Serum Iron Concentration Research Articles

Laboratory Predictors of Hemorrhagic Complications in Patients With Total Hip Arthroplasty and Treatment With Direct Oral Anticoagulants

Introduction. Direct oral anticoagulants (DOAC) rivaroxaban and apixaban have significantly reduced the risk of developing venous thromboembolic complications (VTEC). However, the use of DOAC may be associated with a higher risk of bleeding, especially actual in patients after total hip arthroplasty (THA).Material and methods. We enrolled 38 patients with moderate osteoarthritis of the hip joints undergoing THA. The mean age of patients was 58 (33; 85) years. All the patients received rivaroxaban or apixaban in the doses specified by Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEC). Retrospectively, in the postoperative period, the patients were divided into two groups: Group 1 — 31 patients (20 women and 11 men), who had no hemorrhagic complications after hip replacement; and Group 2 — 7 patients (4 women and 3 men) who experienced hemorrhagic events in the form of hematomas in the wound area. Laboratory tests were performed for all patient baseline (1st day of hospitalization), after surgery (1st day after THA), and on the 7th day after THA. Analyses included the determination of hemostasis parameters (INR, aPPT, fibrinogen, D-dimer), hematological (HGB, PLT, RBC) and biochemical parameters (calcium, ionized calcium, serum iron, hs-CRP).Results. The analysis of biochemical parameters in patients with hemorrhagic complications revealed a significant increase of fibrinogen (p=0,023) compared with uncomplicated cases. Serum iron concentration in men with hemorrhagic complications in the postoperative period was significantly lower than in patients without complications. In patients with hemorrhagic complications, the ionized calcium was lower (p=0,032) than in patients without complications, but within the reference values. The hs-CRP concentration in the group with hemorrhagic complications was twice higher than in the group without complication and eight times above the reference values.Conclusion. The concentration of iron in the blood serum in men below 11 mmol/l and a slight hyperfibrinogenemia of 4.65 g/l in all the patients are the risks of developing hematomas in the area of surgery. These parameters should be used to predict the risk of hemorrhagic complications in patients before THA and recommended for control before the surgery and on the 1st day after THA (hs-CRP).

New Perspectives on Circulating Ferritin: Its Role in Health and Disease

The diagnosis of iron disturbances usually includes the evaluation of serum parameters. Serum iron is assumed to be entirely bound to transferrin, and transferrin saturation—the ratio between the serum iron concentration and serum transferrin—usually reflects iron availability. Additionally, serum ferritin is commonly used as a surrogate of tissue iron levels. Low serum ferritin values are interpreted as a sign of iron deficiency, and high values are the main indicator of pathological iron overload. However, in situations of inflammation, serum ferritin levels may be very high, independently of tissue iron levels. This presents a particularly puzzling challenge for the clinician evaluating the overall iron status of the patient in the presence of an inflammatory condition. The increase in serum ferritin during inflammation is one of the enigmas regarding iron metabolism. Neither the origin, the mechanism of release, nor the effects of serum ferritin are known. The use of serum ferritin as a biomarker of disease has been rising, and it has become increasingly diverse, but whether or not it contributes to controlling the disease or host pathology, and how it would do it, are important, open questions. These will be discussed here, where we spotlight circulating ferritin and revise the recent clinical and preclinical data regarding its role in health and disease.

Prognostic value of three iron deficiency definitions in patients with advanced heart failure

Abstract Background Iron deficiency (ID) is a common co-morbidity in patients with chronic heart failure (HF) and is an independent predictor of adverse prognosis including quality of life and exercise capacity (1-3). Intravenous iron replacement improves outcomes in HF patients including exercise capacity, quality of life, rate of HF hospitalisation and possibly mortality (1-4). Different definitions of ID are used in clinical practice. European HF guidelines define ID as a serum ferritin concentration of < 100 ng/ml, or a serum ferritin of concentration of 100-299 ng/ml with a transferrin saturation (TSAT) < 20% (5) because this definition was used in most trials of iron replacement in HF (1-3). However, other criteria to diagnose ID have been proposed based on comparison to the gold standard of bone marrow biopsy including serum iron ≤ 13 µmol/L and TSAT < 20% (6). Serum ferritin concentrations to diagnose ID has been criticised because inflammation can lead to increased serum ferritin concentrations even in patients who would fulfil ID criteria based on alternative definitions (7). Purpose The prognostic value of ID in patients with advanced HF, assessed for heart transplantation, is currently not well established. This patient population is characterised by relatively young age, single-organ pathology and prognosis is largely determined by the severity of heart disease rather than co-morbidities. In this study we investigated the prognostic value of various ID definitions in this patient cohort. Methods and Results Consecutive patients assessed for heart transplantation at a single UK centre between January 2010 and May 2022 were included. ID was defined as 1) serum ferritin concentration of < 100 ng/ml, or 100-299 ng/ml with transferrin saturation < 20% (guideline definition), 2) serum iron concentration ≤ 13 µmol/L, or 3) transferrin saturation < 20%. The primary outcome measure was a composite of all-cause mortality, urgent heart transplantation or need for mechanical circulatory support. 801 patients were included, and the prevalence of ID was 39-55% depending on definition used. ID, defined by either serum iron or transferrin saturation, was an independent predictor of the primary outcome measure [HR 1.532 (95% CI 1.264 - 1.944) and HR 1.595 (95% CI 1.323 - 2.033), respectively], but the same association was not seen with the guideline definition of ID [HR 1.085 (95% CI 0.8827 - 1.333)]. These findings were robust in multivariable cox regression analysis. ID, by all definitions, was associated with lower six-minute walk distance, lower peak oxygen consumption, higher intra-cardiac filling pressures and lower cardiac output. Conclusions ID, when defined by serum iron concentration or transferrin saturation was associated with increased frequency of adverse clinical outcomes in patients with advanced HF. The same association was not seen with guideline definition of ID.

Association between metals and metalloids with cognitive status in Mild Cognitive Impairment subjects

Abstract Mild Cognitive Impairment (MCI) is regarded as a transitional state between normal aging and dementia. Several risk factors have been related to MCI and dementia vulnerability. Among these, metals and metalloids have been hypothesized to affect dementia risk. Our objective was to study the associations between metals and metalloids (cadmium, copper, iron, manganese, selenium, zinc) concentrations in serum and cerebrospinal fluid (CSF) with cognitive impairment status of MCI subjects. 144 individuals newly diagnosed with MCI were recruited at Neurology Memory Clinics at Modena and Reggio Emilia Hospitals (Italy) in the period 2019-2022. The concentrations of elements in paired serum/CSF were determined using inductively coupled plasma mass spectrometry. Participants’ global cognitive status was assessed using the Mini-Mental State Examination (MMSE). Muti-adjusted spline regression analyses were performed to assess the relation between the serum/CSF concentrations and MMSE. Median serum and CSF concentrations were generally higher in men than women, except copper in serum and iron in CSF demonstrating higher concentrations in women. A positive linear association emerged between serum iron concentrations and MMSE, while a slight negative one emerged for serum selenium levels. Cadmium in serum was positively associated with MMSE until 0.2 µg/L and then the association became null, while in CSF a U-shaped relation emerged. A U-shaped relation was also observed for serum copper and CSF iron and manganese levels. CSF selenium concentrations were inversely related to MMSE, although above 5 µg/L the curve flattened. Zinc exhibited the same pattern of association in both serum and CSF, i.e., an inverted U-shaped one. These findings suggest that CSF and serum content of the investigated elements may be differently related with global cognitive status in MCI subjects. Higher levels of selenium and zinc, in particular, are associated with lower MMSE score. Key messages • Heavy metals and metalloids display different pattern of association with global cognitive status. • High levels of selenium and zinc are inversely related with global cognitive status in MCI subjects.

The Effect of a Six-Week Nordic Walking Training Cycle on Oxidative Damage of Macromolecules and Iron Metabolism in Older Patients with Multiple Myeloma in Remission-Randomized Clinical Trial.

Multiple myeloma (MM) is an incurable hematologic malignancy originating from clonal plasma cell proliferation within the bone marrow, predominantly affecting older individuals. While anemia serves as a diagnostic criterion for MM, it often ameliorates upon achieving disease remission. Iron metabolism parameters have emerged as potential prognostic indicators in MM. Notably, physical exercise has been established to influence iron metabolism. This study aimed to assess alterations in serum iron, ferritin, and transferrin concentrations, as well as leukocyte gene expression, in MM patients undergoing a six-week cycle of Nordic walking training. Thirty patients divided into an exercise group (NW, n = 15, mean age 63.1 ± 8.4 years) and a control group (CG, n = 15, mean age: 63.5 ± 3.6 years) completed the study protocol. Blood samples were collected at baseline, after three and six weeks of training, and after nine weeks. Serum ferritin, transferrin, and iron concentrations were measured, along with the leukocyte expression of genes. Additionally, serum oxidative damage marker levels were determined. Following the Nordic walking training cycle, a declining trend in serum ferritin concentrations was observed. Intracellular mRNA levels of genes associated with iron metabolism were positively influenced by the training regimen, indicating the potential impact of this physical activity on gene expression and ferritin concentrations. Although positive trends were noted, extended training periods might be requisite for significant changes. To conclude, moderate-intensity exercise induces favorable shifts in the analyzed parameters among MM patients, potentially influencing disease progression. Consequently, Nordic walking training is a safe recommendation for MM patients, though sustained training beyond six weeks could be necessary for notable effects on iron metabolism factors.

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

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

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

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

Impact on oxidative stress of oral, high-dose, iron supplementation for management of iron deficiency after bariatric surgery, a preliminary study

ObjectivesHigh-dose oral iron supplementation for patients who develop iron deficiency after bariatric surgery may induce oxidative stress in the gastrointestine. The study’s objective was to test this hypothesis by determining the impact of high-dose oral iron on systemic oxidative stress. MethodsWe used archived plasma samples from a randomized controlled clinical trial (NCT 02404012) comparing FeSO4 (195 mg/day, NatureMade®, West Hills, CA) with a heme iron polypeptide (HIP, 60.4 mg/day, Proferrin®, Colorado Biolabs, Lafayette, CO) for 8 weeks. Systemic oxidative stress was measured using malondialdehyde and total antioxidant capacity (MDA, Abcam, ab238537 and TAC, Abcam, ab65329 Cambridge, UK) assays. Data was log-transformed and presented as means and standard deviations; a mixed model was used to determine the effects of time (0, 2, 4, and 8 weeks) and treatment (FeSO4 versus HIP) on oxidative stress. ResultsThe FeSO4 (N = 8) and HIP (N = 5) participants were balanced in body mass index (35.0 ± 5.5 kg/m2), race (93 % White), time post-surgery (7.3 ± 3.3 years), as well as serum concentrations of iron (P > 0.05). The FeSO4 group tended to be older (44.3 ± 4.5 years) and they had lower concentrations of serum ferritin (6.5 ± 2.7 µg/mL) than the HIP (38.2 ± 9.3 years, and 12.9 ± 16.8 µg/mL) group (P = 0.080, and P = 0.017 respectively). We observed a larger increase in serum iron in the FeSO4 group during the 8 weeks of Fe supplementation, compared to that in the HIP group (p = 0.004). We observed a decreasing trend in MDA over the 8 weeks (p = 0.080) in the FeSO4 treatment group. There were no significant differences in TAC between and within FeSO4 and HIP groups over the 8 week supplementation period. ConclusionsThis preliminary study suggests that high-dose oral iron supplementation for iron deficiency does not adversely impact systemic oxidative stress in patients undergoing bariatric surgery.

Are Twin Pregnancies at Higher Risk for Iron and Calcium Deficiency than Singleton Pregnancies?

The aim of this study was to compare the iron and calcium status in singleton and twin pregnancies and to assess whether there is an increased risk for iron and calcium deficiency in twin gestation. The study included 105 singleton and 9 twin pregnancies at or above 35 weeks of gestation. Information on prenatal supplementation with iron or calcium was acquired, and adverse perinatal outcomes were recorded. Biosamples from all 114 mothers and 73 newborns (61 singleton and 12 twin newborns) were finally analyzed. Total iron and calcium concentrations in serum were measured through total reflection X-ray fluorescence analysis. The results indicated no significant differences in maternal serum iron and calcium concentrations between singleton and twin pregnancies. Similarly, iron and calcium concentrations in newborn umbilical cord serum samples were not different between singleton and twin pregnancies. The comparison of total iron and calcium between mothers and umbilical cord serum indicated significantly lower concentrations in the mothers, with the differences being not homogenous but rather pair-specific. A significant positive correlation between maternal serum and umbilical cord serum calcium concentration was noticed. Prenatal iron supplementation was associated with higher iron concentrations in both mothers and newborns, supporting the efficiency of supplementation and the quality of the study methods. Collectively, the data indicate no significant differences in serum iron and calcium concentrations with regard to singleton or twin pregnancies and the efficiency of iron supplementation during pregnancy for increasing iron status.

Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways.

Thiazolidinediones are useful antidiabetic medications. However, their use is associated with adverse side effects like edema, heart failure and bone fractures. In this study, we investigated the anti-ferroptosis effects of suberosin (SBR; a prenylated coumarin) in diabetic Sprague Dawley rats. Further, we assessed the effects of co-administration of SBR (30 and 90mg/kg/day) with thiazolidinedione (TZ at 15mg/kg) to mitigate TZ-induced cardiomyopathy in diabetic rats. Our results showed that cardiac output, stroke volume, left ventricle systolic and diastolic pressures were aggravated in diabetic rats treated with TZ alone after 4weeks. TZ treatments induced ferroptosis as well as marked histoarchitecture disarrangements in rat cardiomyocytes. The study found that optimizing volume overload alleviated cardiac hypertrophy and mitigated left ventricular dysfunction in diabetic rats co-treated with SBR. SBR co-administration with TZ reduced MDA levels in heart tissue and serum iron concentration (biomarkers of ferroptosis), downregulated mRNA expressions of LOX, ACSL4, LPCAT3, and promoted GPX4 activity as well as upregulated mRNA levels of AKT/PI3K/GSK3β as compared to the group administered with TZ at 15mg/kg. SBR co-administration also helped to retain the normal histoarchitecture of cardiomyocytes in diabetic rats. Hence, our results suggested that SBR is an effective supplement and could be prescribed to diabetic patients along with TZ but this requires further clinical trials.

Comparison of Total Iron Binding Capacities between Type 2 Diabetes Mellitus Patients and Healthy Individuals

Background: Worldwide, diabetes mellitus (DM) is a leading cause of death and disability. Iron overload is increasingly being connected to insulin resistance in patients with type 2 diabetes mellitus (T2DM). Free iron causes the assembly of reactive oxygen species that invariably steer the body’s homeostasis toward oxidative stress-mediated diabetic complications. We have very limited research-based data regarding the total iron binding capacities in type 2 diabetes mellitus patients. Aim of the study: The aim of the study was to compare the total iron binding capacities (TIBC) between type 2 diabetes mellitus patients and healthy individuals. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College (DMC), Dhaka, Bangladesh from July 2015 to June 2016. In total 100 participants were enrolled in 2 groups as the study subjects. In group A, in total 50 diagnosed patients with type 2 diabetes mellitus (T2DM) were included. On the other hand, in group B, 50 age and sex-matched healthy individuals were included. Properly written consent was taken from all the participants before data collection. All the demographic and clinical information of the participants was recorded. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, the mean serum iron in group A and group B were 112.7 μg/dl and 87.6 μg/dl respectively. The mean serum ferritin concentration in group A and group B were 199.3 μg/dl and 107.0 μg/dl respectively. There was a statistically significant increase in serum iron and serum ferritin concentrations in group A compared to group B. Both serum ferritin and serum iron levels showed strong positive correlations with HbA1C ((r=0.724, p&lt;0.001, r=0.724, p&lt;0.001) and FPG (r=0.724, p&lt;0.001, r= 0.724, p&lt;0.001). The mean TIBC level was found 184 μg/dl in group A and 318.8 μg/dl in group B. In analyzing the total iron binding capacities (TIBC) between the groups we observe that the TIBC (µg/dl) levels in group A and group B were 184.0±79.5 and 318.8 ± 14.0 µg/dl respectively. The TIBC levels were significantly lower in group A than in group B (&lt;0.001). Conclusion: The total iron binding capacity level is significantly lower in type 2 diabetes mellitus (T2DM) patients than that in healthy individuals. Routine screening for iron status along with glycemic control in diabetic patients might help prevent complications in such patients.

Prognostic value of three iron deficiency definitions in patients with advanced heart failure.

There is uncertainty about the definition of iron deficiency (ID) and the association between ID and prognosis in patients with advanced heart failure. We evaluated three definitions of ID in patients referred for heart transplantation. Consecutive patients assessed for heart transplantation at a single UK centre between January 2010 and May 2022 were included. ID was defined as (1) serum ferritin concentration of <100 ng/ml, or 100-299 ng/ml with transferrin saturation <20% (guideline definition), (2) serum iron concentration ≤13 μmol/L, or (3) transferrin saturation <20%. The primary outcome measure was a composite of all-cause mortality, urgent heart transplantation or need for mechanical circulatory support. Overall, 801 patients were included, and the prevalence of ID was 39-55% depending on the definition used. ID, defined by either serum iron or transferrin saturation, was an independent predictor of the primary outcome measure (hazard ratio [HR] 1.532, 95% confidence interval [CI] 1.264-1.944, and HR 1.595, 95% CI 1.323-2.033, respectively), but the same association was not seen with the guideline definition of ID (HR 1.085, 95% CI 0.8827-1.333). These findings were robust in multivariable Cox regression analysis. ID, by all definitions, was associated with lower 6-min walk distance, lower peak oxygen consumption, higher intra-cardiac filling pressures and lower cardiac output. Iron deficiency, when defined by serum iron concentration or transferrin saturation, was associated with increased frequency of adverse clinical outcomes in patients with advanced heart failure. The same association was not seen with guideline definition of ID.

Erchen Decoction improves iron homeostasis in mice with non-alcoholic fatty liver disease by regulating iron transport capacity in the spleen

To investigate the effect of Erchen Decoction on iron homeostasis in mice with nonalcoholic fatty liver disease (NAFLD) and its mechanism for regulating iron transport in spleen cells. Thirty male C57BL/6J mice were given a high-fat diet for 12 weeks and randomized (n=6) at the 7th week for gavage (3 times a week) of drinking water (NAFLD model group), Erchen Decoction at low, medium and high doses (7.5, 15, and 30g/kg, respectively), or polyene phosphatidyl choline (PPC; 9.12 mg/kg), with another 6 mice with low-fat and low-sugar feeding as the control group. The active components of Erchen Decoction were determined by HPLC-MS. Lipid accumulation in the liver was evaluated by HE staining and Nile red staining. Prussian blue staining was used to observe iron content in the spleen. The iron ion content in the liver tissue was detected using a detection kit. The expressions of ferroportin1 (Fpn1), transferrin receptor (TfR), Steap3, HO-1, Ter-119, CD163 and CD68 were detected using Western blotting, immunohistochemistry and immunofluorescence staining. Medium- and high-dose Erchen Decoction partially reversed the increase of lipid accumulation in the liver of NAFLD mice and showed better lipid-lowering effect than PPC. The NAFLD mice showed significantly decreased iron ion content in the spleen with increased hepatic and serum iron contents (P < 0.05), decreased TfR protein expression (P < 0.05), and increased Fpn1 and Steap3 protein expressions (P < 0.05), and these changes were significantly improved by the drug interventions. Erchen Decoction also improved the function of CD163 macrophages in the spleen of NAFLD mice by up-regulating the expression of HO-1 (P < 0.05). Erchen Decoction can alleviate high-fat diet-induced iron metabolism disorder by improving the iron ion transport ability of the spleen cells to delay the progression of NAFLD.

Usefulness of Measuring Serum Amyloid A Concentration in Japanese Black Cattle in Clinical Practice.

This study investigated the concentration of serum amyloid A (SAA), an acute phase protein, in Japanese Black cattle. Four practical trials were performed to evaluate the transition of SAA and sialic acid before and after dehorning, the relationship between the SAA concentration and other blood test parameters, the SAA dynamics in the diseased cattle, and the blood test results, including the SAA concentrations, of the two cases with a follow-up. The SAA concentration increased with dehorning but decreased 7 days after dehorning. The SAA concentration is positively correlated with the α-globulin, sialic acid, and fibrinogen concentrations and negatively correlated with the serum iron concentration. The SAA concentration in the deceased herd was significantly higher than that in the cured outcome herd. In addition, the SAA concentration in the cured group decreased significantly from the first test to retesting but increased significantly in the disuse group. Thus, SAA is a sensitive index of inflammation and a monitoring tool in Japanese Black cattle, and its measurement is considered useful in clinical practice.

Maternal Supplementary Tapioca Polysaccharide Iron Improves the Growth Performance of Piglets by Regulating the Active Components of Colostrum and Cord Blood.

The purpose of this study was to investigate the effect of maternal supplementation with TpFe (tapioca polysaccharide iron) on reproductive performance, colostrum composition, cord blood active components of sows, and growth performance of their nursing piglets. Sixty healthy Duroc × Landrace × Yorkshire sows were randomly assigned to three groups at day 85 of gestation. The experimental diets included a basal diet supplemented with 100 mg/kg FeSO4·H2O (CON group), the basal diet supplemented with 50 mg/kg TpFe (TpFe50 group), and the basal diet supplemented with 100 mg/kg TpFe (TpFe100 group), as calculated by Fe content. The experiment lasted from day 85 of gestation to the end of weaning (day 21 of lactation). Results showed that maternal supplementation with 100 mg/kg TpFe improved (p < 0.05) feed intake during lactation, live births, and birth weight of the litter (alive) and increased (p < 0.05) colostrum IgM (immunoglobulin m), IgA (immunoglobulin A), as well as the IgG levels, while it decreased (p < 0.05) the urea nitrogen and somatic cell count of sows. Moreover, sows in the TpFe100 group had higher (p < 0.05) serum iron levels and IgG. Additionally, maternal supplementation with 100 mg/kg TpFe increased (p < 0.05) iron level, total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-px), catalase (CAT), IgG, red blood cells (RBC), and hemoglobin (Hb) of cord blood, similar with the iron content, T-AOC, GSH-px, IgG, RBC, Hb, hematocrit (HCT), and mean corpuscular volume (MCV) of weaned piglet blood. The diarrhea and mortality rates among the nursing piglets were decreased (p < 0.05), while the average weight at day 21 of age was increased (p < 0.05) in the TpFe100 group. Serum PRL (prolactin) levels of sows exhibited a positive correlation (p < 0.05) with live births. Suckling piglet diarrhea was positively correlated with colostrum urea nitrogen level but negatively correlated with colostrum IgM, IgG, and cord blood Hb content (p < 0.05). The mortality of suckling piglets was negatively correlated with serum iron content and IgM in colostrum, GSH-px, and IgG in cord serum of sows (p < 0.05). The average weight of weaning piglets was positively (p < 0.05) related to colostrum IgM and IgG levels, as well as cord serum RBC counts of sows on day 21. In conclusion, maternal supplementation with TpFe can improve the active components of colostrum and umbilical cord blood and improve the growth performance of suckling piglets.

Iron Status and Short-Term Recovery after Non-Severe Acute Myocarditis: A Prospective Observational Study.

Pathomechanisms responsible for recovery from acute myocarditis (MCD) or progression to non-ischemic cardiomyopathy have not been comprehensively investigated. Iron, positioned at the crossroads of inflammation and the energy metabolism of cardiomyocytes, may contribute to the pathophysiology of inflammatory myocardial disease. The aim of this study was to evaluate whether systemic iron parameters are related to myocardial dysfunction in MCD patients. We prospectively enrolled 42 consecutive patients hospitalized for MCD. Their iron status and their clinical, laboratory, and echocardiographic indices were assessed during hospitalization and during ambulatory visits six weeks after discharge. A control group comprising healthy volunteers was recruited. The MCD patients had higher serum ferritin and hepcidin and lower serum iron concentration and transferrin saturation (TSAT) than the healthy controls (all p < 0.01). Six weeks after discharge, the iron status of the MCD patients was already comparable to that of the control group. During hospitalization, lower serum iron and TSAT correlated with higher NT-proBNP (both p < 0.05). In-hospital lower serum iron and TSAT correlated with both a lower left ventricular ejection fraction (LVEF) and worse left ventricular global longitudinal strain at follow-up visits (all p < 0.05). In conclusion, in patients with acute MCD, iron status is altered and normalizes within six weeks. Low serum iron and TSAT are related to greater in-hospital neurohormonal activation and subtle persistent left ventricular dysfunction.

Role of RBC Parameters to Differentiate between Iron Deficiency Anemia and Anemia of Chronic Diseases

Introduction: In the present study we evaluated and compared RBC parameters, iron status, and ferritin for discriminating between patients with iron deficiency anemia and anemia of chronic disease. Anemia that accompanies infection, inflammation, and cancer, is commonly termed anemia of chronic disease (ACD). Methods: We compared the ability of serum ferritin concentration, using the microplate immunoenzymometric assay method with other, more traditional indicators of iron status like total iron binding capacity [TIBC], mean corpuscular volume [MCV], percent transferrin saturation [%TS], RBC distribution width [RDW], and serum iron concentration [SIC]. The ferritin concentration was determined in 80 serum samples selected from men and women above the age of 18 years. The patients were assigned to IDA and ACD groups based on serum ferritin concentration. Observation: By studying the ROC Curve for various red cell parameters for the diagnosis of IDA and ACD, we found that diagnostic accuracy of various indicators was as follows TIBC&gt;TS%&gt;MCV&gt;MCH&gt;SI&gt;MCHC for anemia of chronic diseases, and TIBC&gt;MCH&gt;MCV&gt;MCHC&gt;TS%&gt;SI for iron deficiency anemia. When both the value of AUCs (Area under Curve) of ROC were compared it is apparent that TIBC, TS%, MCV, and MCH are important discriminating factors between IDA and ACD. Conclusion: Conventional laboratory parameters play an important role in distinguishing overt causes of IDA and ACD. MCV, MCH, and TIBC were found to be (p - value &lt; .05) significantly discriminated against IDA and ACD. Serum ferritin is an important diagnostic tool with reasonable accuracy for the detection and differentiation of iron deficiency anemia and anemia of chronic disease.

Pathogenetic Effects of Bacteria of the Genus &lt;i&gt;Desulfovibrio&lt;/i&gt;. Experimental Study. Part One: Iron Metabolism

The aim of the work was to study specific systemic effect of sulfate-reducing bacteria of the genus Desulfovibrio on organism systems through creating an experimental model of intragastric bacterial invasion against the background of dysbiotic conditions of rodent gastrointestinal tract. Materials and methods. The experimental study was conducted on Wistar rats. Intestinal dysbiosis was modeled with the help of antibiotics, amoxicillin and metronidazole. Typical strain Desulfovibrio desulfuricans subsp. desulfuricans VKM B-1799T was used as an infectious agent. Results and discussion. As a result of the experiment performed, during the period of acute infection (on day 15 of the experiment), a direct correlation between the concentration of the injected D. desulfuricans VKM B-1799T bacteria suspension and the serum iron level was observed: the higher the infectious agent dose, the lower the serum iron concentration. During the phase of remote effects (day 38 of the experiment), the inverse correlation between the concentrations of D. desulfuricans VKM B-1799T in the intestines of rodents was revealed: when the concentration of the infecting agent increased from 103 CFU/g and higher, the iron level decreased from 43.5 μmol/l to 38.5 μmol/l. When comparing the level of transferrin and unsaturated iron binding capacity (UIBC), an increase in those parameters was observed in all groups of rats both during the period of acute infection and the period of long-term effects, and the percentage of transferrin iron saturation decreased, indicating the occurrence of iron deficiency against the background of exposure to the infectious agent. Intestinal dysbiosis promotes colonization by opportunistic flora, including Desulfovibrio sp. Changes in the iron metabolism markers in experimental animals against the background of D. desulfuricans VKM B-1799T infestation above 103 CFU/g and the ability of this microorganism to bind iron into an unavailable form suggest that the bacteria Desulfovibrio sp. are one of the key etiological factors of iron deficiency anemia.

Influence of serum transferrin concentration on diagnostic criteria for iron deficiency in chronic heart failure.

Transferrin saturation (TSAT), a marker of iron deficiency, reflects both serum concentrations of iron (SIC) and transferrin (STC). TSAT is susceptible to changes in each of these biomarkers. Little is known about determinants of STC and its influence on TSAT and mortality in patients with heart failure. Accordingly, we studied the relationship of STC to clinical characteristics, to markers of iron deficiency and inflammation and to mortality in chronic heart failure (CHF). Prospective cohort of patients with CHF attending a clinic serving a large local population. A total of 4422 patients were included (median age 75 (68-82) years; 40% women; 32% with left ventricular ejection fraction ≤40%). STC≤2.3g/L (lowest quartile) was associated with older age, lower SIC and haemoglobin and higher high-sensitivity C-reactive protein, ferritin and N-terminal pro-brain natriuretic peptide compared with those with STC>2.3g/L. In the lowest STC quartile, 624 (52%) patients had SIC ≤13μmol/L, of whom 38% had TSAT ≥20%. For patients in the highest STC quartile, TSAT was <20% when SIC was >13μmol/L in 185 (17%) patients. STC correlated inversely with ferritin (r=-0.52) and high-sensitivity C-reactive protein (r=-0.17) and directly with albumin (r=0.29); all P<0.001. In models adjusted for age, N-terminal pro-brain natriuretic peptide and haemoglobin, both higher SIC (hazard ratio 0.87 [95% CI: 0.81-0.95]) and STC (hazard ratio 0.82 [95% CI: 0.73-0.91]) were associated with lower mortality. SIC was more strongly associated with both anaemia and mortality than either STC or TSAT. Many patients with CHF and a low STC have low SIC even when TSAT is >20% and serum ferritin >100μg/L; such patients have a high prevalence of anaemia and a poor prognosis and might have iron deficiency but are currently excluded from clinical trials of iron repletion.

Effect of long-term carnosine/anserine supplementation on iron regulation after a prolonged running session.

Exercise-induced hemolysis, which is caused by metabolic and/or mechanical stress during exercise, is considered a potential factor for upregulating hepcidin. Intramuscular carnosine has multiple effects including antioxidant activity. Therefore, this study aimed to determine whether long-term carnosine/anserine supplementation modulates exercise-induced hemolysis and subsequent hepcidin elevation. Seventeen healthy male participants were allocated to two different groups: participants consuming 1,500 mg/day of carnosine/anserine supplements (n = 9, C+A group) and participants consuming placebo powder supplements (n = 8, PLA group). The participants consumed carnosine/anserine or placebo supplements daily for 30.7 ± 0.4 days. They performed an 80-running session at 70% VO2peak pre-and post-supplementation. Iron regulation and inflammation in response to exercise were evaluated. Serum iron concentrations significantly increased after exercise (p &lt; 0.01) and serum haptoglobin concentrations decreased after exercise in both groups (p &lt; 0.01). No significant differences in these variables were observed between pre-and post-supplementation. Serum hepcidin concentration significantly increased 180 min after exercise in both groups (p &lt; 0.01). The integrated area under the curve of hepcidin significantly decreased after supplementation (p = 0.011) but did not vary between the C+A and PLA groups. Long-term carnosine/anserine supplementation does not affect iron metabolism after a single endurance exercise session.