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Zeidan RS, Yoon HS, Yang JJ, Sobh A, Braithwaite D, Mankowski R, Leeuwenburgh C, Anton S. Iron and cancer: overview of the evidence from population-based studies. Front Oncol 2024; 14:1393195. [PMID: 39246326 PMCID: PMC11377248 DOI: 10.3389/fonc.2024.1393195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/23/2024] [Indexed: 09/10/2024] Open
Abstract
Iron is an essential nutrient required for various physiological processes in the body. However, iron imbalance can potentially contribute to initiating and promoting cancer development. Epidemiological studies have investigated the relationship between dietary iron intake and the risk of different types of cancer, yet, not all studies have consistently shown a significant association between dietary iron and cancer risk. Also, studies have shown different effects of dietary heme and non-heme iron intake on cancer risk. While some epidemiological studies suggest a possible link between high dietary iron (mainly heme-iron) intake and increased cancer risk, the evidence remains inconsistent. Moreover, multiple iron biomarkers, which can mirror physiological iron status, have demonstrated varied correlations with the risk of cancer, contingent upon the specific biomarker analyzed and the type of cancer being investigated. Here, we have investigated the current evidence on the potential relationship between dietary iron intake on one hand, and iron biomarkers on the other hand, with the risk of developing different types of cancer, including breast, prostate, lung, pancreatic, colon, colorectal, and liver cancers. Further research is warranted to better understand the complex relationship between dietary iron, physiological iron and cancer development. Future research should account for factors that affect and interact with dietary iron and physiological iron levels, such as genetic susceptibility, overall diet quality, and lifestyle habits.
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Affiliation(s)
- Rola S Zeidan
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Hyung-Suk Yoon
- Cancer Control and Population Science Division, University of Florida Health Cancer Center, Gainesville, FL, United States
- Division of Hematology and Oncology, University of Florida Health Cancer Center, Gainesville, FL, United States
| | - Jae Jeong Yang
- Cancer Control and Population Science Division, University of Florida Health Cancer Center, Gainesville, FL, United States
- Division of Hematology and Oncology, University of Florida Health Cancer Center, Gainesville, FL, United States
| | - Amin Sobh
- Division of Hematology and Oncology, University of Florida Health Cancer Center, Gainesville, FL, United States
| | - Dejana Braithwaite
- Cancer Control and Population Science Division, University of Florida Health Cancer Center, Gainesville, FL, United States
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL, United States
| | - Robert Mankowski
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Christian Leeuwenburgh
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Stephen Anton
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
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Hassan N, Schapkaitz E, Rhemtula H, Ncete N. Incidence and Impact on Quality of Life of Heavy Menstrual Bleeding in Women on Oral Anticoagulant Therapy. Clin Appl Thromb Hemost 2024; 30:10760296241281366. [PMID: 39211958 PMCID: PMC11367687 DOI: 10.1177/10760296241281366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION Heavy menstrual bleeding affects up to two thirds of women on oral anticoagulation. The rates of heavy menstrual bleeding, its impact on quality of life and associated risk factors in women attending anticoagulation clinics in South Africa are largely unknown. MATERIALS AND METHODS A prospective cohort study was performed over an eight-month period in women on Warfarin (n = 30) and Rivaroxaban (n = 27) for a median [interquartile range] duration of 15.5 [78.0] months attending an anticoagulation clinic in Johannesburg, South Africa. Heavy menstrual bleeding was assessed over one menstrual cycle using the validated pictorial blood loss assessment charts (PBAC) and the menstrual bleeding questionnaire (MBQ). RESULTS In this population of predominantly African ethnicity, with a median age of 39 [8] years, 39 (68.4%) women experienced heavy menstrual bleeding, defined as a PBAC score of >100. Median cycle length on anticoagulation and MBQ scores were significantly higher among women with a PBAC score of >100 (p > 0.05). Univariate analysis identified Rivaroxaban as a risk factor for heavy menstrual bleeding (OR 5.03, 95% CI 1.40-18.12). Heavy menstrual bleeding required treatment in 29 (74.4%) women which included management of iron deficiency, anti-fibrinolytics, modification of anticoagulation and hormonal contraception. CONCLUSION Heavy menstrual bleeding was associated with a considerable negative impact on quality of life. This was most significant for women on Rivaroxaban as compared to Warfarin. It is essential to monitor and appropriately treat heavy menstrual bleeding in at risk women on anticoagulant treatment.
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Affiliation(s)
- Naseerah Hassan
- Dept. of Molecular Medicine and Hematology, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory System Complex and University of the Witwatersrand, Johannesburg, South Africa
| | - Elise Schapkaitz
- Dept. of Molecular Medicine and Hematology, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory System Complex and University of the Witwatersrand, Johannesburg, South Africa
| | - Haroun Rhemtula
- Dept. of Obstetrics, Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Nolukholo Ncete
- Dept. of Molecular Medicine and Hematology, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory System Complex and University of the Witwatersrand, Johannesburg, South Africa
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Aedh AI, Khalil MSM, Abd-Elkader AS, El-Khawanky MM, Alshehri HM, Hussein A, Alghamdi AAL, Hasan A. Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off. Hematol Rep 2023; 15:201-211. [PMID: 36975734 PMCID: PMC10048437 DOI: 10.3390/hematolrep15010021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/18/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
Introduction: Latent iron deficiency (LID), in which iron stores in the body are depleted without incidental anemia, poses a key diagnostic challenge. Reticulocyte hemoglobin content (Ret-Hb) is directly correlated with the functionally available iron for heme synthesis in erythroblasts. Consequently, Ret-Hb has been proposed as an efficient iron status marker. Aim: To assess the importance of Ret-Hb in detecting latent iron deficiency as well as its use in screening for iron deficiency anemia. Materials and Methods: A study involving 108 individuals was conducted at Najran University Hospital, 64 of whom had iron deficiency anemia (IDA) and 44 of whom had normal hemoglobin levels. All patients were subjected to complete blood count (CBC), reticulocyte percentage, Ret-Hb, serum iron, total iron binding capacity (TIBC), and serum ferritin measurements. Results: A significant decrease in Ret-Hb level was observed in IDA patients compared to non-anemic individuals, with a cut-off value of 21.2 pg (a value below which indicates IDA). Conclusion: The measurement of Ret-Hb, in addition to CBC parameters and indices, provides an accessible predictive marker for both iron deficiency (ID) and IDA. Lowering the Ret-Hb cut-off could better allow for its use as a screening parameter for IDA.
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Affiliation(s)
- Abdullah I. Aedh
- Internal Medicine Department, College of Medicine, Najran University, Najran 55461, Saudi Arabia; (A.I.A.)
| | - Mohamed S. M. Khalil
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Alaa S. Abd-Elkader
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed M. El-Khawanky
- Clinical Hematopathology, College of Medicine, Najran University, Najran 55461, Saudi Arabia
| | - Hamdan M. Alshehri
- Internal Medicine Department, College of Medicine, Najran University, Najran 55461, Saudi Arabia; (A.I.A.)
| | - Amr Hussein
- Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Ali A. Lafi Alghamdi
- Laboratory Department, Prince Mishari bin Saud Hospital, Saudi Ministry of Health, Baljurashi 22888, Saudi Arabia
| | - Abdulkarim Hasan
- Laboratory Department, Prince Mishari bin Saud Hospital, Saudi Ministry of Health, Baljurashi 22888, Saudi Arabia
- Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
- Correspondence: ; Tel./Fax: +20-224012932
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Cheung YT, Chan DFY, Lee CK, Tsoi WC, Lau CW, Leung JNS, So JCC, Wong CLP, Tsang STY, Chu YYL, Li CK. Iron Deficiency among School-Aged Adolescents in Hong Kong: Prevalence, Predictors, and Effects on Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2578. [PMID: 36767942 PMCID: PMC9916133 DOI: 10.3390/ijerph20032578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/28/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Iron deficiency (ID) is a prevalent nutritional deficiency affecting children/adolescents worldwide. We reported (1) the prevalence of ID and ID with anemia (IDA) among Chinese school-aged adolescents, (2) clinical and dietary predictors of iron status, and (3) its impact on health-related qualities of life (HRQoL). This cross-sectional study recruited 183 boys and 340 girls (mean age = 17.55) from 16 schools in Hong Kong. ID is defined as serum ferritin <15 μg/L. The participants reported their dietary habits, menstrual patterns (girls), and HRQoL using structured questionnaires. The overall prevalence of ID was 11.1%. None of the boys had ID or IDA. Among girls, the rate of ID was 17.1% and IDA was 10.9%. One-third (36.3%) reported a regular habit of skipping ≥1 meal/day. Lower ferritin was found in adolescents who skipped meals (Est = -35.1, p = 0.017). Lower ferritin is correlated with poorer school functioning (Est = 0.81, p = 0.045) and fatigue (Est = 0.92, p = 0.016). Skipping meals is associated with poorer physical (p = 0.0017) and school functioning (p = 0.027). To conclude, 1 in 10 school-aged adolescents in Hong Kong are iron-deficient. The ID rate in girls (17.1%) is similar to that in other industrialized countries (5.2-16.6%). Future work should promote awareness on the potential health consequences of poor dietary habits on ID and the well-being of adolescents.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | - Wai Chiu Tsoi
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | - Ching Wa Lau
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | | | - Jason Chi Chiu So
- Department of Pathology, Hong Kong Children’s Hospital, Hong Kong SAR, China
| | - Chris Lei Po Wong
- Hong Kong Molecular Pathology Diagnostic Centre, Hong Kong SAR, China
| | | | - Yvonne Yuen Ling Chu
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Kong Li
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
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Tsegaye Negash B, Ayalew M. Trend and factors associated with anemia among women reproductive age in Ethiopia: A multivariate decomposition analysis of Ethiopian Demographic and Health Survey. PLoS One 2023; 18:e0280679. [PMID: 36689422 PMCID: PMC9870172 DOI: 10.1371/journal.pone.0280679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In developing countries like Ethiopia, anemia is a public health problem. Unfortunately, the progress of anemia reduction has been slow. Although the issue of anemia has received considerable critical attention nowadays, trends and factors associated with anemia among women of reproductive age have not been explored in Ethiopia. OBJECTIVE This study aimed to determine trends and factors associated with anemia among women of reproductive age in Ethiopia from 2005 to 2016. METHOD Data from three consecutive Ethiopian Demographic and Health Survey (EDHS) from 2005-2016 were analyzed in this study. EDHS is a two-stage cluster sampling survey. Data were weighted to correct sampling bias in all surveys. A total of 46,268 samples were analyzed using a fixed effect model. For a measure of proportion, differences and slopes were computed. Bivariate and multivariable logistic regression analyses were done to identify predictors of the trend of anemia among women. Adjusted odds ratio (AOR) with a 95% Confidence Interval(CI) was computed, and the p-value < 0.05 is considered significant. RESULT Prevalence of anemia among women was 68%, 20.3%, and 27.3% in 2005, 2011 and 2016, respectively. The trend of anemia was reduced by 47.7 percentage points from 2005 to 2011; however, it increased by 7% points again from 2011 in 2016. Lack of mobile phones (AOR = 1.4, 95%CI, 1.2,1.6), Afar women (AOR = 1.5, 95%CI, 1.1,2.3) and Somali women (AOR = 1.5, 95%CI, 1.1,1.9) were associated with anaemia among women. On the contrary, the history of heavy menstruation in the last six months (AOR = 0.9; 95%CI, 0.85,0.98) was a factor negatively associated with anemia in 2005. In 2011, single women (AOR = 0.8,95%CI,0.7,0.9), watching TV less than once per wk (AOR = 0.9,95%CI,0.7,0.95), watching TV at least once per week (AOR = 0.8,95%CI,0.7,0.98) were variables associated with anemia. On the contrary, widowed women (AOR = 1.7,95%CI,1.4,2.0) were affected by anemia. In 2016, the richest women (AOR = 0.7, 95%CI, 0.6,0.8) and single (AOR = 0.8, 95%CI, 0.7,0.9) were affected little by anemia. Women of traditional belief followers (AOR = 2.2,95%CI,1.6,2.9) were more highly influenced by anemia than their counterparts. CONCLUSION The prevalence of anemia declined rapidly from 2005 to 2011, and increased from 2011 to 2016. Stakeholders should develop policies and programs to enhance the socio-demographic status of women and basic infrastructure for the community. Furthermore, they should design strategies for extensive media coverage of the prevention of anemia. The federal government should balance the proportion of anemia among regions by ensuring health equality.
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Affiliation(s)
- Berhan Tsegaye Negash
- Department of Midwifery, College of Medicine and Health sciences, Hawassa University, Hawassa, Ethiopia
| | - Mohammed Ayalew
- Department of Psychatric Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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The relationship between anemia and obesity. Expert Rev Hematol 2022; 15:911-926. [PMID: 36189499 DOI: 10.1080/17474086.2022.2131521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Obesity is linked to a variety of unfavourable outcomes, including anaemia, which is a serious global public health problem. The prevalence of obesity along with anaemia suggests a relationship between obesity and anaemia. Recent studies have demonstrated strong associations between anaemia and obesity, chronic diseases, ageing, hepato-renal impairment, chronic infection, autoimmune diseases, and widespread malignancy. Thus, the intersection point of obesity and anaemia is an important area of attention. AREA COVERED This paper reviews the pathophysiology of obesity and anaemia. Then, It deliberates the relationship between obesity and different types of anaemia and other clinical forms associated with anaemia. EXPERT OPINION Obesity, especially obesity-related to excessive visceral fat distribution, is accompanied by several disturbances at the endothelial, hormonal, and inflammatory levels. These disturbances induce activation of several mechanisms that contribute to the anaemic state. Over-weight patients with chronic anaemias are required to maintain the related vitamins and minerals at optimum levels and appropriate BMI. In addition, a regular clinical follow-up is essential to be scheduled to reduce the risk of complications associated with anaemia in obese patients.
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Skolmowska D, Głąbska D, Kołota A, Guzek D. Effectiveness of Dietary Interventions to Treat Iron-Deficiency Anemia in Women: A Systematic Review of Randomized Controlled Trials. Nutrients 2022; 14:nu14132724. [PMID: 35807904 PMCID: PMC9268692 DOI: 10.3390/nu14132724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/11/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
Iron-deficiency anemia is the most frequent nutritional deficiency, with women of reproductive age being particularly at risk of its development. The aim of the systematic review was to assess the effectiveness of dietary interventions to treat iron-deficiency anemia in women based on the randomized controlled trials. The systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (CRD42021261235). The searching procedure was based on PubMed and Web of Science databases, while it covered records published until June 2021. It included all randomized controlled trials assessing effectiveness of various dietary interventions on treatment of iron-deficiency anemia in women of childbearing age. The total number of 7825 records were screened, while 14 of them were finally included in the systematic review. The studies were screened, included, and reported, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials by two independent researchers. The included studies compared the effectiveness of various dietary interventions with supplementation, placebo, control, or any other dietary intervention, while the assessed dietary interventions were based either on increasing iron supply and/or on increasing its absorption (by increasing vitamin C or vitamin D or decreasing phytate intake). The duration of applied intervention was diversified from 3 months or less, through 4 or 5 months, to half of a year or more. Among the assessed biochemical measures, the following were analyzed in majority of studies: hemoglobin, ferritin, transferrin receptor, hematocrit, and transferrin. The majority of included studies supported the influence of dietary interventions on the treatment of iron-deficiency anemia, as the applied dietary intervention was not effective in only three studies. The majority of included studies were assessed as characterized by medium risk of bias, while the overall risk was high for only four studies, which resulted from the randomization process, deviations from the intended interventions, and selection of the reported result. The majority of included studies were conducted for increasing iron supply and/or increasing vitamin C supply; however, only for the interventions including increasing iron supply and simultaneously increasing its absorption by vitamin C supply were all results confirmed effective. Vitamin D also seems to be an effective dietary treatment, but further studies are necessary to confirm the observations. Considering this fact, dietary interventions recommended for anemic female patients should include increased intake of iron and vitamin C.
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Affiliation(s)
- Dominika Skolmowska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Aleksandra Kołota
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
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Zhu Z, Wang Z, Zang J, Lu Y, Xiao Z, Zheng G, Wu F. The SNP rs516946 Interacted in the Association of MetS with Dietary Iron among Chinese Males but Not Females. Nutrients 2022; 14:nu14102024. [PMID: 35631165 PMCID: PMC9147551 DOI: 10.3390/nu14102024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
This study aimed to explore the role of the single nucleotide polymorphism (SNP) rs516946 of the Ankyrin 1 (ANK1) gene in the relationship between dietary iron and metabolic syndrome (MetS) in the Chinese population. A total of 2766 Chinese adults (1284 males and 1482 females) were recruited. A 3-day 24-h dietary recall and weighing of household condiments were used to assess dietary intake. Anthropometric and laboratory measurements were obtained. After adjusting for age, region, years of education, intentional physical exercise, physical activity level, smoking, alcohol use and energy intake, dietary iron and the SNP rs516946 were both correlated with MetS risk and interacted among the male participants. The trend between dietary iron and MetS risk remained among T allele non-carriers of males but not among T allele carriers of males. Both the SNP rs516946 and the ferritin level correlated positively with the aspartate aminotransferase (AST) level. ANK1 SNP rs516946 interacted in the association of MetS with dietary iron among Chinese males while no association was found among females. Periodic blood loss might prevent females from these associations. The SNP rs516946 might correlate with liver function.
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Affiliation(s)
- Zhenni Zhu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China; (Z.Z.); (Z.W.); (J.Z.); (Y.L.)
| | - Zhengyuan Wang
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China; (Z.Z.); (Z.W.); (J.Z.); (Y.L.)
| | - Jiajie Zang
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China; (Z.Z.); (Z.W.); (J.Z.); (Y.L.)
| | - Ye Lu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China; (Z.Z.); (Z.W.); (J.Z.); (Y.L.)
| | - Ziyi Xiao
- Department of Social Science, New York University Shanghai, Shanghai 200122, China;
| | - Guangyong Zheng
- Bio-Med Big Data Center, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai 200031, China
- Correspondence: (G.Z.); (F.W.)
| | - Fan Wu
- Shanghai Medical College, Fudan University, 130 Dongan Road, Shanghai 200032, China
- Correspondence: (G.Z.); (F.W.)
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Royal JT, Eiken O, Keramidas ME, McDonnell AC, Mekjavic IB. Heterogeneity of Hematological Response to Hypoxia and Short-Term or Medium-Term Bed Rest. Front Physiol 2021; 12:777611. [PMID: 34975531 PMCID: PMC8715762 DOI: 10.3389/fphys.2021.777611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Hematological changes are commonly observed following prolonged exposure to hypoxia and bed rest. Typically, such responses have been reported as means and standard deviations, however, investigation into the responses of individuals is insufficient. Therefore, the present study retrospectively assessed individual variation in the hematological responses to severe inactivity (bed rest) and hypoxia. The data were derived from three-bed rest projects: two 10-d (LunHab project: 8 males; FemHab project: 12 females), and one 21-d (PlanHab project: 11 males). Each project comprised a normoxic bed rest (NBR; PIO2=133mmHg) and hypoxic bed rest (HBR; PIO2=91mmHg) intervention, where the subjects were confined in the Planica facility (Rateče, Slovenia). During the HBR intervention, subjects were exposed to normobaric hypoxia equivalent to an altitude of 4,000m. NBR and HBR interventions were conducted in a random order and separated by a washout period. Blood was drawn prior to (Pre), during, and post bed rest (R1, R2, R4) to analyze the individual variation in the responses of red blood cells (RBC), erythropoietin (EPO), and reticulocytes (Rct) to bed rest and hypoxia. No significant differences were found in the mean ∆(Pre-Post) values of EPO across projects (LunHab, FemHab, and PlanHab; p>0.05), however, female EPO responses to NBR (Range - 17.39, IQR – 12.97 mIU.ml−1) and HBR (Range – 49.00, IQR – 10.91 mIU.ml−1) were larger than males (LunHab NBR Range – 4.60, IQR – 2.03; HBR Range – 7.10, IQR – 2.78; PlanHab NBR Range – 7.23, IQR – 1.37; HBR Range – 9.72, IQR – 4.91 mIU.ml−1). Bed rest duration had no impact on the heterogeneity of EPO, Rct, and RBC responses (10-d v 21-d). The resultant hematological changes that occur during NBR and HBR are not proportional to the acute EPO response. The following cascade of hematological responses to NBR and HBR suggests that the source of variability in the present data is due to mechanisms related to hypoxia as opposed to inactivity alone. Studies investigating hematological changes should structure their study design to explore these mechanistic responses and elucidate the discord between the EPO response and hematological cascade to fully assess heterogeneity.
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Affiliation(s)
- Joshua T. Royal
- Environmental Physiology and Ergonomics Lab, Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
- Jožef Stefan International Postgraduate School, Ljubljana, Slovenia
| | - Ola Eiken
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Solna, Sweden
| | - Michail E. Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Solna, Sweden
| | - Adam C. McDonnell
- Environmental Physiology and Ergonomics Lab, Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Igor B. Mekjavic
- Environmental Physiology and Ergonomics Lab, Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- *Correspondence: Igor B. Mekjavic,
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Shumoy H, Raes K. Dissecting the facts about the impact of contaminant iron in human nutrition: A review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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