Iron Binding Capacity Research Articles

Serological Screening for Celiac Disease and Gastrointestinal Absorption Disorders in Patients with Autoimmune Endocrine Diseases.

Celiac disease (CD) accompanying autoimmune endocrine diseases (AED) is generally asymptomatic. This study aimed to evaluate the frequency of clinically overt or silent CD in patients diagnosed with autoimmune endocrinopathy and the clinical effects of silent CD in these endocrinopathies. The study included 166 patients with known or newly diagnosed mono-/polyglandular AED and 90 age- and gender-matched healthy controls. The patients were classified into four groups: type 1 diabetes mellitus (DM) (n=44), Hashimoto's thyroiditis (HT) (n=68), Addison's disease (AD) (n=17), and autoimmune polyglandular syndrome (APS) (n=37). All subjects were serologically screened for tissue transglutaminase antibody (tTG) IgA and IgG. In addition, to evaluate the possible systemic consequences of CD, serum parathormone (PTH), 25-hydroxicholecalsiferol (25-OH-Vit D), vitamin B12, folic acid, iron, iron-binding capacity (IBC), and ferritin levels were measured. In the total series, 193 (75.4%) individuals were females, and 63 (24.6%) were males. TTG IgA antibody positivity was found in 23 among 166 patients, while no positivity was encountered in the healthy control group. The highest rates of positive tTg IgA frequency were detected in AD, with 29.4% (5/17). Serum 25-OH-Vit D, vitamin B12, folic acid, iron, and ferritin levels were significantly lower in AEDs compared to controls (p<0.001), and the lowest these parameters were detected in patients with AD. The serologic CD prevalence is higher in autoimmune mono-/and polyglandular endocrine diseases than in the control group. The data support recommends regular screening for CD in all patients with AEDs.

Relationship between Iron Metabolic Parameters and Platelet Counts in Blood Donors

To investigate the correlation of iron metabolic parameters with platelet counts in blood donors. A total of 400 blood donors who met requirements of apheresis platelet donation were collected, and their hematological parameters were analyzed. The donors were divided into low ferritin group and normal group, the differences of hematological parameters between the two groups were compared, and the correlation of iron metabolic parameters and routine hematology parameters with platelet counts were analyzed. Whether male or female, low ferritin group had higher platelet counts than normal group (P < 0.01). Among the iron metabolic parameters, the platelet counts was negatively correlated with serum ferritin (SF), serum iron (SI), and transferrin saturation (TSAT) (r =-0.162, r =-0.153, r =-0.256), and positively correlated with total iron binding capacity (TIBC) and unsaturated iron binding capacity (UIBC) (r =0.219, r =0.294) in female blood donors. Platelet counts was also negatively correlated with SF, SI and TSAT (r =-0.188, r =-0.148, r =-0.224) and positively correlated with UIBC (r =0.220) in male blood donors. Among the routine hematology parameters, platelet counts was negatively correlated with mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and reticulocyte hemoglobin equivalent (Ret-He) in female blood donors (r =-0.236, r =-0.267, r =-0.213, r =-0.284). Platelet counts was also negatively correlated with MCH, MCHC and Ret-He in male blood donors (r =-0.184, r =-0.221, r =-0.209). In blood donors with low C-reactive protein level, the lower the iron store capacity, the lower the iron utilization, and the platelet counts tends to rise.

Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes

ObjectivesDisordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its...

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.

Exploring the Roles of Arbuscular Mycorrhizal Fungi in Plant–Iron Homeostasis

Arbuscular mycorrhizal fungi (AMF) form a vital symbiotic relationship with plants. Through their extensive hyphal networks, AMF extend the absorptive capacity of plant roots, thereby allowing plants to reach otherwise inaccessible micronutrient sources. Iron, a critical micronutrient involved in photosynthesis and other metabolic processes, often becomes inaccessible owing to its tendency to form insoluble complexes in soil. AMF symbiosis significantly ameliorates this challenge by enhancing iron uptake and homeostasis in plants, altering root architecture, and producing root exudates that improve iron solubility. Moreover, the interaction with diverse soil bacteria, particularly plant growth-promoting rhizobacteria, can potentiate the benefits of AMF symbiosis. Siderophores are low-molecular-weight chelators with iron-binding capacities produced by various microorganisms and plant roots. They play pivotal roles in regulating intracellular iron and have been identified in different mycorrhizal associations, including AMF. While molecular mechanisms behind AMF-mediated iron uptake have been partially explored, the intricate networks involving AMF, plants, siderophores, and other soil microbiota are largely unknown. This review focuses on the multifaceted roles of AMF in plant–iron homeostasis, interactions with soil bacteria, and the potential of siderophores in these processes, emphasizing the possibilities for harnessing these relationships for sustainable agriculture and enhancing plant productivity.

Postoperative micronutrient changes in bariatric surgery patients compliant with nutritional supplementation.

Bariatric surgery is commonly used in patients with body mass indexes over 35kg/m and obesity-related comorbidities. Despite the significant clinical benefits of bariatric surgery, nutritional deficiencies post-surgery remain a challenge for both patient and healthcare provider [Toninello et al. in Nutrients 13:1565, 2021, Gasmi et al. in Eur J Nutr 61:55-67, 2022]. Nutritional supplementation is a way of reducing the likelihood of postoperative deficiencies; however, prior studies have shown varying degrees of mostly poor to moderate patient adherence [Spetz et al. in Obes Res Clin Pract 16:407-412, 2022, Mahawar et al. in Obes Surg 29:1551-1556, 2019, Santonicola et al. in J Am Nutr Assoc 41:11-19, 2022, Sherf Dagan et al. in Obes Surg 27:2258-2271, 2017]. Our present study aims to provide insights into the micronutrient biochemical profile in patients previously found to be compliant with supplementation following roux-en-y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG). An 11-point outpatient survey was administered to consecutive patients ≥ 18years who had undergone either RYGB or VSG to determine adherence with nutritional supplementation. Medical records were retrospectively reviewed to determine preoperative and postoperative lab values, including vitamins A, B1, B12, and D, thyroid stimulating hormone (TSH), iron binding capacity, transferrin, ferritin, folate, iron, albumin, hemoglobin A1C, zinc, glomerular filtration rate (GFR, and liver function values. Values were classified as "abnormal" or "normal." Preoperative and postoperative values were compared for differences. Postoperative values were also compared between RYGB and VSG. There were no significant differences between preoperative and postoperative values for any nutritional marker aside from vitamin B12. A total of 51/60 patients (85.0%) had normal preoperative B12 measurements, compared with 40/65 (61.5%) patients postoperatively (P = 0.03). Notably, of 25 "abnormal" postoperative measurements, 20 (80%) were elevated values. There were no differences in postoperative deficiencies between RYGB and VSG. Patients in our sample did not have worsened micronutrient deficiencies following bariatric surgery, and there were no differences in micronutrient deficiencies between surgical technique.

Vitamin D Levels in Children Presenting with Breath-Holding Spells: An Example of A University Hospital

Aim: This study aimed to examine the vitamin D levels in children who experience breath-holding spells (BHS) and to compare these levels with those of a healthy control group. The goal was to establish a connection between BHS and vitamin D levels.&#x0D; Method: The records of 98 patients, who presented to the Pediatric Neurology and Pediatric Cardiology polyclinics of Adıyaman University Training and Research Hospital between December 2019 and October 2022, were retrospectively reviewed. Fifty-two patients who did not meet the inclusion criteria were excluded. The study included forty-six patients with BHS whose laboratory results were assessed and a healthy control group of fifty-three individuals. Fe, serum iron binding capacity, ferritin, vitamin B12, and vitamin D levels were measured in all patients.&#x0D; Results: The study group comprised 46 patients (female/male ratio = 1.4), consisting of 27 girls (58.6%) and 19 boys (41.3%). Within our patient cohort, 39 individuals (84.8%) were diagnosed with cyanotic-type spells, three (6.5%) with pallid-type spells, and four (8.7%) with mixed-type spells. For patients experiencing BHS, a comprehensive analysis was conducted on parameters including complete blood count, iron levels, iron-binding capacity, ferritin levels, vitamin B12, and vitamin D levels. Although no significant correlation was identified with vitamin D levels in this study, noteworthy connections were established with lower hemoglobin levels, decreased vitamin B12 levels, and reduced ferritin levels. Moreover, upon exclusion of patients exhibiting low vitamin B12 values from the analysis, a statistically significant relationship emerged between iron deficiency anemia and the occurrence of BHS (p

A-128 Analytical Performance Evaluation of Assays Used for Iron Studies on the Atellica® CI 1900 Analyzer

Abstract Background The Atellica® CI 1900 Analyzer is an automated, mid-throughput, integrated chemistry and immunoassay analyzer employing both Atellica CH and Atellica IM assays. This study was designed to evaluate the analytical performance of the Atellica CH Iron_2 (Iron_2), Total Iron Binding Capacity (TIBC), and Transferrin (Trf) assays* and the Atellica IM Ferritin (Fer) assay on the Atellica CI 1900 Analyzer. Methods The Atellica CI 1900 Iron_2, TIBC, and Trf assays use the same reagents and calibrators as the comparable Atellica chemistry assays. The Atellica CI 1900 Fer assay uses the same reagents and calibrators as the Atellica immunoassay. Precision and method comparison (MC) were used as performance indicators for the Atellica CI 1900 Analyzer. Precision studies were performed according to CLSI EP05-A3 using native and contrived human serum samples. MC studies were performed according to CLSI EP09-A3. Native and contrived human samples were analyzed using the Atellica CH Iron_2, TIBC, and Trf assays on both the Atellica® CH 930 and Atellica CI 1900 Analyzers. For Fer, native and contrived human samples were analyzed using the Atellica IM Fer assay on both the Atellica® IM 1600 and Atellica CI 1900 Analyzers. Results Representative precision and MC results for each assay are listed in the table. For the four assays tested, repeatability and within-lab %CVs were &amp;lt;3.5% and &amp;lt;4.5%, respectively. Slopes determined by the Deming linear regression model were approximately equal to 1. Conclusion Evaluation of the Atellica CH Iron_2, TIBC, and Trf and Atellica IM Fer assays using the Atellica CI 1900 Analyzer demonstrated good precision and equivalent performance compared to the same assays on their respective Atellica CH 930 and Atellica IM 1600 Analyzers. *The products mentioned are not commercially available in all countries. Their future availability cannot be guaranteed.

A-139 Investigating the Utility of Reticulocyte Hemoglobin Equivalent for Diagnosis of Iron Deficiency Anemia

Abstract Background Iron deficiency anemia (IDA) is one of the most common leading global health problems, which could cause extreme fatigue, chest pain, headache, and even neurodevelopment deterioration in children. Traditionally, assessing serum ferritin, transferrin, and iron are the tools to diagnose IDA. However, a high false-positive rate of these conventional biomarkers might be observed due to inflammation, infection, or malignancy. Reticulocyte hemoglobin equivalent (RET-He) is a new parameter that reflects the recent functional availability of iron for erythropoiesis, with the advantage of real-time results as part of automated reticulocyte analysis. The present study, therefore, aimed to investigate the utility of RET-He for the diagnosis of patients with IDA. Methods This retrospective study collected laboratory data from patients with both serum ferritin and reticulocyte results from January 2022 through December 2022, and excluded the high white blood cell count (WBC &amp;gt; 9380 cells/μL) and high C-reaction protein (CRP &amp;gt; 0.5 mg/dL). RET-He was measured by Sysmex XN-10 or XN-20 automated hematology analyzer (Sysmex, Kobe, Japan). Serum ferritin was measured by Roche Cobas e801 (Roche Diagnostics, Mannheim, Germany). Iron and total iron binding capacity (TIBC) were measured by Roche Cobas c702 (Roche Diagnostics, Mannheim, Germany). Anemia was defined as hemoglobin concentration &amp;lt;13 g/dL for men and &amp;lt; 12 g/dL for women. Iron deficiency was defined as serum ferritin &amp;lt;15 μg/L. Student T-tests and Pearson correlation were performed, and P-values less than 0.05 were considered statistically significant. Statistical analyses were performed with SPSS software (Version 22.0). Results A total of 2208 patient data were enrolled in this study and were classified into the IDA, iron deficiency, anemia, and control groups according to ferritin level and hemoglobin concentration. The RET-He were 20.6, 27.7, 30.4, and 32.3 pg in the IDA, iron deficiency, anemia, and control groups, respectively. The IDA group showed significantly lower RET-He levels than the control group (P &amp;lt; 0.001). By Pearson correlation analysis, the RET-He showed a weak positive correlation with ferritin and hemoglobin (r = 0.236, 0.274), moderate positive correlation with iron (r = 0.354), and moderate negative correlation with TIBC (r = −0.369). In addition, the average turn-around time (received-reported) of RET-He was 16.4 min, which was shorter than other biochemical markers such as ferritin, iron, and TIBC (57.7, 34.2, 34.4 min). Conclusion The RET-He could be an assessment of the iron actually used for the biosynthesis of hemoglobin and as a useful and rapid tool for diagnosing and monitoring iron deficiency anemia.

B-014 Impact of Centrifugation Time Reduction in Laboratory Automation System

Abstract Background The centrifugation of specimens is an important preanalytical process which will be impact the most on turnaround time of the laboratory results. To verify the automation systems, we tested different combinations of tube and centrifugation settings to determine the most efficient for routine chemistry procedure. The outcomes of each combination were then compared to the benchmark to find out the best setting to reduce turnaround time for laboratory results. Methods In this study, we evaluated a total of 40 leftover blood samples that were collected on 4 mL plastic Vacutainer® (Becton Dickinson) lithium heparin tubes and 2 mL plastic Vacuette® (Greiner bio-one) lithium heparin tubes. All tubes were centrifuged on Abbott Automation GLP systems. The first set of samples was centrifuged according to the manufacturer’s guideline (10 min at 1300 × g, room temperature for Vacutainer® tubes and 10 min at 2200 × g, room temperature for Vacuette® tubes). The second set was centrifuged 7 min at 2700 × g, room temperature. And the third set was centrifuged 5 min at 2700 × g, room temperature. Then, analyzed all samples with 22 routine chemistry parameters on Alinity ci analyzers. The allowable total error and correlation coefficient (R) were used to determine the significance of the differences between 3 protocols of the centrifugation time. Results The study showed that the centrifugation times of 7 min and 5 min were not significantly different from the manufacturer’s protocol (10 min) after testing with 22 routine chemistry parameters (albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, direct bilirubin, total bilirubin, calcium, chloride, cholesterol, creatinine, low-density lipoprotein-cholesterol, iron, potassium, lactate dehydrogenase, sodium, phosphorus, total protein, triglycerides, unsaturated iron-binding capacity, high-density lipoprotein-cholesterol, urea nitrogen and uric acid) in both 4 mL plastic Vacutainer® lithium heparin tubes and 2 mL plastic Vacuette® lithium heparin tubes. Overall, the results of the study indicate that shorter centrifugation times of 7 min and 5 min at 2700 × g able to use for routine chemistry. Conclusion The study concluded that the centrifugation time did not affect the analytical results of 22 routine chemistry parameters. This suggests that shorter centrifugation times able to use with no impact on accuracy or reliability. The results of the study will support laboratory to have efficiency improvements by shorten the turnaround time on the results release.

Assessment of erythroferrone levels in children with chronic kidney disease on regular hemodialysis

Anemia is a common comorbidity in children with chronic kidney disease (CKD) and is associated with adverse outcomes. Erythroferrone (ERFE) is a hepcidin inhibitor whose synthesis is stimulated by erythropoietin, which increases iron absorption and mobilization. Aim of the study: to assess the levels of ERFE hormone in children with CKD on regular hemodialysis. This case–control study was carried out at Menoufia University Hospital and included 70 subjects: 38 healthy individuals (controls) and 32 children with CKD on regular dialysis (cases). The study was approved by the Faculty of Medicine Ethics Committee at Menoufia University. All children were subjected to full history taking, complete clinical examination, blood tests such as complete blood count, reticulocyte count, serum iron, ferritin, and total iron binding capacity, liver and renal function tests, and an immunoassay to measure human ERFE. There was a statistically significant difference in the levels of ERFE between the cases and controls (p &lt; 0.001). There was a significant, strong correlation between the levels of hemoglobin and serum iron and the level of ERFE (r = –0.655, p &lt; 0.001). There was no significant correlation between the administered dose of exogenous erythropoietin and the level of ERFE (p = 0.460). Serum ERFE levels in the children with CKD on regular hemodialysis were significantly higher than in the controls and were negatively correlated with hemoglobin and iron levels. There was no significant correlation between ERFE levels and both serum ferritin and total iron binding capacity levels.

Blood biomarker profiles and exceptional longevity: comparison of centenarians and non-centenarians in a 35-year follow-up of the Swedish AMORIS cohort

Comparing biomarker profiles measured at similar ages, but earlier in life, among exceptionally long-lived individuals and their shorter-lived peers can improve our understanding of aging processes. This study aimed to (i) describe and compare biomarker profiles at similar ages between 64 and 99 among individuals eventually becoming centenarians and their shorter-lived peers, (ii) investigate the association between specific biomarker values and the chance of reaching age 100, and (iii) examine to what extent centenarians have homogenous biomarker profiles earlier in life. Participants in the population-based AMORIS cohort with information on blood-based biomarkers measured during 1985–1996 were followed in Swedish register data for up to 35 years. We examined biomarkers of metabolism, inflammation, liver, renal, anemia, and nutritional status using descriptive statistics, logistic regression, and cluster analysis. In total, 1224 participants (84.6% females) lived to their 100th birthday. Higher levels of total cholesterol and iron and lower levels of glucose, creatinine, uric acid, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, lactate dehydrogenase, and total iron-binding capacity were associated with reaching 100 years. Centenarians overall displayed rather homogenous biomarker profiles. Already from age 65 and onwards, centenarians displayed more favorable biomarker values in commonly available biomarkers than individuals dying before age 100. The differences in biomarker values between centenarians and non-centenarians more than one decade prior death suggest that genetic and/or possibly modifiable lifestyle factors reflected in these biomarker levels may play an important role for exceptional longevity.

The effects of a single dialysis session on serum hepcidin levels

Abstract Objectives Hepcidin plays an important role in regulating iron metabolism. Elevated levels of hepcidin in renal failure contribute to the development of anemia. We aimed to evaluate the association between hepcidin and inflammation in hemodialysis patients and how dialysis affects hepcidin levels. Methods Hepcidin clearance with hemodialysis was investigated by measuring hepcidin concentrations by enzyme-linked immunosorbent assay (ELISA) method before and after hemodialysis of 40 patients in a single dialysis session. Hemogram parameters and ferritin, iron, total iron binding capacity (TIBC), and C-reactive protein (CRP) were measured and evaluated their relations with predialysis hepcidin levels. Results Hepcidin levels decreased significantly with dialysis treatment (p=0.009). Median hepcidin concentration before dialysis was measured as 330 ng/mL (83–459) and post-dialysis median hepcidin concentration was 250 ng/mL (94–384). There was a significant correlation between predialysis hepcidin levels and ferritin (r=0.858, p&lt;0.001), TIBC (r=−0.451, p=0.004), and MCV (r=0.384, p=0.016). It was found that increases in ferritin levels in time were positively correlated with hepcidin before dialysis. Conclusions We think that understanding the removal of the hepcidin by dialysis, which causes a decrease in the amount of iron available in the anemia, is important in managing future therapy.

Correlation of Plasma Iron Profile and Intradialytic Hypotension in Hemodialysis Patients

Abstract: Intradialytic hypotension (IDH) has been a common complication which should be aware of, in hemodialysis procedure. Its pathogenesis is multifactorial, and severe anemia is considered as one of the most notable risk factors on IDH. This study aimed to evaluate the correlation between plasma iron profile and intradialytic hypotension in hemodialysis patients. This was an analytical and retrospective study using medical records of hemodialysis patients at Prof. Dr. R. D. Kandou Hospital, Manado from January to May 2022. Sampling was conducted through consecutive sampling method, on available records. Patients with CKD grade 5 which undergoes routine HD twice a week for &gt;3 weeks, aged 18-60 years old were included, while subjects with sepsis, malignancy, autoimmune disease, crisis hypertension, and unstable congestive heart failure were excluded for further studies. The details on iron profile and blood pressure measurement were then extracted, which then analyzed with descriptive analysis and Pearson correlation using IBM SPSS Statistics 26.0. The results obtained a total of 35 patients; 57.1% were male. The Pearson correlation analysis on all variables reported several notable significant results, with a correlation between iron profile and blood pressure measurement were seen in TIBC and systole pre- and post-procedure (-.496 and -.611 respectively) with strong negative relationship; and serum ferritin value with systole post-procedure (.373) implying moderate positive relationship. The results suggested that the increase of ferritin value and decrease of TIBC value were correlated with the increase of systole blood pressure. Meanwhile, the TIBC had a strong positive correlation with systolic changes (.473) meanwhile serum iron had a moderate negative correlation with diastolic changes (-.365). In conclusion, there is a significant correlation between iron profile and changes in blood pressure, with higher iron profile value (lower TIBC) is positively correlated with the increase of both systole and diastole measurement; also negatively correlated with the reduction of blood pressure in hemodialysis patients Keywords: iron; ferritin; intradialytic hypotension; hemodialysis; transferrin; total iron binding capacity

Prevalence and pattern of iron deficiency and its correlation with different hematological parameters in a segment of patients coming to a tertiary care hospital in Lahore

Background: Iron is an essential micronutrient, abundantly present in nature. Very low quantities of iron are required in our daily diet to prevent its deficiency. But paradoxically, its deficiency is very common all around the world. In keeping with its wide and varied functions in the body, the deficiency of iron also has multiple manifestations. This study aimed to study the prevalence and pattern of iron deficiency in a segment of our population. The effect on various hematological parameters was also studied.&#x0D; Materials and Methods: Fifty cases including both genders and all ages were included in the study. The parameters analyzed were iron status and hematological indices. The status of serum iron levels was compared with total iron binding capacity (TIBC). Blood examination included total leukocyte count, differential leukocyte count, hemoglobin level, total RBC count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and platelet count. The correlation of serum iron levels with the different hematological indices was analyzed.&#x0D; Results: Iron deficiency was even more prevalent than previously reported (70%). It was seen in both genders and all age groups. Only the elderly male group showed a mean that was in the normal range. Females were affected more severely than males in all age groups. Red cell indices showed expected correlation with serum iron levels. Platelet counts showed an increase with falling iron levels.&#x0D; Discussion: Iron deficiency continues to be rampant despite decades of public health measures to correct it. Iron deficiency anemia impacts multiple body functions with a myriad of health consequences. The ensuing symptoms are those classically related to anemia as well as some that are both unexpected and hard to explain. Increase in platelet count seen in iron deficiency carries the risk of creation of a thrombogenic state. The factors contributing to iron deficiency need to be identified and addressed.&#x0D; Key words: Serum iron levels, Complete Blood Count, iron deficiency, platelet count.

Assessment of the potential role of Trefoil Factor-3 marker as a predictive marker of complication in splenectomized and non splenectomized patients with beta thalassemia major

Abstract The study’s goal is to appraise the immunological inflammatory marker Trefoil Factor 3, which interacts with thalassemia pathogenesis particularly following splenectomy, and may offer new therapy options for the illness and its repercussions. This is a case-control study design that included 60 patients identified as β-thalassemia major as participators in this study, in addition to 30 seemingly healthy subjects with age and sex close to the patients group who served as a control group. The participants were distributed into four groups: control group, splenectomized patients, non-splenectomized patients, and total patients. Suitable statistical techniques were employed to investigate the results. The study’s findings demonstrated that there was a significance increase in the serum levels of TFF3 when comparing between (splenectomized, non-splenectomized and total patients) with healthy group (322.16±51.241, p-value=0.01, 317.20±42.449, p-value=0.01, 320±46.6, p-value=0.01), vs (309.38±21.94), respectively. Moreover, a comparison between splenectomized and non-splenectomized showed a significantly decrease in TFF3 (322.16±51.241) vs (317.20±42.449), (p-value=0.043).The presented study also revealed significant positive correlation between TFF3 level with ferritin, iron, total iron binding capacity, transferrin saturation, transferrin, fasting serum glucose, insulin and homeostasis model assessment-insulin resistance. Furthermore, unsaturated iron binding capacity and homeostasis model assessment-beta found a significant negative correlation with TFF3 level. High serum levels of TFF3 in beta thalassemia patients, especially in splenectomies patients, are downregulated by inflammatory cytokines, which are primarily regarded as traditional inflammatory cytokines and are related to insulin resistance. Hence, TFF3 level can serve as a potential predictive for the early detection of beta thalassemia in the development and progression of complications.

Screening of iron deficiency anemia in children with chronic functional constipation

Background Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies worldwide. Constipation is one of the most common gastrointestinal disorders in childhood. Aim To screen for IDA or iron deficiency (ID) among children with chronic functional constipation (CFC). Patients and methods It was a prospective study. Two groups of children in the age range of 1–15 years were collected for 6 months from June 2022 to December 2022 at Alexandria University gastroenterology clinic. Children who fulfilled Rome IV criteria of CFC were assigned to CFC group. Children who did not have constipation were considered as the control group. Complete blood count, serum iron, total iron binding capacity, and serum ferritin were done for both groups. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. Quantitative data were described using range (minimum and maximum), mean, standard deviation, and median. Results Hemoglobin levels, serum ferritin and serum iron were significantly lower in the CFC group when matched with the control group. ID and IDA were significantly higher in the CFC group. The longer days of constipation were correlated with significantly lower hemoglobin, serum iron, and serum ferritin. Conclusion CFC causes mild IDA or ID. The longer the days of CF, the lower values of hemoglobin, iron and ferritin are present. ID and IDA are more common in the CFC group.

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.

A clinical study on roxadustat for anemia in diabetic nephropathy: a 8-week study.

The development of roxadustat is a standard treatment for renal anemia, and multiple clinical trials have proved its safety and efficacy. However, less information is available from trials of the population with diabetic nephropathy (DN). This study aimed to determine whether roxadustat is effective for treating DN. This was a single-center, retrospective, institutional review board-approved cohort study. The patients with DN were chosen and given roxadustat or erythropoietin (EPO) for 8weeks. The mean hemoglobin (Hb) level after 8weeks of treatment served as the primary outcome. Alterations in the iron index and lipid levels were considered secondary objectives. Sub-group analysis was performed to observe the impact of inflammation and glycemic status on Hb. A total of 80 patients were enrolled, 40 in each group. After 8weeks of treatment, the Hb levels in the roxadustat group were higher than those in the control group. The number of patients who achieved Hb response was higher in the roxadustat group than in the control group (77.5% versus 27.5%; P < 0.001). In addition to lowering total cholesterol and low-density lipoprotein cholesterol, roxadustat decreased ferritin and elevated total iron-binding capacity. Compared to the control group, roxadustat was more beneficial for patients with an inflammatory condition and poor glycemic control. Roxadustat treatment remarkably corrected anemia in patients with DN, and its effectiveness was unaffected by inflammation or glycemic control levels. In addition, roxadustat can also reduce a patient's blood lipid level and enhance the body's use of iron. ChiCTR2200057232.

Total iron binding capacity: an independent predictor of prognosis for pulmonary arterial hypertension in systemic lupus erythematosus

Objective To investigate the role of parameters of iron metabolism in systemic lupus erythematosus (SLE) patients with pulmonary arterial hypertension (PAH). Method This was a prospective observational study recruiting patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH). Patients with other factors that might lead to PAH were excluded from the study. All patients were assessed for PAH every 1–3 months and were followed up for 6 months. The primary outcome was considered improved if the grade of risk stratification declined at the endpoint; otherwise, it was considered unimproved. Results In total, 29 patients with SLE-PAH were included in this study. The mean of serum ferritin was higher than normal, and total iron binding capacity (TIBC) decreased in 48% of patients. Correlation analyses showed that serum iron (SI) was negatively correlated with World Health Organization functional class (WHO-FC) (r = −0.409, p = 0.028), and positively correlated with Six-Minute Walk Test distance (6MWD) (r = 0.427, p = 0.021) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.388, p = 0.037). Primary outcomes improved in 12 patients at the endpoint, and univariate logistic regression analyses indicated that TIBC was associated with improved primary outcomes in patients with SLE-PAH (odds ratio 12.00, 95% confidence interval 1.90–75.72). Conclusion SI was negatively correlated with WHO-FC, and positively correlated with 6MWD and TAPSE. Furthermore, TIBC was associated with improved outcomes of patients with SLE-PAH, which could be an independent predictor of prognosis. Further research is needed to verify the findings.