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PubMed1990

Effect of decreased food consumption during iron deficiency upon growth rate and iron status indicators in the rat.

Weanling Wistar rats were given a low-iron diet (4-5 mg Fe/kg), a medium-iron diet (20 mg Fe/kg) or a control diet (40 mg Fe/kg) for 7 weeks. Pair-fed rats received the control diet in amounts equivalent to that consumed by animals on a low-Fe diet. Blood samples from the tail vein were taken after 4 weeks of diet and weekly during the following 3 weeks for determination of iron status parameters. Animals were weighed weekly. After 4 weeks of diet, the rats fed the 5 mg iron/kg diet were severely anemic and rats fed 20 mg iron/kg diet were moderately iron-deficient. Ad libitum and pair-fed controls had normal iron status. Total liver iron stores were lowest in anemic rats (p less than 0.001) and were also low in moderately iron-deficient animals (p less than 0.05). Growth rates decreased early in anemic and pair-fed rats. Both groups were smaller than controls and moderately iron-deficient rats after 2 weeks (p less than 0.05) and this continued until the end of the experiment (p less than 0.001). Body weights of pair-fed rats were lower than those of anemic rats from the 1st to the 3rd week of diet; thereafter, differences between the two groups were no longer significant.

Anemia, Hypochromic↗
PubMed2004

Iron deficiency and risk factors for lower iron stores in 6-24-month-old New Zealanders.

OBJECTIVES: To determine the prevalence of biochemical iron deficiency and identify factors associated with ferritin levels among 6-24-month-old urban South Island New Zealand children. DESIGN: Cross-sectional survey conducted from May 1998 to March 1999. SETTING: The cities of Christchurch, Dunedin and Invercargill. SUBJECTS: A total of 323 randomly selected 6-24-month-old children participated (response rate 61%) of which 263 provided a blood sample. METHODS: A complete blood cell count, zinc protoporphyrin, serum ferritin and C-reactive protein were measured on nonfasting venipuncture blood samples, 3-day weighed food records and general questionnaire data were collected. RESULTS: Among children with C-reactive protein<10 mg/l (n=231), 4.3% had iron deficiency anaemia, 5.6% had iron deficiency without anaemia, and 18.6% had depleted iron stores, when a ferritin cutoff of < or =12 g/l was used. Age (negative), sex (girls>boys), ethnicity (Caucasian>non-Caucasian), weight-for-age percentiles (negative) and birth weight (positive) were associated with ferritin after adjusting for infection and socioeconomic status. When current consumption of iron fortified formula and >500 ml of cows' milk per day were included, these were associated with a 22% increase and 25% decrease in ferritin, respectively (R2=0.28). CONCLUSIONS: The presence of suboptimal iron status (29%) among young New Zealand children is cause for concern, even though severe iron deficiency is rare, because children with marginal iron status are at risk of developing severe iron deficiency if exposed to a physiological challenge.

Anemia, Iron-Deficiency↗
PubMed2000

Brainstem auditory evoked potential responses in iron-deficient anemic children.

Iron deficiency is a major health problem in developing countries manifesting not only as overt anemia but also involving the CNS resulting in cognitive and behavioral deficits. Iron is an important nutrient and essential element involved in myelin formation and neurotransmitter synthesis and thus contributes to normal neurological activity. Hypomyelination has been reported in iron deficient states with possible neural conduction defects. The brainstem auditory evoked potential response is used extensively to identify lesions associated with various demyelinating diseases and hence has been used in the present study to observe the effect of iron deficiency on sensory brain function. A trend of increased absolute and interpeak latencies and reduced amplitudes of the waves leading to a definite linear correlation between the severity of anemia and the degree of neurophysiological deficit suggests a subclinical involvement of the auditory pathway in the brainstem of iron deficient children.

Adolescent↗
PubMed1986

Decreased bone marrow iron in chronic granulocytic leukaemia: a consistent finding not reflecting iron deficiency.

The iron status of 50 patients with Ph'-positive chronic granulocytic leukaemia (CGL) was evaluated at diagnosis by means of bone marrow and blood studies. A decreased or absent iron in semiquantitative estimation on bone marrow smears was observed in 92% of patients, and 88% had a low sideroblast score. In contrast, normal Hb and serum iron concentrations were found in the majority of cases, and only two out of the 50 patients displayed a decreased serum ferritin. To ascertain whether the bone marrow pattern of iron depletion could be due to an expansion of the red cell mass, the latter parameter was measured by isotopic methods in a subgroup of 11 patients. Normal or slightly increased values were obtained in all cases. We conclude that absent or decreased marrow iron is a common feature in the chronic phase of CGL, that generally does not reflect true iron deficiency. Since such a finding is also usual in polycythaemia vera and idiopathic myelofibrosis, it should be included among the features shared by the chronic myeloproliferative disorders.

Anemia, Hypochromic↗
PubMed2007

The G277S transferrin mutation does not affect iron absorption in iron deficient women.

BACKGROUND: Iron deficiency anaemia is one of the most important nutritional diseases, with high prevalence worldwide. The G277S transferrin mutation has been implicated as a risk factor for iron deficiency in menstruating women. However, the subject is controversial and there are no data concerning the possible influence of this polymorphism on iron absorption. AIM OF THE STUDY: To undertake a pilot study to investigate the effect of carrying the G277S transferrin mutation on non-haem iron absorption from a meal in young menstruating women compared to wild-type controls. METHODS: Menstruating women with low iron stores (serum ferritin < 30 microg/l) or who had suffered from iron deficiency anaemia or had a family history of anaemia were recruited (n = 162). Haematological parameters were analysed, including haemoglobin, ferritin, total-iron binding capacity and transferrin saturation. Non-haem iron absorption from a meal was measured in 25 non-anaemic women either with the G277S/G277G (n = 10) or the wild type G277G/G277G (n = 15) genotype. The incorporation of stable isotopes of iron into erythrocytes was used to measure absorption. RESULTS AND CONCLUSIONS: There were no significant differences in iron status indices or non-haem iron absorption between genotypes. However, G277S carriers did not show the usual inverse association between iron stores and non-haem iron absorption. Further studies should focus on the effects of a combination of polymorphisms in iron metabolism genes on iron absorption.

Adult↗
PubMed1998

Evaluation of the gastrointestinal tract in premenopausal women with iron deficiency anemia.

PURPOSE: Iron deficiency anemia is often attributed to menstrual blood loss in premenopausal women. The aims of this study were to determine the diagnostic yield of endoscopy and to evaluate the clinical outcome in these women. METHODS: Charts, endoscopy records, and pathology reports were reviewed in consecutive premenopausal women with documented iron deficiency anemia who were referred for diagnostic endoscopy. Follow-up was obtained by telephone contact and review of medical records. RESULTS: Endoscopy revealed a clinically important lesion in 23 (12%) of 186 patients. An upper gastrointestinal source was identified in 12 patients, most commonly due to gastric cancer (3%) or peptic ulcer disease (3%). A colonic lesion was detected in 11 patients, with colon cancer in six (3%). No patient had a lesion identified in both the upper and lower gastrointestinal tract. Small bowel biopsies and radiography were normal in all patients in whom they were obtained. Independent predictors for having a gastrointestinal lesion identified by endoscopy include a positive fecal occult blood test, a hemoglobin of <10 g/dL, and abdominal symptoms. Long-term follow-up data suggested a favorable prognosis, and iron deficiency anemia resolved with appropriate therapy in nearly all patients. CONCLUSIONS: Endoscopy yields important findings in premenopausal women with iron deficiency anemia, which should not be attributed solely to menstrual blood loss.

Adult↗
PubMed1996

Serum transferrin receptor levels in the evaluation of iron deficiency in the neonate.

Iron deficiency anemia (IDA) is a major global problem. Early onset of iron deficiency in developing countries makes it imperative to identify iron deficiency in neonates. Most conventional laboratory parameters of iron status fail to distinguish neonates with iron deficient erythropoiesis. Serum transferrin receptor (STFR) levels are a recent sensitive measure of iron deficiency and the present study was carried out to evaluate the usefulness of cord serum transferrin receptors in identifying iron deficient erythropoiesis in neonates. A complete hemogram, red cell indices, iron profile: serum iron (SI), percent transferrin saturation (TS%) and serum ferritin (SF) was carried out in 100 full-term neonates and their mothers at parturition. Cord and maternal STFR levels were estimated using a sensitive enzyme-linked immunosorbent assay (ELISA) technique. Anemic women had a significantly lower SI, their TS% and high STFR levels suggesting that iron deficiency was responsible for the anemia. In the neonates of iron deficient mothers, cord SI, TS% and cord ferritin were not significantly different from those of neonates born to non-anemic mothers. Cord STFR level correlated well with hemoglobin (Hb) and laboratory parameters of iron status, and its level was significantly higher in neonates born to anemic mothers than in those born to non-anemic mothers. It was the only laboratory parameter to differentiate between neonates born to anemic and non-anemic mothers. Therefore, STFR is a sensitive index of iron status in neonates and identifies neonates with iron deficient erythropoiesis.

Adolescent↗
PubMed1989

Change in red blood cell distribution width with iron deficiency.

Red cell volume distribution width (RDW-CV) was examined as a means of diagnosing iron deficiency. Iron deficiency was classified as iron deficiency anaemia, prelatent or latent iron deficiency in 1648 students. MCV and RDW-CV (mean +/- ISD) in each group were 89 +/- 4 ft, 12.7 +/- 0.7% in normal individuals, 89 +/- 4 fl, 13.2 +/- 0.8% in prelatent deficiency, 86 +/- 6 fl, 14.0 +/- 1.5% in latent deficiency, and 79 +/- 7 fl, 15.6 +/- 1.7% in iron deficiency anaemia, respectively. Although microcytosis was evident only in iron deficiency anaemia, RDW-CV showed larger values concomitant with the development of iron deficiency. The sensitivity of RDW-CV for the diagnosis of iron deficiency anaemia was 77.1%, and for iron deficiency anaemia and latent deficiency 49.2%, the specificity being 90.6%. In countries with a high prevalence of iron deficiency and low thalassaemia, iron deficiency should be screened by RDW-CV determination without serum iron or ferritin measurements.

Adolescent↗
PubMed1989

Conceptual and methodological issues regarding the epidemiology of iron deficiency and their implications for studies of the functional consequences of iron deficiency.

This paper reviews the measures of iron status (hemoglobin, hematocrit, mean corpuscular hemoglobin concentration, mean cell volume, free erythrocyte protoporphyrin, serum iron, transferrin saturation, and serum ferritin) that are potentially available for inclusion in field studies of the relationship between iron and mental performance. The characteristics of these measures (sensitivity to iron status, specificity to iron, and diurnal and day-to-day variability) are reviewed and the implications of choice of variable for the design, analysis, and interpretation of studies are discussed. Brief consideration is given to the question of confounding variables and to sources of both false-positive and false-negative conclusions. The explicit message of the paper is that there is no perfect choice of measure of iron status but, given explicit definition of the research question, there are preferred choices that can most effectively combine the choice of variable and the design of the study.

Adult↗
PubMed1989

[Women and iron deficiency--a problem? Iron levels in a group of fertile Norwegian women and the bioavailability of 3 low-dose iron supplements in women with low iron stores].

Serum ferritin levels were determined in 170 healthy Norwegian women (18-48 y, median age 36 y) including 23 blood donors. Exhausted iron stores, defined by serum ferritin levels less than 17 micrograms/l, were found in 21.8% of the non-donors, and in 30.4% of the donors. Women with serum ferritin levels less than or equal to 20 micrograms/l participated in a bioavailability study. They were randomized to one of three groups and given one of three different low dose iron supplements (18-20 mg iron per day) for six months. One of the supplements contained heme iron and non-heme iron, the other two contained non-heme iron only. Mean serum ferritin increase was significant for two of the supplements, the one containing heme iron giving the best result. All the supplements resulted in a significant decrease in TIBC.

Adult↗
PubMed1995

Responses to iron deficiency in Arabidopsis thaliana: the Turbo iron reductase does not depend on the formation of root hairs and transfer cells.

Arabidopsis thaliana (L.) Heynh. Columbia wild type and a root hair-less mutant RM57 were grown on iron-containing and iron-deficient nutrient solutions. In both genotypes, ferric chelate reductase (FCR) of intact roots was induced upon iron deficiency and followed a Michaelis-Menten kinetic with a Km of 45 and 54 microM FeIII-EDTA and a Vmax of 42 and 33 nmol Fe2+.(g FW)-1.min-1 for the wild type and the mutant, respectively. The pH optimum for the reaction was around pH 5.5. The approximately four fold stimulation of FCR activity was independent of formation of root hairs and/or transfer cells induced by iron deficiency. Iron-deficiency-induced chlorosis and the development of a rigid root habit disappeared when ferric chelate was applied to the leaves, while FCR activity remained unchanged. The time course of the responses to iron deficiency showed that morphological and physiological responses were controlled separately.

Arabidopsis↗
PubMed1961

The tongue and oesophagus in iron-deficiency anaemia and the effect of iron therapy.

Biopsies of the tongue and oesophagus were performed on 14 patients with uncomplicated iron-deficiency anaemia before and after treatment with iron. Haemoglobin and serum iron estimations were performed at the same time. Nine patients had clinical evidence of atrophic changes in the tongue before therapy was started. Evidence of regeneration appeared within one or two weeks of starting iron therapy. Two patients showed persistent atrophy. Angular stomatitis and koilonychia were longer in disappearing. Biopsies confirmed that filiform papillae and kerato-hyalin granules are frequently absent from the epithelium of the smooth tongues of iron-deficient patients. Iron therapy is followed by the re-appearance of keratohyalin granules and keratinized filiform papillae. Two patients complained of dysphagia, which disappeared after treatment. No abnormality in the oesophageal epithelium was found in any of the patients either before or after therapy. The relationship of oesophageal carcinoma to antecedent iron-deficiency epithelial changes is considered suspect.

Anemia↗
PubMed1991

Long-term developmental outcome of infants with iron deficiency.

BACKGROUND: Iron-deficiency anemia has been associated with lowered scores on tests of mental and motor development in infancy. However, the long-term developmental outcome of infants with iron deficiency is unknown, because developmental tests in infancy do not predict later intellectual functioning. METHODS: This study is a follow-up evaluation of a group of Costa Rican children whose iron status and treatment were documented in infancy. Eighty-five percent (163) of the 191 children in the original group underwent comprehensive clinical, nutritional, and psychoeducational assessments at five years of age. The developmental test battery consisted of the Wechsler Preschool and Primary Scale of Intelligence, the Spanish version of the Woodcock-Johnson Psycho-Educational Battery, the Beery Developmental Test of Visual-Motor Integration, the Goodenough-Harris Draw-a-Man Test, and the Bruininks-Oseretsky Test of Motor Proficiency. RESULTS: All the children had excellent hematologic status and growth at five years of age. However, children who had moderately severe iron-deficiency anemia as infants, with hemoglobin levels less than or equal to 100 g per liter, had lower scores on tests of mental and motor functioning at school entry than the rest of the children. Although these children also came from less socioeconomically advantaged homes, their test scores remained significantly lower than those of the other children after we controlled for a comprehensive set of background factors. For example, the mean (+/- SD) adjusted Woodcock-Johnson preschool cluster score for the children who had moderate anemia in infancy (n = 30) was 448.6 +/- 9.7, as compared with 452.9 +/- 9.2 for the rest of the children (n = 133) (P less than 0.01); the adjusted visual-motor integration score was 5.9 +/- 2.1, as compared with 6.7 +/- 2.3 (P less than 0.05). CONCLUSIONS: Children who have iron-deficiency anemia in infancy are at risk for long-lasting developmental disadvantage as compared with their peers with better iron status.

Anemia, Hypochromic↗