Obesity and iron deficiency anemia as risk factors for asymptomatic bacteriuria

Iron in the General Population and Specificities in Older Adults: Metabolism, Causes and Consequences of Decrease or Overload, and Biological Assessment

Iron is involved in many types of metabolism, including oxygen transport in hemoglobin. Iron deficiency (ID), ie a decrease in circulating iron, can have severe consequences. We provide an update on iron metabolism and ID, highlighting the particularities in older adults (OAs). There are three iron compartments in the human body: 1) the functional compartment, which consists of heme proteins including hemoglobin, myoglobin and respiratory enzymes; 2) iron reserves (IR), which consist mainly of liver stocks and are stored as ferritin; and 3) transferrin. There are two types of ID. Absolute ID is characterized by a decrease in IR. Its main pathophysiological mechanism is bleeding, which is often digestive and can be due to neoplasia, frequent in OAs. Biological assessment shows low serum ferritin and transferrin saturation (TS) levels. Furthermore, hypochromic microcytic anemia is frequent, and the serum-soluble transferrin receptor (sTfR) level is high. Functional ID, in which IR are high or normal, is due to inflammation, which is also frequent in OAs, particularly in its chronic form. Biological assessments show high serum ferritin, normal or low TS, and normal sTfR levels. Moreover, C-reactive protein is elevated, and there is moderate non-regenerative non-macrocytic anemia. The main characteristics of iron metabolism anomalies in the elderly are the high frequency of ID (20% of ID with anemia in adults ≥85 years) and the severity of its consequences, which include cognitive impairment in case of ID or iron overload and decrease of physical activity in case of ID. In conclusion, causes of ID are frequently intertwined in OAs as a result of the polymorbidity that characterizes them. ID can have dramatic consequences, especially in frail OAs. Thus, measuring the appropriate biological markers prevents errors in the positive diagnosis of ID type, clarifies etiology, and informs treatment-related decision-making.

Incidence of Nitrituria and Its Association With Metabolic Syndrome: Results From the Korean National Health and Nutrition Examination Survey V (2010–2012)

Purpose:

To investigate the incidence of nitrituria and the relationship between nitrituria and metabolic syndrome (MetS).

Methods:

Data from the Korean National Health and Nutrition Examination Survey V were used. A total of 19,083 participants were included. The chi-square test, the Mantel-Haenszel extension, logistic regression analysis, and multiple linear regression were used to analyze the data.

Results:

A total of 2.0% of the participants had nitrituria. The incidence of nitrituria significantly increased with age (P trend<0.001). In addition, nitrituria in women began to significantly increase in the fifth decade, more than in men, and this difference was maintained in the 60s, 70s, and greater than 70s age groups (P<0.001). After adjusting for confounders, the odds ratio (OR) for nitrituria in the MetS group was significantly increased, as compared to the OR for nitrituria in the group without MetS (MetS: OR, 1.577; 95% confidence interval [CI], 1.134–2.192; P=0.007). The glycosylated hemoglobin of the nitrite positive group was significantly higher than the negative group (adjusted mean ±standard error: 6.108 ±0.081 vs. 5.883±0.065, P<0.001).

Conclusions:

An effective health policy for urinary tract infection (UTI) is needed for older age groups and women. Screening or management guidelines for UTI are needed in MetS patients.