Functional Consequences of Iron Deficiency Nonerythroid Effects
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Transferrin saturation
Background: Dietary requirement for iron is negligible and iron deficiency is very unlikely unless there is inadequate intake, utilization, absorption or excessive loss of blood. Iron status however differs from population to population depending upon a number of factors. Iron deficiency anemia occurs at a stage when iron stores are absolutely finished. This study was done to look for magnitude of iron deficiency through various parameters of iron deficiency' in the subjects diagnosed to have iron deficiency anemia in Qatary adults. Methods: Among patients visiting outpatient departments of Hamad Medical Corporation, Qatar in the year 1993-1994, 108 were diagnosed for iron-deficiency anemia. Serum Iron, TIBC and transferrin saturation were done to look for exact status of iron deficiency'. Results: Out of 108, 24% were males and 76% females. In these patient’s serum iron (21.73 pg/dl) and transferrin saturation (6.96%) was low while the total iron binding capacity' (TIBC) was within normal range. In male’s iron (20.73 pg/dl) and transferrin saturation (5.68%) was comparatively lower than females having iron 24.41 (µg/dl and transferrin saturation 7.36 % respectively
Transferrin saturation
Total iron-binding capacity
Outpatient clinic
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Background:Iron is a vital constituent of cells but in excess may be harmful and is associated with a raised risk for some malignant diseases including breast cancer. We aimed to study changes in iron profile in Sudanese females newly diagnosed with breast cancer.Methods: A case- control study in which serum iron, Total Iron Binding Capacity (TIBC), and transferrin saturation percent were measured for fifty females with breast cancer referred to Khartoum Oncology Hospital and seventy apparently healthy females, using manual method (IRON-FERROZINE). Results: Mean age was 47years and 42years in cases and control, respectively and the mean of parity was 4 in both groups. Mean of serum iron ±SD in case group was 244.30 ± 151.598(µg/dL)and in control group was 57.59 ± 43.191(µg/dL) (P. value = 0.000). Mean of TIBC ±SD in cases was 412.98 ± 177.460(µg/dL)and in controls it was 403.71 ± 168.765(µg/dL) (P.value = 0.838). The mean of transferrin saturation percent ± SD in cases was 61.08 % ±41.523 and in controls was 223.23 % ±149.195 (P.value=0.000). The mean of TIBC in grade I 343.00(µg/dL), 467.10(µg/dL) in grade II and 321.25(µg/dL) in grade III (P.value 0.019).Conclusion: There is a statistically significant increase in the mean of serum iron and decrease in transferrin saturation percent in women with breast cancer. TIBC vary significantly according to histopathological grade. Serum iron and transferrin saturation percent may be helpful as biochemical risk markers for breast cancer and TIBC may act as a predictor of disease grade.
Transferrin saturation
Total iron-binding capacity
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Introduction: Anemia and iron deficiency are the most common extra-intestinal complications in IBD. Iron deficiency may be found in patients with normal hemoglobin levels, and it is the preface of anemia. Iron deficiency causes fatigue and is frequently associated with a reduced quality of life. This study aimed to determine the proportion of non-anemic IBD patients with iron deficiency and examine possible associations between iron deficiency and socio-demographic and clinical characteristics. Methods: Patients with confirmed diagnosis of IBD were recruited. Demographic and medical data were obtained. A total of 55 patients aged ≥18 y/o were included; 45 had Crohn's disease (CD) and 10 had Ulcerative colitis (UC). Patients with normal hemoglobin levels (defined by the World Health Organization as hemoglobin >13 g/dL in males, and >12 g/dL in females), were screened for iron deficiency using a combination of serum iron, ferritin, transferrin saturation and C-reactive protein (CRP). Among patients with normal CRP, iron deficiency was considered if serum ferritin was < 30 ng/mL or transferrin saturation was < 16%. Among patients with elevated CRP, iron deficiency was considered if serum ferritin was < 100 ng/mL. The data was stratified according to Iron Deficiency status. T-test was used to compare the mean duration of the disease between groups. Results: Iron deficiency without anemia was found in 89.1% of patients. Thirty-seven percent (37.0%) of the patients with iron deficiency were female and 63.3% male. However, 100% of female patients were iron deficient. The age of the majority of patients with iron deficiency (49%) was 20-34 years. Iron deficiency was identified in 81.6% of the patients with CD and 18.4% in patients with UC. Among patients with Crohn's and UC with iron deficiency, the most frequent disease locations were the small bowel and pancolitis, respectively. A marginally significant difference was observed in years of duration of disease and iron deficiency (p = 0.09). Those with iron deficiency showed in average 9.6±0.9 years (95% CI: 7.74-11.45) and their counterpart 6.8±1.2 years (95% CI: 3.76-9.90). Conclusion: A high proportionof non-anemic patients with iron deficiency was identified. Assessment of the iron status is imperative in order to institute early recognition and treatment, which may prevent iron deficiency anemia and improve quality of life. The sample size was small; larger studies are required to confirm these results.
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Transferrin saturation
Saturation (graph theory)
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Transferrin saturation
Total iron-binding capacity
Reticulocyte
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The effect of transfusion of packed red blood cells on serum iron level, total iron-binding capacity, and transferrin saturation was studied. Samples of blood from 37 hemodynamically stable patients were obtained for analysis at various intervals following the transfusion of packed red blood cells. In 10 patients with possible iron deficiency, a significant rise in serum iron level and transferrin saturation occurred during the 24 hours following transfusion, which persisted at a marginally significant level up to 36 hours. In the remaining 27 patients, a significant rise was also noted in serum iron level and transferrin saturation results, but the rise did not persist beyond the 24 hours after transfusion. No change in total iron-binding capacity was noted in either group. These data show that the diagnosis of iron deficiency (based on a transferrin saturation of < 0.16) might be missed if iron studies are performed on patients within 24 hours following packed red blood cell transfusion. Therefore, if serum iron studies are obtained for patients suspected of having iron deficiency anemia, these studies are best done on blood samples obtained before blood transfusion.
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Introduction: Iron deficiency anaemia (IDA) is a common finding among patients with chronic kidney disease (CKD) and a major contributor to the high morbidity, mortality and poor quality of life associated with the disease. Assessment of iron deficiency anaemia has become routine in the evaluation of patients with CKD and iron studies such as serum ferritin, total iron binding capacity and transferrin saturation are recommended as standard diagnostic work up. However, in Nigeria and other low and middle income countries (LMICs) where most patients pay out of pocket, only few patients could afford iron studies, in addition to other cost of care. It is therefore imperative to find and establish the utility of other relatively affordable markers of iron deficiency among patients in LMICs. In studies done within the general population, the percentage of hypochromic (PHRC) red blood cells (RBC) indices and reticulocyte haemoglobin concentration (CHr) have been shown to predict iron deficiency. However, the usefulness of these in CKD patients had not been established. Thus, we determined the utility of PHRC and RBC indices among patients with CKD.
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This case control cross sectional study was carried out in the department of Biochemistry, Mymensingh Medical College in collaboration with Cardiology department of Mymensingh Medical College Hospital, Mymensingh during the period of July 2004 to June 2005. The aim of the study was to explore the status of body iron among acute myocardial infarction (AMI) patients in Bangladesh as a means to monitor the possibility of management of these patients. A total of 100 subjects were selected and were grouped as Group I (50 healthy Control subjects) and Group II (50 subjects of AMI Cases). Serum iron, total iron binding capacity (TIBC) & transferrin saturation were estimated from each sample. Statistical analysis was done by using SPSS windows package. Among the groups, mean±SD of Group I serum iron, TIBC & transferrin saturation were 71.84±9.10, 336.66±35.39 & 21.73±4.88 respectively and of Group II serum iron, TIBC & transferrin saturation were 137.55±18.22, 267.99±34.97 & 52.40±11.74 respectively. By comparing Group I with Group II highly significant difference were found in case of serum iron (p<0.001), TIBC (p<0.001) and transferrin saturation (p<0.001). It is evident from the study that body iron (serum iron, TIBC & transferrin saturation) level significantly increases among acute myocardial infarction patients in Bangladesh.
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In order to assess the prevalence of iron deficiency in the Danish population, a randomised cross sectional investigation was carried out one year after repealing of the order from 1939 concerning supplementing of corn products with iron. A randomised group of 198 persons divided into ten groups of 20 persons with equal numbers of men and women in the age group 20-69 years was submitted to determinations of serum-iron, serum-transferrin and serum-ferritin. The prevalence of iron deficiency as determined by serum-ferritin values of below 15 micrograms/l was 18% and 12% respectively, for women under and over 45 years while iron deficiency determined by transferrin saturation under 16% was 18% for both groups. 6% of the women under 45 years had severe iron deficiency as determined by low transferrin saturation and low ferritin. The prevalence among men was 1% and 3% as assessed by serum-ferritin levels and transferritin saturation. These results were compared with corresponding population investigations from Sweden where iron enrichment is the highest in the world and the sale of iron tablets is the greatest in the world. No significant differences in the frequency of latent iron deficiency could be demonstrated but the number of persons with severe iron depletion appears to be less in Sweden. Differences in the methodological procedures, however, cannot be excluded.
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Prior to treatment, 48 patients with different forms of pulmonary tuberculosis were examined. Serum iron concentrations, total iron-binding capacity of the serum (STIBC), its unsaturated iron-binding capacity (SUSIB), serum transferrin iron saturation coefficient (SC), total protein in the serum, red blood cells, hemoglobin, colour index were determined. All the parameters under study were in the normal range in patients with a favourable involutional course of pulmonary tuberculosis. In patients with acutely progressive pulmonary tuberculosis, serum iron levels, STIBC, SC were drastically decreased, while SUSIB was in the normal range. All this was attended by phenomena of hypochromic anemia. The pattern of the found changes leads to the conclusion that patients with acutely progressive tuberculosis develop iron-redistributing anemia caused by the changes in the amount and quality of transferrin, iron binding during free radical processes and mobilization of the antioxidant defense system rather than true iron deficiency.
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