant (p &lt; 0.05) but not with serum ferritin status. Students belonging to the middle income group had the highest prevalence of ferritin deficiency followed by the high income group and low income group respectively. Both the Hb and serum ferritin levels of students who do hand wash before meals were significantly higher than those who do not. Both hemoglobin and serum ferritin levels do not differ significantly among students who prefer home-made traditional food and junk food.&#x0D; Conclusion: This study revealed that the majority of the students, especially females, have IDA that might become worse by malnutrition, lifestyle habits, and lack of awareness. Our results suggest that IDA can be prevented by providing proper knowledge on the healthful diet, improved lifestyle, and harmful effect of IDA to the students.

The Prevalence and Risk Factors of Iron Deficiency Anemia in Thai Infants by Complete Blood Count at 9-Month-Old

Background: Infants are the most at risk from iron deficiency (ID) and iron deficiency anemia (IDA), but the prevalence of the latter in this group is unclear. Estimation as to the prevalence of IDA using Hb of less than 11 g/dL may have been exaggerated due to thalassemia and hemoglobinopathies. On the other hand, iron studies are costly and not routinely available in low resource settings. In the present research, the authors estimated the prevalence of IDA in 9-month-old infants at the authors’ well-baby clinic by improving the post-iron-treatment criteria of Hb and defined the risk factors of IDA in infants. Objective: To estimate the prevalence of IDA in 9-month-old infants at the well-baby clinic and to define the risk factors of IDA. Materials and Methods: A retrospective cohort study of 391 children who had complete blood count (CBC) screening at 9-month-old at the well-baby clinic. Anemia was defined according to the WHO criteria (hemoglobin of 11 g/dL or less for children aged six months to five years). IDA was defined as an increase of at least Hb 1 g/dL after receiving iron treatment for one to two months. Mean levels of hematological parameters were compared between groups using independent samples t-test. The characteristics with potential risk factors for IDA were compared with iron non-responder and normal group. Multivariable adjusted odd ratios and 95% confidence intervals (CIs) of IDA were calculated using multinomial logistic regression with control for risk factors. Results: One hundred fourteen children (29.1%) were anemic. There was no difference between anemic and non-anemic children in baseline characteristics. Seventy children in the anemic group were diagnosed with IDA. The prevalence of IDA in the present study was 17.9%. The IDA group showed significant improvement in Hb, Hct, MCV, MCH after receiving iron treatment, but there were no significant changes in the iron non-responder group. The risk factor for IDA was exclusive breastfeeding for at least six months (odds ratio 3.14, 95% CI 1.67 to 5.90, p&lt;0.001). Conclusion: The prevalence of IDA and anemia in the present study was 17.9% and 29.1%, respectively. The risk factor for IDA was exclusive breastfeeding for at least six months. Keywords: Anemia, Iron deficiency anemia, Prevalence of anemia in infants, Complete blood count screening, Thai infants

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy.

Iron deficiency and iron-deficiency anemia (IDA) affects approximately two billion people worldwide, and most of them reside in low- and middle-income countries. In these nations, additional causes of anemia include parasitic infections like malaria, other nutritional deficiencies, chronic diseases, hemoglobinopathies, and lead poisoning. Maternal anemia in resource-poor nations is associated with low birth weight, increased perinatal mortality, and decreased work productivity. Maintaining a normal iron balance in these settings is challenging, as iron-rich foods with good bioavailability are of animal origin and either expensive and/or available in short supply. Apart from infrequent consumption of meat, inadequate vitamin C intake, and diets rich in inhibitors of iron absorption are additional important risk factors for IDA in low-income countries. In-home iron fortification of complementary foods with micronutrient powders has been shown to effectively reduce the risk of iron deficiency and IDA in infants and young children in developing countries but is associated with unfavorable changes in gut flora and induction of intestinal inflammation that may lead to diarrhea and hospitalization. In developed countries, iron deficiency is the only frequent micronutrient deficiency. In the industrialized world, IDA is more common in infants beyond the sixth month of life, in adolescent females with heavy menstrual bleeding, in women of childbearing age and older people. Other special at-risk populations for IDA in developed countries are regular blood donors, endurance athletes, and vegetarians. Several medicinal ferrous or ferric oral iron products exist, and their use is not associated with harmful effects on the overall incidence of infectious illnesses in sideropenic and/or anemic subjects. However, further research is needed to clarify the risks and benefits of supplemental iron for children exposed to parasitic infections in low-income countries, and for children genetically predisposed to iron overload.

Iron Deficiency Anemia among Children during Weaning

Background: Iron-deficiency anemia (IDA) presents a significant burden in infancy and childhood. Also in infancy and early childhood is causally associated with growth and developmental delay. Aim: Assess iron deficiency anemia among children during weaning. Study design: A descriptive analytical study was utilized in study. Setting: the study conducted at three maternal and child health centers in Shoubra El Khemia (Begam MCH, Osman MCH, Nopar MCH). Sampling: 500 mother and their children were selected randomly from maternal and child health centers .Tools: First tool; an interviewing questionnaire to assess. demographic data, mothers' knowledge, mothers' practice risk factors of iron deficiency anemia during weaning among children .and health needs among children with iron deficiency anemia during weaning. Second tool; Medical follow up record to assess health status of the children with iron deficiency anemia. Third tool; Assessment of children according to Denver Developmental Screening Test (Denver scale). Results: there were more four fifth of the studied mothers had unsatisfactory knowledge about iron deficiency anemia during weaning among their children, and had inadequate practices toward prevention, above half of children suffered from diarrheal disease. and had respiratory tract infection. Also more than three fifth of them had poor level of health needs achievement. Conclusion: There was a highly statistical significant relation between mothers' knowledge and practices about iron deficiency anemia during weaning. Also, there was statistically significant relation between mothers' practices and their socio-demographic characteristics as mothers' age and educational level. Recommendations: Further research studies are needed for ongoing assessment of children including large sample for generalization of results.

Prevalence of Iron-deficiency anemia and its associated risk factors in female undergraduate students at prince sultan military college of health sciences

OBJECTIVES: This study's objectives are to (1) determine the current prevalence of iron-deficiency anemia (IDA) and risk factors for female college students at Prince Sultan Military College of Health Sciences (PSMCHS) in the Eastern Province of Saudi Arabia and (2) address the gap in the current literature. A written survey in both Arabic and English was administrated to 214 female students, and only 201 students completed the survey. It was randomly selected from all registered female students. A number of factors possibly associated with IDA were examined using the Chi-square test. CONTEXT: Globally, iron deficiency is known to be the most common nutritional disorder. About 30% of the world's population are iron deficient (ID). Women seem to be more affected with IDA than men, which constitute an epidemic public health issue. AIMS: The aim of the study was to determine the prevalence of IDA and the risk factors among healthy Saudi undergraduate female college students studying at PSMCHS in Dhahran. SETTINGS AND DESIGN: A cross-sectional study on 201 female students (18–25 years) was conducted between January and March 2019. SUBJECTS AND METHODS: A questionnaire which contains sociodemographic data was completed by each participant. Two blood samples were collected from each participant to estimate the iron profile and to analyze the complete blood counts. STATISTICAL ANALYSIS: The statistical analysis was carried out using the Statistical Packages for the Social Sciences software. RESULTS: The overall prevalence of IDA was 35.3%. The questionnaire analysis of the dietary habit and clinical characteristics revealed that family history of hereditary disease and physical activity have a significant effect on the development of IDA. Statistical analysis showed that having breakfast regularly significantly reduced the development of IDA compared with irregularly having breakfast. CONCLUSIONS: The prevalence of IDA in this study was moderately high, and our results suggest that further education regarding IDA is highly encouraged. This is the first study that demonstrated the prevalence and risk factors of IDA among undergraduate female college students in PSMCHS, and the data generated will provide a database for further studies.

The role of TMPRSS6 gene variants in iron-related hematological parameters in Turkish patients with iron deficiency anemia

TMPRSS6 gene mutations can result in iron deficiency anemia (IDA) and cause an increased iron-regulatory hormone, hepcidin, levels. TMPRSS6 encodes a serine protease, matriptase-2, which functions as negative regulatory protein of hepcidin transcription. Thus, TMPRSS6 variations might be risk factors for IDA. The aim of the study was to investigate the association of rs855791, rs4820268, rs5756506, rs2235324, rs2413450, rs2111833, rs228919, and rs733655 SNPs in TMPRSS6 gene with IDA susceptibility and iron-related clinical parameters. The study consisted of 150 IDA patients and 100 healthy controls. We analyzed the genotype distributions by using Real-Time polymerase chain reaction (Real-Time PCR) technique. We did not find any statistically differences for all SNPs between patients and controls (P > 0.05). In IDA patients, variations rs855791 and rs2413450 were associated with increased RBC (P = 0.03) and TIBC (P = 0.04), respectively. Also, increased of TIBC for rs4820268 (P < 0.05). On the other hand, in control group, rs5756506 was associated with two parameters, Hb (P = 0.02) and Hct (P = 0.03). We did not find markedly hepcidin levels in IDA patients compared to controls (P = 0.32). Our findings suggest that TMPRSS6 variations may not be risk factors for IDA. However, TMPRSS6 polymorphisms are associated with increased many iron-related hematological parameters.

The Prevalence and Predictors of Iron Deficiency Anemia among Rural Infants in Nablus Governorate.

Iron deficiency anemia (IDA) in infants and young children remains a significant public health problem in most developing countries. IDA had short and long-term adverse impacts on infants' health and development. We aimed to assess the frequency of IDA and associated risk factors among infants aged between 9-12 months in rural areas of Nablus Governorate. A cross-sectional study. The study was conducted between Jan and Mar 2015. A random sample of 654 infants aged 9-12 months were selected from thirty villages in Nablus Governorate, Central Highlands of the West Bank, north of Jerusalem. Data were collected using pre-designed structured interviewing questionnaire, complete blood count analysis and anthropometric measurements were done. The prevalence of anemia and IDA among infants was 34.6%, and 32.6%, respectively. Predictors of IDA were increased in infants' age OR=1.19 (95% CI: 1.02, 1.40), maternal anemia during the third trimester OR=2.39 (95% CI: 1.55, 3.71), birth spacing less than three years OR=2.86 (95%CI: 1.58, 5.18), exclusive breastfeeding during the first six months OR=2.40 (95% CI: 1.46, 3.95), early OR=1.64 (95%CI: 1.03, 2.613) and late introduction of complementary feeding OR=2.26 (95% CI: 1.27, 4.05), and non-compliance to iron supplement in the correct frequency and duration during pregnancy OR=1.81 (95% CI: 1.19, 2.75). Different dietary and non-dietary risk factors for IDA should be considered for any intervention aimed to reduce the prevalence of IDA among infants.

Unexplained iron deficiency anemia: does Helicobacter pylori have a role to play?

Background and aimTesting for Helicobacter pylori (Hp) infection is recommended for work-up of unexplained iron deficiency anemia (IDA), although the evidence supporting this recommendation is scant. The aim of this study was to investigate the association between Hp infection and unexplained iron deficiency (ID) or IDA in the older adult population without significant upper gastrointestinal source of blood loss.MethodsRetrospective single-center cohort study; 523 out of 1253 consecutive patients who underwent esophagogastroduodenoscopy with no significant upper and/or lower gastrointestinal source for blood loss or risk factors for IDA. Comparisons were made between the Hp-positive and Hp-negative groups using Fisher exact test, chi-square test and Student’s t-test. Univariate and multiple logistic regression analyses were used to identify significant risk factors associated with ID and IDA.ResultsOne hundred and three subjects (19.7%) had Hp infection and 420 (80.3%) were negative for Hp. Sixty-eight (22.1%) out of 307 subjects with available serum iron profile had unexplained ID and 28 (5.4%) out of 510 subjects with available hemoglobin profile had unexplained IDA. No association was found between ID/IDA and Hp infection in univariate and multiple logistic regression analyses.ConclusionWe found no association between unexplained ID or IDA and Hp infection in older adult population without peptic ulcer disease or significant upper gastrointestinal source of blood loss.

Prevalence and risk factors of iron-deficiency anemia in Saudi female medical students

Introduction: Iron-deficiency anemia (IDA) is quite common in female adolescents and adults worldwide. Despite the higher prevalence of IDA, there is a paucity of research in finding its prevalence and potential causes in young Saudi female population. Thus, the aim of this study was to determine the prevalence and possible causes of IDA in young female medical students and search for risk factors in the studied group. Materials and Methods: One hundred and twenty female students from Imam Abdulrahman Bin Faisal University were selected by randomized sampling whose blood samples were taken to measure their hemoglobin (Hb) and serum ferritin levels. According to the World Health Organization criteria, individuals with Hb 0.05) was found between IDA and the background, gynecological history, and dietary habits of the anemic participants. Conclusions: The higher prevalence rate of anemia among Saudi female medical students (38.3%) was similar to the earlier reports of the Gulf region. Considering the higher ratio of anemic students, iron supplements should be prescribed to the affected youngsters to improve their Hb level.

Anemia after biliopancreatic diversion

At present, biliopancreatic diversion (BPD) is one of the most effective surgery for the treatment of morbid obesity. However, long-term complications, including different types of anemia are known to occur after such intervention. Objective of the study. To investigate pathogenetic mechanisms of anemia and clinical condition of the patients undergone BPD taking into account risk factors of anemia development, its therapy and prevention. Material and methods. Eighty patients who had undergone BPD surgery were included in the study. Postoperative oral administration of iron medications (IMs) was recommended to all patients. 49 of them regularly received IMs, 31 patients were not given IMs or took them for no more than 2 months after surgery. The follow-up was 3-7 years. Results. A reliable decrease of hemoglobin levels was observed in all patients after BPD. This reduction began as early as month 3 after surgery and progressed during the 7 year follow-up. Iron deficiency anemia (IDA) was diagnosed in 30% of the patients after BPD. Mean levels of hemoglobin, ferritin and serum iron after BPD were significantly lower in patients having risk factors of IDA as well as in patients not receiving iron therapy. Iron deficiency anemia was revealed in 33.3% of the patients regularly receiving IMs in doses containing 100 mg elemental iron per day. There was no significant decrease of vitamin B12 and folic acid levels during 7 years of follow-up. Only one case (1.25%) of B12 deficiency anemia was registered. Normochromic normocytic anemia characterized by normal serum iron and increased ferritin and C-reactive protein levels, was diagnosed after BPD in 7.85% of the patients. Conclusion. BPD surgery is the important risk factor of anemia (especially IDA) development. In compliant patients. Continuous intake of IMs makes up for iron deficiency but in some others IDA occurred despite regular IMs administration. Normochromic normocytic anemia after BPD may be due to chronic inflammation.

Screening and Treatment for Iron Deficiency Anemia in Women: Results of a Survey of Obstetrician-Gynecologists.

Objective To better understand the knowledge, attitudes and practices of obstetrician-gynecologists with respect to screening and treatment for iron deficiency anemia (IDA). Methods A total of 1,200 Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists were invited to participate in a survey on blood disorders. Respondents completed a questionnaire regarding their patient population, screening and treatment practices for IDA, and general knowledge about IDA and its risk factors. Results Overall response rate was 42.4%. Thirty-eight percent of respondents screen non-pregnant patients regularly, based on risk factors; 30.5% screen only when symptoms of anemia are present. For pregnant patients, 50.0% of respondents screen patients at their initial visit, while 46.2% screen every trimester. Sixty-one percent of respondents supplement pregnant patients when there is laboratory evidence of anemia; 31.6% supplement all pregnant patients. Forty-two percent of respondents screen post-partum patients based on their risk factors for IDA. However, when asked to identify risk factors for post-partum anemia, slightly more than half of respondents correctly identified young age and income level as risk factors for post-partum anemia; only 18.9% correctly identified pre-pregnancy obesity as a risk factor. Conclusion There are opportunities for increased education on IDA for obstetrician-gynecologists, specifically with respect to risk factors. There also appears to be substantial practice variance regarding screening and supplementation for IDA, which may correspond to variability in professional guidelines. Increased education on IDA, especially the importance of sociodemographic factors, and further research and effort to standardize guidelines is needed.

Breastfeeding and Red Meat Intake Are Associated with Iron Status in Healthy Korean Weaning-age Infants.

The present study investigated risk factors for iron deficiency (ID) and iron deficiency anemia (IDA) during late infancy, including feeding type and complementary feeding (CF) practice. Healthy term Korean infants (8–15 months) were weighed, and questionnaires regarding delivery, feeding, and weaning were completed by their caregivers. We also examined levels of hemoglobin, serum iron/total iron-binding capacity, serum ferritin, and mean corpuscular volume (MCV). Among 619 infants, ID and IDA were present in 174 infants (28.1%) and 87 infants (14.0%), respectively. The 288 infants with exclusively/mostly breastfeeding until late infancy (BFL) were most likely to exhibit ID (53.1%) and IDA (28.1%). The risk of ID was independently associated with BFL (adjusted odds ratio [aOR], 47.5; 95% confidence interval [CI], 18.3–122.9), male sex (aOR, 1.9; 95% CI, 1.2–2.9), fold weight gain (aOR, 2.6; 95% CI, 1.5–4.6), and perceived inadequacy of red meat intake (aOR, 1.7; 95% CI, 1.0–2.7). In addition to the risk factors for ID, Cesarean section delivery (aOR, 1.9; 95% CI, 1.1–3.2) and low parental CF-related knowledge (aOR, 2.8; 95% CI, 1.5–5.2) were risk factors for IDA. In conclusion, prolonged breastfeeding and perceived inadequacy of red meat intake may be among the important feeding-related risk factors of ID and IDA. Therefore, more meticulous education and monitoring of iron-rich food intake, such as red meat, with iron supplementation or iron status testing during late infancy if necessary, should be considered for breastfed Korean infants, especially for those with additional risk factors for ID or IDA.

The concern of iron-replacement therapy on hepatocellular carcinoma in a patient with mild anemia

Background and Objective: Anemia is very common in cancer patients with many etiologies. Palliative care patients also have a number of risk factors for iron-deficiency anemia. Prescribers of iron-replacement therapy often overlook that iron-loading can negatively affect the cancer prognosis. Methods and results: A 66-year-old male was diagnosed with hepatitis B virus-related hepatocellular carcinoma (HCC). After resection, he received the transarterial chemo-embolization (TACE) and radiofrequency ablation (RFA) on the recurred HCC. He was also diagnosed with renal cell carcinoma (RCC), and received RFA. Meanwhile, his hemoglobin level was slightly low (11.0 g/dL). After 21 months, his HCC recurred, together with a significant rise in blood hemoglobin level from 11.0 to 15.0 g/dL due to oral iron supplementation. Further TACE was recommended but refused by the patient. Only after discontinuation of the iron supplement, the follow-up MRI scans did prove that the recurrent tumor improved as the hemoglobin level returned to 11.0 g/dL. His disease is currently stable. Conclusion: Iron-replacement therapy should not be indiscriminately prescribed to all cancer patients with anemia. Further studies about the effect of mild iron deprivation on survival in the palliative care population are necessary since mildly low hemoglobin index can be beneficial to the prognosis of HCC in this case. DOI:10.3781/j.issn.1000-7431.2016.24.569