Weeks Of Iron Supplementation Research Articles

Personalized medicine comes to a blood center near you

Personalized medicine comes to a blood center near you

Influence of iron supplementation on fatigue, mood states and sweating profiles of healthy non-anemic athletes during a training exercise: A double-blind, randomized, placebo-controlled, parallel-group study

Iron is specifically important to athletes, and attention has grown to the association between sports performance and iron regulation in the daily diets of athletes. The study presents new insights into stress, mood states, fatigue, and sweating behavior among the non-anemic athletes with sweating exercise habits who consumed a routine low dose (3.6 mg/day) of iron supplementation. In this double-blind, randomized, placebo-controlled, parallel-group study, both non-anemic male (N = 51) and female (N = 42) athletes were supplemented either with a known highly bioavailable iron formulation (SunActive® Fe) or placebo during the follow-up training exercise period over four weeks at their respective designated clinical sites. The effect of oral iron consumption was examined on fatigue, stress profiles, as well as the quality of life using the profile of mood state (POMS) test or a visual analog scale (VAS) questionnaire, followed by an exercise and well-being related fatigue-sweat. Also, their monotonic association with stress biomarkers (salivary α-amylase, salivary cortisol, and salivary immunoglobulin A) were determined using spearman's rank correlation coefficient test. Repeated measure multivariate analysis of variance (group by time) revealed that the total mood disturbance (TMD) score was significantly lower (P = 0.016; F = 6.26) between placebo and iron supplementation groups over the four weeks study period among female athletes. Also, a significant reduction in tired feeling/exhaustion after the exercise (P = 0.05; F = 4.07) between the placebo and iron intake groups was noticed. A significant within-group reduction (P ≤ 0.05) was noticed in the degree of sweat among both male and female athletes after 2 and 4 weeks of iron supplementation, while athletes of the placebo intake group experienced a non-significant within-group reduction in the degree of sweat. Overall, the result indicates routine use of low dose (3.6 mg/day) iron supplementation is beneficial for non-anemic endurance athletes to improve stress, mood states, subjective fatigue, and sweating conditions.

Parental Iron Therapy to Treat Iron Deficiency Anemia in Malnourished Children

Objective: To evaluate the safety and efficacy of parental iron therapy to treat iron deficiency anemia in malnourished children. Study Design: Quasi experimental design. Place and Duration of Study: Stabilization Centre, Children Hospital and the Institute of Child Health, Multan from 1 December 2014 to 31 December 2020. Materials and Methods: A total of 250 malnourished children with iron deficiency were included in the study. The laboratory parameters i.e., Hemoglobin, Hematocrit, Red Blood Cells Count, mean corpuscular hemoglobin, mean corpuscular volume, and Serum ferritin of all patients were done. Using the iron deficit formula, all participants were given the measured iron sucrose complex. The iron sucrose complex was diluted with 0.9% normal saline and administered steadily for 3-4 hours. After 6 weeks of therapy, hemoglobin, RBC count , ferritin was measured. Comparison of mean ±SD of baseline laboratory parameters and after 6 weeks of iron supplementation was analyzed by using t-test. Results: A total of 250 participants were registered, male patients (57.2%) were more than female patients (42.8 %). Most of the 92(36.8%) participants were 12-24 months old. The key cause of anemia among 102(40.8%) admitted patients was inadequate diet or excessive milk consumption. The mean ±SD value of the Hb level at admission was 7.5±1.9 and it increased to 11±1.15g/dL after 6 weeks of active supplementation which is statistically significant (P-value < 0.05). Six weeks after giving intravenous iron therapy mean serum Ferritin increased from 11.5ml to 21.61 ng/ml. Conclusion: Current study concluded that controlled administration of IV iron sucrose for treatment of iron deficiency anemia among inpatients is efficacious and safe. IV iron sucrose should be considered for patient with severe IDA, those who are not compliant with oral formulations, and patients with malabsorption.

Effect of iron supplementation on platelet count in adult patients with iron deficiency anemia

Iron deficiency anemia (IDA) affects more than 1.2 billion individuals globally. In addition to anemia, reactive thrombocytosis is also a common clinical hematological condition in patients with IDA. However, some case reports have described the thrombotic complications in association with IDA-induced thrombocytosis. Patients with a high risk of thrombosis need prompt identification and effective treatment to prevent thrombotic complications. While iron replacement treatment has been shown to decrease platelet count in this context, there is limited published evidence on how iron supplementation affects the thrombocytosis caused by IDA. We retrospectively examined the clinical records of 440 patients with IDA from an RCT completed from 1 January 2016, to 30 December 2017, and data obtained from this study was used for post hoc analysis to examine the effect of iron on platelet count in IDA-induced thrombocytosis. The mean ± standard deviation (SD) platelet counts of the 440 patients with IDA was 310.23 ± 98.72 × 109/L. With baseline platelet counts>450 × 109 /L as the cutoff for thrombocytosis, patients were divided into 2 groups: 36 (8.1%) in the IDA with thrombocytosis group (mean ± SD platelet count, 521.67 ± 73.85 × 109/L) and the remaining 404 in the IDA without thrombocytosis group (mean ± SD platelet count, 291.39 ± 76.11 × 109/L). Differences were found in baseline characteristics including white blood cell (WBC) count, hemoglobin (Hb) level, mean corpuscular volume (MCV), transferrin saturation (TSAT), serum iron (SI) level, and total iron-binding capacity (TIBC) between the two groups (P < .05). From baseline to 8 weeks of continuous iron supplementation treatment, the mean platelet counts in both groups were decreased at 2-week treatment intervals. And in the IDA with thrombocytosis group, half of the patients resolved thrombocytosis after 2 weeks of iron supplementation, and the counts of all patients with thrombocytosis decreased below 450 × 109 /L within 6 weeks. In conclusion, the rate of reactive thrombocytosis in patients with IDA was 8.1%. IDA patients with thrombocytosis showed more severe anemia, lower ferritin, and more advanced iron deficiency than those without thrombocytosis. Platelet counts of half of the patients with thrombocytosis reduced below cut off of 450 × 109/L for thrombocytosis after 2 weeks of treatment, and all patients resolved thrombocytosis after 6 weeks. Our study provided clinical evidence for more effective and individualized iron management in the future. IDA patients with thrombocytosis should take active iron treatment and increase follow-up frequency to prevent thrombotic events. For patients with persistent thrombocytosis, a concomitant clonal process should be considered.

Nutrition Intervention among Children under 24 months suffering from Iron Deficiency Anemia in rural Cameroon

Almost 63% of young children living in Cameroon are anemic. However, young children in rural area are most affected. Current policy recommends the need to combine several strategies to reduce the burden of anemia in rural areas. A 20-week nutrition intervention program consisting of 4 weeks of nutrition education and 16 weeks of iron supplementation was carried out in 50 Cameroonian children aged 6-23 months in rural area, with mild iron deficiency anemia (IDA). Participants were distributed randomly by drawing lots into intervention and control groups with 25 participants in each group. A nutrition knowledge questionnaire, anthropometric measurements, hemoglobin (Hb) level, serum ferritin (SF), serum iron and iron status biomarkers were obtained in both groups before and after nutrition intervention. At the end of the study, the mothers of intervention group had greater knowledge on iron, IDA and dietary strategies to reduce IDA in children. Concerning anthropometric parameters, there were no significant differences in the weight/age, height/age and weight/height (p>0.05) before and after the intervention in both groups. At the end of nutrition intervention, a significant gain in Hb level was found in the both groups but significant difference was observed in the intervention group (10.63±0.18 and 11.46±0.19g/L; p=0.0001). However, the SF and serum iron were significantly lower in the control group compared to the intervention group (18.89±7.54 µg/L vs 28.93±5.81 µg/L; p=0.03) and (11.46±1.02 µg/L vs 19.65±0.78 µg/L; p=0.01) respectively. Iron status has improved in the both group. The incidence of anemia (28% and 76%; p=0.0007), iron deficiency (56% and 68%; p>0.05) and iron deficiency anemia (32% and 64%; p=0.02) was significantly lower in the intervention group compared to the control group. The study findings showed that, nutrition education combined with iron supplementation impact positively on the iron status of young children. It is therefore important to educate mothers or caregivers about good nutrition in addition to with others strategies.

Anemia and Associated Factors among Pregnant Women Attending Prenatal Care in Rural Dembia District, North West Ethiopia: A cross-Sectional Study

ABSTRACTIntroduction: About 22% of pregnant women are anemic in Ethiopia, but there is a large variation across the country. Hence, the aim of this study identifies the prevalence of anemia and associated factors among pregnant women attending prenatal appointments in Dembia District, northwest Ethiopia.Methods and materials: A facility-based, cross-sectional study was conducted among 713 pregnant women. A multi-stage, stratified sampling technique was used to select the study participants. A structured and pretested questionnaire, laboratory data, and chart review were used to collect data. Bivariate and multivariate logistic regression analyses were used to identify factors associated with anemia in pregnant women.Results: Prevalence of anemia was 32.4% with a majority of these having moderate anemia. Type of health center being rural/urban health center, water sources, days since fasting, 4 weeks of iron supplementation, craving unusual foods, mid-upper arm circumference scores, and decision power were significant predictors of anemia.Conclusion: The present study suggests anemia among pregnant women attending prenatal in Dembia district was high. Working to enhance adherence to iron supplementation and partner involvement for joint decision-making is recommended to avert prenatal anemia. Health-care providers and programmers are advised to pay special attention to rural and fasting pregnant mothers.Abbreviations: AOR: Adjusted Odd Ratio; CMHS: College of medicine and health sciences; CI: Confidence Interval; HFIAS: Household Food Insecurity Access Scale; RCSI: Reduced Coping Strategies Index; Hgb: Hemoglobin; MCMC: Marco Chain Monte Carlo; EPV: Events per variable; BMI: Body Mass Index; PPS: Population proportionate to size sampling; SRS: simple random sampling; DALYS: Disability-adjusted life years; MUAC: Mid-upper-arm-circumference; WHO: World Health Organization; EDHS: Ethiopian Demographic and Health Survey; SPSS: Statistical package for social science; ANC: Ante natal care; PCA: Principal component analysis; MASL: Meter above sea level; g/dl: gram per decilitre HALE: Health Action Leicester Ethiopia; WDDS: Women’s Dietary Diversity Scale

Role of vitamin A supplementation in management of iron deficiency anemia in children

Background: The objective of the study were to study the effect of the supplementation of vitamin A along with standard dose of iron on hematopoiesis in children with documented iron deficiency anemia, a hospital based prospective study is carried out for 6 months on children with documented iron deficiency anemia in OPD and indoor patients of the department of paediatric medicine, Medical College Kolkata..Methods: Thirty children (1-12 years age) presenting with iron deficiency anemia (hemoglobin less than 10 g/dl, mean corpuscular volume (MCV) &lt;75 fl, and serum iron &lt;55 mcg/dl) were studied in two groups of 15 each. Group I was supplemented with iron (ferrous sulphate 3 mg/kg/d) while group II in addition to iron was also supplemented with vitamin A (5000 IU/d).Collected data were expressed as mean±SE. Comparison of variables was done by using student t test or chi square test as applicable. P&lt;0.0001 was taken as statistically significant.Results: Hemoglobin concentration was found to be significantly increased after 4 weeks of iron supplementation. Rise in hemoglobin was comparatively more in group II, as compared to group I, after 4 and 8 weeks.Conclusions: The result of this study suggests that supplementation of vitamin A improves hematopoiesis.

Hemoglobin Response to 12 Weeks of Iron Supplementation is Substantially Lower among Non‐Pregnant Cambodian Women with Genetic Hemoglobin Disorders

ObjectiveWe measured the effect of 12 wk of oral iron (Fe) with or without multiple micronutrients (MMN) on hemoglobin (Hb) response (Hb increase of ≥10 g/L) among Cambodian women of reproductive age screened as anemic.MethodsIn this 2×2 factorial double‐blind randomized controlled supplementation trial, 2,846 non‐pregnant women (18–45 y) were convenience sampled from 26 rural villages in Kampong Chhnang province, Cambodia. Those (n=809) with Hb ≤117 g/L (capillary blood, HemoCue® 301) were randomized to 12 wk of daily oral Fe (60 mg elemental), MMN (14 nutrients excluding Fe), Fe+MMN, or placebo capsules.ResultsBaseline anemia prevalence (Hb &lt;120 g/L) was 58% (n=468/808) based on a Sysmex hematology analyzer (venous blood collected 1 wk post HemoCue® screening). Baseline iron deficiency was 25% and 22% based on serum soluble transferrin receptor (&gt;8.3 mg/L) and inflammation‐adjusted ferritin (&lt;15 μg/L), respectively. Overall, 74% of women (n=596/808) had a genetic Hb disorder (primarily, Hb E variants and α‐thalassemia). Of all women who received Fe (with or without MMN), 25% (n=95/383) responded with an Hb increase ≥10 g/L at 12 wk; among women confirmed anemic using the Sysmex analyzer, 37% (n=85/232) responded. Among women with depleted iron stores at baseline (ferritin &lt;15 μg/L) who received Fe (with or without MMN), 67% (n=57/85) had an Hb response ≥10 g/L at 12 wk. The proportion of women with an Hb increase ≥10 g/L at 12 wk was substantially lower among women with a genetic Hb disorder who received Fe (with or without MMN) (18%, n=53/287), as compared to women with no Hb disorder who received Fe (with or without MMN) (44%, n=42/96). There were no significant differences in the proportions of Hb responders and non‐responders in the MMN and placebo groups, by baseline iron status (iron‐depleted or replete) or by the presence/absence of a genetic Hb disorder.ConclusionThe proportion of anemia amenable to iron supplementation among our surveyed population of women (~37%) is at the low end of the 95% CI of the estimate for Southeast Asia (45% [95% CI: 35%, 53%]) as reported in the 2011 WHO Global Prevalence of Anemia Report. The proportion of Hb responders among women with a genetic Hb disorder was substantially lower than among women without an Hb disorder (less than half; 18% vs. 44%, respectively), demonstrating that women with an Hb disorder were much less likely to derive benefit from Fe supplementation. We conclude that it is crucial to understand the multifactorial causes of anemia in each country‐specific setting or population (e.g., the prevalence of Hb disorders) in order to design and implement effective anemia reduction strategies and programs.Support or Funding InformationFunding was provided by the Micronutrient Initiative, Sight and Life, and the Canadian Institutes of Health Research (CIHR). C.D.K. received a CIHR Vanier Scholarship, a CIHR Michael Smith Foreign Study Supplement, and a Doctoral Research Award from the International Development Research Centre.

Effects on Hematopoiesis in Children Suffering from Iron Deficiency Anemia with Vitamin A Supplementation

Objective: To study the effect of the supplementation of vitamin A along with standard dose of iron on hematopoiesis in children with documented iron deficiency anemia. Design: A hospital based prospective study. Place and Duration: Carried out for 6 months on children with documented iron deficiency anemia in OPD and indoor patients of the department of paediatric medicine, Medical College Kolkata. Methods: Thirty children (1-12 years age) presenting with iron deficiency anemia (hemoglobin less than 10g/dl, mean corpuscular volume (MCV) < 75fl, and serum iron < 55 mcg/dl) were studied in two groups of 15 each. Group I was supplemented with iron (ferrous sulphate 3 mg/kg/d) while group II in addition to iron was also supplemented with vitamin A (5000 IU/d).Collected data were expressed as mean +/- SE. Comparison of variables was done by using student t test or chi square test as applicable. p< 0.0001 was taken as statistically significant. Results: Hemoglobin concentration was found significantly increased after 4 weeks of iron supplementation. Rise in hemoglobin was comparatively more in-group II, as compared to group I, after 4 and 8 weeks. Conclusions: The result of this study suggests that supplementation of vitamin A improves hematopoiesis.

Effect of iron supplementation on iron stores and total body iron after whole blood donation.

Understanding the effect of blood donation and iron supplementation on iron balance will inform strategies to manage donor iron status. A total of 215 donors were randomized to receive ferrous gluconate daily (37.5 mg iron) or no iron for 24 weeks after blood donation. Iron stores were assessed using ferritin and soluble transferrin receptor. Hemoglobin (Hb) iron was calculated from total body Hb. Total body iron (TBI) was estimated by summing iron stores and Hb iron. At 24 weeks, TBI in donors taking iron increased by 281.0 mg (95% confidence interval [CI], 223.4-338.6 mg) compared to before donation, while TBI in donors not on iron decreased by 74.1 mg (95% CI, -112.3 to -35.9; p < 0.0001, iron vs. no iron). TBI increased rapidly after blood donation with iron supplementation, especially in iron-depleted donors. Supplementation increased TBI compared to controls during the first 8 weeks after donation: 367.8 mg (95% CI, 293.5-442.1) versus -24.1 mg (95% CI, -82.5 to 34.3) for donors with a baseline ferritin level of not more than 26 ng/mL and 167.8 mg (95% CI, 116.5-219.2) versus -68.1 mg (95% CI, -136.7 to 0.5) for donors with a baseline ferritin level of more than 26 ng/mL. A total of 88% of the benefit of iron supplementation occurred during the first 8 weeks after blood donation. Donors on iron supplementation replaced donated iron while donors not on iron did not. Eight weeks of iron supplementation provided nearly all of the measured improvement in TBI. Daily iron supplementation after blood donation allows blood donors to recover the iron loss from blood donation and prevents sustained iron deficiency.

Effects of oral iron (ferrous versus ferric) supplementation on oxidative stress and antioxidant status in pregnant women with iron deficiency: controlled trial

Background Pregnant women are more prone to oxidative stress. Iron deficiency anemia not only affects hematological parameters but also disturbs body oxidative balance, which impairs pregnancy outcome. Besides, iron therapy may generate harmful oxygen species. Objectives The aim of this study was to investigate the effect of the nature of oral iron supplementation (ferrous vs. ferric) in pregnant women with iron deficiency on oxidative stress and its correlation with peripheral systemic inflammatory response markers. Patients and methods A clinical trail study involves study included 30 healthy and 50 anemic pregnant women in their 20th-36th gestational weeks who fulfilled the inclusion criteria. They were randomly distributed to receive either ferrous sulfate or ferric polymaltose complex. Outcome was assessed after 8 weeks of iron supplementation and included hematological parameters, neutrophil : lymphocyte ratio, platelet : lymphocyte ratio, mean platelet volume, serum malondialdehyde (MDA), total antioxidant capacity (TAC), iron, and ferritin. Results Anemic pregnant women have increased oxidative stress with high levels of MDA and TAC, both at baseline and following iron supplementation (P Conclusion Iron polymaltose complex was as effective as ferrous sulfate as both were able to correct hematologic parameters in parallel to a decrease in MDA and peripheral inflammatory markers together with an increase in TAC levels to maintain oxidative balance.

Iron supplementation prevents a decline in iron stores and enhances strength performance in elite female volleyball players during the competitive season

The primary aim of this study was to examine the effects of 11 weeks of iron supplementation on hematological and strength markers in elite female volleyball players. Twenty-two volleyball players (aged 27.0 ± 5.6 years) from 2 Spanish First National League teams participated and were counterbalanced into 1 of 2 groups based upon iron status: (i) control group (CG, n = 11); or (ii) iron treatment group (ITG, n = 11), which received 325 mg/day of ferrous sulphate daily. Subjects performed their team's regimen of training or match play every day. Both groups were tested for hematological and strength levels at 2 points: (i) baseline (T0, before preseason) and (ii) 11 weeks later (T11, post-testing). Hematological parameters were serum iron (sFe), serum ferritin (FER), transferrin saturation index (TSI), and hemoglobin (Hb); strength assessments were bench press, military press, half-squat, power clean, clean and jerk, and pull-over. CG experienced a significant decrease (p < 0.05) for sFe (T0, 112.7 ± 31.5; T11, 69.0 ± 20.5 μg·dL(-1); -33.9%), FER (T0, 60.2 ± 28.6; T11, 38.2 ± 16.4 ng·mL(-1); -34.6%), TSI (T0, 29.4% ± 9.5%; T11, 17.4% ± 5.1%; -35.3%), and Hb (T0, 14.1 ± 1.0; T11, 13.0 ± 0.8 g·L(-1); -7.44%); however, ITG experienced no changes (p > 0.05). Consequently, in ITG all hematological parameters were significantly greater (p < 0.05) than CG at T11. There was greater (p < 0.05) percent increase in the clean and jerk (CG: +5.1% ± 20.9 vs. ITG: +29.0% ± 21.3%), power clean (CG: -5.8% ± 30.3% vs. ITG: +44.6% ± 56.6%), and total mean strength (CG: +10.9% ± 3.2% vs. ITG: +26.2% ± 3.6%) in ITG. Our findings suggest that oral iron supplementation prevents iron loss and enhances strength in female volleyball players during the competitive season.

Effect of weekly iron supplementation on iron indices in pregnant women

Introduction: The serum iron and ferritin concentrations decline after midpregnancy. The amount of dietary iron, together with that mobilized from stores, will be insufficient to meet the average demands imposed by pregnancy. Without supplementation, the haemoglobin concentration and hematocrit fall appreciably as the blood volume increases leading to iron deficiency anaemia (IDA). Aims & objectives: To compare effectiveness of weekly supplementation of 200 mg elemental iron with daily supplementation of 100 mg elemental iron on iron indices along with haemoglobin and hematocrit values in pregnant women. Materials & Methods: A prospective randomised longitudinal study was conducted at a tertiary care teaching hospital. Study included 100 pregnant women randomly allocated to two groups. Group I (n=50) received daily iron and group II (n=50) received weekly iron supplementation. During follow-up haemoglobin and hematocrit values were estimated at 4, 8 , 12 and 16 weeks of iron supplementation. Iron indices: serum iron, total iron binding capacity (TIBC) and serum ferritin were estimated before and after 12 and 16 weeks of iron supplementation. Results: Significant increase in haemoglobin, hematocrit and serum iron levels was ovserved in both the groups (p < 0.001) but on intergroup comparison it was significantly higher in group I than group II (p < 0.001). Serum ferritin improved in both the groups but improvement was not significant in weekly supplemented group. Compliance was better and sideeffects were less in group II as compared to group I (11.36% versus 39.9%). Conclusion: The weekly supplementation with 200 mg of elemental iron of pregnant women had desired effect on iron indices except for the serum ferritin level which can be overcome by extending the supplementation to the post-partum period.

Hepcidin profile of anemic adolescent schoolgirls in Indonesia at the end of 12 weeks of iron supplementation.

Iron deficiency is still the major nutritional problem in the developing world, and iron supplementation remains one of the most effective intervention strategies. Hepcidin, a newly discovered iron regulatory hormone, is an acute phase protein, and its role in iron supplementation has not been well explored. To investigate the hepcidin profiles of anemic adolescent girls who had received weekly iron supplementation. A cross-sectional study was conducted at the end of iron supplementation among adolescent schoolgirls (n = 83) in Pramuka Island, Indonesia. All the girls were anemic at the beginning and received 60 mg of elemental iron twice weekly for 12 weeks. Hemoglobin, hepcidin, serum ferritin, and red cell parameters were measured, together with inflammation markers. At the end of the 12-week supplementation, 65.1% (n = 64) of the girls were no longer anemic, but 43.4% (n = 36) were still iron deficient. The rate of subclinical inflammation, measured by C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP), was 38.6% (n = 32). Hepcidin was not correlated with either ferritin or red cell parameters. There was no association between hepcidin and the inflammatory markers CRP and AGP. The mean hepcidin concentration was 42.9 +/- 17.9 ng/mL and was not significantly different between anemic and nonanemic girls (44.2 +/- 14.9 and 42.3 +/- 19.2 ng/mL, respectively; p = .708). However, hepcidin concentration was slightly higher in the iron replete-group than in the iron-deficient group (45.2 +/- 20.0 and 39.3 +/- 13.5 ng/mL, respectively), a suggestive trend that did not reach statistical significance (p = .218). Hepcidin concentrations tended to be higher among the subset of girls who responded poorly to iron supplementation as a consequence of increased subclinical inflammation. A longitudinal study should be conducted to explore the role of hepcidin in iron supplementation.

Nutritional iron supplementation studies based on enriched 57Fe, added to milk in rats, and isotope pattern deconvolution‐ICP‐MS analysis

Enriched stable iron isotopes in combination with isotope pattern deconvolution and ICP-MS have been used to study the absorption and bioavailability of iron from supplemented formula milk administrated to lactating rats. The use of two enriched stable isotope tracers, one as the metabolic tracer (here (57) Fe) and the other ((54) Fe) as quantitation tracer, is shown to provide quantitative data about endogenous and exogenous (supplemented) total Fe distribution in rat feces, urine, red blood cells (RBCs), serum, liver, and kidney. The proposed analytical methodology was validated using reference materials (serum, urine, and liver) spiked with both (54) Fe and (57) Fe. Quantitative information about iron absorption/bioavailability and/or metabolism can be obtained from the amounts of endogenous and exogenous iron found in the tissues and fluids analyzed, and about its kinetic after 2 weeks of iron supplementation. The obtained results are discussed in terms of iron exchanged and its half-life in lactating rats and the observed iron levels in serum, RBCs, liver, and kidney comparing nonsupplemented rats and maternal feed rats.

Double‐blind Randomized Trial of Quadruple Sequential Helicobacter pylori Eradication Therapy in Asymptomatic Infected Children in El Paso, Texas

We assessed the efficacy of a novel quadruple sequential 10-day eradication therapy, its compliance, and reported adverse events in a sample of asymptomatically Helicobacter pylori-infected children in El Paso, Texas, as part of a study aiming to assess the influence of this infection on the levels of markers of iron stores. Using a double-blind randomized trial design, 110 asymptomatic children ages 3 to 11 with H pylori infection were randomly assigned to receive either a 10-day course of sequential eradication therapy plus 6 weeks of iron supplementation, eradication therapy plus placebo, iron supplementation plus placebo, or placebo only. H pylori infection status was assessed ≥45 days after treatment using the urea breath test. Analyses compared the proportion of subjects cured according to assignment to and completion of the sequential eradication therapy. Intent-to-treat and per-protocol analyses indicated that 44.3% and 52.9%, respectively, of the children receiving the novel quadruple sequential therapy had their infection eradicated compared with 12.2% and 15.4% in the arms receiving iron or placebo only, respectively (P < 0.001 in both analyses). Study medications were taken with no or only mild adverse events in most children. A quadruple sequential regimen eradicated H pylori in only half the asymptomatic children receiving this treatment. There was no difference in the cure rates of those receiving iron supplementation and those receiving placebo.

血液透析患者における鉄欠乏の指標としての網状赤血球ヘモグロビン量,低色素赤血球比率,血清トランスフェリンレセプター/血清鉄比の有用性

Reticulocyte hemoglobin content(CHr), percentage of hypochromic red blood cells(%HRC, level of serum transferrin receptor(sTfR), and sTfR/serum iron ratio(sTfR/Fe) were measured in 132 hemodialysis patients. On univariate analysis, CHr was positively correlated with serum amyloid A(SAA) and negatively correlated with Kt/V. %HRC showed a positive correlation with the recombinant human erythropoietin(rHuEPO) dosage. The dependency of each iron-status index on 5 variables, SAA, sFt, TS, KtN, and dose of rHuEPO administered, was determined by stepwise multiple regression analysis. CHr was influenced only by TS, while %HRC, sTfR and sTfR/Fe were influenced by both logrHuEPO dosage and TS. Patients whose hemoglobin concentration increased by more than 1 g/dl following iron supplementation were defined as Iron-Responders, and the remaining patients were defined as Iron-Nonresponders. Fifteen out of 20 patients responded to 10 consecutive intravenous administrations of 80 mg of saccharated ferric oxide at each dialysis session, while five did not. The baseline CHr was significantly lower in Iron-Responders than Iron-Nonresponders. The baseline %HRC, sTfR, and sTfR/Fe were significantly higher in Iron-Responders than Iron-Nonresponders. The baseline CHr, %HRC, and sTfR/Fe were correlated with the degree of change in Hb concentration at 4 weeks of iron supplementation. The absolute change in CHr at 2 weeks of iron supplementation was positively correlated with the absolute change in Hb concentration over the first 4 weeks. (1) In assessing the iron metabolic status of dialysis patients, CHr, %HRC, and sTfR/Fe were unique indices compared with the ordinary indices, particularly in diagnosing the functional iron deficiency state. (2) CHr was a valuable marker of iron deficiency anemia and could predict the degree of increase in Hb level following iron supplementation. (3) The %HRC and sTfR/Fe seemed to reflect both erythropoiesis induced by rHuEPO and the iron supply to erythropoietic cells.

Effect of vitamin A supplementation on hematopoiesis in children with anemia

Fifty children (1-4 years age) presenting with microcytic hypochromic anemia (hemoglobin less than 10g/dl) were studied in two groups of 25 each. Group I was supplemented with iron (ferrous sulphate 6 mg/kg/d) while group II in addition to iron was also supplemented with vitamin A (5000 IU/d). Hemoglobin concentration was found to be significantly increased after 4 weeks of iron supplementation. Rise in hemoglobin was comparatively more in-group II, as compared to group I, after 8 and 12 weeks. Serum iron was significantly higher after 4 weeks in both the groups. Packed cell volume (PCV) and retinol levels increased significantly in-group II only. The data suggests that supplementation of vitamin A improves hematopoiesis.

Daily versus intermittent iron supplementation in pregnant women: Hematological and pregnancy outcome

To compare the hematological parameters and pregnancy outcome in women receiving daily versus weekly iron supplements during pregnancy. A prospective randomized controlled study was carried out at the Department of Obstetrics and Gynaecology of the All India Institute of Medical Sciences, New Delhi, India, during which 111 women were randomized to receive either 100 mg elemental iron daily (n=55) or 200 mg elemental iron weekly (n=56). Hemogram and serum ferritin level estimation were carried out at the beginning of pregnancy and within the 32-34-week period of gestation. Side-effects, compliance and the number of tablets consumed were noted for each group. The mean birth weight, period of gestation at delivery and mode of delivery were also compared between the two intervention groups. There was no significant difference in the mean hemoglobin levels between the two intervention groups at the end of an average 17 weeks of iron supplementation. However, among anemic women who received daily supplementation, there was a greater rise in hemoglobin compared with those receiving supplementation weekly. The serum ferritin level was lower in the weekly supplemented group compared with that in the daily. There was no difference in the mean birth weight, period of gestation and mode of delivery between the two groups. Side-effects and non-compliance were significantly higher (P<0.001) in the daily supplemented group. Weekly iron supplementation is an effective option for prophylaxis in non-anemic pregnant women, but has less than optimal benefit in anemic women.

Effects of iron supplementation on human serum level of transferrin receptor

To study trend of dynamic change in level of serum transferrin receptor (sTfR) in the process of iron supplementation to provide evidence for sTfR in evaluating the efficacy of iron supplementation. Totally, 942 child-bearing-age women aged 18 to 45 years were selected from Longfang City, Hebei Province and Shunyi County, Beijing. Biochemical indicators of iron metabolism were measured for all of them, including serum levels of ferritin (SF) and zinc protoporphyrin (ZPP), and hemoglobin (Hb). According to the current criteria for assessing iron status, women were screened for iron deficiency erythropoiesis (IDE) or iron deficiency anemia (IDA). Seventy-two women agreed to participate in the study, and 59 of them finished whole dynamic observations with signed informed consent. Four capsules of ferrous L-threonate (containing 7 mg of iron element per capsule) were administered for women with IDE every other day and for women with IDA every day, respectively, for 12 weeks. Serum biochemical indicators and level of sTfR were measured in 0 wk, 3 wk, 6 wk, 9 wk and 12 wk, respectively, during the process of iron supplementation, and their dynamic changes were observed. Level of sTfR in women with IDE and IDA was (26.62 +/- 10.57) nmol/L and (41.25 +/- 21.96) nmol/L, respectively, significantly higher than normal level. During the process of iron supplementation, level of sTfR changed as the following characteristics. In women with IDE, level of sTfR kept stable within the first 3 weeks of iron supplementation, then dropped gradually and progressively, reached to normal, with (17.86 +/- 5.57) nmol/L, in the 12 wk after iron supplementation. In women with IDA, level of sTfR dropped quickly within the first 3 wk of iron supplementation, then dropped slowly until the 9th wk and kept stable, and reached to normal level in the 12 wk, with (19.54 +/- 5.94) nmol/L and a ratio of sTfR/SF of 12.23 +/- 4.34. Ratio of sTfR/SF changed as level of sTfR during the process of iron supplementation. Level of sTfR correlated reversely with levels of Hb and SF and positively with level of ZPP. Serum level of sTfR in child-bearing age women gradually decreased to normal with the restoration of their normal iron status during the process of iron supplementation and could be used as a specific indicator for assessing efficacy of iron supplementation.