Serum Iron Profile Research Articles

Association of serum iron profile in female patients with melasma

Background: Melasma, an acquired pigmentary disorder, presents as symmetric, hyperpigmented macules and patches, primarily on the face. Its prevalence ranges from 1.5% to 33.3% and affects women more than men, impacting self-image and quality of life. Genetic predisposition, sun exposure, and hormonal factors significantly increase tyrosinase activity. The study aims to find an association between serum iron profile and melasma among female patients. Methods: This hospital-based cross-sectional study occurred in the Department of Dermatology and Venereology at Dhaka Medical College Hospital, enrolling 100 women from July 2022 to June 2023. Participants were divided into groups: Group A (patients with melasma) and Group B (healthy respondents without melasma). Results: The study compared two groups, finding no significant differences in age, marital status, occupation, or income. Group A had a higher percentage of patients with a family history of melasma (70% vs 28%) and significantly lower levels of hemoglobin, serum ferritin, iron, and transferrin saturation, but higher TIBC levels compared to Group B. Melasma was mainly central facial and symmetrical. Group A had a higher frequency of low haemoglobin, ferritin, iron, and transferrin saturation. The mMASI scores showed a negative correlation with hemoglobin, iron, ferritin, and transferrin saturation, and a positive correlation with TIBC, indicating more severe melasma with poorer iron profiles. Conclusions: There was a significant inverse correlation between low body iron stores and the severity of melasma, indicating that iron deficiency may contribute to or aggravate melasma in females. Therefore, the findings suggest that iron supplementation could improve treatment outcomes for melasma.

Association of Serum Iron Profile among Patients with Type 2 Diabetes Mellitus with or without Diabetic Nephropathy

Background: Diabetes mellitus (DM) is the most significant public health challenges in both developed and developing countries. Diabetic nephropathy (DN) is one of the major causes of morbidity and mortality among patients with DM worldwide. Iron modify glucose metabolism and glucose metabolism impinges on iron. Objective: To evaluate serum iron profile in type 2 diabetic patients with or without diabetic nephropathy. Methods: This cross-sectional study was conducted at Department of Biochemistry and Molecular Biology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorder (BIRDEM), Dhaka, Bangladesh from January 2019 to December 2019. Total 150 participants were enrolled according to the selection criteria and were divided into three groups, 50 patients were with type 2 diabetes mellitus (T2DM), 50 patients were with DN and another 50 respondents were healthy controls. All relevant data were recorded and their serum iron profile was estimated accordingly. Data were analyzed and compared by statistical tests. Results: Male and female were 41.3% and 58.7% respectively and majority (31.3%) was in 51-60 years. The mean value of HbA1C of DN patients was significantly higher among groups (p<0.001). It was found that serum iron and serum ferritin were significantly (p<0.001) higher and total iron binding capacity (TIBC) was significantly (p<0.001) lower in T2DM and DN patients compare with healthy controls. The mean serum creatinine level was significantly (p<0.001) higher and mean value of estimated glomerular filtration rate (eGFR) was significantly (p<0.001) lower in DN patients. There were significant negative correlation of serum iron and significant positive correlation of TIBC with eGFR in patients with DN; but a negative correlation of serum ferritin with eGFR in patients with DN. Conclusion: It was observed that, serum iron, serum ferritin levels were significantly increased and TIBC was significantly decreased ........

Anti-oxidant activity of coenzyme Q10 against AlCl3/D-galactose in albino rat induced cognitive dysfunctions: Behavioral, biochemical, and BACE-1/GSK-3β alterations.

The relationship between amyloid beta (Aβ) and oxidative stress (OS), both prominent factors in Alzheimer's disease-related neural degeneration, is deeply interconnected. The cleavage of the extracellular domain of Amyloid precursor protein (APP) and phosphorylating different substrates, respectively, the β-site amyloid precursor protein cleaving enzyme-1 (BACE-1) and Glycogen synthase kinase-3-beta (GSK-3β) enzymes initiate the synthesis of Aβ, which causes cognitive deficits in AD. This study aimed to explore the protective potential of Coenzyme Q10 (CoQ10). It also sought to uncover any synergistic effects when combined with donepezil, an acetylcholinesterase inhibitor, in treating Alzheimer's disease in male albino rats, focusing on the modulation of the BACE-1/GSK-3β pathway. The experiment involved 70 rats categorized into different groups: control, donepezil alone, CoQ10 alone, AD-model, donepezil co-treatment, CoQ10 co-treatment, and CoQ10+donepezil combination. Various assessments, such as cholinesterase activity, oxidative stress, serum iron profile, Brain Derived Neurotrophic Factor (BDNF), Tau protein, β-site amyloid precursor protein cleaving enzyme-1 (BACE-1), phosphatase and tensin homolog (Pten), and Glycogen synthase kinase-3-beta (GSK-3β), were conducted on behavioral and biochemical aspects. CoQ10 treatment demonstrated memory improvement, enhanced locomotion, and increased neuronal differentiation, mainly through the inhibition of the dual BACE-1/GSK-3β. These findings were substantiated by histological and immunohistological examinations of the hippocampus.

Gene expression of iron transporters, markers of vascularization and structural integrity in placenta of mothers with and without anemia.

To compare the mRNA expression of placental iron transporters (TfR-1 and FPN), markers of placental vascularization (VEGF and sFLT1) and marker of structural integrity (LMN-A) in term women with and without iron deficiency anemia. A total of 30 pregnant women were enrolled; 15 cases of iron deficiency anemia (Hb 7-10.9 gm/dL) and 15 gestational age matched healthy controls (Hb ≥ 11 gm/dL). Peripheral venous blood was collected for assessment of hemoglobin levels and serum iron profile. Placental tissue was used for assessing the mRNA expression of TfR-1, FPN, VEGF, sFLT-1 and LMN-A via real time PCR. Placental expression of TfR-1, VEGF and LMN-A was increased in pregnant women with anemia compared to healthy pregnant controls. Placental expression of sFLT-1 was decreased in pregnant women with anemia compared to healthy pregnant controls. There was no change in the placental expression of FPN. The increased expression of TfR-1, VEGF and LMN-A in cases of iron deficiency anemia are most likely to be compensatory in nature to help maintain adequate fetal iron delivery. Compensatory changes in the placenta aimed at buffering transport of iron to the fetus are seen in pregnant women with anemia compared to healthy pregnant controls.

Serum iron Profile of Patients with Sickle Cell Disease and its Association with Socio-demographic Characteristics and Duration of Diagnosis.

Sickle cell anemia is the most common hemoglobinopathy in the world. The study aimed to evaluate the iron profile and its association with socio-demographic characteristics in patients with sickle cell disease. A hospital-based descriptive cross-sectional study was conducted to know the iron profile and its socio-demographic association in patients with sickle cell disease. The average serum iron, TIBC, and transferrin saturation were 16.75 ± 6.40 mcgMole/L, 69.46 ± 16.94 mcg/dl and 25.15 ± 12.51% respectively. The serum ferritin ranged from 10.00 to 3000.00 ng/ml. The proportion of participants with normal serum iron, TIBC, serum ferritin, and transferrin saturation were 86.10%, 0.00%, 33.90% and 36.40% respectively. All of the participants of this study had low TIBC (1005), and more than half of the participants had elevated serum ferritin (56.40%). Iron overload is a common complication of sickle cell disease. There was no association of age and sex with iron profile. The TIBC variation between the Chaudhary ethnic group compared to other ethnic groups signifies the ethnic role in the iron profile.

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

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

Anemia profiling in antenatal women at a tertiary care center in northern India: An observational study

: Anemia is a common health issue during pregnancy, with various factors influencing its occurrence. Iron deficiency often leads to iron deficiency anemia (IDA), significantly impacting maternal and fetal health.: This study aims to investigate the complete blood count and nutritional status, including serum iron profile, vitamin B12, and folate levels in antenatal patients. : The study involved 160 participants, predominantly from rural areas. The severity of anemia among the participants was classified according to WHO guidelines.: Iron deficiency was observed in 33.75% of women, folate deficiency in 20%, and vitamin B12 deficiency in 11.25%. Some women exhibited a combination of deficiencies. The average hemoglobin level was found to be 8.69 g/dL, and the mean iron level was 35.95 µg/dL. The average ferritin levels were observed to be 49.65 ng/mL. Lastly, the Vitamin B12 and folate levels averaged at 130.21 pg/mL and 14.76 ng/mL respectively.: These findings provide valuable insights into the nutritional status of pregnant women and highlight the need for targeted interventions to address micronutrient deficiencies during pregnancy.

Orodispersible Film Based on Maltodextrin: A Convenient and Suitable Method for Iron Supplementation.

Orodispersible film (ODF) is an innovative dosage form used to administer drugs and nutrients, designed to disintegrate or dissolve in the oral cavity without needing water. One of the advantages of ODF is that it is suitable for administration in older people and children who have difficulty swallowing because of psychological or physiological deficiencies. This article describes the development of an ODF based on maltodextrin, which is easy to administer, has a pleasant taste, and is suitable for iron supplementation. An ODF containing 30 mg of iron as pyrophosphate and 400 µg of folic acid (iron ODF) was developed and manufactured on an industrial scale. The kinetic profile for serum iron and folic acid upon consumption of ODF compared with a Sucrosomial® iron capsule (known for its high bioavailability) was evaluated in a crossover clinical trial. The study was conducted in nine healthy women, and the serum iron profile (AUC0-8, Tmax, and Cmax) of both formulations was defined. Results showed that the rate and extent of elemental iron absorption with iron ODF was comparable to that obtained using the Sucrosomial® iron capsule. These data represent the first evidence of iron and folic acid absorption concerning the newly developed ODF. Iron ODF was proven to be a suitable product for oral iron supplementation.

Variations in Serum Iron Profile, in Pre and Post Hemodialysis Patients of Chronic Renal Failure

Objective: To determine the variations in iron profile in pre- and post-hemodialysis patients with chronic renal failure. Material and methods: This cross-sectional study was conducted at the physiology department with the collaboration of the urology department of Liaquat University Hospital Hyderabad, from April 2021 to September 2021. Patient of either gender with chronic kidney disease between the ages of 18- and 50-years undergoing hemodialysis were included. Blood samples were collected using serum tubes to analyze the iron profile before and after dialysis. Changes in hematological parameters were evaluated by comparing pre and post data. All data were recorded in a proforma and entered into the SPSS 26.0 version for the purpose of analysis. Results: A total of 167 patients were studied; their mean age was 43.23+12.90 years. Out of all study subjects 61.1% were males and 38.9% were females. The mean duration of dialysis was 13.40 ± 2.88 months. As per the pre- and post-serum iron profiles, the average serum iron level, serum ferritin level, and serum TIBC were statistically insignificant (p- >0.05). Conclusion: In conclusion, the iron levels before dialysis were observed to be higher than after dialysis, and the average levels of serum ferritin and total iron binding capacity (TIBC) were found to be higher after dialysis, albeit statistically insignificant. Keywords: Hemodialysis, serum iron, ferritin, TIBC

A Randomized Controlled Trial to Compare Intraveous Ferric Carboxymaltose with Oral Iron for Treatment of Post-Partum Anemia

Objectives: To compare the efficacy of ferric carboxymaltose (FCM) with oral iron in management of post-partum anemia. Materials and Methods: A total of 230 post-partum women aged >18 years having Hb level <10 g/dl on post-natal day 1 were randomized to receive either oral iron (ferrous fumarate tablets 200 mg for 06 weeks) or intravenous FCM (dose calculated by Ganzoni’s Formula, total iron dose = [actual body weight x (15 - actual Hb)] x 2.4 + iron stores). Demographic, obstetric and hematological profile (Hb and serum iron profile) was estimated at the time of enrolment. The women were followed up after six weeks. Non-complying women were excluded from the study. Change in Hb levels, serum iron profile and number of women achieving Hb>10 g/dl was noted. Data was compared using Chi-square and Independent samples ‘t’-test respectively. Results: A total of 218 women (107 in FCM and 111 in oral iron group) completed the study. Mean age of women was 26.67±4.31 years. Mean pre-intervention Hb level was 9.11±0.62 and 9.15±0.61 g/dl respectively in FCM and oral iron groups (p=0.630). At follow-up these values were 11.11±0.89 and 10.78±0.88 g/dl respectively in the corresponding groups (p=0.006). Mean change in Hb level and number of women achieving targeted Hb level were significantly higher in FCM as compared to that in oral iron group (p<0.05). Serum iron reserves were also found to be significantly higher in FCM as compared to oral iron group. Conclusion: Intravenous FCM had an edge over oral iron in management of post- partum anemia.

To evaluate the hematological markers in patients having nutritional anemia attending National Institute of Medical Sciences Hospital of Jaipur, Rajasthan

Abstract Background: Nutritional anemia is the most common preventable cause of anemia. Anemia of nutritional origin is an acquired problem caused by consumption of diets that lack sufficient quantity of vitamin B12 levels and serum iron and other components. As per World Health Organization guidelines, hemoglobin (Hb) of <10 g/dL concentration treated as anemia. Nutritional anemia is identified by determining Hb concentrations, evaluating red cell indices and examining peripheral blood picture accompanying serum iron parameters and serum vitamin B12 level. Objectives: To study complete blood count indices with different serum vitamin B12 levels and serum iron profile among nutritional anemia patients attending NIMS Hospital, Jaipur. Materials and Methods: An observation study was conducted among 274 patients having nutritional anemia from General medicine out patients between 15 and 60 years. Two blood samples were collected from each participant to estimate the complete blood counts and red blood cells (RBCs) morphology and to analyze the iron profile and vitamin B12. Results: This presence study shows nutritional anemia in 55% of women than men. 15.6% of patients were from age group 15–20 years. 56.57% patients had moderate anemia, 29.92% patients had severe anemia, and 13.56% patients had mild anemia. Study shows 55% population were nonvegetarians and 45% had vegetarian diet. Microcytic hypochromic blood picture was found in 59.49% patients. Conclusions: Nutritional deficiency anemia was the most prevalent anemia. Peripheral smear is in concordance with serum iron parameters and serum vitamin B12 level. Our study suggests RBC morphology along with red cell indices in diagnosis and management of nutritional anemia which can be cured by dietary adjustment and fortification of food with iron and other micronutrients.

Spectrum of hemoglobinopathies with hematological and biochemical profile: A five year experience from a tertiary care hospital.

Determination of hemoglobinopathies is significant for epidemiological studies. There is a need to identify burden of hemoglobinopathies at national level to lay down the foundation of appropriate screening and prevention programs. The present study aimed to evaluate the spectrum of hemoglobinopathies along with hematological and biochemical parameters in a tertiary care hospital. This retrospective study included results of high performance liquid chromatography (HPLC) test from July 2015 - May 2020 in the department of Hematology, Indus Hospital and Health Network, Karachi, Pakistan. Data of all patients collected for red blood cell (RBC) indices, serum iron profile, and vitamin B12 and red cell folate levels. Diagnosis of hemoglobinopathies was done by an automatic analyzer ADAMS A1C Model No. HA-8180T Arkray/Japan. Among 2422 participants, hemoglobinopathy observed in 14.5% (n=352). Beta thalassemia trait is observed as the most common hemoglobinopathy (6.4%). Severe anemia (Hb=5.1-5.5 g/dl) found in beta thalassemia major (BTM) and HbE disease. Red cell parameters showed significant association with different types of hemoglobinopathies. Mean ferritin level was high in E-beta thalassemia (687.8±591.9) followed by sickle cell disease (615.7±543.5). Apparently, overall frequency is static however, results of this study are not applicable to general population due to sample bias. Moreover, true figures are difficult to identify due to high incidence of iron deficiency anemia that masks the diagnosis by conventional techniques. Molecular characterization by DNA analysis is the most reliable tool of diagnosis. However, this method is not widely available in our country due to lack of expertise and cost issues.

Pulmonary Arterial Pressure Changes Under Dobutamine Stress Echocardiography in Non-Anemic Iron Deficient COPD Subjects.

PurposeNon-anemic iron deficiency (NAID) is common in COPD, and could induce functional/structural changes in the pulmonary vascular bed. Thus, we aimed to study, during resting and ambient oxygen conditions, the systolic pulmonary arterial pressure (sPAP) changes during dobutamine stress echocardiography (DSE) for NAID+ compared to NAID- subjects with COPD.Patients and MethodsWe analyzed 24 patients with COPD and evaluated their clinical parameters, including lung function and serum iron profile, followed by the changes in the sPAP under DSE.ResultsTen subjects with NAID+ were compared with fourteen NAID- subjects for sPAP measurement. At baseline, only left atrial volume was significantly different between groups (30±4 vs 23±5 mL*m2), respectively (p-value=0.002). For the right side, tricuspid annular plane systolic excursion (TAPSE) was similar between-groups (22±2 vs 20±4, p-value >0.05), at baseline. The sPAP (mmHg) changes were also not significantly different between groups (pre 32±14 vs peak 48±14 for NAID+ and pre 29±7 vs peak 43±10 for NAID-, Group p-value=0.400, Time p-value <0.0001, and Interaction p-value=0.606).ConclusionCOPD subjects with NAID do not show increased sPAP responses during DSE, compared with iron-replete subjects.

Role of Soluble Transferrin Receptor in Diagnostic Work Up for The Assessment of Iron Status and Iron Deficiency

Background: Iron deficiency anaemia (IDA) is the most frequent form of anaemia in human population. For diagnosing IDA usually conventional laboratory tests such as serum iron, serum ferritin and transferrin saturation are used. However, both ferritin and transferrin proteins are markedly influenced by inflammation, behaving as acute-phase reactants and making it difficult to diagnosis iron-deficiency anemia (IDA) when it is combined with any inflammatory condition. Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. Serum transferrin receptor (sTfR) levels are raised in iron deficiency but are not influenced by inflammatory changes.&#x0D; Aim: The aim of this study is to evaluate the significance of soluble transferrin receptors in diagnostic work up of iron deficiency.&#x0D; Materials and Methods: It was a prospective observational study carried out from June 2021 to November 2021 at the Department of Haematology and Biochemistry of Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment. A total of 50 blood sample were collected and subjected to diagnose as microcytic hypochromic anaemia through complete blood count (CBC) and peripheral blood film (PBF). Then serum iron profile and serum sTfR was done by automated analyzer to evaluate differentials of microcytic hypochromic anaemia.&#x0D; Results: Among 50 cases 5 (10%) were male and 45 (90%) were female. Most of the patients were between 31-40 years age group (34%). Out of 50 patients 42 (84%) showed mild anaemia,6 (12%) showed moderately anaemia and 2(4%) showed severely anaemia according to reference range. Then serum iron profile was done. Among 50 samples 37 (74 %) had low serum iron, 18 (36 %) had high TIBC and 45 (90%) had low serum ferritin in comparison with reference range. Also this study revealed high serum sTfR than normal in 48 (96%) patients. While evaluating the frequency of sTfR level in perspective of both male and female anaemic patients, p-value was found &lt; 0.0001 which was statistically significant.&#x0D; Conclusion: This study demonstrates that sTfR level in conjunction with other biochemical markers of iron deficiency anaemia is very useful in evaluating iron status. Serum sTfR is a new diagnostic tool for evaluating of iron deficiency anemia when it is associated with other inflammatory condition.

Association between use of low-dose aspirin on hemoglobin levels and serum iron homeostasis in patients with acute coronary syndrome or ischemic stroke

Background: Association between low-dose aspirin (LDA) and possible covert effects on hemoglobin (without overt bleeding) has been inconsistent. The current study was planned to assess the effects of LDA on hemoglobin level and serum iron status over a period of 6 months in nonanemic patients with acute coronary syndrome (ACS) or ischemic stroke. Methods: This was a hospital-based open cohort prospective study conducted on newly diagnosed patients with ACS or ischemic stroke discharged on secondary prophylaxis of LDA (&lt;162 mg/day) The study period was 6 months of patient recruitment and 6 months of follow-up. Results: Out of originally recruited 81 patients, 52 were followed up for the entire 6 months. The mean age was 61.8 ± 8 years. In 43 (82.6%) patients, the hemoglobin level had a fall at 6 months from the baseline level. Male patients had a significant fall in hemoglobin levels while as females had an insignificant change. Anemia was detected in 20 (38%) cases at the end of 6 months. The incidence of anemia was 0.38 cases/180 days. A fall in serum ferritin was observed in 30 patients and a rise was observed in 22 patients. At the end of 6 months, serum ferritin fell to &lt;20 μg/L in five patients, out of which two patients had serum ferritin &lt;15 μg/L. Conclusion: The study provided insight about the effect of LDA on the hemoglobin level and serum iron profile among the patients who were started on LDA for the secondary prophylaxis.

Clinical and hematological evaluation of geriatric anemia.

ABSTRACTBackground:Anemia in the elderly is a cause of concern. It is not merely physiological due to aging and requires appropriate evaluation. Anemia has a significant negative impact on cardiac function, cognition, sleep, frequent hospitalization, mobility, morbidity, and mortality. Anemia in the elderly is attributable to many causes: nutrient deficiencies, chronic inflammatory diseases, thyroid disorders, diabetes mellitus, gastrointestinal (GI) tumors and bleeding, chemotherapy-induced anemia, and drug-induced hemolysis.Objectives:We aimed to evaluate the clinical and hematological profile of anemia in 100 patients aged above 60 years.Methods and Material:We performed a cross-sectional type of study in a tertiary care center including male and female patients aged 60 years and above and whose hemoglobin was less than 13 g/dl and less than 12 g/dl, respectively. Clinical history, complete blood picture, and peripheral smear were obtained in all patients. Serum iron profile was done in patients with micro-normocytic anemia. Vitamin B12 and folate assays were done in patients with normo-macrocytic anemia and those with pancytopenia. Bone marrow studies and endoscopies were done in cases wherever deemed appropriate.Results:The majority of the patients had either severe or moderate anemia. 49% of the patients had normocytic anemia. The commonest cause for anemia was nutritional deficiencies (45%) followed by anemia of chronic inflammation (40%) and unexplained anemia (8%).Conclusions:It is essential that anemia deserves its due attention in clinical practice in older patients and is not normal always.

The correlation between hepcidin levels and iron parameters in patients with end-stage renal disease on regular hemodialysis successfully treated from hepatitis C virus by directly acting antiretrovirals

Background Hepcidin is a polypeptide secreted from the liver. It regulates iron metabolism by blocking further iron absorption when iron stores are high. Hepcidin levels are usually higher than the normal range in hemodialysis (HD) patients. Hepatitis C virus (HCV) infection leads to lowering of hepcidin levels, leading to more iron overload. The objectives were to determine whether there is a correlation between iron stores and hepcidin levels in HD patients after HCV treatment and to assess the level of hepcidin in those patients who were treated from HCV compared with those who have chronic HCV infection. Patients and methods In total, 60 patients on regular HD were recruited and 30 healthy controls. Group I: 30 patients who have been successfully treated from HCV by directly acting antiretroviral drugs with a persistently negative PCR for at least 3 months, group II: 30 patients with chronic HCV infection, and 30 healthy controls form group III. Serum hepcidin levels, iron profile, and complete blood count were compared in all groups. Results Hepcidin levels were significantly higher in the HCV-treated group versus the HCV-infected group (mean 226.77±144.13 and 87.77±40.77 ng/dl), respectively, significantly higher transferrin-binding capacity (TIBC), and mean levels 410.5±74.65 and 310.93±122.57 μg/dl. Ferritin levels were higher in the HCV-infected group (355.13±196, 899.5±1522 ng/dl) than in HCV-treated. There was a significant correlation between hepcidin and serum iron, TIBC, and transferrin saturation in the HCV-treated group. On regression analysis, only TIBC and transferrin saturation correlated significantly. Conclusions Post HCV treatment with directly acting antiretroviral drugs, hepcidin levels are higher than during HCV-infection state and correlate significantly to higher TIBC. Further studies are needed to establish the effect of iron supplementation on hepcidin level in this subgroup of patients.

Tissue biodistribution of intravenous iron-carbohydrate nanomedicines differs between preparations with varying physicochemical characteristics in an anemic rat model

Intravenously administered iron-carbohydrate preparations are a structurally heterogenous class of nanomedicines. Iron biodistribution to target tissues is greatly affected by the physicochemical characteristics of these nanoparticles. Some regulatory agencies have recommended performing studies in animal models for biodistribution characterization and bioequivalence evaluation. In the present work, a systematic comparison of iron exposure, tissue biodistribution and pharmacodynamics of four intravenous iron-carbohydrates in anemic CD rats was conducted. A pilot study was performed to establish the anemic rat model, followed by a control study to evaluate the pharmacokinetics (serum iron, biodistribution) and pharmacodynamics (hematological parameters) in healthy and anemic controls and anemic rats receiving ferric carboxymaltose (FCM). The same parameters were then evaluated in a comparative study in anemic rats receiving FCM, iron sucrose (IS), iron isomaltoside 1000 (IIM), and iron dextran (ID). Despite similar serum iron profiles observed across the investigated nanomedicines, tissue iron biodistribution varied markedly between the individual intravenous iron-carbohydrate complexes. Tissue iron repletion differences were also confirmed by histopathology. These results suggest that employing serum iron profiles as a surrogate for tissue biodistribution may be erroneous. The variability observed in tissue biodistribution may indicate different pharmacodynamic profiles and warrants further study.

UTILITY OF SERUM FERRITIN AS A PREDICTOR OF COLORECTAL CANCER IN ELDERLY PATIENTS

Objective: Ferritin is an indicator of iron deficiency. Colorectal cancer is an important cause of morbidity and mortality in older subjects. The aim of this study was to determine the value of serum ferritin and ferritin-transferrin saturation in the diagnosis of colorectal cancer in older subjects. Material and Methods: 600 older patients who had undergone upper and lower gastrointestinal endoscopic examination were included into the study. Serum iron profile and C-reactive protein were also recorded. Patients were then evaluated by three different ferritin levels according to their iron profiles: method 1: ferritin < 50 µg/L; method 2: ferritin < 100 µg/L; method 3: ferritin+transferrin saturation index. The relationship between existence of colorectal cancer and serum ferritin level was investigated. Results: 528 patients had normal upper and lower endoscopic findings. 72 patients had colorectal carcinoma with normal upper gastrointestinal findings. Method 1 (ferritin<50 µg/L) predicted 58.4% of patients with colorectal carcinoma with a sensitivity and specificity of 63% (95% CI:52-74) and 53% (95% CI: 48-57) respectively. However, sensitivity [91% (95% CI:82-96)] of method 3 was greater than method 1 and 2 with a AUROC value of 70.4%. There was no difference by means of median ferritin levels. Median transferrin saturation index was significantly higher in group I (Normal subjects) compared to patients in group II (Colorectal cancer patients) (17.5 vs 8%, p<0.001). Conclusion: Serum ferritin <50 μg/L and <100 μg/L have rather low diagnostic yield in the decision making of colonscopic examination for colorectal carcinoma. However, ferritin <100 μg/L and TSI <16% values can be more useful in selecting older patients for colonoscopic examination.

Iron and Ferritin as novel screening markers of Acute Myocardial Infarction

Introduction: Cardiovascular disease is a public health problem globally. In India, the prevalence of Acute Myocardial Infarction (AMI) was 6.43%. Several causes lead to AMI, among which excess serum Iron and Ferritin is responsible for an increase in the generation of free radicals, thus accelerate atherogenesis through oxidation of Low-density lipoprotein – cholesterol (LDL-C). Assess serum Iron and Ferritin status and compare them with the cardic marker (CK-MB) among patients with AMI. Methods: The study was performed in a tertiary care centre in TamilNadu, India. This casecontrol study was conducted on 25 patients diagnosed with AMI and 25 age and sex-matched healthy participants as control group. Iron, Ferritin, CK-MB and lipid profile parameters were analyzed in serum samples of the participants. Result: The mean levels of serum Iron, Ferritin, CK-MB and lipid profile parameters were increased significantly among the cases when compared to the control group. CK-MB had a strong positive correlation with serum Iron and Ferritin. Serum Iron and Ferritin also had a positive correlation with total cholesterol and LDL-C, and a negative correlation with Highdensity lipoprotein – cholesterol. The odds of developing AMI in those with serum Iron &gt;51.5µg/dl and Ferritin &gt;137ng/dl were 36 and 61.7 times at higher risk respectively. Conclusion: Higher levels of serum Iron and Ferritin seem to be stronger risk factors for AMI, and shall be considered as early screening cardiac markers for AMI.