Risk Of Iron Deficiency Anemia Research Articles

Compliance with weekly iron folic acid supplementation and associated factors among secondary school adolescent girls, in Jimma Arjo District, West Ethiopia, 2022: A mixed method cross-sectional Study

Background: Iron deficiency anemia is a prevalent and major public health problem in low- and middle-income countries among adolescent girls. The risk of Iron deficiency anemia and its consequences are prevented by taking and complying with a weekly iron-folic acid supplement. However, there was no information regarding compliance and its associated factors in Ethiopia. The study aimed to determine the magnitude of compliance with weekly Iron-folic acid supplementation and associated factors among Jimma Arjo secondary school adolescent girls. Methods: Institutional-based cross-sectional study was conducted on 417 adolescent girls in three secondary schools of Jimma Arjo, West Ethiopia from March 1st to 31st, 2022 using interviewer-administered structured and semi-structured questionnaires. Bivariable and multivariable logistic regression analyses were used to determine the association of variables. Results: Compliance with iron-folic acid supplementation was 29.3% with 95% CI (24.9, 33.3). Mother`s secondary level of education (AOR=4.94 (95% CI:2.45,9.94)), awareness of anemia (AOR=4.23 (95% CI:2.35,7.61)), good knowledge about iron-folic acid supplementation (AOR=3.96 (95% CI:2.17,7.22)), lack of iron-folic acid supplementation (AOR=0.42 (95% CI:0.23,0.75)), and iron-folic acid supplementation side effects (AOR=0.17 (95% CI:0.08,0.37)) were factors significantly associated with iron-folic acid supplementation compliance. Misconceptions about iron-folic acid supplementation, forgetfulness of tablet, lack of access to drinking water, and irregularity of school weekly iron-folic acid supplementation days were identified as the main barriers to adolescent girls' compliance with iron-folic acid supplementation in a qualitative study. Conclusions: Weekly iron-folic acid supplementation compliance was low at 29.3%. Scheduled health education, parental participation in the program, access to drinking water, refresher training for school focal persons, and fixed weekly iron-folic acid supplementation days can improve compliance with iron-folic acid supplementation and are recommended.

Pre- and Postnatal Vitamin A Deficiency Impairs Motor Skills without a Consistent Effect on Trace Mineral Status in Young Mice

Pregnant women and children are vulnerable to vitamin A deficiency (VAD), which is often compounded by concurrent deficiencies in other micronutrients, particularly iron and zinc, in developing countries. The study investigated the effects of early-life VAD on motor and cognitive development and trace mineral status in a mouse model. C57BL/6J dams were fed either a vitamin A-adequate (VR) or -deficient (VD) diet across two consecutive gestations and lactations. Offspring from both gestations (G1 and G2) continued the same diets until 6 or 9 weeks of age. Behavioral assays were conducted to evaluate motor coordination, grip strength, spatial cognition, and anxiety. Hepatic trace minerals were analyzed. A VD diet depleted hepatic retinoids and reduced plasma retinol across all ages and gestations. Retracted rear legs and abnormal gait were the most common clinical manifestations observed in VD offspring from both gestations at 9 weeks. Poor performance on the Rotarod test further confirmed their motor dysfunction. VAD didn’t affect hemoglobin levels and had no consistent effect on hepatic trace mineral concentrations. These findings highlight the critical role of vitamin A in motor development. There was no clear evidence that VAD alters the risk of iron deficiency anemia or trace minerals.

Enhancing referral practices: A bariatric department's education initiative to reduce unnecessary referrals to hematology oncology.

82 Background: Bariatric surgery patients face an elevated risk of iron deficiency anemia. Referrals from the Bariatric department to Hematology Oncology for work up of these anemias strain clinic resources and delay timely care for cancer patients. We initiated a targeted education program to reduce unnecessary referrals from the Bariatric department to Hematology Oncology by raising awareness among staff about appropriate referral criteria. Methods: We developed a curriculum highlighting the differences between symptoms of bariatric surgery complications and hematologic malignancies. Interactive training sessions were held with Bariatric department staff, supplemented by informational materials. Case studies and real-world examples reinforced understanding and decision-making. Staff were also educated on managing iron deficiency anemia internally. Referral rates were tracked before and after the intervention. Results: Baseline data were collected from July 2023 to November 2023, showing an average of 17 referrals per month (85 total over 5 months). The educational initiative included three sessions in December 2023 on anemia management and referral criteria. These sessions highlighted the distinction between symptoms of bariatric complications and hematologic malignancies, as well as education to the bariatric surgery providers on management of hematologic diagnoses resulting from bariatric surgery. Post-intervention data from January 2024 to May 2024 showed a substantial reduction in referrals for bariatric-related iron deficiency anemias to an average of 4.4 referrals per month (22 total over 5 months), indicating a 74% reduction. Improved internal management of iron deficiency anemia contributed to this outcome. The percentage of cancer patients receiving a consult within 7 days of referral contemporaneously improved from 85.7% to 88.1%, indicating improved access to oncology care. Conclusions: The educational intervention significantly reduced unnecessary referrals from the Bariatric department to Hematology Oncology, improving access for cancer patients. Empowering staff with the knowledge to make informed referral decisions and manage common hematologic issues internally improved patient care and clinic efficiency, reducing healthcare costs and patient burden in both departments.

Efficacy of Vidangadi lauha in the management of Pandu roga (~iron deficiency anemia) in adolescent girls

Introduction: Pandu roga can be correlated to Iron Deficiency Anemia (IDA) in the modern context. Adolescent girls are at high risk of IDA due to the high requirement of iron, low intake of nutrients, and blood loss during menses. Iron and folic acid are the drugs of choice for IDA, but it has some side effects such as stomach pain and constipation. Considering this, in the present study efficacy of Vidangadi lauha was compared with that of iron and folic acid as supplements. Materials and Methods: Adolescent girls aged 10–16 years were screened for the signs and symptoms of Pandu roga and those who were coming under the inclusion criteria for IDA were randomly arranged into two groups. The first group (Group A) was given 10 ml syrup of Vidangadi lauha once daily; while iron and folic acid tablets were given to the control group (Group B) as per the weekly iron-folic acid supplementation schedule for 3 months. For the assessment of therapy clinical features such as Panduta, Daurabalya, and Rukshata and hematological parameters were assessed before and after treatment. Results: On comparing Group A and Group B, the hematological parameters including hemoglobin show nonsignificant results. The difference in subjective parameters was also found statistically insignificant. Conclusion: Statistically, Vidangadi lauha and Iron and folic acid both showed improvement in hematological as well as clinical parameters. However, the formulation Vidangadi lauha is still preferred over iron and folic acid due to its holistic mode of action over Agni (~digestive and metabolic capacity) and the metabolic system of the body with no side effects.

Effects of soy protein on alleviating iron deficiency anemia in suckling rats with different iron supplements

Iron deficiency anemia (IDA) is common in infants and the fortification of infant formula with iron is an effective preventive strategy. Because of the severity of cow's milk allergy and the popularity of vegetarianism, soy-based infant formula has been widely used. However, whether soy-based infant formula is detrimental to iron absorption and increases the risk of IDA in infants requires further investigation. In this study, FeSO4 and its potential alternative encapsulated ferric pyrophosphate (FePP) were dissolved in soy protein and whey protein solution, and administered to IDA suckling rats by gavage to investigate the effects of protein system on the IDA remission by iron. Results showed that both types of iron supplement increased the body weight and improved the organ coefficients of IDA suckling rats irrespective of the protein system. In addition, for each type of iron supplement, both protein systems had the same recovery effects on hemoglobin, red blood cell count, hematocrit and body iron status. And, soy protein did not affect the expression of key iron absorption proteins or genes in the suckling rats. In conclusion, for IDA suckling rats, either FePP or FeSO4 in soy protein system has the same beneficial effect as whey protein system, and can effectively improve IDA. These findings provide a reference for the further application of soy-based infant formula and novel iron supplements.

Iron Status, Thyroid Dysfunction, and Iron Deficiency Anemia: A Two-Sample Mendelian Randomization Study.

Given the clinical association between thyroid dysfunction and iron deficiency anemia (IDA), as well as their shared association with iron status, this study aimed to investigate the causal relationship between iron status and thyroid dysfunction, while also examining the risk of IDA in relation to thyroid dysfunction. A two-sample mendelian randomization (MR) study was conducted to identify the causal relationship of iron status on thyroid dysfunction, as well as thyroid dysfunction on IDA. Large-scale European population-based genome-wide association study databases were utilized (Genetics of Iron Status consortium, ThyroidOmics consortium, FinnGen consortium, and UK Biobank). Inverse variance-weighted (IVW) was used as the main analysis. In addition, we used weighted median and MR-Egger to enhance the robustness. Sensitivity analysis was conducted to evaluate the robustness of MR results. The IVW estimates did not reveal any significant causal relationship between serum iron status markers and thyroid dysfunction. However, a significant causal relationship was observed between hypothyroidism and IDA (odds ratio [OR] = 1.101, 95% confidence interval [CI] = 1.048-1.157, p < 0.001). Repeated analyses also demonstrated a similar trend (OR = 1.023, 95% CI = 1.011-1.035, p < 0.001). Sensitivity analysis supported that the MR estimates were robust. In our MR study, an upregulation of the hypothyroidism-associated gene was found to be significantly associated with an elevated risk of IDA in the European population. These findings may offer novel therapeutic insights for clinicians managing patients with hypothyroidism, IDA, or their comorbidities.

Impact of vitamin D deficiency on iron status in children with type I diabetes

Vitamin D deficiency (VDD) and anemia are both public health nutrition concerns. An association between VDD and anemia has been suggested in various healthy and diseased populations. The current study aimed to elucidate the effect of VDD on iron status in children with type I diabetes mellitus (T1DM). The study recruited two groups of children with T1DM: control group comprised of 38 T1DM children with sufficient vitamin D (> 30 ng/ml) and a case group, consisted of 52 T1DM children with VDD (< 20 ng/ml). Both groups had comparable gender, age, BMI, and disease duration. The laboratory measurements included analysis of blood indices, markers of iron metabolism, hepcidin and inflammatory markers included interleukin 6 (IL-6) and C-reactive protein (CRP). Compared to control group, T1DM children with VDD differs specifically in terms of some markers of blood indices, such as decreased hemoglobin and increased red blood cell distribution width. Moreover, decreased serum iron, ferritin, total iron-binding capacity and transferrin along with elevated inflammatory markers were observed in case group. Results of the study indicated that VDD had increased the risk of iron deficiency anemia in children with T1DM as well as inflammatory related anemia. Furthermore, in T1DM children, VDD had raised the incidence of both absolute and functional iron deficiency, with greater incidence of the former. This study may indicate that VDD may be a risk factor that may worsen iron deficiency anemia in T1DM.

The association between osimertinib and nutritional deficiency among patients with non-small cell lung cancer.

8031 Background: Osimertinib, a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the standard-of-care in EGFR mutation-positive non-small-cell lung cancer (NSCLC) in various settings. Osimertinib commonly causes gastrointestinal adverse effects thereby potentially leading to nutritional deficiencies. Therefore, we aim to evaluate the association between the use of osimertinib and nutritional deficiencies among patients with NSCLC. Methods: We performed a retrospective, propensity score matched study using the TriNetX database, a network comprising deidentified data across more than 120 participating healthcare institutions. We included patients with NSCLC who received either osimertinib or other EGFR-TKIs (afatinib, dacomitinib, erlotinib, gefitinib). The outcomes of interest included vitamin B deficiency, vitamin D deficiency, iron deficiency as well as associated anemia including vitamin B12 deficiency anemia, folate deficiency anemia, and iron deficiency anemia within 5 years of EGFR-TKI initiation. Results: We matched 4264 patients who received osimertinib to patients who received other EGFR-TKIs. In Cox proportional hazard analysis, osimertinib was associated with a 50% higher risk of vitamin B deficiency (Hazard ratio, 1.52 [95% CI: 1.07-2.16]) compared to other EGFR-TKIs. Consistent with this observation, osimertinib was associated with an increased risk of vitamin B12 deficiency anemia and a tendency towards folate deficiency anemia. We also noted a 2-fold higher risk of vitamin D and 5-fold higher risk of iron deficiency in the osimertinib cohort. Consistent with this observation, osimertinib was associated with an increased risk of iron deficiency anemia compared to other EGFR-TKIs. Conclusions: The use of osimertinib is associated with a higher risk of nutritional deficiencies and associated anemias compared to other EGFR-TKIs. One potential explanation is the extended duration of osimertinib therapy, driven by its potent anti-cancer effects. Therefore, it is advisable to consider screening for specific nutritional deficiencies in individuals receiving osimertinib therapy. [Table: see text]

Early identification of patients at risk for iron-deficiency anemia using deep learning techniques.

Iron-deficiency anemia (IDA) is a common health problem worldwide, and up to 10% of adult patients with incidental IDA may have gastrointestinal cancer. A diagnosis of IDA can be established through a combination of laboratory tests, but it is often underrecognized until a patient becomes symptomatic. Based on advances in machine learning, we hypothesized that we could reduce the time to diagnosis by developing an IDA prediction model. Our goal was to develop 3 neural networks by using retrospective longitudinal outpatient laboratory data to predict the risk of IDA 3 to 6 months before traditional diagnosis. We analyzed retrospective outpatient electronic health record data between 2009 and 2020 from an academic medical center in northern Texas. We included laboratory features from 30,603 patients to develop 3 types of neural networks: artificial neural networks, long short-term memory cells, and gated recurrent units. The classifiers were trained using the Adam Optimizer across 200 random training-validation splits. We calculated accuracy, area under the receiving operating characteristic curve, sensitivity, and specificity in the testing split. Although all models demonstrated comparable performance, the gated recurrent unit model outperformed the other 2, achieving an accuracy of 0.83, an area under the receiving operating characteristic curve of 0.89, a sensitivity of 0.75, and a specificity of 0.85 across 200 epochs. Our results showcase the feasibility of employing deep learning techniques for early prediction of IDA in the outpatient setting based on sequences of laboratory data, offering a substantial lead time for clinical intervention.

Risk analysis of air pollutants and types of anemia: a UK Biobank prospective cohort study.

Previous studies have suggested that exposure to air pollutants may be associated with specific blood indicators or anemia in certain populations. However, there is insufficient epidemiological data and prospective evidence to evaluate the relationship between environmental air pollution and specific types of anemia. We conducted a large-scale prospective cohort study based on the UK Biobank. Annual average concentrations of NO2, PM2.5, PM2.5-10, and PM10 were obtained from the ESCAPE study using the Land Use Regression (LUR) model. The association between atmospheric pollutants and different types of anemia was investigated using the Cox proportional hazards model. Furthermore, restricted cubic splines were used to explore exposure-response relationships for positive associations, followed by stratification and effect modification analyses by gender and age. After adjusting for demographic characteristics, 3-4 of the four types of air pollution were significantly associated with an increased risk of iron deficiency, vitamin B12 deficiency and folate deficiency anemia, while there was no significant association with other defined types of anemia. After full adjustment, we estimated that the hazard ratios (HRs) of iron deficiency anemia associated with each 10 μg/m3 increase in NO2, PM2.5, and PM10 were 1.04 (95%CI: 1.02, 1.07), 2.00 (95%CI: 1.71, 2.33), and 1.10 (95%CI: 1.02, 1.20) respectively. The HRs of folate deficiency anemia with each 10 μg/m3 increase in NO2, PM2.5, PM2.5-10, and PM10 were 1.25 (95%CI: 1.12, 1.40), 4.61 (95%CI: 2.03, 10.47), 2.81 (95%CI: 1.11, 7.08), and 1.99 (95%CI: 1.25, 3.15) respectively. For vitamin B12 deficiency anemia, no significant association with atmospheric pollution was found. Additionally, we estimated almost linear exposure-response curves between air pollution and anemia, and interaction analyses suggested that gender and age did not modify the association between air pollution and anemia. Our research provided reliable evidence for the association between long-term exposure to PM10, PM2.5, PM2.5-10, NO2, and several types of anemia. NO2, PM2.5, and PM10 significantly increased the risk of iron deficiency anemia and folate deficiency anemia. Additionally, we found that the smaller the PM diameter, the higher the risk, and folate deficiency anemia was more susceptible to air pollution than iron deficiency anemia. No association was observed between the four types of air pollution and hemolytic anemia, aplastic anemia, and other types of anemia. Although the mechanisms are not well understood, we emphasize the need to limit the levels of PM and NO2 in the environment to reduce the potential impact of air pollution on folate and iron deficiency anemia.

Anaemia of chronic disease among pulmonary tuberculosis patients is associated with inflammatory marker at the start of intensive phase.

Tuberculosis (TB) disrupts iron balance through systemic inflammation. Pulmonary tuberculosis (PTB) is linked to diverse anaemia types, necessitating intricate haematological and biochemical assessments for diagnosis. This study aims to describe the prevalence of anaemia of chronic disease (ACD), iron deficiency anaemia (IDA) among PTB patients and factors associated with these types of anaemia. A cross-sectional analysis was conducted from community-based cohort study involving sputum-positive PTB patients from 2018 to 2020 in urban Puducherry. Participants were enrolled from 10 primary health centres within 2 weeks of initiating anti-tubercular treatment (ATT). Blood samples were collected for assessing haematological and biochemical parameters. The sTfR/log ferritin ratio was used to distinguish between ACD and IDA. Data were captured using Epicollect5 and analysed using STATA V14. Of the 176 PTB patients included, 63.07% (111/176) had anaemia, with ACD being the predominant type (84.6%, 94/111). The C-reactive protein (CRP) levels were higher among the anaemic group [40.77 (16.66-58.51) mg/dl vs 24.65 (14.23-47.26) mg/dl] and higher among the ACD as compared to IDA [46.9 (22.3-61.2) vs 20.8 (13.0-39.1) mg/dl]. Undernourished [adjusted prevalence ratio (APR) =3.43; confidence interval (CI): 1.21-9.69] and patients having low risk of dependence on tobacco [APR = 1.52; CI: 1.10-2.11] had higher risk of ACD. Female patients had higher risk of IDA [APR = 4.95, P < 0.01]. The largest proportion of the PTB participants with anaemia had ACD. Acute-phase reactant and inflammatory marker are increased among newly diagnosed new sputum smear-positive (NSP) PTB participants at the start of ATT. Addressing inflammation is needed for combating anaemia in PTB patients.

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

&lt;b&gt;Objective:&lt;/b&gt; 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. &lt;b&gt;Material and Methods: &lt;/b&gt;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. &lt;b&gt;Results:&lt;/b&gt; 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&lt;sup&gt;2&lt;/sup&gt; value = 57.7%; P&amp;lt; 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.

Impact of educational intervention on mothers of infants with iron-deficiency anemia.

This intervention study aimed to assess mothers' knowledge of iron-deficiency anemia (IDA). It also measured the impact of a health education program on their level of knowledge and their infants' IDA rates in rural areas of Nablus Governorate. Using a randomized pretest-posttest control group design, the efficacy of 3 months' education program was examined against control group. Assessments were made at baseline and after 3 months of conducting the intervention. A structured interviewing questionnaire was used to assess the knowledge about IDA, and blood samples were collected from infants in both groups. Only 1.9% of mothers in the intervention group and 3.5% of mothers in the control group had good level of knowledge at baseline. After the educational intervention, a significant statistical difference was observed in the mean total knowledge score between the intervention and control groups (33.68 + 5.366 versus 26.12 + 5.243), and the intervention group was seven times more likely to have good knowledge (relative risk = 7.332). Regarding IDA rate, there was a decrease in the infants with IDA in the intervention group (relative risk = 0.671) compared to infants in the control group. The planned health education program was effective in improving mothers' knowledge and reducing the risk of IDA among their infants.

Reticulocyte hemoglobin content associated with the risk of iron deficiency anemia

Background/ObjectiveReticulocyte hemoglobin content (MCHr) was recognized as a rapid and reliable marker for investigating iron deficiency (ID). We hypothesized that MCHr was associated with the risk of iron deficiency anemia in adults. MethodsThis is a dual-center case-control study. A total of 806 patients and healthy individuals were recruited from Ruijin Hospital and Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between January 2021 and December 2021. The participants were categorized into iron deficiency anemia (IDA) group (n = 302), non-IDA group (n = 366), and healthy control group (n = 138). According to the MCHr level, the participants were divided into two groups, i.e. normal MCHr (≥25 pg) and decreased MCHr (<25 pg) group. Multivariate logistic regression analysis and adjusted subgroup analysis were conducted to estimate the relative risk between MCHr and IDA, with confounding factors including age, sex, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), Hematocrit (HCT), serum iron (Fe), ferritin (Ferrit), and total iron binding capacity (TIBC). ResultsCompared with the non-IDA, the MCHr level with IDA decreased significantly. ROC curve analysis showed that MCHr had the largest area under the AUC curve. After comprehensive adjustment for confounding factors, individuals with normal level of MCHr exhibited a decreased risk of IDA (OR = 0.68 [0.60, 0.77], P < 0.01), while the risk of IDA was up to 5 times higher for those with decreased MCHr. ConclusionOur findings supported the hypothesis that MCHr was associated with the risk of IDA in adults and could serve as an indicator of IDA severity. MCHr holds clinical value as an auxiliary diagnostic indicator, providing valuable insights into whether invasive examinations are warranted in the assessment of IDA.

Transferrin receptor 1 rs3817672 variant genotyping in Egyptian children diagnosed with iron-deficiency anemia: a case–control study

Background Cell surface transferrin receptor 1 (TFR1) is a gatekeeper controling cellular iron uptake. The association of iron-deficiency anemia (IDA) in humans with TFR1 variants was not extensively studied. Among these variants is TFR1 rs3817672, an exonic missense variation that may affect the TFR1 protein structure. This is the first study in Egypt and the second worldwide that genotype TFR1 rs3817672 variant in IDA pediatric patients. Aim The aim of the current study was to investigate the association between TFR1 rs3817672 variant with susceptibility risk for IDA. Patients and methods The study was conducted on 50 IDA Egyptian pediatric patients and 50 healthy controls. Complete blood count, iron profile, and TFR1 rs3817672 variant genotyping were performed for all participants. Results TT genotype was associated with a high risk of IDA among cases compared to controls in the recessive model (odds ratio 24, 95% confidence interval 5.253–109.650, P≤0.001) with the predominance of T allele (odds ratio 7.3187, 95% confidence interval 3.919–13.669, P≤0.001). TT genotype was associated with a significant decrease in serum iron (P=0.001 and 0.003) and transferrin saturation (P=0.003 and 0.005) compared to CT genotype and CC+CT genotypes in the recessive model, respectively. In IDA patients, serum iron had a significant positive correlation with transferrin saturation (r=0.984, P≤0.001) and a significant negative correlation with total iron-binding capacity (r=−0.555, P≤0.001). Conclusion TT genotype was the predominant genotype among Egyptian pediatric IDA patients. TFR1 rs3817672 genotyping might be used as a potential screening test for IDA risk susceptibility in pediatrics.

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.

The relationship between serum 25-hydroxyvitamin D and iron status and anaemia in undernourished and non-undernourished children under five years in South Africa

BackgroundVitamin D (vitD) plays a role in iron metabolism by the suppression of hepcidin, while iron deficiency also impairs vitD metabolism. In undernourished children, iron and vitamin D deficiency are common. There is little knowledge of the inter-relationship between these two nutrients in undernourished and non-undernourished children. AimTo assess the association between 25-hydroxyvitamin D (25(OH)D) and iron status, and the effect of 3 doses of 50,000 IU of vitD on iron status in undernourished and non-undernourished children. MethodsWe measured serum 25(OH)D, haemoglobin (Hb), ferritin and soluble transferrin receptor in 121 undernourished and 51 non-undernourished children in clinics in the North-West Province of South Africa. Three doses of 50,000 IU/week of vitD was supplemented to children with suboptimal vitD levels. ResultsThe overall prevalence of suboptimal vitD concentration (25(OH)D < 30 ng/mL) was 20.3 %. Anaemia and iron deficiency anaemia (IDA) prevalence were 62 % and 49.2 % in the undernourished and 56.9 % and 42.9 % in the non-undernourished group. In the overall group, 25(OH)D < 30 ng/mL was associated with significantly higher IDA prevalence compared to those with 25(OH)D ≥ 30 ng/mL (64.7 % vs 43.0 %, p = 0.023), and was associated with an increased risk of IDA in the crude analysis (OR: 2.434 1.114, 5.318, p = 0.026). Serum 25(OH)D < 30 ng/mL was associated with 4 times (OR: 4.046, 95%CI: 1.022, 16.009, p = 0.046) and greater than 5 times (OR: 5.386, 95%CI: 1.528, 18.985, p = 0.009) increased odds of anaemia and IDA in the undernourished children, respectively. VitD supplementation resulted in a significant reduction of 55.9 % in TNF-α concentration (p = 0.008) in the overall group. ConclusionSuboptimal vitD concentration is associated with increased odds of anaemia and IDA. VitD status should be considered in anaemia prevention strategies, especially in populations where both vitD and iron deficiencies co-exist.

Compliance to iron folic acid supplementation and its associated factors among pregnant women attending Antenatal clinic in Wondo district: a cross-sectional study

Pregnant women are at high risk for iron deficiency anemia due to increased nutrient requirements during pregnancy. Despite high coverage of iron and folic acid supplementation (IFAS), low compliance is reported. The study aimed to assess compliance with IFAS and its associated factors among antenatal care (ANC) attendees in Wondo District, Southern Ethiopia. A facility-based cross-sectional study was conducted among 400 pregnant women. Pregnant women were selected through systematic random sampling. Pre-tested structured questionnaire was used to collect data through face to face interview. Data were entered into Epi-info and exported to Statistical Package for Social Sciences for analysis. The variables with p-value < 0.25 in the bivariable analysis were entered into the multivariable logistic regression model. P values less than 0.05 were considered significant. Results were reported as crude and adjusted odds ratios with 95% confidence intervals. The prevalence of compliance to IFAS was (177, 44.3%). Factors significantly associated with compliance to IFAS were maternal age ≥ 25 years [AOR 2.27, 95% CI (1.21, 4.28)], maternal education [AOR 2.62, 95% CI (1.43, 4. 79)], husband's education [AOR 3.60, 95% CI (2.07, 6.25)], knowledge of anemia [AOR 4.40, 95% CI (2.65, 7.30)], and knowledge of IFA [AOR 2.21, 95% CI (1.40, 3.50)]. This study showed that compliance to IFAS was low. Maternal age, maternal education, husband's education, knowledge about anemia and iron folic acid was found to be significantly associated with adherence to IFAS. Emphasis should be placed on young, uneducated mothers and their husbands.

Elevated first-trimester hepcidin level is associated with reduced risk of iron deficiency anemia in late pregnancy: a prospective cohort study.

Iron deficiency (ID) and iron deficiency anemia (IDA) during pregnancy are highly prevalent worldwide. Hepcidin is considered an important biomarker of iron status. Currently, few longitudinal cohort studies have assessed the potential causal relationship between hepcidin and ID/IDA. Therefore, we aimed to investigate the association of first-trimester maternal serum hepcidin with third-trimester ID/IDA risk in a prospective cohort. Total of 353 non-ID/IDA pregnant women at 11-13 weeks' gestation were enrolled in Southern China and followed up to 38 weeks of gestation. Data on demography and anthropometry were obtained from a structured questionnaire at enrollment. Iron biomarkers including hepcidin were measured at enrollment and follow-up. Regression models were used to evaluate the association of first-trimester hepcidin with third-trimester ID/IDA risk. Serum hepcidin levels substantially decreased from 19.39 ng/mL in the first trimester to 1.32 ng/mL in the third trimester. Incidences of third-trimester ID and IDA were 46.2 and 11.4%, respectively. Moreover, moderate and high levels of first-trimester hepcidin were positively related to third-trimester hepcidin (log-transformed β = 0.51; 95% CI = 0.01, 1.00 and log-transformed β = 0.66; 95% CI = 0.15, 1.17). Importantly, elevated first-trimester hepcidin was significantly associated with reduced risk of third-trimester IDA (OR = 0.38; 95% CI = 0.15, 0.99), but not with ID after adjustment with potential confounders. First-trimester hepcidin was negatively associated with IDA risk in late pregnancy, indicating higher first-trimester hepcidin level may predict reduced risk for developing IDA. Nonetheless, given the limited sample size, larger studies are still needed.

Machine Learning Prediction of Iron Deficiency Anemia in Chinese Premenopausal Women 12 Months after Sleeve Gastrectomy.

Premenopausal women, who account for more than half of patients for bariatric surgery, are at higher risk of developing postoperative iron deficiency anemia (IDA) than postmenopausal women and men. We aimed at establishing a machine learning model to evaluate the risk of newly onset IDA in premenopausal women 12 months after sleeve gastrectomy (SG). Premenopausal women with complete clinical records and undergoing SG were enrolled in this retrospective study. Newly onset IDA after surgery, the main outcome, was defined according to the age- and gender-specific World Health Organization criteria. A linear support vector machine model was developed to predict the risk of IDA after SG with the top five important features identified during feature selection. Four hundred and seven subjects aged 31.0 (Interquartile range (IQR): 26.0-36.0) years with a median follow-up period of 12 (IQR 7-13) months were analyzed. They were divided into a training set and a validation set with 285 and 122 individuals, respectively. Preoperative ferritin, age, hemoglobin, creatinine, and fasting C-peptide were included. The model showed moderate discrimination in both sets (area under curve 0.858 and 0.799, respectively, p < 0.001). The calibration curve indicated acceptable consistency between observed and predicted results in both sets. Moreover, decision curve analysis showed substantial clinical benefits of the model in both sets. Our machine learning model could accurately predict newly onset IDA in Chinese premenopausal women with obesity 12 months after SG. External validation was required before the model was used in clinical practice.