Serum Total Iron Binding Capacity Research Articles

Effect of inulin, galacto oligosaccharides and iron fortification on iron deficiency anemia among women of reproductive age; a randomized controlled trial

Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO4) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G3 which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO4. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm3), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 μg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 μg/dL) were observed in G4 group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO4 level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.

Evaluating the effect of digital game-based nutrition education on anemia indicators in adolescent girls: A randomized clinical trial.

Iron deficiency anemia is the most common type of micronutrient deficiency in the world. Adolescence represents a period of increased risk of iron deficiency. Therefore, we aimed to determine the impact of nutrition education by a digital game on markers of iron-deficient anemia in adolescent girls. In this study, 176 adolescent girls were randomly dichotomized into the intervention and control groups. At the beginning and the end of the intervention, knowledge, attitude, and practice of both groups were assessed by a questionnaire. Girls in the intervention group received the necessary education through a digital game during a 14-week period, while those in the control group received basic nutritional education through PowerPoint and pamphlets. Additionally, serum transferrin, serum iron, transferrin saturation, ferritin, CBC difference, and total iron binding capacity (TIBC) tests were checked. In this study, nutrition education significantly increased the level of knowledge, attitude, and practice of adolescent girls regarding their diet (p˂.05). Hemoglobin level was also significantly raised (p˂.05). However, no significant effect was observed on other markers of iron-deficient anemia, such as serum iron, TIBC, and hematocrit, in the intervention group compared with the control group (p˃.05). The results of this study indicated the positive impact of nutrition education based on digital game on knowledge, attitude, and practice scores, as well as a significant difference in hemoglobin. It is recommended that educational games be designed for students in the future to promote health and nutrition information.

Frequency of Iron Deficiency Anemia (IDA) Among Patients with Helicobacter Pylori Infection

Objective: The purpose of this study is to identify the prevalence of iron deficiency anaemia (IDA) in helicobacter pylori-infected patients. Study Design: Prospective/cross-sectional study Place and Duration: This study was conducted at Benazir Bhutu Hospital Rawalpindi during the period from July, 2022 to September, 2022. Methods: Total 105 patients of Helicobacter pylori infection, who ranged in age from 18 to 65 years included. All patients gave their informed written consent after being asked about their age, sex, body mass index, level of education, and place of residence. Blood samples from the subjects were analysed to determine their levels of serum iron, transferrin saturation, ferritin, and total iron-binding capacity. H. pylori infection can be found by histopathology, stool antigen testing, a fast urease test, or a urea breath test. The entire data set was analyzed using SPSS 24.0. Results: Among all there were majority females. Majority of the patients were illiterate and were from rural areas. 60 (57.1%) had poor socio-economic status. Mean Hemoglobin level was 12.1±0.6 (g/dl) mean serum iron level was 49.8 ±10.33(ug/dl) and mean serum ferritin level was 121.7±42.87 (ng per ml).Frequency of iron deficiency anemia was found in 43 (40.95%) patients. Among 43 cases of IDA, majority of the patients had age &gt;35 years. Conclusion: In this research, we found that patients with helicobacter pylori infection, the majority of whom were adult female patients, had a considerably greater frequency of iron deficiency anaemia. Keywords: Prevalence, H.pylori infection, Iron Deficiency Anemia (IDA), Females

Parameters of Iron Metabolism in Patients with Iron Deficiency Anemia and Erosive Lesions of the Gastroduodenal Zone

The most common disease in the world is erosive-ulcerative lesions of the gastroduodenal zone (EULGZ). These are chronic polyetiological, recurrent diseases with disruption of the neuro-endocrine and humoral mechanisms that regulate the secretory-trophic process in the gastroduodenal zone with the development of ulcers. In this disease, ulcers have different localization and clinical course, significantly reduce the quality of life, affect work capacity and personal life. Lack of timely diagnosis and treatment can have adverse consequences. The objective: to analyse the characteristics of clinical and metabolic disorders in iron deficiency anemia (IDA) and its combination with EULGZ in order to develop the methods for assessing the disease severity, optimizing diagnostics and treatment tactics. Materials and methods. The observation group included 26 patients (15 men and 11 women) with iron-deficiency anemia (IDA) on background of EULGZ with localization of ulcerative defects of the mucous membrane in the stomach or duodenal bulb. The diagnosis of IDA was verified on the basis of changes in the basic characteristics of clinical manifestations (signs of anemic hypoxia and sideropenic syndrome), specific changes in peripheral blood and indicators of iron metabolism. Patients with IDA and EULGZ, were examined by endoscopic methods, underwent ultrasound and, if necessary, radiological examination. The control group included 35 primary donors (16 women and 19 men), who underwent two laboratory tests for hepatitis B and C, as well as HIV infection/AIDS. All examined donors underwent a comprehensive examination of peripheral blood and determined biochemical indicators. The indicators of iron metabolism were determined in all participants: iron content in the blood serum (IS), total iron-binding capacity of the blood serum (TIBS). The index of unsaturated iron-binding capacity of blood serum was calculated as the difference between TIBS and IS. The coefficient of transferrin saturation with iron was determined as the ratio of the content of IS to TIBS. The content of transferrin was determined according to the TIBS indicator, ferritin – by the radiometric method. Results. Peripheral blood indicators in primary donors and morphometric changes in peripheral blood in patients with IDA were analyzed. The results of investigations of the indicators of iron exchange in blood serum are presented: iron concentration, total iron-binding capacity of serum and the degree of saturation of serum with iron. It was found that male donors have significantly higher levels of iron and ferritin in blood serum compared to female donors. The dynamic of changes in peripheral blood parameters in patients with IDA caused by long-term blood loss due to EULGZ during the treatment process is shown. Treatment of the EULGZ led to the significant changes of such indicators as the number of erythrocytes, hemoglobin concentration, erythrocyte indices towards normalization. The normalization of the reticulocyte count was observed on the 90th day of treatment. The detected changes in the number of platelets in patients with IDA due to EULGZ were observed in the absence of active bleeding from the digestive tract. Conclusions. As a result of the progression of IDA due to the erosive-ulcerative lesions of the gastroduodenal zone, the imbalance of iron metabolism deepens, serious disorders of iron metabolism develop, especially in the content of plasma ferritin. Patients with IDA caused by long-term blood loss as a result of EULGZ, should be prescribed a drug for oral use containing ferrous sulfate with a mucosa-protective effect at a dose of 2 mg/kg per day, followed by a decreased dose after normalization of the serum ferritin level.

Association between iron status and incident coronary artery disease: a population based-cohort study

Disorders of iron metabolism has been implicated in cardiovascular disease. However, the association of serum iron stores and coronary artery disease (CAD) remains inconsistent. Here, we investigated the associations of serum iron metabolism with the incidence of CAD, the severity of coronary artery stenosis, metabolic biomarkers, and the risk of major adverse cardiovascular event (MACE). A total of 643 CAD patients and 643 healthy controls were enrolled to assess the associations of serum iron status with the presence of CAD, the severity of CAD, and the risk of MACE. Serum iron metabolism and other metabolic markers were measured in all subjects. All statistical analyses were analyzed using SPSS22.0 software and STATA statistical package. Serum level of iron metabolism markers, including serum iron, unsaturated transferrin iron binding capacity (UIBC), Total iron binding capacity (TIBC) levels, in CAD groups was significantly lower than the control group (P < 0.001). UIBC and TIBC were negatively correlated with ferritin in both sexes. Each unit increase of serum iron and TIBC were found to have a protective role for CAD in women (iron: OR 0.794, 95% CI (0.647–0.973), TIBC: OR 0.891, 95% CI (0.795–0.999), P < 0.05). However, high ferritin level was significant associated the CAD incident in both sexes (OR 1.029, 95% CI (1.002–1.058) in men, OR 1.013, 95% CI (1.0–1.025) in women, P < 0.05). Serum iron metabolism markers exhibited no significant association with the severity of CAD. Increased serum level of iron and TIBC levels were found to have a protective role for CAD in women, but not in men. Elevated serum ferritin is independently and positively associated with CAD in men and women.

Role of oral lactoferrin as a source of iron supplementation in correction of anemia in pediatric patients with chronic kidney disease stages 2–4

Background Children with chronic kidney disease (CKD) have multiple risk factors for anemia such as primary erythropoietin deficiency, blood loss, decreased red blood cell (RBC) survival, bone marrow suppression, iron deficiency, inflammation and infection, malnutrition, hyperparathyroidism, vitamin B12 and folate deficiency, aluminum toxicity, and carnitine deficiency. This study was performed to evaluate the effect of oral bovine lactoferrin on patients with iron deficiency with CKD stages 2–4. Patients and methods This follow-up cohort clinical study was conducted on children with CKD in the conservative clinic, Pediatric Nephrology Unit, Children's Hospital, Ain Shams University. It included 45 pediatric patients with CKD stages from 2 to 4 for 6 months without a control group. This is a follow-up case study in which all the included patients were on erythropoietin therapy ranging from 150 to 300 IU/kg once per week. The patients were subjected to history and laboratory evaluation, including hemoglobin (Hb), serum iron, serum ferritin, and total iron-binding capacity (TIBC), which were done for the patients at baseline and 6 months after treatment with bovine lactoferrin for 6 months. Results Blood Hb and RBC volume were significantly increased beginning from first month after oral lactoferrin therapy, serum iron and serum ferritin were significantly increased 6 months after intervention, and serum TIBC was significantly decreased after intervention. The current study had shown no significant difference between males and females regarding laboratory changes 6 months after intervention. Laboratory improvements were significantly lowest among cases with stage 4, followed by stage 3, and the highest among cases with stage 2. There was a decrease in all anemia clinical manifestations after 6 months of lactoferrin administration; the differences were significant only in easy fatigability, constipation, and gastrointestinal upset, which were the most frequent adverse effects. Conclusion Oral lactoferrin was found to be effective in treating iron-deficiency anemia regarding blood Hb, blood RBCs, serum iron, serum ferritin, and TIBC in association with erythropoietin therapy. The effect declines with the progression of CKD.

Changes in Iron Availability with Roxadustat in Nondialysis- and Dialysis-Dependent Patients with Anemia of CKD.

Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, increases hemoglobin by stimulating erythropoietin synthesis and improving iron availability through facilitation of iron uptake and/or release from stores. In this exploratory analysis, we assessed the effect of roxadustat treatment on laboratory parameters related to iron metabolism in patients with anemia of chronic kidney disease (CKD). Data were pooled from pivotal, randomized, phase 3 roxadustat trials: three placebo-controlled, double-blind trials in nondialysis-dependent (NDD) CKD and three open-label, active-comparator (epoetin alfa) trials in dialysis-dependent (DD) CKD. In this exploratory analysis, mean changes from baseline in hemoglobin, iron parameters, and hepcidin, and intravenous (iv) iron use were evaluated. Pooled results in NDD CKD and DD CKD patients are reported. Overall, 4277 patients with NDD CKD and 3890 patients with DD CKD were evaluated. Hemoglobin increases with roxadustat treatment were accompanied by increases in serum iron and total iron-binding capacity (TIBC) and decreases in serum ferritin and hepcidin from baseline through week 52. With epoetin alfa, the hemoglobin increase was accompanied by decreases in serum ferritin and hepcidin, but serum iron decreased, and there was no change in TIBC. With placebo, there were no changes in hemoglobin, iron parameters, or hepcidin. During treatment, iv iron use was reduced with roxadustat versus placebo and epoetin alfa. In patients with NDD CKD and DD CKD, roxadustat treatment is associated with increases in serum iron and TIBC, accompanied by reduced hepcidin and indicative of improved iron kinetics. Patients treated with roxadustat achieved target hemoglobin levels with less iv iron use versus comparators. Practitioners treating patients with anemia of CKD with roxadustat should consider its unique effects when interpreting iron parameters.

Effects of chronic Helicobacter pylori strain PMSS1 infection on whole brain and gastric iron homeostasis in male INS-GAS mice

Iron deficiency, the most common micronutrient deficiency in humans, is associated with long-term deficits in cognition and memory if left untreated. Infection with the gastric pathogen Helicobacter pylori has been linked to iron deficiency anemia (IDA). The H. pylori virulence factor cytotoxin-associated gene A (cagA) is proposed to be especially pertinent in iron deficiency. Male INS-GAS/FVB mice were infected with the CagA+ strain pre-murine Sydney strain 1 (PMSS1) for 12–13 or 27–29 weeks to investigate the role of chronic H. pylori infection in iron deficiency and neurological sequelae. Mice at both timepoints demonstrated significantly elevated gastric histopathology scores and inflammatory cytokines compared to sham-dosed controls. However, only mice at 27–29 weeks post infection had changes in hematological parameters, with significantly decreased erythrocyte count, hematocrit, serum hemoglobin, and increased serum total iron binding capacity. Gastric transcription of iron-regulatory genes Hamp and Bmp4 were significantly downregulated at both timepoints. In the brain, iron-dependent myelingergic and synaptic markers were significantly downregulated at 27–29 weeks. These results indicated that long-term infection of the CagA + PMSS1 strain of H. pylori in this study caused anemia, altered gastric iron homeostasis, and neurological changes similar to those reported in other rodent H. pylori CagA− strain infection models.

THE IMPACT OF AGE, SEX, AND SOCIO-ECONOMIC STATUS ON SERUM VITAMIN B12, FOLATE CONCENTRATION AND IRON STATUS IN TURKISH CHILDREN: A CROSS-SECTIONAL STUDY

Objective: The aim of this study is to evaluate the effects of age, sex, and socio-economic status (SES) on concentrations of vitamin B12 (vit-B12), folate, iron, and ferritin through the pediatric age span, and to show the relationship of these nutrients with blood count parameters such as hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), and red cell distribution (RDW). Material and Method: The study comprised of 30,504 venous blood samples (54.5% of girls and 45.5% of boys). The study group was stratified; group I: 1-6 years (n=3,870), group II: 7-12 years (n=11,019), and group III: 13-18 years (n=15,615). Serum vit-B12, folate, ferritin, iron and total iron-binding capacity (TIBC) were measured using a Beckman Coulter DXI 800, and the blood count was analyzed using a Sysmex XE 2100 analyzer. Results: The Hb, Hct, MCV, and RDW levels were significantly different between the age groups of boys and girls (p&lt;0.001, for all). Hb and Hct were the highest in boys aged 13-18 years, and higher than those of girls in the same age group (p&lt;0.001). The MCV and RDW were also significantly different across the age groups (p&lt;0.001). The iron deficiency prevalences were 12.3% and 4.2% for the girls and boys respectively. Serum folate and vit-B12 showed decrement with age across the age groups. The prevalences of vit-B12 deficiency were 27.1% and 28.3% and 6.0% and 6.8% for folate deficiency for girls and boys. Iron, TIBC,&nbsp;and ferritin levels were significantly different between the high and medium SES. Conclusion: The results of this study are important in that the monitorization of ferritin, vit-B12, and folate levels greatly contribute to clinical practice because of the roles of vit-B12, folate, and iron in mental, emotional, and metabolic development. However, there is a need for larger and multicenter studies that can represent the nutrients of Turkish children and adolescents nationwide.

Appropriate Method of TIBC Estimation in Reference to Serum Transferrin Levels.

Background The currently available various methods of estimation of total iron binding capacity (TIBC) show marked variation in reference range. Although serum transferrin (TF) level is a sensitive indicator of iron status, its measurement requires immunoassay equipment which may not be available in many routine biochemistry laboratories. So, this study was planned to find the most appropriate method to estimate TIBC. Objectives This study aimed to compare different methods of TIBC estimation and to corelate the TIBC values obtained by different methods with serum TF concentration. Material and Methods This analytical cross-sectional study was performed in the clinical chemistry laboratory of the Biochemistry Department of Medical College Baroda & SSG Hospital, Vadodara, Gujarat, on 250 leftover serum samples destined to be discarded. In all these samples, serum TIBC was estimated by direct method, indirect method, as well as calculated method (iron + unsaturated iron binding capacity [UIBC]) along with the measurement of serum TF level. Statistical Analysis Among the different methods, repeated analysis of variance (ANOVA) analysis and Bland-Altman plot were used to find out significance of difference. Correlation coefficients were found between different methods of TIBC estimation and serum TF levels. Results The means of TIBC by calculated, indirect, and direct methods were 344.51, 342.23, and 378.24 µg/dL, respectively. The mean of serum TF was 295.3 mg/dL. There was statistically significant difference between TIBC by direct and indirect methods and between direct and calculated methods. There was a strong positive correlation between TIBC by direct method and serum TF ( r = 0.888, p < 0.0001), but there was moderate correlation between TIBC by indirect method and serum TF ( r = 0.748, p < 0.04), and between TIBC by calculated method and serum TF ( r = 0.725, p < 0.05). Conclusion Among different methods of estimation of TIBC, direct method is more reliable in reference to serum TF levels.

Roxadustat regulates iron metabolism in dialysis-dependent and non-dialysis-dependent chronic kidney disease patients: A meta-analysis

The effect of roxadustat on iron homeostasis in patients with chronic kidney disease (CKD) is unclear. This study aimed to evaluate the efficacy of roxadustat for the treatment of iron metabolism disorders in dialysis-dependent (DD) and non-dialysis-dependent (NDD) CKD patients. We searched the PubMed, Embase, China National Knowledge Internet and Web of Science databases for randomized controlled trials (RCTs). The primary outcomes were changes in serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), ferritin, transferrin, and hepcidin. The secondary outcomes included the changes in hemoglobin (Hb) and the incidences of adverse events (AEs) and severe adverse events (SAEs). Twelve RCTs comprising 4976 participants were included. Compared to the control group, increases in the serum iron (SMD=0.21, 95% CI: 0.15 to 0.27, P<0.00001), TIBC (SMD=1.02, 95% CI: 0.82 to 1.22, P<0.00001) and transferrin levels (WMD=0.55, 95% CI: 0.41 to 0.69, P<0.00001) were found in the roxadustat group. Compared to the control group, decreases in the ferritin levels (WMD=-37.82, 95% CI: -59.89 to -15.74, P=0.0008) and hepcidin levels (WMD=-24.04, 95% CI: -36.28 to -11.79, P=0.0001) were observed in the roxadustat group. The meta-analysis showed that roxadustat significantly increases Hb levels (WMD=0.77, 95% CI: 0.42 to 1.12, P<0.0001). The incidences of AEs and SAEs in the roxadustat group was significantly higher than that in the control group (RR=1.03, 95% CI: 1.00 to 1.07, P=0.04; RR=1.08, 95% CI: 1.00 to 1.15, P=0.04). Our findings suggest that roxadustat could effectively improve iron metabolism in patients with CKD.

Preclinical study for the ameliorating effect of l-ascorbic acid for the oxidative stress of chronic administration of organic nitrates on myocardial tissue in high sucrose/fat rat model

BackgroundThe therapeutic activity of Glyceryl trinitrate (GTN) is mainly regulated by liberating nitric oxide (NO) and reactive nitrogen species (RNS). During this biotransformation, oxidative stress and lipid peroxidation inside the red blood cells (RBCs) occur. Hemoglobin tightly binds to NO forming methemoglobin altering the erythrocytic antioxidant defense system. AimThe principal objective of our research is to show the ameliorating effect of l-ascorbic acid for the deleterious effects of chronic administration of nitrovasodilator drugs used in cardiovascular diseases such as oxidative stresses and tolerance. MethodWe studied some biochemical parameters for the oxidative stress using groups of high sucrose/fat (HSF) diet Wistar male rats chronically orally administered different concentrations of Isosorbide-5-mononitrate (ISMN) 0.3 mg/kg, 0.6 mg/kg and 1.2 mg/kg. Afterwards, we evaluated the role of l-ascorbic acid against these biochemical changes in cardiac tissues. ResultsChronic treatment with organic nitrates caused elevated serum levels of lipid peroxidation, hemoglobin derivatives as methemoglobin and carboxyhemoglobin, rate of hemoglobin autoxidation, the cellular levels of the pro-inflammatory cytokines marker (NF-κB) and apoptosis markers (caspase-3) in the myocardium muscles in a dose-dependent manner. Meanwhile, such exposure caused a decline in the enzymatic effect of SOD, GSH and CAT accompanied by a decrease in the level of mitochondrial oxidative stress marker (nrf2) in the myocardium muscles and a decrease in the serum iron and total iron-binding capacity (TIBC) in a dose-dependent manner. Concomitant treatment with l-ascorbic acid significantly diminished these changes for all examined parameters. ConclusionChronic administration of organic nitrates leads to the alteration of the level of oxidative stress factors in the myocardium tissue due to the generation of reactive oxygen species. Using l-ascorbic acid can effectively ameliorate such intoxication to overcome nitrate tolerance.

A correlative study of copper, ceruloplasmin, iron, total iron binding capacity and total antioxidant capacity in diabetic nephropathy

Introduction and Aim: Diabetic nephropathy is the common cause of final stage of kidney disease. Studies on trace elements and oxidant-antioxidant status in diabetes mellitus are required for establishing the mechanisms involved in pathogenesis of diabetic complications, and also to establish biomarkers of diabetic nephropathy in addition to the conventional markers. The present study aimed to assess and correlate the blood levels of copper, iron, ceruloplasmin, total iron binding capacity (TIBC) and total antioxidant capacity (TAC) in diabetic nephropathy patients in comparison to diabetic individuals without complications and normal healthy controls. Materials and Methods: The study subjects were, diabetic patients with nephropathy (group 1), diabetic patients without complications (group 2), and healthy controls (group 3). In the serum samples of all study subjects levels of copper, iron, ceruloplasmin, TIBC and TAC were estimated by standard spectrophotometric methods. Results: Levels of copper, ceruloplasmin, iron and TIBC in serum were significantly higher and TAC was lower in diabetic patients when compared to controls, and more pronounced changes were seen in diabetic nephropathy patients when compared to diabetic patients with no complications. There was significant positive correlation among glycated hemoglobin, copper, iron and microalbumin in diabetic patients with or without nephropathy. Serum Total antioxidant capacity showed significant negative correlation with HbA1c, microalbuminuria, copper, and iron in diabetic patients with and without nephropathy. Conclusion: Serum levels of trace elements could serve as diagnostic and prognostic biomarkers of diabetic nephropathy complimentary to microalbuminuria and glycated haemoglobin. Monitoring the trace elements and oxidative stress biomarkers in diabetic patients could be beneficial to prevent oxidative stress and pathogenesis of diabetic complications.

ASSOCIATION BETWEEN IRON STATUS AND GESTATIONAL DIABETES MELLITUS

Background: Early identification of risk factors for gestational diabetes may result in its prevention and better management. In this study, we aimed to compare serum iron, total iron binding capacity and transferring saturation in pregnant women with and without gestational diabetes. Methods: A comparative cross sectional analytical study was conducted at Army Medical College and Centre for Research in Experimental and Analytical Medicine (CREAM) in association with Pak Emirates Military Hospital. Thirty healthy pregnant women and thirty patients of gestational diabetes mellitus matched for age, gestational age and body mass index (BMI) were recruited for the study. The diagnosis of gestational diabetes was made on the basis of abnormal glucose tolerance test at twenty four weeks of gestation. Serum iron and total iron binding capacity of all subjects were measured using colorimetric assay and transferrin saturation was calculated. Analysis of data was carried using SPSS-22. Mean values were calculated for all variables and compared by two sample t-test. Pearson correlation was determined to find association between different quantitative variables in two groups and p?0.05 was considered significant. Results: Serum iron was significantly higher (p=0.007), TIBC significantly lower (p=0.004) and transferrin saturation significantly higher (p&lt;0.001) in gestational diabetes group as compared to control group. Conclusion: Markers of iron status including serum iron and transferrin saturation were higher in patients of gestational diabetes and may pose a risk of developing gestational diabetes mellitus. Pak J Physiol 2022;18(2):47–50

Association between Iron Deficiency Anemia with Helicobacter Pylori Infection

Objective: The purpose of this research is to examine the link between helicobacter pylori infection and iron deficiency anaemia (IDA). Study Design: Retrospective study Place and Duration: Poonch Medical College Rawalakot and Dr. Ziauddin Hospital, North Nazim Abad, Karachi, during from July, 2021 to Dec, 2021. Methods: Eighty-six patients aged 18-55 were presented. All patients gave written informed permission that included age, sex, BMI, education, and citizenship. All study participants had helicobacter pylori. Participants' blood samples were tested for serum iron, transferrin saturation, ferritin, and total iron-binding capacity. A urea breath test, stool antigen testing, a fast urease test, or histopathology was used to detect H. pylori. Data was analyzed using SPSS 19.0. Results: Majority of the patients 43 (50%) were aged between 31-40, followed by 25 (29.1%) patients of age 18-30 years and 18 (20.9%) were aged 41-55 years. Among 86 cases, 55 (63.9%) had body mass index &lt;25kg/m2 and 31 (36.1%) had body mass index &gt;25kg/m2. Frequency of males was higher 50 (58.1%) as compared to females 36 (41.9%). Stomach pain, nausea, loss of appetite, frequent burping and bloating was the most common symptoms among all cases. The frequency of IDA was found in 38 (44.2%) in which majority of the patients were aged between 35-5 years and females were higher in number among them. Conclusion: In this study, we found that the prevalence of iron deficiency anemia was considerably greater among patients with helicobacter pylori infection, and that the majority of adult patients were females. Keywords: Symptoms, Iron Deficiency Anemia (IDA), Adult Patients, H.pylori infection, Association

Erythrocyte blood indices and state of iron metabolism in children with juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is a systemic chronic disease. One of the extra-articular manifestations of JIA are hematological changes. The most common is anemia. The aim of the study was to explore the indicators of the red blood cells and the state of iron metabolism in children with JIA, depending on the form and duration of the disease. A retrospective analysis of the medical history of patients was carried out. The study of the indicators of the red blood cells consisted in determining the number of erythrocytes, the amount of hemoglobin, the ratio of the number of erythrocytes to blood volume, the average volume of erythrocytes, the average hemoglobin content in the erythrocyte, the average concentration of hemoglobin in the erythrocyte, as well as the distribution of red blood cells along the length in the form of the difference between the largest and smallest size of red blood cells and the deviation of the volume of red blood cells from the average value. The state of iron metabolism was represented by such indicators as the content of serum iron, ferritin, transferrin, latent iron-binding capacity of blood serum, total iron-binding capacity of serum, transferrin saturation coefficient with iron. In 18.7 % of children with JIA, a decrease in hemoglobin of less than 120 g/l was noted. There was a significant (p &lt; 0.001) decrease in the average hemoglobin content in the erythrocyte in 37.9 % of patients. As a result of the study, it was found that the decrease in the iron content in the blood serum is due not only to the true iron deficiency state, but also to the redistribution of iron reserves against the background of chronic autoimmune inflammation. In the systemic form of the disease, changes in the latent iron deficiency state are more pronounced. With a long course of the disease, normalization of red blood cell parameters occurs. The duration of the disease has no effect on ferrokinetics, which is due to the development of iron deficiency compensation against the background of ongoing treatment.

Evaluation of Iron Profile among Ischemic Heart Disease Patients in Shendi City, Sudan

Background: Ischemic heart disease (IHD), is a group of diseases that includes: stable angina, unstable angina, myocardial infarction, and sudden cardiac death. It is within the cluster of cardiovascular conditions of which it is the multiple expected kinds. Iron is an essential trace element. It has a pivotal role in maintaining various cellular functions and enzyme reactions; whereas, iron overload has been known as a risk factor in the progression of atherosclerosis. Abnormal deposition of iron in the heart cause hemochromatosis and dilated cardiomyopathy and this causes ischemic heart disease. This study aimed to investigate the role of serum iron, serum ferritin, and total iron-binding capacity (TIBC) in the causation of coronary heart disease (CHD) and their relationship with other risk factors of CHD. Methods: This is a cross-sectional case-control prospective analytical study conducted at Al-Mc Nemir University Hospital in Shendi town to evaluate the iron profile in ischaemic heart disease patients in the period between (March 2018—July 2018). The study included (50) patients who were diagnosed with ischaemic heart disease and the study groups were compared with a mean of the normal value. Serum iron, ferritin, and TIBC were estimated by spectrophotometer. Data was collected using a structured face-to-face questionnaire and the (SPSS) version (11.5) program was used for data analysis. Results: The study revealed that the ischaemic heart disease patients were; (40%) male and (60%) female, and the mean age was (57.612 ± 28.24), with a range of (36-65) years distributed as (96%). The study showed that the mean of s. iron was 203.9ug/dl (p.value 0.170), the mean of s. ferritin was 207.6ug/dl(p.value 0.447), the mean of TIBC was 663.0ug/dl( p.value 0.281) when compare with the mean of normal value. No significant difference was found between iron profile and CHD. Serum iron and serum ferritin levels are elevated in patients with CHD when compared with normal values. TIBC levels were lower in patients than normal values. When body iron was analogized with different risk factors (like smoking, hypertension, diabetes mellitus, tobacco, etc) of the condition it was found to be seriously raised. Conclusion: The study concluded that the level of serum iron, ferritin, and TIBC might not be associated with coronary heart disease.

Is Iron Deficiency Anemia still Becoming Community Health Problem in Urban Area?

Background: Iron deficiency anemia is one of the common public health problems that found in various countries, including Indonesia. The incidence of iron deficiency anemia does not only occur in rural areas but also in urban areas. Iron deficiency that occurs in adolescent girls with or without anemia has a negative impact on immune function, growth and physical and mental development. Purpose: To determine the incidence of anemia in adolescent girls in urban areas. Patients and methods: This study was an observational study with a cross sectional design. The research subjects were 52 young women aged 15-25 years living in the city of Semarang, Central Java. The subject will be taken a blood sample to check the complete blood profile and iron status, namely serum ferritin, serum iron, and serum TIBC (total iron binding capacity). Research data analysis was carried out using a computer program. Results: The prevalence of iron deficiency anemia among female adolescents in urban areas in this study was 13.4% while adolescent girls who experienced iron deficiency without anemia were 13.4%. Conclusion: Iron deficiency anemia can occur in urban areas with a prevalence &gt; 5%.&#x0D;

Efficacy of Different Doses of Daprodustat for Anemic Non-dialysis Patients with Chronic Kidney Disease: A Systematic Review and Network Meta-Analysis.

(1) Background: Anemia affects about 40% of patients with chronic kidney disease (CKD). Daprodustat improves serum hemoglobin in anemic patients by inhibiting prolyl hydroxylase of hypoxia-inducible factor. We conducted a network meta-analysis to investigate the direct and indirect effects of different doses of daprodustat compared to each other and erythropoietin and placebo. (2) Methods: We searched PubMed, Cochrane Library, Web of Science, and Scopus, for randomized clinical trials (RCTs) reporting data about different doses of daprodustat for anemia in nondialysis of CKDs. (3) Results: We eventually included five RCTs with a total sample size of 4566 patients. We found that the higher the dose of daprodustat, the greater the change in serum total iron binding capacity (TIBC), hemoglobin, and ferritin from baseline. Compared to placebo, daprodustat 25–30 mg was associated with the highest significant increase in serum hemoglobin (MD = 3.27, 95% CI = [1.89; 4.65]), a decrease in serum ferritin (MD = −241.77, 95% CI = [−365.45; −118.09]) and increase in serum TIBC (MD = 18.52, 95% CI = [12.17; 24.87]). (4) Conclusion: Higher daprodustat doses were associated with a higher impact on efficacy outcomes as serum total iron-binding capacity (TIBC), hemoglobin, and ferritin. However, data about the safety profile of different doses of daprodustat is still missing.

Pattern of iron profile in type 2 diabetes mellitus patients: experience from outpatient department of Bangladesh Diabetic Network

Background: Worldwide diabetes mellitus (DM) has been recognized as the most prevalent endocrine disorder. Excess iron has been implicated in the pathogenesis of diabetes and its complications. Iron is a transitional metal and a potential catalyst in cellular reaction that produces reactive oxygen species. Free iron causes the assembly of reactive oxygen species that invariably steer the body’s homeostasis towards oxidative stress-mediated diabetic complications. On the other hand, ferritin is an index of body iron stores and acts as an iron overload marker. Elevated iron indices are more common in patients with diabetes. Excess iron may have a role in the development of diabetes and subsequently in glycemic control. In this context, this study was aimed to assess the pattern of plasma iron profile in type 2 DM patients and compare with healthy controls.&#x0D; Methods: This cross-sectional study included 284 subjects attending the outpatient department of Endocrinology of Bangladesh Diabetic Network Ltd. (BDN) from January 2021 to June 2021. This study was done to evaluate the serum iron, total iron binding capacity (TIBC) and ferritin of 284 subjects divided into two groups (I and II) of 182 Type 2 DM patients constituted Group I and Group II consisted of 182 healthy individuals (controls).&#x0D; Results: Mean serum free iron concentration in Group I and Group II were 14.24± 6.7 and 11.29±4.1 ìmol/ l respectively. Mean TIBC in Group I and Group II were 54.19 ±9.8 and 64.08±7.5 ìmol/l respectively. However, mean serum ferritin concentration were 169.50±15.1and 121.29±11.9 mg/ml respectively. The difference between serum iron, TIBC and ferritin between Group I and Group II were highly significant with the p values 0.003, 0.016 and 0.042 respectively. In Group I, glycated hemoglobin (HbA1c) and fasting blood glucose levels both increased. However In this investigation, HbA1c levels were found to have a substantial relationship with serum iron levels and TIBC. However, there was no significant link between serum ferritin and HbA1c.&#x0D; Conclusion: The results obtained from this study suggests that serum iron and serum ferritin were increased and TIBC was decreased in T2DM patients as compared to healthy control. In patients with T2DM, there was a potentiated disparity in the readings. The findings suggest that these micronutrient levels can be employed as biomarkers for T2DM patients.&#x0D; BIRDEM Med J 2022; 12(2): 124-128