Serum Iron Levels Research Articles

Efficacy of different doses of daily prophylactic iron supplementation in pregnant women: A systematic review and meta-analysis

IntroductionSeveral randomized controlled trials (RCT) have been conducted in the past to determine the optimum dose of iron supplementation during pregnancy, but there is a lack of consensus among different guidelines regarding the appropriate dosage of iron for prophylaxis during pregnancy. MethodsRelevant electronic databases were searched to identify publications describing RCTs comparing different daily dosages of iron supplementation during pregnancy. Meta-analysis for various efficacy and safety outcomes such as changes in blood hemoglobin, serum ferritin, serum iron, and serum transferrin saturation, as well as the frequency of adverse effects, was performed using random and fixed effect models suitably depending on the degree of heterogeneity. Two groups were compared: those receiving 60 mg elemental iron or less and those receiving more than 60 mg elemental iron per day. Additionally, the efficacy of those receiving 30 mg elemental iron per day and those receiving 60 mg elemental iron per day were also compared. ResultsA to total of 15 RCTs comprising 2726 participants were included in the meta-analysis. Change in blood hemoglobin levels was comparable between the ≤60 mg/day and >60 mg/day group (pooled estimate for mean difference, 0.01 [-0.11, 0.09], p=0.86, I2=96%), but serum ferritin, iron level, and serum transferrin saturation change were higher in the >60 mg group (p<0.0001, 0.008, and 0.02, respectively). Change in blood hemoglobin level was better in the 60 mg/day group compared to the 30 mg/day group (pooled estimate for mean difference, -0.11 [-0.21, 0.00], p=0.04, I2=90%), as well as changes in serum ferritin and serum transferrin saturations (p=0.004 and 0.0004, respectively). ConclusionDaily supplementation of 60 mg elemental iron is more efficacious than daily supplementation of 30 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate), and daily supplementation of ≤60 mg elemental iron is equally efficacious compared to daily supplementation of >60 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate). PROESPERO registration NoCRD42023455485

Lif-deficiency promote systemic Iron metabolism disorders and increases the susceptibility of osteoblasts to ferroptosis

Leukemia inhibitory factor (LIF) is a multifunctional cytokine that plays a crucial role in various biological processes. However, LIF involvement in iron metabolism remains almost unexplored. This study aimed to explore the impact of LIF on systemic iron transportation and its potential role in ferroptosis in osteoblasts. We observed that the Lif-deficient (Lif−/−) mice is characterized by a reduction in bone mass and a decrease in bone mineral density compared with wild-type (WT) mice. Energy-dispersive X-ray spectroscopy revealed a marked increase in iron content on the surface of femurs from Lif−/− mice. Meanwhile, iron stores test lower iron levels in the spleens and higher levels in the femurs of Lif−/− mice. Besides, Lif−/− mice display increased levels of serum iron, total iron-binding capacity, unsaturated iron-binding capacity, and transferrin saturation and serum ferritin relative to WT mice. Hepcidin mRNA expression reduction in the liver of Lif−/− mice. It also holds true in the AML-12 hepatocyte cell line after Lif-knockdown. Immunohistochemistry and RT-PCR revealed elevated ferroportin (FPN) in duodenal cells of Lif−/− mice. Lif-deficiency decreases SLC7A11 levels in osteoblasts. In addition, overexpression of LIF downregulates CD71, DCYTB, and DMT1, thereby reducing iron uptake in iron-overloaded cells. Femur immunohistochemistry (IHC) revealed increased ACSL4 and decreased GPX4 and SLC7A11, indicating an increase in ferroptosis of osteoblasts in Lif−/− mice. Whole-transcriptome sequencing showed gene expression changes after Lif-knockdown, exhibiting a negative correlation with genes involved in long-chain fatty acid transport, mitochondrial organization, and the p38 MAPK signaling pathway. These results demonstrate that Lif-deficiency alter systemic iron metabolism and increases the susceptibility of osteoblasts to ferroptosis.

Association between serum iron levels and atherosclerotic cardiovascular diseases among American older adults: a cross-sectional study based on the National Health and Nutrition Examination Survey, 2009-2018.

There is controversy regarding the relationship between serum iron levels and atherosclerotic cardiovascular disease (ASCVD). To investigate the relationship between serum iron levels and ASCVD among older adults using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). We performed a cross-sectional analysis involving 8,682 participants aged 60 years and older, with complete data on serum iron levels and confirmed ASCVD status, sourced from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression models were used to examine the association between serum iron levels and ASCVD. To assess the consistency of this association across different demographic groups, subgroup analyses, and interaction tests were performed. The group with the highest serum iron levels (fourth quartile, 100-369 μg/dL) exhibited several distinct characteristics: they were the youngest on average (69.57 ± 6.91 years), had the highest proportion of males (61.42%), and the highest hemoglobin levels (14.43 ± 1.33 g/dL). This group also showed the lowest iron supplement usage (19.71 ± 12.85 mg/30 days), white blood cell counts (6.73 ± 2.41 1,000 cells/μL), and serum creatinine levels (0.98 ± 0.45 mg/dL). Moreover, they had higher levels of education and income, a higher likelihood of being married, and a lower body mass index (BMI). Additionally, they had significantly lower rates of diabetes, hypertension, stroke, and heart attacks (all p < 0.05). After adjusting for potential confounders, a linear relationship between serum iron levels and ASCVD was initially observed (OR = 0.97; 95% CI, 0.95-0.99, p < 0.05). However, further analysis using a two-part logistic regression model with an inflection point at 131 μg/dL revealed more nuanced results. For serum iron levels below 131 μg/dL, each 10 μg/dL increase was associated with a 4% decrease in the odds of ASCVD (OR = 0.96; 95% CI, 0.93-0.98, p < 0.001). Conversely, for serum iron levels above 131 μg/dL, each 10 μg/dL increase corresponded to a 1% increase in the odds of ASCVD, though this finding was not statistically significant (OR = 1.01; 95% CI, 0.98-1.08, p > 0.05). In the US elderly population, serum iron levels are negatively associated with ASCVD, particularly when serum iron levels are below 131 μg/dL.

A Study of the Clinical Profile of Iron Deficiency Anemia in Children With Sickle Cell Disease in a Tertiary Care Center.

Background Sickle cell disease (SCD) and iron deficiency anemia (IDA) are significant global health concerns, particularly in pediatric populations. This study investigates the prevalence, clinical impact, and management challenges of IDA in children with SCD. Methods A prospective observational study was conducted at the Department of Pediatrics, Jawaharlal Nehru Medical College(JNMC) and Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, from June 2022 to May 2024. The study included 60 children diagnosed with SCD. Comprehensive assessments were performed, including medical histories, physical examinations, and hematological investigations. Diagnosis of IDA was based on hemoglobin levels, mean corpuscular volume (MCV), red cell distribution width (RDW), peripheral blood smears, serum iron levels,and serum ferritin concentrations. Results Of the 60 participants, 15% exhibited iron deficiency. No significant gender differences were found in iron deficiency status. A significant association was observed between SCD type and the presence of pallor (p = 0.025) and sickle cell crises (p = 0.023). The study also found no significant association between SCD type and the presence of organomegaly (p = 0.079) or iron deficiency status (p = 0.675). The mean hemoglobin levels varied across SCD types, with sickle cell anemia patients showing lower levels than those with sickle cell trait or disease. Conclusion Diagnosing and managing IDA in children with SCD is complex due to overlapping hematological features and the risk of iron overload from frequent transfusions. Tailored diagnostic and therapeutic approaches are essential to improving hemoglobin levels, reducing complications, and enhancing the quality of life for affected children. This study provides valuable insights for refining clinical practices and emphasizes the need for a multidisciplinary approach to managing these intertwined conditions.

Taurolithocholic acid protects against viral haemorrhagic fever via inhibition of ferroptosis.

Bile acids are microbial metabolites that can impact infection of enteric and hepatitis viruses, but their functions during systemic viral infection remain unclear. Here we show that elevated levels of the secondary bile acid taurolithocholic acid (TLCA) are associated with reduced fatality rates and suppressed viraemia in patients infected with severe fever with thrombocytopenia syndrome virus (SFTSV), an emerging tick-borne haemorrhagic fever virus. TLCA inhibits viral replication and mitigates host inflammation during SFTSV infection in vitro, and indirectly suppresses SFTSV-mediated induction of ferroptosis by upregulating fatty acid desaturase 2 via the TGR5-PI3K/AKT-SREBP2 axis. High iron and ferritin serum levels during early infection were correlated with decreased TLCA levels and fatal outcomes in SFTSV-infected patients, indicating potential biomarkers. Furthermore, treatment with either ferroptosis inhibitors or TLCA protected mice from lethal SFTSV infection. Our findings highlight the therapeutic potential of bile acids to treat haemorrhagic fever viral infection.

Serum levels of iron, zinc, selenium, copper and oxidative stress in hypertensive patients: A comparative study of age-related changes in the governorate of Basrah, Iraq

Hypertension is the force of blood through blood vessels, where the heart works harder and blood vessels are under more pressure. The relationship between trace element levels and oxidative stress in hypertension is under investigation, with conflicting results. This study aimed to determine the relationship between concentrations of certain antioxidant trace elements (iron, zinc, selenium, and copper) and protein carbonyl concentration as an indicator of oxidative stress in the serum of hypertensive patients compared to the control group in Basra, Iraq, according to age. The study included 100 hypertensive patients (44 males and 56 females) compared to 50 healthy individuals (25 males and 25 females). Patients were divided into three age groups: 35–45, 46–56, and over 57 years. The study showed a significant decrease (p&lt;0.001) in the mean concentration of all selected elements in the patients' serum compared to the control group. Conversely, the mean protein carbonyl level showed a significant increase (p&lt;0.001) in patients compared to the control group. Trace element concentrations decreased in patients with increasing age, while carbonyl protein levels increased, especially in the third age group. The study also showed a significant negative correlation between protein carbonyl level and all trace elements at p&lt;0.001. These results suggest that hypertension is associated with an imbalance in oxidative stress and trace elements. Monitoring trace element intake may help reduce oxidative stress and improve overall health in individuals with hypertension, especially with advancing age, by restoring the balance of essential elements and antioxidants in the body.

Evaluation of Serum Ferritin, Iron and C-Reactive Protein Level in Children with Febrile Seizure in Wasit Province, Iraq

Background: Febrile seizures are a commonplace pediatric neurological sickness, often related to fever and infections. Recent research suggest a capability hyperlink among iron deficiency, inflammation, and the prevalence of febrile seizures, but the relationship remains underexplored in particular populations. This study aimed to assess the affiliation between serum iron, ferritin levels, and inflammatory markers (C-reactive protein [CRP] and white blood cell [WBC] remember) in youngsters with febrile seizures in comparison to healthful controls.Methods: A case-manage study become performed involving a hundred youngsters aged 6 months to 6 years, with 50 kids who skilled febrile seizures (patient institution) and 40 age-matched healthful controls. Serum ferritin, iron, CRP degrees, and WBC counts had been measured and compared between the 2 groups. The data have been analyzed the usage of impartial t-assessments, Pearson correlation, and multivariate logistic regression.Results: Children within the febrile seizure institution had extensively decrease serum ferritin (40.5 ± 30.2 ng/mL) and iron levels (40.8 ± 15.3 μg/dL) as compared to controls (85.7 ± 20.4 ng/mL and 75.4 ± 18.7 μg/dL, respectively; p &lt; 0.001). CRP ranges and WBC counts had been notably better within the affected person organization (25.6 ± 48 mg/L and 18,400 ± 5,200 cells/μL, respectively) compared to controls (2.3 ± 1.1 mg/L and 7,200 ± 1,800 cells/μL; p &lt; 0.001). A robust bad correlation was observed among CRP ranges with each serum ferritin (r = -0.462) and serum iron (r = -0.625). Multivariate logistic regression identified lower serum iron and ferritin stages, and better CRP and WBC counts as good sized unbiased predictors of febrile seizures.Conclusion: The findings advise that iron deficiency and accelerated inflammatory markers are tremendous chance factors for febrile seizures in kids. These effects highlight the importance of monitoring iron repute and managing inflammation in pediatric sufferers prone to febrile seizures.

Iraqi patients suffering from valvular heart diseases' serum iron levels

Valve heart disease (VHD), caused by a heart valve becoming too narrow (valvular stenosis) or not closing adequately (valvular insufficiency), is one of the heart illnesses that causes the most morbidity and mortality. The study included ninety participants, who were divided into three groups: Thirty people in excellent health, thirty patients with aortic valve disease (atrioventricular valve group: 14 men, 16 females), and thirty patients with mitral valve disease (mitral valve group: 13 males, 17 females). group C, the control group, consisted of 16 men and 14 women. Serum UIBC decreased significantly (P &lt; 0.001) while serum ferritin, transferrin saturation, and iron increased significantly (P &lt; 0.001) when the patient groups were compared to group C. Conversely, there were no statistically significant changes (P&gt;0.05) seen in the concentrations of transferrin and TIBC in the serum between the two patient groups and the control group. Moreover, no appreciable variations were noted in the concentrations of iron, TIBC, UIBC, transferrin, transferrin saturation, or ferritin between the AV and MV groups.

Type 2 Diabetes Mellitus and Helicobacter pylori Gastritis in Patients Referred for Endoscopy-A Single-Center Romanian Study.

Type 2 diabetes mellitus (T2DM) affects up to 10% of adults globally, and its complications can mask the risk of gastrointestinal bleeding or malignancy. Our study enrolled 633 endoscopic patients stratified according to T2DM presence (4:1 ratio in favor of the control group). T2DM patients referred for endoscopy experienced lower prevalence of epigastric pain and heartburn (OR = 0.637/OR = 0.346, p < 0.05). Often being anemic (OR = 2.23, p < 0.001), they had significantly lower hemoglobin (p = 0.001) and serum iron (p = 0.02), but serum cholesterol was higher in non-diabetics. Ulcers, erosions and mucosal hemorrhages were comparable between groups (p < 0.05), although low-dose aspirin use was more prevalent in diabetics (p = 0.000, OR = 2.34). T2DM was associated with the increased frequency of antro-corporal active gastritis (OR = 1.451/OR 1.501), with smokers presenting a higher frequency of active H. pylori infection (OR = 3.37). T2DM predicted anemia (adjusted OR = 1.70) and the absence of gastroesophageal reflux symptoms (adjusted OR = 0.37), but not active H. pylori gastritis or premalignant lesions. In an endoscopic population, patients with T2DM had lower hemoglobin and serum iron levels. There was an inverse correlation between T2DM and heartburn. H. pylori gastritis and premalignant lesions occurred more frequently in diabetic patients (predominantly pangastritis) before adjusting for age or associated comorbidities, with smoking increasing the risk for active infection.

Association between iron status, preeclampsia and gestational hypertension: A bidirectional two-sample Mendelian randomization study

BackgroundSeveral recent observational studies have reported that iron overload during pregnancy is associated with preeclampsia (PE) and gestational hypertension (GH). However, the causal association between iron status, PE, and GH is still not clear. MethodsWe performed a two-sample Mendelian randomization (MR) study using the genome-wide association study (GWAS) summary statistics of iron status, included serum iron, ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) from the largest available GWAS meta-analysis, and the summary statistics of PE and GH were obtained from the FinnGen consortium. Fixed-effect inverse variance weighted (IVW), random-effect IVW, maximum likelihood (ML), MR-Egger regression, weighted median, and MR-PRESSO methods were used. ResultsA total of 21, 58, 28, and 22 SNPs were used as IVs for serum iron, ferritin, TIBC, and TSAT, respectively. The F-statistics of IVs ranged from 95.23 to 421.36. The results of the fixed effects IVW method suggested that for per SD unit increase in serum iron, the risk of PE increases by 24 % (OR = 1.24, 95 % CI: 1.03–1.50, P = 0.02). No significant heterogeneity or horizontal pleiotropy was found. The association between ferritin, TIBC, TSAT and PE were statistically insignificant (P>0.05). Furthermore, the results of each MR methods do not support a causal association between iron status and GH, nor a reverse causal association between PE and GH and iron status. ConclusionThis two-sample MR study provides evidence supporting a causal association between serum iron level and PE.

Association between urinary phthalate metabolites and Anemia in US adults

Initial research indicates a possible connection between exposure to phthalates and the development of anemia. To fill the gap in epidemiological data, our study utilized data from across the United States, representative on a national scale, to evaluate the association between the concentration of phthalate metabolites in urine and both anemia and iron levels. We gathered data on 11,406 individuals from the National Health and Nutrition Examination Survey (NHANES) database, spanning 2003–2018. We conducted logistic and linear regression analyses, adjusted for potential confounding factors, to evaluate the correlations between different phthalate metabolites and anemia, as well as serum iron levels, including gender-stratified analysis. Most urinary phthalate metabolites were positively correlated with an increased risk of anemia, and the majority were negatively correlated with serum iron levels. The study revealed that for every unit increase in ln-transformed metabolite concentrations, the odds ratios (ORs) for anemia increased to varying degrees, depending on the phthalate: Monobutyl phthalate (MBP) at 1.08 (95% CI 1.01–1.17, P = 0.0314), mono(3-carboxypropyl) phthalate (MCPP) at 1.17 (95% CI 1.10–1.24, P < 0.0001), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) at 1.08 (95% CI 1.02–1.15, P = 0.0153), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) at 1.14 (95% CI 1.07–1.21, P < 0.0001), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) at 1.11 (95% CI 1.03–1.18, P = 0.0030), monocarboxynonyl phthalate (MCNP) at 1.11 (95% CI 1.03–1.19, p = 0.0050), and monocarboxyoctyl phthalate (MCOP) at 1.13 (95% CI 1.07–1.19, P < 0.0001). Increased levels of MBP, MEHP, MBzP, MCPP, MEHHP, MEOHP, MIBP, MECPP, MCNP, and MCOP were linked with changes in serum iron levels, ranging from − 0.99 µg/dL (95% CI − 1.69 to − 0.29) to − 3.72 µg/dL (95% CI − 4.32 to − 3.11). Mixed-exposure analysis shows consistency with single-exposure model. Further mediation analysis showed that the association between single urinary phthalates and the risk of anemia was mediated by serum iron with a mediation ratio of 24.34–95.48% (P < 0.05). The presence of phthalate metabolites in urine shows a positive correlation with the prevalence of anemia, which was possibly and partly mediated by iron metabolism. Nonetheless, to confirm a definitive causal link and comprehend the underlying mechanisms of how phthalate exposure influences anemia, additional longitudinal and experimental research is required.

Association of FGF23 Levels and Development of Anemia in Patients with Non Dialysis Chronic Kidney Disease

Background: Anemia is one of the common complication of Chronic Kidney Disease that intensifies in grade and severity as eGFR decline which also increases the risks for cardiovascular mortality. The development of anemia and elevated fibroblast growth factor 23 levels are the earliest changes observed in chronic kidney disease. Objective: This study aims to understand the association of FGF23 levels development of anemia in chronic kidney disease patients prior to renal replacement therapy. Methods: This is an analytical type of cross sectional study carried out among 95 respondent'1ged between 18 and 75 years with CKD stage 1-5 before dialysis, divided into two groups- Group I­ comprised of 68 patients and Group 11- included 27 age and sex matched respondents not having CKD, enrolled from two te1tiary-care hospitals, namely- Sir Salimullah Medical College &amp; Mitford Hospital and National Institute of Kidney Diseases &amp; Urology (NIKDU). Socio-demographic status, disease profile and laboratory findings including serum iron, iron binding capacity, ferritin, transferrin saturation, calcium, phosphorus, intact parathormone, vitamin D, eGFR and FGF-23 levels were studied. Result: Mean age of the respondents was 50.1±10.74 (SD) years, mean estimated glomerular filtration rate was 35.92± 22.61 in group I and 91.66± 14.2 in group II. The mean FGF23 level in group I and II were 85.76± 207.54, 21.99± 12.12 pg/mL respectively, serum iron level was 81.61± 39.24 mcg/dL and 95.0± 32.38 mcg/dL in group I and II respectively, serum ferritin level was 225.59± 2 I 2.5 ng/mL and 157.85± 220.89 ng/ml. TIBC was 312.65± 95.83 mcg/dL and 418.85± 118.25 mcg/dL in group I and II respectively. In Group I and II, iron deficiency was found in 23% and 25%respectively when stratified according to serum ferritin level and 26.5% and 22.22% respectively, when stratified according to serum transferrin saturation level. This difference was significant among the group. Serum iron, ferritin, TIBC and TSAT were significantly associated with serum FGF23 levels. Conclusion: Disrupted iron metabolism and high FGF23 levels is commonly found in chronic kidney disease. Clinical laboratory findings have revealed the relation between FGF23 and anemia in no dialysis chronic kidney disease patients.

Role of Quercetin Supplementation on Iron Parameters in Blood Transfusion-Dependent Thalassemia Patients

Background: Thalassemia is a group of inherited blood disorders that affect the production of hemoglobin, a protein in red blood cells that carries oxygen throughout the body. Iron overload is a condition in which the body absorbs and stores too much iron. In addition to repeated blood transfusions, increased gastrointestinal tract (GIT) iron absorption plays an important role in iron overload with thalassemia. Quercetin, a common flavonoid present in fruits and vegetables, exhibits diverse biological effects. Objective: To assess the effect of quercetin on iron overload parameters in blood transfusion-dependent thalassemia patients (TDT). Methods: A randomized, double-blind, placebo-placebo group-led study was conducted on 110 TDT patients, more than 12 years of age, who were supplemented with either quercetin or a placebo capsule daily (500 mg) for 3 months. A blood sample was obtained for laboratory parameters at baseline and at the end of 3 months. Results: At the baseline time of the study, the demographic features and iron overload parameters of patients and the placebo group were not statistically different, while after three months of supplementation, there was a significant decrease in levels of serum iron, UIBC, serum ferritin and ferritin saturation rate, and a significant increase in TIBC in the patients compared with the placebo group. Conclusions: The study shows the significant role of quercetin on iron overload parameters in blood transfusion-dependent thalassemia patients.

The oral ferroportin inhibitor vamifeport prevents liver iron overload in a mouse model of hemochromatosis.

Hemochromatosis is an inherited iron overload condition caused by mutations that reduce the levels of the iron-regulatory hormone hepcidin or its binding to ferroportin. The hepcidin-ferroportin axis is pivotal to iron homeostasis, providing opportunities for therapeutic intervention in iron overload disorders like hemochromatosis. The aim of this study was to evaluate the efficacy of the oral ferroportin inhibitor vamifeport in the Hfe C282Y mouse model, which carries the most common mutation found in patients with hemochromatosis. A single oral dose of vamifeport lowered serum iron levels in Hfe C282Y mice, with delayed onset and shorter duration than observed in wild-type mice. Vamifeport induced transient hypoferremia by inhibiting ferroportin and resulted in a feedback regulation of liver Hamp in wild-type mice, which was absent in Hfe C282Y mice, reflecting the dysregulated systemic iron sensing in this hemochromatosis model. Chronic dosing with vamifeport led to sustained serum and liver iron reductions in Hfe C282Y mice, as well as markedly reducing liver Hamp expression in Hfe C282Y mice, suggesting distinct regulation of liver Hamp expression following acute or continuous iron restriction via vamifeport. At the tested dose, vamifeport retained its activity when combined with phlebotomy and did not significantly interfere with liver iron removal by phlebotomy in Hfe C282Y mice. These data demonstrate that chronic vamifeport treatment significantly reduces serum iron levels and prevents liver iron loading in the Hfe C282Y mouse model of hemochromatosis, thus providing preclinical proof of concept for the efficacy of vamifeport in hemochromatosis with or without phlebotomy.

Iron Deficiency Anemia among Sanitation Workers in a Tertiary Care Hospital: A Cross-sectional Study

ABSTRACT Background: Iron deficiency anemia (IDA) has been the main cause of the health burden in India over the past decade. The aim of the present study was to examine the iron status and prevalence of iron deficiency anemia using biochemical markers among sanitation workers working at a tertiary healthcare center. Methodology: This hospital-based cross-sectional observational study was conducted on 80 sanitation workers for a period of 18 months (age 31–40 years). Dietary intake patterns were collected through the structured questionnaires. Blood samples were analyzed for complete blood count, serum iron level and unsaturated iron binding capacity, and ferritin. Total iron binding capacity and percentage transferrin saturation were calculated. Stool samples were screened for intestinal helminthic ova and cysts of intestinal protozoa. Results: Of the 80 sanitation workers, IDA was found in 38.7%; out of this, mild anemia was found in 16 (20%) participants, while 11.3% and 7.5% participants had moderate and severe anemia, respectively. Higher plasma sTfR levels were observed in women with severe iron depletion than in those with iron sufficiency (median 17.6 versus 15.5 nmol/L; P = 0.001). A statistically significant positive correlation between hemoglobin and serum iron, serum ferritin, and transferrin saturation was found. Hemoglobin was positively correlated with white blood cells, red blood cells, hematocrit, and mean corpuscular hemoglobin. Conclusion: This study highlights the presence of mild IDA among sanitary workers and lower levels of iron intake than the recommended dietary allowance.

Hindlimb immobilization induces insulin resistance and elevates mitochondrial ROS production in the hippocampus of female rats.

Alzheimer's disease (AD) is the fifth leading cause of death in older adults, and treatment options are severely lacking. Recent findings demonstrate a strong relationship between skeletal muscle and cognitive function, with evidence supporting that muscle quality and cognitive function are positively correlated in older adults. Conversely, decreased muscle function is associated with a threefold increased risk of cognitive decline. Based on these observations, the purpose of this study was to investigate the negative effects of muscle disuse [via a model of hindlimb immobilization (HLI)] on hippocampal insulin sensitivity and mitochondrial function and identify the potential mechanisms involved. HLI for 10 days in 4-mo-old female Wistar rats resulted in the following novel findings: 1) hippocampal insulin resistance and deficits in whole body glucose homeostasis, 2) dramatically increased mitochondrial reactive oxygen species (ROS) production in the hippocampus, 3) elevated markers for amyloidogenic cleavage of amyloid precursor protein (APP) and tau protein in the hippocampus, 4) and reduced brain-derived neurotrophic factor (BDNF) expression. These findings were associated with global changes in iron homeostasis, with muscle disuse producing muscle iron accumulation in association with decreased serum and whole brain iron levels. We report the novel finding that muscle disuse alters brain iron homeostasis and reveal a strong negative correlation between muscle and brain iron content. Overall, HLI-induced muscle disuse has robust negative effects on hippocampal insulin sensitivity and ROS production in association with altered brain iron homeostasis. This work provides potential novel mechanisms that may help explain how loss of muscle function contributes to cognitive decline and AD risk.NEW & NOTEWORTHY Muscle disuse via hindlimb immobilization increased oxidative stress and insulin resistance in the hippocampus. These findings were in association with muscle iron overload in connection with iron dysregulation in the brain. Overall, our work identifies muscle disuse as a contributor to hippocampal dysfunction, potentially through an iron-based muscle-brain axis, highlighting iron dysregulation as a potential novel mechanism in the relationship between muscle health, cognitive function, and Alzheimer's disease risk.

Study of Nutritional Anemia in Children Admitted to Pediatric Department in Rural Teaching Hospital of Telangana

Abstract Background: Globally, around 600 million preschool and school aged children are affected by anemia. According to World Health Organization, 65.5% of preschool children in southeast asia are anemic. Nutritional anemia is the commonest cause of anemia resulting from deficiencies of nutrients essential for red blood cell formation. Iron deficiency anemia is the most common nutritional deficiency amounting to 50%, followed by vitamin B12 and folate deficiency. This study is conducted to study the incidence of nutritional anemia among hospitalised children in a territory care teaching hospital in rural Telangana, in the age group of 6 months to 18 years and to bring awareness regarding the diet requirements in children in order to prevent deficiencies thereby the consequences of nutritional deficiencies. Method: This was a prospective hospital-based study conducted to study the incidence of Nutritional anemia along with clinical and hematological profile of nutritional anemia amongst children admitted to the Department of pediatrics in the age group of 6 months to 18 years at Mediciti Institute of Medical Sciences, Ghanpur, Telangana, from January 1st 2020 to June 30th 2021. All the children who had satisfied the inclusion criteria after taking consent from their parents were included in the study. Result: The incidence of nutritional anemia in the present study was found to be 52.08%, with both males and females equally affected. The age group of 6–12 years was particularly impacted, accounting for 49.3% of the cases. A significant 94% of the cases were associated with inadequate protein intake as per ICMR guidelines. Children from socio-economic classes 2 and 3, as per the Kuppuswamy scale, were more frequently affected. Severe anemia was observed in 8.7% of the cases. Peripheral smear analysis revealed microcytic, hypochromic red blood cells in 64.4% of the cases, with 94% of the children showing decreased serum iron levels. Conclusion: Nutritional anemia is the major cause of anemia in hospitalised children affecting majorly children in the age group of 6-12 years. Inadequate protein intake is the major contributor accounting to 94%, which can be prevented with proper dietary measures

Iron Dysregulation: Unveiling Predictive Biomarkers for Severity in COVID-19 Patients

Objective: This study aimed to elucidate the association between iron dysregulation and the severity of COVID-19, examining serum levels of iron-related biomarkers in hospitalized patients. The primary objective was to identify reliable predictors for disease severity, specifically focusing on the role of ferritin, Hemoglobin (Hb), Total Iron-binding Capacity (TIBC), and iron. Materials and Methods: The study enrolled 117 consecutive COVID-19 patients, classified into mild, severe, and critical groups. Serum levels of Hb, TIBC, iron, and ferritin were measured using standardized methods. Data were analyzed using ROC analysis, logistic regression models, and correlation assessments. The study adhered to ethical guidelines, obtaining informed consent from all participants. Results: Results revealed a consistent elevation in iron and ferritin levels as disease severity increased, accompanied by a reciprocal decline in Hb and TIBC. Ferritin emerged as a robust predictor for disease prognosis, with an AUC of 0.808, providing a sensitivity of 62.50% and a specificity of 91.74%. Age and education were identified as exacerbating factors influencing patient outcomes. The findings have been found to align with previous studies linking higher ferritin levels to adverse outcomes, supporting ferritin’s utility as a prognostic marker. Conclusion: The intricate relationship between iron metabolism and COVID-19 severity has been highlighted in this study, emphasizing elevated ferritin levels as potential predictors for severe outcomes and indicators of inflammation-induced cellular damage. These findings may contribute valuable insights into personalized patient management strategies and the potential for targeted interventions in severe COVID-19 cases. Further research involving larger populations is essential to validate these observations and enhance our understanding of the complex host response to SARS-CoV-2.

Quantification of Cardiac Iron Overload at 3 T MRI in a Rabbit Model Utilizing ME-GRE T2* Sequence.

Myocardial iron overload can lead to myocardial dysfunction, muscle cell injury, and end-stage heart failure. The enhanced signal-to-noise ratio and technical advancements have made 3 T magnetic resonance imaging (MRI) more accessible in clinical settings. However, 3 T assessments for early diagnosis of myocardial iron overload are scarce. To evaluate the feasibility of myocardial iron quantification using 3 T MRI in a rabbit model of iron overload. Animal model. Overall, 40 male New Zealand white rabbits were categorized into control (N = 8; no treatment) and experimental (N = 32; weekly 200 mg/kg iron dextran injections) groups. 3 T MRI with multi-echo gradient echo (ME-GRE) T2* sequence. Each week, two experimental rabbits were randomly selected for blood collection to determine serum iron (SI) levels; their tissue was harvested to assess myocardial and hepatic iron deposition. Spearman's rank correlation tests were used to evaluate the correlations among R2*, cardiac iron concentration (CIC), liver iron concentration (LIC), total amount of iron injected, and SI levels. P ≤ 0.05 was considered statistically significant. The myocardial T2* value in the experimental group was significantly lower than that of the control group. An excellent correlation was observed between R2* values and CIC (r = 0.854). CIC moderately correlated with LIC (r = 0.712) and the total amount of iron injected (r = 0.698). A strong correlation was observed between the total amount of iron injected and LIC (r = 0.866). SI levels poorly correlated with the total amount of iron injected (r = 0.205, P = 0.277) and LIC (r = 0.170, P = 0.370) but fairly correlated with CIC (r = 0.415, P = 0.022). A 3 T MRI with an ME-GRE sequence may serve as a noninvasive method for evaluating cardiac iron content. N/A TECHNICAL EFFICACY: Stage 1.

Comparison of the Effectiveness of Single Anastomosis Sleeve Ileal Bypass and Roux-en-Y Gastric Bypass in Obese Patients with Type 2 Diabetes.

The rapid increase in obesity and related problems has heightened the importance of obesity and metabolic surgery, resulting in a continuing search for the ideal surgical method. This study aimed to compare the effectiveness of Roux-en-Y gastric bypass (RYGB), which is the gold standard method, and the relatively newer method of single anastomosis sleeve ileal (SASI) bypass. The medical records of patients who underwent RYGB and SASI bypass were reviewed and compared regarding excess weight loss (EWL) and HgA1c, fasting glucose, serum iron, ferritin, hemoglobin (Hgb), and vitamin B12 levels. The body mass index was significantly lower (p = 0.003), and the %EWL was significantly higher (p = 0.023) at 6months postoperative in patients who underwent SASI bypass. Both groups had similar results at the other follow-up visits. The mean HgA1c levels at the 6- and 12-month follow-up visits were significantly lower in SASI patients (p = 0.037 and p = 0.012, respectively). At the 24-month follow-up, no difference was detected in HgA1c levels between the groups (p = 0.476). In patients who underwent RYGB, ferritin (p < 0.001), plasma iron (p = 0.001), and Hgb levels (p = 0.001) were significantly lower at 12, 24, and 12months postoperatively, respectively. SASI bypass is effective and comparable to RYGB in terms of EWL and metabolic control and has the advantage of not producing excluded segments and reducing nutritional deficiencies.