Objective: This study investigated the iron deficiency of female university students and clarified the erythrocyte-related test in the normal-ferritin group.Methods: We examined the ferritin ...deficiency (ferritin <12 ng/ml) and erythrocyte-related tests of 177 adult female university students. Additionally, a dietary survey was conducted to explore the diet pattern of the low-ferritin group, which combined the ferritin-deficient and declined-ferritin groups (ferritin 12–25 ng/ml).Results: The iron deficiency anemia incidence was 3.3%, and latent iron deficiency without anemia was 18.1%. The mean corpuscular hemoglobin (MCH) cutoff value of 28.6 pg, was 89.4% for sensitivity and 76.3% for specificity in screening for iron deficiency by erythrocyte-related test. The declined-ferritin group had significantly higher chicken intake than that of the ferritin-satisfied group. The ferritin-deficient group had a significantly lower ham intake and considerably higher western confectionery than that of the satisfied group. Comparing the low-ferritin group with that of the ferritin-satisfied group, greasy fish and natto intakes were significantly lower and coffee intake was significantly higher. The median iron intake per 1,000 kcal was 4.83 mg, 4.52 mg, and 4.42 mg in the satisfied, declined, and deficient groups, respectively; however, there was no significant difference.Conclusions: Iron deficiency was found in 21.4% of female university students. As MCH of 28.6 pg was used as the cutoff value, iron deficiency could be screened with high sensitivity and specificity. However, the low-ferritin group consumed significantly more western confectionery and coffee; therefore, their diet pattern could not be well balanced.
The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene ...and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).
Iron deficiency with or without anemia in pregnant women is quite common today. In fact, anemia affects nearly 30% of women of reproductive age, and its prevalence among pregnant women is estimated ...to be 38% worldwide. Although iron deficiency (IR) is not the only cause of anemia, it is the most prevalent one. Anemia-reduction strategies among pregnant women are often ineffective, and severe anemia can greatly increase the risk of maternal mortality, as reported by WHO. Now therefore, the current guidelines for screening and treatment of ID-anemia (IDA) in pregnant women and new-borns require change. Severe anemia can greatly increase the risk of maternal death and adversely affect a developing fetus and new-born. In this review, we analyse the available data on the epidemiology and the effects of iron deficiency on mothers and infants, current treatment strategies and screening recommendations, as well as examine the treatment of IDA in pregnant women and newborns and the problem of poor compliance in patients with latent iron deficiency. A continuous long-term course of administration of oral iron supplements is one of the components of success in the treatment of IDA, and particularly latent forms of iron deficiency in pregnant women. It is often the case that poor patients’ compliance with therapy leads to poor treatment outcomes and misleading conclusions about the ineffectiveness of oral iron dosage forms in the battle against IDA. The data we have analysed suggest the possibility of increasing compliance with IDA treatment in pregnant women.
Iron deficiency anemia (IDA) and latent iron deficiency are common. The article describes the mechanisms of development, diagnostic criteria, the clinical presentation of the IDA. The current options ...for treating anemia with oral iron supplements and their indications, effectiveness and safety criteria.
Aim. To analyze and prove the effectiveness of iron fumarate combined with folate for treating and preventing iron deficiency in women of reproductive age.
Materials and methods. Sixty women aged 1847 with mild to moderate iron deficiency were examined. All patients received of iron fumarate (equivalent to 150 mg of elemental iron) combined with 1500 mcg of folic acid for 2142 days. Hemoglobin, ferritin, serum iron, and erythrocyte indices were measured.
Results. In most patients, recovery from anemia was observed: an increase in hemoglobin by 2732% and ferritin by a mean of 35%, i.e., 1.67 times compared with alternative iron therapy (iron sulfate and gluconate). The rate of side effects was less than 4%.
Conclusion. Co-administration of iron fumarate with folic acid has been shown to increase the therapeutic efficacy and has a high safety profile in patients with IDA (especially in pregnant women requiring additional folate supplements).
According to various studies, the overall population incidence of latent iron deficiency (LID) ranges from 70% and more. However, routine tests cannot detect LID during preconception examination and ...in the first trimester of pregnancy; therefore, women receive no proper treatment, and iron deficiency manifest in the second and third trimesters of pregnancy. LID causes hypoxia, leading to pregnancy, labor, and postpartum complications.
Aim. To evaluate the effectiveness of iron with folic acid supplements compared to vitamin-mineral complexes in pregnant women with LID to improve maternal and perinatal outcomes.
Materials and methods. A prospective cohort non-interventional study (observational program) in real clinical practice was conducted. In total 461 pregnant women aged 19 to 35 with LID were included in the study. During the study, women were divided into two groups according to the method of LID correction: administration of iron sulfate 247.25 mg, which corresponds to an iron content of 80 mg + folic acid 350 g (Gyno-Tardyferon), or vitamin-mineral complexes with an iron content of 1418 mg. Routine complete blood count, serum iron, serum ferritin, and transferrin were monitored over time.
Results. Gyno-Tardyferon showed high therapeutic and prophylactic efficacy; the rate of favorable outcomes was 100% and 35% for multivitamin iron-containing complexes. No LID progression to manifest iron deficiency during pregnancy can also be considered a favorable outcome.
Conclusion. The results showed that timely treatment of LID with an iron-containing medication (Gyno-Tardyferon) prevents manifested iron deficiency and hemic and circulatory hypoxia, which ultimately reduces the rate of pregnancy, labor, and postpartum complications.
Background and Objectives
The present study was planned to assess the clinical utility of reticulocyte haemoglobin content (CHr) and immature reticulocyte fraction (IRF) in the early detection of ...latent iron deficiency in blood donors.
Materials and Methods
The prospective longitudinal observational study was conducted using the purposive sampling method. Written informed consent was obtained and donors were allocated into the first‐time (FTD) and regular donor (RD) group. The enrolled blood donors (n = 205 in each group) were followed up for two subsequent whole blood donations. Haemoglobin (Hb), CHr, IRF and serum ferritin values were recorded at enrolment and two follow‐ups.
Results
The sensitivity of CHr in detecting iron‐deficient erythropoiesis (serum ferritin values ≤ 26 μg/dl) was 45% and 56.7%, specificity 96.7%, positive predictive value (PPV) 85.6% and 90.8% and negative predictive value (NPV) 80.1% and 78.7%, respectively in FTD and RD cohorts. The sensitivity of IRF was 45.1% and 44.8%, specificity 93.4% and 97.1%, PPV 74.8% and 90.4% and NPV 79.6% and 74.5%, respectively in both the cohorts.
The sensitivity of CHr in detecting absent iron stores (serum ferritin values ≤ 15 μg/dl) was 66.2% and 74.4%, specificity 92% and 90.6%, PPV 56.7% and 68.7% and NPV 94.5% and 92.8% among FTD and RD cohort, respectively. The sensitivity of IRF was 72.7% and 65.3%, specificity 90.3% and 94.3%, PPV 54.4% and 76% and NPV 95.4% and 90.8%, respectively in both the cohorts.
Conclusion
Reticulocyte hemoglobin content and IRF can be used along with complete blood count for early detection of iron deficiency in blood donors using the same blood sample at no extra cost.
This study analyzed the relationship between latent iron deficiency evaluated by ferritin, and the myelination of the central nervous system evaluated through the brainstem evoked response audiometry ...test.
A total of 109 full-term newborns, born without anemia and risk factor for hearing deficiency, were enrolled. After delivery, umbilical cord blood was collected to determine ferritin and hematocrit levels. The brainstem evoked response audiometry test was carried out in the first 28 days of life. Analysis was performed between the control group (n=71) with ferritin greater than 75ng/mL, and the latent iron deficiency group (n=38) with ferritin between 11 and 75ng/mL. Results were presented as mean±standard deviation. Statistical analysis was performed using GraphPad prism7 and SPSS with a significance level of 5%.
A significant higher V-wave (p=0.02) and interpeak intervals I–III (p=0.014), I–V (p=0.0003), and III-V (p=0.0002) latencies were found in the latent iron deficiency group, as well as a significant inversely proportional correlation between ferritin and the same wave and intervals (p=0.003, p=0.0013, p=0.0002, p=0.009, respectively). Multiple correlation analysis showed a significant correlation of latent iron deficiency with all interpeak intervals, even taking into account newborn gestational age.
Iron deficiency anemia is a prevalent pathology; this study showed auditory delayed maturation associated to intrauterine iron deficiency, even in its latent form. This reinforces the importance of adopting effective measures, on a global scale, to prevent and treat this pathology in different life periods, especially in the most vulnerable population.
Este estudo analisou a relação entre deficiência de ferro latente avaliada pela ferritina e a mielinização do sistema nervoso central avaliada pelo teste de Potenciais Evocados Auditivos de Tronco Encefálico.
Foram incluídos no estudo 109 recém-nascidos a termo, nascidos sem anemia e fator de risco para deficiência auditiva. Após o parto, o sangue do cordão umbilical foi coletado para determinar os níveis de ferritina e hematócrito. O teste de Potenciais Evocados Auditivos de Tronco Encefálico foi realizado nos primeiros 28 dias de vida. A análise foi realizada entre o grupo controle (n=71) com ferritina acima de 75ng/mL e o grupo com deficiência de ferro latente (n=38) com ferritina entre 11 e 75ng/mL. Os resultados foram apresentados como média±desvio-padrão. A análise estatística foi realizada utilizando o software GraphPad prism7 e SPSS com nível de significância de 5%.
Latências significativamente maiores da onda V (p=0,02) e dos intervalos interpicos I-III (p=0,014), I-V (p=0,0003) e III-V (p=0,0002) foram encontradas no grupo de deficiência de ferro latente, assim como uma correlação significativa inversamente proporcional entre a ferritina e a mesma onda e intervalos (p=0,003, p=0,0013, p=0,0002, p=0,009, respectivamente). A análise de correlação múltipla mostrou uma correlação significativa da deficiência de ferro latente com todos os intervalos interpicos, mesmo se levarmos em consideração a idade gestacional do recém-nascido.
A anemia ferropriva é uma patologia prevalente e este estudo demonstrou maturação auditiva tardia associada à deficiência intrauterina de ferro, mesmo em sua forma latente. Isso reforça a importância da adoção de medidas efetivas, em escala global, para prevenir e tratar essa patologia em diferentes períodos da vida, principalmente na população mais vulnerável.
Background: In utero latent iron deficiency has been associated with abnormal neurodevelopmental outcomes during childhood. Its concomitant effect on auditory neural maturation has not been well ...studied in late preterm and term infants.
Objective: The objective was to determine whether in utero iron status is associated with auditory neural maturation in late preterm and term infants.
Design: This prospective cohort study was performed at Sir Ganga Ram Hospital, New Delhi, India. Infants with a gestational age ≥34 wk were eligible unless they met the exclusion criteria: craniofacial anomalies, chromosomal disorders, hemolytic disease, multiple gestation, third-trimester maternal infection, chorioamnionitis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex virus infections (TORCH), Apgar score <5 at 5 min, sepsis, cord blood not collected, or auditory evaluation unable to be performed. Sixty consecutive infants with risk factors for iron deficiency, such as small for gestational age and maternal diabetes, and 30 without risk factors for iron deficiency were enrolled. Absolute wave latencies and interpeak latencies, evaluated by auditory brainstem response within 48 h after birth, were measured and compared between infants with latent iron deficiency (serum ferritin ≤75 ng/mL) and infants with normal iron status (serum ferritin >75 ng/mL) at birth.
Results: Twenty-three infants had latent iron deficiency. Infants with latent iron deficiency had significantly prolonged wave V latencies (7.10 ± 0.68 compared with 6.60 ± 0.66), III–V interpeak latencies (2.37 ± 0.64 compared with 2.07 ± 0.33), and I–V interpeak latencies (5.10 ± 0.57 compared with 4.72 ± 0.56) compared with infants with normal iron status (P < 0.05). This difference remained significant on regression analyses after control for confounders. No difference was noted between latencies I and III and interpeak latencies I–III.
Conclusion: Latent iron deficiency is associated with abnormal auditory neural maturation in infants at ≥34 wk gestational age. This trial was registered at clinicaltrials.gov as NCT02503397.
The aim of the study: to assess changes in myocardial electrical activity and heart rate variability (HRV) in patients with coronary artery disease (CAD) depending on the stage of iron deficiency ...(ID) and identify their relationship with ferrokinetic parameters.
Materials and methods. In total, 90 patients with CAD, stable angina II–III FC were examined (men – 35, women – 55, age – 69 (61; 72) years). The patients were divided into 4 groups: the 1st group (n = 16) consisted of patients with concomitant ID anemia (IDA) of mild and moderate severity, the 2nd (n = 15) – with latent ID, the 3rd (n = 14) – with functional ID, the 4th (n = 45) – patients with CAD without iron metabolism disorders. The HRV features during 24 hours, daytime and nighttime as well as their relationships with ferrokinetic and hematological parameters were analyzed. The data analysis was performed using Statistica 13.0.
Results. CAD patients with concomitant IDA demonstrated a tendency to have a higher average daytime heart rate value (U = 14.0; p ≈ 0.08), a longer duration of tachycardia (U = 20.0; p ≈ 0.06), and a significantly greater number (2.4 times) of ventricular extrasystoles (VE) (U = 7.0; p < 0.05) compared to patients without iron metabolism disorders. There were no statistically significant differences in heart rate, episodes of tachycardia, and the number of arrhythmic events in CAD patients with different stages of ID. During the temporal analysis of HRV indicators, patients with different stages of concomitant ID demonstrated a decrease in overall HRV due to SDNN-index, rMSSD (%) and HRVT triangular index both in active and passive periods as compared to patients without iron metabolism disorders. Spectral analysis of HRV has revealed reduced parasympathetic activity of the autonomic nervous system due to HF indicator in patients of the 1st–3rd groups. The presence of concomitant IDA was characterized by maximum changes in HRV indicators and the predominance of central mechanisms of HRV regulation over autonomic ones, which was confirmed by a significant increase in the centralization index (IC) and stress index (SI). For CAD patients with concomitant IDA and latent ID, a number of relationships between ferrokinetic and HRV parameters was found. There were no statistically significant correlations between indicators of iron metabolism and HRV in patients with CAD and functional ID.
Conclusions. The decrease in iron stores in the body due to its tissue and transport reserves is accompanied by changes in the myocardial electrical activity, a progressive reduction in heart rate variability, autonomic dysfunction towards a suppression of the parasympathetic domain activity, confirming the relevant correlations with the ferrokinetic parameters.
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