scholarly journals Iron Status of Kenyan Pregnant Women after Adjusting for Inflammation Using BRINDA Regression Analysis and Other Correction Methods

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 420 ◽  
Author(s):  
Martin Mwangi ◽  
Elizabeth Echoka ◽  
Marthe Knijff ◽  
Lydia Kaduka ◽  
Brenda Werema ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Serum Ferritin ◽  
Iron Status ◽  
Correction Method ◽  
Plasmodium Infection ◽  
Ferritin Concentration ◽  
Regression Methods ◽  
Reactive Protein ◽  
Serum Ferritin Concentration

Serum ferritin concentration is the preferred biomarker to assess population iron status in the absence of inflammation. Interpretation of this biomarker is complicated in populations with a high burden of infection, however, because inflammation increases serum ferritin concentration independently of iron status. We aimed to compare estimates of iron status of Kenyan pregnant women, with circulating ferritin concentrations adjusted for inflammation using newly proposed methods by the BRINDA project, or using previously proposed adjustment methods. We re-analyzed data from pregnant Kenyan women living in a rural area where malaria is highly endemic (n = 470) or in an urban area (n = 402). As proposed by the BRINDA group, we adjusted individual ferritin concentration by internal regression for circulating concentrations of C-reactive protein (CRP) and α1-acid glycoprotein (AGP). Other adjustment methods comprised: (a) arithmetic correction factors based on CRP or AGP; (b) exclusion of subjects with inflammation (CRP >5 mg/L or AGP >1 g/L); and (c) higher ferritin cut-off value (<30 μg/L). We additionally adjusted for Plasmodium infection as appropriate. Lastly, we assessed iron status without adjustment for inflammation. All correction methods increased prevalence of iron deficiency compared to the unadjusted estimates. This increase was more pronounced with the internal regression correction method. The iron deficiency prevalence estimate increased from 53% to 87% in rural Kisumu study and from 30% to 41% in the urban Nairobi study after adjusting for inflammation (CRP and AGP) using the BRINDA internal regression method. When we corrected for both inflammation and Plasmodium infection using the regression correction, it resulted in lower prevalence estimates compared to uninfected women. Application of linear regression methods to adjust circulating ferritin concentration for inflammation leads to markedly decreased point estimates for ferritin concentration and increased estimates for the prevalence of iron deficiency in pregnancy.

scholarly journals Association between central obesity indices and iron status indicators among Qatari adults

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250759
Author(s):  
Abdelhamid Kerkadi ◽  
Reem Mohsen Ali ◽  
Alaa A. H. Shehada ◽  
Eman Abdelnasser AbouHassanein ◽  
Joyce Moawad ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Iron Deficiency ◽  
Central Obesity ◽  
Iron Status ◽  
C Reactive Protein ◽  
Ferritin Concentration ◽  
Reactive Protein ◽  
Android Fat ◽  
Gynoid Fat ◽  
Obesity Indices

Co-existence of iron deficiency and obesity in adults has been reported in many countries. However, little is known on the association between obesity and iron deficiency in Qatar. This study aimed to investigate the link between abdominal obesity indices and iron status among adults in Qatar. A random sample of 1000 healthy Qatari adults, aged 20–50 years, was obtained from Qatar Biobank study. Body weight, waist circumference, dual x-ray absorptiometry (DXA) parameters and iron status indicators were measured using standard techniques. Multiple regression analysis was used to examine the associations. The prevalence of iron deficiency and anaemia were 35.4 and 25%, respectively. Of the participants with a large waist circumference, 31.7% had anaemia. Ferritin significantly increased with the increase in the android fat to gynoid fat ratio and visceral fat in both genders. Serum iron and transferring saturation decreased significantly with the increase in waist circumference in women. In both genders, C-reactive protein increased with the increase in all obesity indices. Standardized values of waist circumference, android fat, gynoid fat ratio and visceral fat were significantly associated with log transformed ferritin in men and women. Waist circumference was inversely related to serum iron (β:-0.95, 95% CI:-1.50,-0.39) and transferrin saturation (β:-1.45, 95%CI:-2.46, -0.43) in women. In men, waist circumference was positively associated with haemoglobin level (β: 0.16, 95% CI:0.04, 0.29). Central obesity coexists with anaemia among the study population. Elevated central obesity indices were associated with an increase in ferritin concentration. The increased ferritin concentration may be attributed to the increase in inflammatory status as a result of an increase in c-reactive protein concentration associated with central obesity.

scholarly journals Weekly Supplementation with Iron and Vitamin A during Pregnancy Increases Hemoglobin Concentration but Decreases Serum Ferritin Concentration in Indonesian Pregnant Women

2001 ◽  
Vol 131 (1) ◽  
pp. 85-90 ◽  
Author(s):  
Siti Muslimatun ◽  
Marjanka K. Schmidt ◽  
Werner Schultink ◽  
Clive E. West ◽  
Joseph G.A.J. Hautvast ◽  
...  
Keyword(s):  
Vitamin A ◽  
Pregnant Women ◽  
Serum Ferritin ◽  
Hemoglobin Concentration ◽  
Ferritin Concentration ◽  
Serum Ferritin Concentration

Hepatic computed tomography for monitoring the iron status of haemodialysis patients with haemosiderosis treated with recombinant human erythropoietin

1991 ◽  
Vol 81 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Sergio De Marchi ◽  
Emanuela Cecchin
Keyword(s):  
Computed Tomography ◽  
Serum Ferritin ◽  
Recombinant Human Erythropoietin ◽  
Chelation Therapy ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Ferritin Concentration ◽  
Human Erythropoietin ◽  
Serum Ferritin Concentration ◽  
Erythropoietin Treatment

1. A randomized, partial-crossover study was conducted in uraemic patients with dialysis-associated anaemia and transfusional iron overload to evaluate the effects of desferrioxamine chelation therapy and of recombinant human erythropoietin treatment on hepatic iron storage determined by computed tomography, as well as by serum ferritin concentration and transferrin saturation. 2. Twenty-one haemodialysis patients with moderate iron overload, confirmed by values of serum ferritin concentration, transferrin saturation and hepatic computed tomography density exceeding 1000 μg/l, 45% and 68 Hounsfield units respectively, were randomly allocated to three groups and were followed for 12 months. 3. During the first 6 months group 1 (n = 7) received desferrioxamine chelation therapy (30 mg/kg intravenously three times a week) and group 2 (n = 7) underwent recombinant human erythropoietin treatment (36 units/kg intravenously three times a week). Thereafter, in the second 6 months of observation patients in group 1 were switched to receive recombinant human erythropoietin. Because of a poor response in the desferrioxaminetreated group in the initial 6 months, patients in group 2 continued on the maintenance dose of recombinant human erythropoietin (18 units/kg three times a week) until the end of the trial. Patients in group 3 (n = 7) were maintained on placebo throughout the study. 4. In comparison with placebo, recombinant human erythropoietin treatment, but not desferrioxamine chelation therapy, reduced serum ferritin concentration, transferrin saturation and hepatic computed tomography density, and was associated with a rise in haemoglobin and packed cell volume. Hepatic computed tomography density, serum ferritin concentration and transferrin saturation decreased in 13 out of 14 patients (93%) during treatment with recombinant human erythropoietin. However, when the changes in hepatic computed tomography density were compared with those in the biochemical indices, we observed that the decreases in serum ferritin concentration and transferrin saturation were much slower and delayed. More specifically, within 6 months of starting recombinant human erythropoietin treatment, hepatic computed tomography density was normalized in 13 out of 14 patients (93%), whereas serum ferritin concentration and transferrin saturation were within the normal limits in only two (14%) and six patients (43%), respectively. 5. In conclusion, the strategies for monitoring the iron status of haemodialysis patients with transfusional haemosiderosis may evolve to a new level of sophistication with the introduction of computed tomography scanning. This technique has the advantage of estimating directly the effect of recombinant human erythropoietin treatment on hepatic iron storage. Hepatic computed tomography density is complementary to serum ferritin concentration and transferrin saturation in monitoring the iron status of haemodialysis patients treated with recombinant human erythropoietin.

Correlation between Diagnostic 59Fe2+-Absorption and Serum Ferritin Concentration in Man

1977 ◽  
Vol 32 (11-12) ◽  
pp. 1023-1025 ◽  
Author(s):  
H. C. Heinrich ◽  
J. Brüggemann ◽  
E. E. Gabbe ◽  
M. Gläser ◽  
Fatima Icagic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Correlation Coefficient ◽  
Serum Ferritin ◽  
Inverse Relationship ◽  
Sensitive Indicator ◽  
Ferritin Concentration ◽  
Iron Stores ◽  
Serum Ferritin Concentration ◽  
The Relationship

Abstract A high correlation coefficient r = -0.832 (Pr≠0 <0.0001) was estimated in man for the inverse relationship between the diagnostic 59Fe2+-absorption and the serum ferritin concentration which is very close to the correlation r = - 0.88 as described for the relationship between the diagnostic 59Fe2+-absorption and the diffuse cytoplasmic storage iron in the bone marrow macrophages. The increase of the diagnostic 59Fe2+-absorption seems to be an earlier and more sensitive indicator of depleted iron stores whereas the serum ferritin decreases somewhat later during the development of iron deficiency.

scholarly journals Enzyme-linked Immunosorbent Assay to Measure Serum Ferritin and the Relationship between Serum Ferritin and Nonheme Iron Stores in Cats

1994 ◽  
Vol 31 (6) ◽  
pp. 674-678 ◽  
Author(s):  
G. A. Andrews ◽  
P. S. Chavey ◽  
J. E. Smith
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Immunosorbent Assay ◽  
Serum Iron ◽  
Nonheme Iron ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ferritin Concentration ◽  
Iron Stores ◽  
Tissue Iron ◽  
Serum Ferritin Concentration

Serum ferritin concentration correlates with tissue iron stores in humans, horses, calves, dogs, and pigs but not in rats. Because serum iron and total iron-binding capacity can be affected by disorders unrelated to iron adequacy (such as hypoproteinemia, chronic infection, hemolytic anemia, hypothyroidism, and renal disease), serum ferritin is probably the most reliable indicator of total body iron stores in larger species. To test the hypothesis that serum ferritin might be correlated with tissue iron levels in cats, we developed a quantitative enzyme-linked immunosorbent assay that uses two monoclonal antibodies in a sandwich arrangement to measure feline serum ferritin. The recovery of purified ferritin added to feline sera ranged from 94% to 104%; the within-assay coefficient of variability was 8.4%, and the assay-to-assay variability was 13.2%. Mean serum ferritin from 40 apparently healthy cats was 76 ng ml (SD = 24 ng/ml). Serum ferritin concentration was significantly correlated ( P < 0.001, n = 101, r = 0.365) with the nonheme iron in the liver and spleen (expressed as milligrams of iron per kilogram of body weight), as determined by Pearson product-moment correlation analysis. Because serum iron can decrease in diseases other than iron deficiency, the combination of serum iron and serum ferritin should provide sufficient evidence to differentiate anemia of chronic inflammation from anemia of iron deficiency in the cat.

scholarly journals Prevalence of Iron Deficiency in Pregnancy: A Single Centre Canadian Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4896-4896
Author(s):  
Grace Tang ◽  
Andrea Lausman ◽  
Jessica Petrucci ◽  
Jameel Abdulrehman ◽  
Rosane Nisenbaum ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Serum Ferritin ◽  
Iron Status ◽  
Tertiary Care ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Iron Deficient ◽  
In Pregnancy

Abstract Background Iron deficiency (ID) is the most common and widespread nutritional deficiency in both developing and developed countries (WHO, 2001; Mei et al., 2011). Women of child bearing age are at the highest risk, but this risk increases even more during pregnancy. The expansion of blood volume, growth of the fetus and placenta increase demand for iron to approximately 5.0mg/day by the third trimester (Met et al., 2011). Common symptoms of ID during pregnancy include fatigue, shortness of breath, and difficulty concentrating (WHO, 2001). Poor prenatal iron status is associated with diminished cognitive performance, language ability, and motor functions in the child (Tamura et al, 2002). For the mother, it is associated with risk of blood transfusion and post-partum depression. Despite international recommendations and guidelines on the management of ID in pregnancy, it remains a problem of epidemic proportions and is often unrecognized and left untreated. To increase awareness of ID, a quality improvement project, IRON Deficiency project in Pregnancy: Maternal Iron Optimization (IRON MOM) was implemented January 1st, 2017 at St. Michael's Hospital (SMH), in Toronto, Canada. Phase 1 of the project involved adapting lab requisitions and workflow in the obstetrics clinic to incorporate routine measurement of ferritin in week 12, 16 and 28 of pregnancy. As part of the IRON MOM, laboratory requisitions were modified to include ferritin as part of routine screening for all pregnant women. Objective The primary objective of this study was to assess the prevalence of ID in pregnant women consistently screened for ID after the implementation of the IRON MOM quality improvement project at a tertiary hospital in Toronto, Canada. Methods Administrative laboratory data was collected from the electronic medical record system at SMH, Toronto, Canada between January 1 and December 31, 2017. Suboptimal iron stores was defined as serum ferritin between 30-50μg/L. ID was defined as serum ferritin between 15-29μg/L, and severe ID was defined as <15μg/L. Significant anemia was defined as hemoglobin levels <100 g/L. Descriptive statistics were used to calculate proportions. SAS version 9.4 was used to perform the analyses. Results In 2017, 2400 ferritin tests were completed on pregnant women at our institution. A total of 76.8% (1844/2400) of tests demonstrated iron deficiency with a ferritin <30μg/L. Of those, 30.2% (726/2400) had ferritin between 15-29μg/L, and 46.6% (1118/2400) were severely iron deficient with a ferritin <15μg/L (Figure 1). 3282 hemoglobin checks, at delivery, occurred in this same one-year period and 10.5% (345/3282) were significantly anemic (<100 g/L). Of those, 6.2% (204/3282) had hemoglobin levels between 90-99g/L, 2.6% (85/3282) had hemoglobin levels between 80-89g/L, and 1.7% (56/3282) had hemoglobin levels <80g/L. Conclusion We found an extremely high prevalence of ID in our pregnant patient population. This confirms that ID remains an underappreciated problem, even at a tertiary care centre. Our findings highlight a tremendous gap in awareness, which demands strategies to improve knowledge translation. Future directions include the simplification and digitization of IRON MOM to empower pregnant patients to advocate for their care. Figure 1. Figure 1. Disclosures Lausman: Ferring: Other: gave a talk.

scholarly journals Correlation between vivax malaria infection and iron deficiency in children

2015 ◽  
Vol 55 (1) ◽  
pp. 44
Author(s):  
Desmansyah Desmansyah ◽  
Rini Purnamasari ◽  
Theodorus Theodorus ◽  
Sulaiman Waiman
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Vivax Malaria ◽  
Malaria Infection ◽  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Hemoglobin Level ◽  
Ferritin Concentration ◽  
Iron Deficient

Background Iron deficiency is considered to be a major public health problem around the world due to its high prevalence as well as its effect on growth, development, and infection-resistance in children. In malaria-endemic areas, malaria infection is thought to contribute to the occurrence of iron deficiency, by means of hepcidin and hemolysis mechanisms. Objective To assess the prevalence of asymptomatic vivax malaria, compare hemoglobin levels and iron status parameters between vivax malaria-infected and uninfected children, assess the prevalence of iron deficiency, and evaluate a possible correlation between vivax malaria infection and iron deficiency. Methods This cross-sectional study was conducted from February to April 2013 at Sanana City of Sula Islands District, North Maluku. Six parameters were evaluated in 5-11-year-old children: malaria parasite infection, hemoglobin level, serum iron concentration, total iron-binding capacity (TIBC), serum transferrin saturation, and serum ferritin concentration. Results Among 296 children aged 5-11 years, 75 (25.3%) were infected with Plasmodium vivax. In infected children, hemoglobin, serum iron, transferrin saturation, TIBC and serum ferritin were significantly lower than in non-infected children (P<0.01). Using a serum ferritin cut-off of <15 μg/dL, 142 (48.0%) of the children were found to be iron deficient. There was a strong correlation between vivax malaria infection and iron deficiency (OR 3.573; 95%CI 2.03-6.29). ConclusionThe prevalence of asymptomatic vivax malaria infection was 25.3%. The hemoglobin level and iron status parameters in vivax malaria-infected subjects were significantly lower than in uninfected children. The prevalence of iron deficiency was 48.0% for all study subjects. Malaria vivax infection was correlated with iron deficiency in 5-11-year-old children at Sanana City.

scholarly journals Zinc protoporphyrin as screening test in female blood donors

1998 ◽  
Vol 44 (4) ◽  
pp. 800-804 ◽  
Author(s):  
Else J Harthoorn-Lasthuizen ◽  
Jan Lindemans ◽  
Mart M A C Langenhuijsen
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Blood Donors ◽  
Deficiency Anemia ◽  
Zinc Protoporphyrin ◽  
Ferritin Concentration ◽  
Iron Deficient ◽  
Serum Ferritin Concentration ◽  
Low Serum

Abstract Erythrocyte zinc protoporphyrin (ZPP) was measured in 102 women blood donors to evaluate its usefulness in screening for evolving iron deficiency anemia, a reason for the deferral of donors. The results were compared with serum ferritin determinations. Five women were deferred before their first donation and eight women were deferred after one or two donations. Women with increased ZPP values all had low serum ferritin concentrations, indicating iron-deficient erythropoiesis that was caused by iron depletion. The positive predictive value of an increased ZPP in predicting deferral of the donor after one or two donations was 75%, whereas a serum ferritin concentration ≤12 μg/L predicted deferral in 26% of the donors. The results indicate that the ZPP test can be recommended as a feasible and inexpensive predonation test to determine a subset of donors with iron-deficient erythropoiesis at risk of developing iron deficiency anemia.

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