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Jia Q, Lei P, Sun L, Jia WL, Pan Y, Yuan B, Wang Y, Zhou Q, Meng X, Jing J, Lin J, Wang A, Zhang S, Hong Z, Yang Y, Xiong Y, Li Z, Wang Y, Zhao X, Wang Y. Efficacy and safety of Ferrous iron on the prevention of Vascular cOgnitive impaiRment among patients with cerebral Infarction/TIA (FAVORITE): rationale and design of a multicentre randomised trial. Stroke Vasc Neurol 2024:svn-2023-002644. [PMID: 38789134 DOI: 10.1136/svn-2023-002644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The incidence of vascular cognitive impairment (VCI) is high in patients suffering from ischaemic stroke or transient ischaemic attack (TIA) or with vascular risk factors. Effective prevention strategies for VCI remain limited. Anaemia or low haemoglobin was found as an independent risk factor for adverse outcomes after acute stroke. Anaemia or low haemoglobin was possibly associated with an increased risk of poststroke cognitive impairment. Whether supplement of ferrous iron to correct anaemia reduces the risk of VCI and improves adverse outcomes in patients with ischaemic cerebrovascular disease remains uncertain. AIM We aim to introduce the design and rationale of the safety and efficacy of Ferrous iron on the prevention of Vascular cOgnitive impaiRment in patients with cerebral Infarction or TIA (FAVORITE) trial. DESIGN FAVORITE is a randomised, placebo-controlled, double-blind, multicentre trial that compares supplement of ferrous iron with placebo for recent minor stroke/TIA patients complicated with mild anaemia or iron deficiency: Ferrous succinate sustained-release tablet 0.2 g (corresponding to 70 mg of elemental iron) once daily after or during breakfast for 12 weeks or placebo with much the same colour, smell and size as ferrous iron once daily during or after breakfast for 12 weeks. All paticipants will be followed within the next year. STUDY OUTCOMES The primary effective outcome is the incidence of VCI at 3 months after randomisation and the primary safety outcome includes any gastrointestinal adverse event during 3 months. DISCUSSION The FAVORITE trial will clarify whether supplement of ferrous iron to correct low haemoglobin reduces the risk of VCI in patients with recent ischaemic stroke or TIA complicated with mild anaemia or iron deficiency compared with placebo. TRIAL REGISTRATION NUMBER NCT03891277.
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Affiliation(s)
- Qian Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Peng Lei
- Department of Neurology and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Li Sun
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Li Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Baoshi Yuan
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yinkai Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Qi Zhou
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing Jing
- Neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jinxi Lin
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Anxin Wang
- Neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Shuting Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zhen Hong
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yu Yang
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yunyun Xiong
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Giovannini S, Iacovelli C, Loreti C, Lama E, Morciano N, Frisullo G, Biscotti L, Padua L, Castelli L. The role of nutritional supplement on post-stroke fatigue: a pilot randomized controlled trial. J Nutr Health Aging 2024; 28:100256. [PMID: 38696891 DOI: 10.1016/j.jnha.2024.100256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES Post-stroke fatigue (PSF) is an experience characterized by an early feeling of exhaustion with fatigue, a lack of energy, and difficulty in exertion, both motor and cognitive. To counteract fatigue and limit its effects on activities of daily living, the use of vitamins and minerals is known in addition to the pharmacological approach. However, few studies have evaluated the effect of vitamin and mineral supplementation on fatigue management. SiderAL® Med is a food for special medical purposes with a complete formulation containing vitamins, sucrosomal minerals, copper and algal calcium. The aim of the study is to evaluate whether nutritional supplementation with SiderAL® Med improves the symptom of fatigue and motor and cognitive function in stroke patients. DESIGN This is a pilot, randomized study with a control group. SETTING Post-Acute Rehabilitation Unit of the Fondazione Policlinico "A. Gemelli" IRCCS. PARTICIPANTS Twenty-four patients with stroke outcomes, admitted to rehabilitation, were recruited and randomized into the experimental group (Sid-G) and the control group (CG). INTERVENTION The Sid-G patients, in association with the pharmacological and rehabilitation therapy foreseen during hospitalization, took SiderAL® Med, one sachet per day for 8 weeks, while the CG patients underwent only the pharmacological and rehabilitation therapy foreseen in the daily routine. MEASUREMENTS All patients were assessed at baseline (T0), after 4 weeks (T1), after 8 weeks (T2) and after 12 weeks (T3) for motor and cognitive fatigue, balance, walking, functional capacity, cognitive performance, autonomy, quality of life and body composition. RESULTS Both Sid-G and CG patients showed significant improvement on most rating scales between T0-T1-T2-T3 (p = 0.0001). When comparing the two groups, a statistically significant difference emerged in favor of Sid-G with regard to motor fatigue (p = 0.007), cognitive fatigue (p = 0.009) and total fatigue (p = 0.034); balance (p < 0.001), functional capacity (p < 0.001); cognitive performance (p = 0.004); bone mineral content (p = 0.005), lean mass (p = 0.005), total mass (p < 0.001) and percentage of fat mass (p = 0.039). CONCLUSION Nutritional supplementation with SiderAL® Med, in concert with intensive rehabilitation treatment, appears to be effective in managing fatigue and improving motor and cognitive performance and body composition, representing a valuable tool to associate with rehabilitation treatment in stroke patients.
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Affiliation(s)
- Silvia Giovannini
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; UOS Riabilitazione Post-Acuzie, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Chiara Iacovelli
- Department of Emergency, Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Loreti
- Department of Emergency, Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elisabetta Lama
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Nadia Morciano
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Frisullo
- UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Lorenzo Biscotti
- Unità Supporto Amministrativo Dipartimenti Universitari, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Padua
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Letizia Castelli
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Dentand AL, Schubert MG, Krayenbuehl PA. Current iron therapy in the light of regulation, intestinal microbiome, and toxicity: are we prescribing too much iron? Crit Rev Clin Lab Sci 2024:1-13. [PMID: 38606523 DOI: 10.1080/10408363.2024.2331477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
Iron deficiency is a widespread global health concern with varying prevalence rates across different regions. In developing countries, scarcity of food and chronic infections contribute to iron deficiency, while in industrialized nations, reduced food intake and dietary preferences affect iron status. Other causes that can lead to iron deficiency are conditions and diseases that result in reduced intestinal iron absorption and blood loss. In addition, iron absorption and its bioavailability are influenced by the composition of the diet. Individuals with increased iron needs, including infants, adolescents, and athletes, are particularly vulnerable to deficiency. Severe iron deficiency can lead to anemia with performance intolerance or shortness of breath. In addition, even without anemia, iron deficiency leads to mental and physical fatigue, which points to the fundamental biological importance of iron, especially in mitochondrial function and the respiratory chain. Standard oral iron supplementation often results in gastrointestinal side effects and poor compliance. Low-dose iron therapy seems to be a valid and reasonable therapeutic option due to reduced hepatic hepcidin formation, facilitating efficient iron resorption, replenishment of iron storage, and causing significantly fewer side effects. Elevated iron levels influence gut microbiota composition, favoring pathogenic bacteria and potentially disrupting metabolic and immune functions. Protective bacteria, such as bifidobacteria and lactobacilli, are particularly susceptible to increased iron levels. Dysbiosis resulting from iron supplementation may contribute to gastrointestinal disorders, inflammatory bowel disease, and metabolic disturbances. Furthermore, gut microbiota alterations have been linked to mental health issues. Future iron therapy should consider low-dose supplementation to mitigate adverse effects and the impact on the gut microbiome. A comprehensive understanding of the interplay between iron intake, gut microbiota, and human health is crucial for optimizing therapeutic approaches and minimizing potential risks associated with iron supplementation.
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Affiliation(s)
- Anaëlle L Dentand
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland
| | - Morton G Schubert
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland
| | - Pierre-Alexandre Krayenbuehl
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland
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Newbolds SF, Wenger MJ. Assessing the pattern electroretinogram as a proxy measure for dopamine in the context of iron deficiency. Nutr Neurosci 2024:1-12. [PMID: 38272898 DOI: 10.1080/1028415x.2024.2304943] [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: 01/27/2024]
Abstract
OBJECTIVES Animal studies have suggested that dietary iron deficiency (ID) negatively affects dopamine (DA) synthesis and re-uptake, which in turn negatively affects memory and cognition. This study was intended to assess whether the pattern electroretinogram (pattern ERG) could be used as an indirect measure of DA in college-age women with and without ID by determining the extent to which features of the ERG were sensitive to iron status and were related to other indirect measures of DA. METHODS The pattern ERG was measured in 21 iron deficient non-anemic (IDNA) and 21 iron sufficient (IS) women, who also performed a contrast detection and probabilistic selection task, both with concurrent electroencephalography (EEG). Both spontaneous and task-related blink rates were also measured. RESULTS The implicit times of the A- and B-waves were significantly longer for the IDNA than for the IS women. Both the amplitudes and implicit times of the A- and B-waves were significantly correlated with levels of serum ferritin (sFt). Only the amplitude of the A-wave was correlated with spontaneous blink rate. It was possible to accurately identify a woman's iron status solely on the basis of the implicit time of the B-wave. Finally, the implicit times of the ERG features mediated the relationship between iron levels and accuracy in the probabilistic selection task. CONCLUSIONS Results suggest the utility of the pattern ERG in testing the hypothesis that iron deficiency affects DA levels in humans and that this may be one of the mechanisms by which iron deficiency negatively affects cognition.
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Affiliation(s)
- Sarah F Newbolds
- Psychology and Cellular and Behavioral Neurobiology, The University of Oklahoma, Norman, OK, USA
| | - Michael J Wenger
- Psychology and Cellular and Behavioral Neurobiology, The University of Oklahoma, Norman, OK, USA
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Al-Rawaf HA, Gabr SA, Iqbal A, Alghadir AH. Circulating microRNAs and hepcidin as predictors of iron homeostasis and anemia among school children: a biochemical and cross-sectional survey analysis. Eur J Med Res 2023; 28:595. [PMID: 38102707 PMCID: PMC10724951 DOI: 10.1186/s40001-023-01579-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND MicroRNAs (miRNAs) can control several biological processes. Thus, the existence of these molecules plays a significant role in regulating human iron metabolism or homeostasis. PURPOSE The study aimed to determine the role of circulating microRNAs and hepcidin in controlling iron homeostasis and evaluating possible anemia among school children. METHODS The study was based on a biochemical and cross-sectional survey study that included three hundred fifty school children aged 12-18 years old. RT-PCR and immunoassay analysis were accomplished to estimate iron concentration, Hgb, serum ferritin (SF), soluble transferrin receptor (sTfR), total body iron stores (TIBs), total oxidative stress (TOS), total antioxidant capacity (TAC), α-1-acid glycoprotein (AGP), high sensitive C-reactive protein (hs-CRP), and miRNAs; miR-146a, miR-129b, and miR-122 in 350 school adolescents. RESULTS Iron disorders were cross-sectionally predicted in 28.54% of the study population; they were classified into 14.26% with ID, 5.7% with IDA, and 8.6% with iron overload. The overall proportion of iron depletion was significantly higher in girls (20.0%) than in boys (8.6%). MicroRNAs; miR-146a, miR-125b, and miR-122 were significantly upregulated with lower hepcidin expression in adolescence with ID and IDA compared to iron-overloaded subjects, whereas downregulation of these miRNAs was linked with higher hepcidin. Also, a significant correlation was recorded between miRNAs, hepcidin levels, AGP, hs-CRP, TAC, and other iron-related indicators. CONCLUSION Molecular microRNAs such as miR-146a, miR-125b, and miR-122 were shown to provide an additional means of controlling or regulating cellular iron uptake or metabolism either via the oxidative stress pathway or regulation of hepcidin expression via activating genes encoding Hfe and Hjv activators, which promote iron regulation. Thus, circulating miRNAs as molecular markers and serum hepcidin could provide an additional means of controlling or regulating cellular iron and be associated as valuable markers in diagnosing and treating cases with different iron deficiencies.
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Affiliation(s)
- Hadeel A Al-Rawaf
- Departments of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sami A Gabr
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Amir Iqbal
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Tateishi Y, Toyoda S, Murakami H, Uchida R, Ichikawa R, Kikuchi T, Sato W, Suzuki K. A short-term intervention of ingesting iron along with methionine and threonine leads to a higher hemoglobin level than that with iron alone in young healthy women: a randomized, double-blind, parallel-group, comparative study. Eur J Nutr 2023; 62:3009-3019. [PMID: 37480367 PMCID: PMC10468430 DOI: 10.1007/s00394-023-03213-w] [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: 03/14/2023] [Accepted: 07/10/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Enhancing iron absorption and utilization is important for amelioration iron status faster and thereby, for improving quality of life. Dietary protein and amino acids, including methionine and threonine, have been reported to facilitate the absorption and utilization of dietary iron. Here, we investigated the effect of combined ingestion of methionine, threonine, and iron on the improvement of iron status during a short-term intervention, by comparing that with iron ingestion alone in healthy young women. METHODS This was a randomized, double-blind, parallel-group, comparative study with 45 participants (aged 20-39) randomly assigned to three groups (n = 15 each): one group was administered 200 mg methionine, 400 mg threonine, and 6 mg iron once daily (FEMT); another ingested 6 mg iron alone (FE); and the third group ingested a placebo (PCG). Blood samples and dietary nutrient data were collected before the intervention (week 0) and after 2, 4, and 6 weeks. Serum iron, hemoglobin, transferrin, and ferritin levels were measured. RESULTS Blood hemoglobin levels were significantly higher in the FEMT than in the FE group (P < 0.05) at week 4. Serum iron, transferrin, and ferritin levels were not changed across groups. In addition, our analyses showed that the observed increase in hemoglobin levels was affected by the intervention rather than changes in dietary nutrient intake. CONCLUSIONS Ingestion of methionine and threonine with low doses of iron leads to a higher hemoglobin levels than that with iron alone in a short period of 4 weeks. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trial Registry (UMIN000046621).
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Affiliation(s)
- Yuko Tateishi
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan.
| | - Sakiko Toyoda
- Research Institute for Bioscience Products and Fine Chemicals, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
| | - Hitoshi Murakami
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
| | - Ryo Uchida
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
| | - Reiko Ichikawa
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
| | - Takuya Kikuchi
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
| | - Wataru Sato
- Research Institute for Bioscience Products and Fine Chemicals, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
| | - Katsuya Suzuki
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kanagawa, 210-8681, Japan
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Alghadir AH, Gabr SA, Iqbal A. Mineral elements and adiposity-related consequences in adolescents with intellectual disabilities. BMC Mol Cell Biol 2023; 24:29. [PMID: 37730529 PMCID: PMC10512604 DOI: 10.1186/s12860-023-00490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Patients with intellectual disabilities are shown to have a limited capacity for cooperation, communication,and other biological consequences, which significantly require a specialized interest in healthcare professionals worldwide. AIM In this respect, the present study was designed to evaluate the levels mineral elements, and their correlation with oxidative stress markers and adiposity markers; leptin (L), adiponectin (A), and L/A ratio in adolescents with intellectual disabilities. METHODS A total of 350 schoolchildren aged (12-18 years) were randomly invited to participate in this prospective, observational study. Only 300 participants agreed to participate in this study. According to Intelligence quotients scores (IQ) measured by WISC-III, the participants were classified into two groups; the healthy control group (no = 180; IQ = 90-114); and the moderate intellectual disability (MID) group (no = 120; IQ = 35-49). Adiposity markers; body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), physical activity scores, adipokines biomarkers; leptin, adiponectin, L/A ratio, oxidative stress, and plasma mineral elements were evaluated by prevalidated questionnaires, inductively coupled plasma-mass spectrometry (ICP-MS), colorimetric, and immunoassay techniques. RESULTS Intellectual disability of moderate type was reported in 40% of the studied populations most of them are men aged 12-18 years (66.6% for men vs. 33.3 for females). Obesity was shown to be associated with the degree of intellectual disability of the students. There was a significant (P = 0.001) increase in the BMI, WHR, and WHtR scores as obesity markers with poor physical activity (P = 0.01) in students with poor disability compared to healthy controls (HC). The levels of leptin (P = 0.001), adiponectin (P = 0.01), and L/A ratio (P = 0.01) as adiposity biomarkers were significantly increased in students with MID compared to healthy controls. Also, oxidative stress measured by malondialdehyde (MDA) (P = 0.01) and total antioxidant capacity (TAC) (P = 0.01) were significantly increased in students with MID compared to healthy control subjects. In addition, mineral elements were shown to be linked with intellectual disability. The data showed that the levels of Fe, Mn, Zn, Hg, Pb, Ca, Cr, Mg, and Ni significantly (P = 0.001) increased, and the levels of Al, Na, K, Cu, and Zn/Cu ratio significantly (P = 0.001) decreased in subjects with MID compared to healthy controls. Correlation analysis concluded that changes in mineral elements significantly correlated with adiposity markers, oxidative stress, and the scores of intellectual disability (WISC III-IQ score). CONCLUSION The intellectual disability of moderate type (MID) was associated with abnormal changes in the levels of essential mineral elements and adipokines and increased levels of cellular oxidative stress. Thus, evaluating plasma mineral elements and adipokines levels could be a potential diagnostic parameter for diagnosing MID.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Vinke JSJ, Ziengs AL, Buunk AM, van Sonderen L, Gomes-Neto AW, Berger SP, Bakker SJL, Eisenga MF, Spikman JM, De Borst MH. Iron deficiency and cognitive functioning in kidney transplant recipients: findings of the TransplantLines biobank and cohort study. Nephrol Dial Transplant 2023; 38:1719-1728. [PMID: 36662046 PMCID: PMC10310504 DOI: 10.1093/ndt/gfad013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Neurocognitive impairment is common in kidney transplant recipients (KTRs). Adequate brain functioning requires energy and neurotransmitter activity, for which iron is essential. We aimed to investigate iron deficiency (ID) as a potentially modifiable risk factor for cognitive impairment in KTRs. METHODS We analyzed stable KTRs participating in the TransplantLines Biobank and Cohort study. Participants underwent neuropsychological tests for memory, mental speed, and attention and executive functioning. ID was defined as ferritin <100 µg/mL or 100-299 µg/mL with transferrin saturation (TSAT) ≤20%. Associations between iron status and norm scores of neurocognitive outcomes, corrected for age, sex and education, were assessed using multivariable linear regression analyses adjusted for potential confounders including hemoglobin. RESULTS We included 166 KTRs [median (IQR) age 57 (45-65) years, 59% male, estimated glomerular filtration rate 51±18 mL/min/1.73 m2]. Time since transplantation was 5.8 (1.0-12.0) years. Prevalence of ID was 65%. ID was independently associated with lower scores for mental speed (std.β = -0.19, P = .02) and attention and executive functioning (std.β = -0.19, P = .02), and tended to be associated with worse memory (std.β = -0.16, P = .07). Lower plasma ferritin levels were associated with worse memory (std.β = 0.23, P = .007), mental speed (std.β = 0.34, P < .001), and attention and executive functioning (std.β = 0.30, P = .001). Lower TSAT was associated with worse memory (std.β = 0.19, P = .04) and mental speed (std.β = 0.27, P = .003), and tended to be associated with worse attention and executive functioning (std.β = 0.16, P = .08). CONCLUSIONS Iron-deficient KTRs performed worse on neurocognitive tasks measuring memory, mental speed, and attention and executive functioning. These findings set the stage for prospective studies addressing whether ID correction restores cognitive function after kidney transplantation.
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Affiliation(s)
- Joanna Sophia J Vinke
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
| | - Aaltje L Ziengs
- Department of Neuropsychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne M Buunk
- Department of Neuropsychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Lisanne van Sonderen
- Department of Neuropsychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Antonio W Gomes-Neto
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
| | - TransplantLines Investigators
- Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P Berger
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
| | - Michele F Eisenga
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
| | - Jacoba M Spikman
- Department of Neuropsychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin H De Borst
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
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Tateishi Y, Ichikawa R, Suzuki K, Kitahara Y, Someya Y, Tamura Y. Effect of imbalance in dietary macronutrients on blood hemoglobin levels: a cross-sectional study in young underweight Japanese women. Front Nutr 2023; 10:1121717. [PMID: 37408992 PMCID: PMC10319048 DOI: 10.3389/fnut.2023.1121717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/31/2023] [Indexed: 07/07/2023] Open
Abstract
Background Iron deficiency and underweight are common nutritional problems among young Japanese women, many of whom show unhealthy dietary patterns owing to a desire for thinness. We conducted a cross-sectional analysis of the relationship between iron status, nutritional status, and dietary intake among young Japanese women with underweight to identify dietary risk factors for iron deficiency. Methods Of the 159 young women (18-29 years of age) enrolled, 77 underweight and 37 normal-weight women were included in the study. They were further categorized into four groups based on quartiles of hemoglobin levels among all participants. Dietary nutrient intake was ascertained using a brief self-administered diet history questionnaire. Blood level of hemoglobin and nutritional biomarkers such as total protein, albumin, insulin-like growth factor-1 (IGF-1), and essential amino acids were measured. Results In underweight, the multiple comparison test showed that dietary intakes of fat, saturated fatty acid, and monosaturated fatty acid were significantly higher and carbohydrate intake was significantly lower in the group with the lowest hemoglobin level, whereas intakes of iron were the same across groups. Multivariate regression coefficients suggested that replacing fat with protein or carbohydrates increased hemoglobin levels under isocaloric conditions. Additionally, significant positive correlations were observed between hemoglobin levels and nutritional biomarkers. Conclusion Dietary iron intake did not change across different hemoglobin groups among Japanese underweight women. However, our results suggested that an imbalanced dietary macronutrient induces anabolic status and hemoglobin synthesis deterioration among them. Especially, a higher fat intake may be a risk factor for lower hemoglobin.
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Affiliation(s)
- Yuko Tateishi
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Tokyo, Japan
| | - Reiko Ichikawa
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Tokyo, Japan
| | - Katsuya Suzuki
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Tokyo, Japan
| | - Yoshiro Kitahara
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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10
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Leroy F, Smith N, Adesogan A, Beal T, Iannotti L, Moughan P, Mann N. The role of meat in the human diet: evolutionary aspects and nutritional value. Anim Front 2023; 13:11-18. [PMID: 37073319 PMCID: PMC10105836 DOI: 10.1093/af/vfac093] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Affiliation(s)
- Frédéric Leroy
- Industrial Microbiology and Food Biotechnology (IMDO), Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nick W Smith
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Adegbola T Adesogan
- Department of Animal Sciences, Global Food Systems Institute, Feed the Future Innovation Lab for Livestock Systems, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL
| | - Ty Beal
- Global Alliance for Improved Nutrition (GAIN), Washington, DC
- Institute for Social, Behavioral and Economic Research, University of California, Santa Barbara, CA
| | - Lora Iannotti
- Institute for Public Health, Brown School, Washington University in St. Louis, St. Louis, MO
| | - Paul J Moughan
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Neil Mann
- School of Agriculture and Food, FVAS, University of Melbourne, Victoria, Australia
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11
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Vinke JS, Eisenga MF, Sanders JSF, Berger SP, Spikman JM, Abdulahad WH, Bakker SJ, Gaillard CAJM, van Zuilen AD, van der Meer P, de Borst MH. Effect of Intravenous Ferric Carboxymaltose on Exercise Capacity After Kidney Transplantation (EFFECT-KTx): rationale and study protocol for a double-blind, randomised, placebo-controlled trial. BMJ Open 2023; 13:e065423. [PMID: 36948568 PMCID: PMC10040026 DOI: 10.1136/bmjopen-2022-065423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Iron deficiency (ID) is common and has been associated with an excess mortality risk in kidney transplant recipients (KTRs). In patients with chronic heart failure and ID, intravenous iron improves exercise capacity and quality of life. Whether these beneficial effects also occur in KTRs is unknown. The main objective of this trial is to address whether intravenous iron improves exercise tolerance in iron-deficient KTRs. METHODS AND ANALYSIS The Effect of Ferric Carboxymaltose on Exercise Capacity after Kidney Transplantation study is a multicentre, double-blind, randomised, placebo-controlled clinical trial that will include 158 iron-deficient KTRs. ID is defined as plasma ferritin <100 µg/L or plasma ferritin 100-299 µg/L with transferrin saturation <20%. Patients are randomised to receive 10 mL of ferric carboxymaltose (50 mg Fe3+/mL, intravenously) or placebo (0.9% sodium chloride solution) every 6 weeks, four dosages in total. The primary endpoint is change in exercise capacity, as quantified by the 6 min walk test, between the first study visit and the end of follow-up, 24 weeks later. Secondary endpoints include changes in haemoglobin levels and iron status, quality of life, systolic and diastolic heart function, skeletal muscle strength, bone and mineral parameters, neurocognitive function and safety endpoints. Tertiary (explorative) outcomes are changes in gut microbiota and lymphocyte proliferation and function. ETHICS AND DISSEMINATION The protocol of this study has been approved by the medical ethical committee of the University Medical Centre Groningen (METc 2018/482;) and is being conducted in accordance with the principles of the Declaration of Helsinki, the Standard Protocol Items: Recommendations for Interventional Trials checklist and the Good Clinical Practice guidelines provided by the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use. Study results will be disseminated through publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER NCT03769441.
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Affiliation(s)
- Joanna Sj Vinke
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Michele F Eisenga
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Jan-Stephan F Sanders
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Stefan P Berger
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Jacoba M Spikman
- Department of Neuropsychology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Wayel H Abdulahad
- Department of Immunology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Stephan Jl Bakker
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Carlo A J M Gaillard
- Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Arjan D van Zuilen
- Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P van der Meer
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin H de Borst
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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12
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O'Sullivan TA, Jayasuriya PH, Tsalis N, Calogero N, Manocha R. Nurses' understanding and management of iron deficiency in Australia: a cross-sectional, exploratory study. BMJ Open 2023; 13:e065706. [PMID: 36806134 PMCID: PMC9944295 DOI: 10.1136/bmjopen-2022-065706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES To assess the experiences and knowledge of nurses in the area of iron deficiency. DESIGN A cross-sectional, exploratory study using online survey. SETTING Data were collected from nurses working at various primary, secondary and tertiary Australian health practices and organisations. PARTICIPANTS Australian nurses currently in practice. METHOD Australian nurses currently in practice were invited to complete an online survey about their work background, personal experiences with iron deficiency and iron-deficiency identification and treatment. The survey included a nine-item questionnaire to assess knowledge of iron-deficiency risk factors and biochemistry. RESULTS A total of 534 eligible nurses participated in the survey. Participants were more likely to be female, aged 55-64 years, and working in general practice. Just under half (45.1%) reported being diagnosed with iron deficiency themselves. Unusual fatigue or tiredness was the most frequent symptom that alerted nurses to potential iron deficiency in patients (reported by 91.9% of nurses). Nurses who had participated in formal training around iron deficiency in the last 5 years demonstrated a significantly higher knowledge score (4.2±2.1) compared with those who had not or were not sure about their formal training status (3.7±1.9, p=0.035). Knowledge around the understanding of functional iron deficiency was limited. CONCLUSIONS Nurses report personal experiences of iron deficiency and show good knowledge of symptoms, demonstrating the potential for them to take a leading role in managing iron deficiency in patients. Educational programmes are required to address knowledge gaps and should be offered via various methods to accommodate a diverse nurse cohort. Our research highlights the potential for an expanded scope of practice for nurses in the primary care setting in the area of iron deficiency.
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Affiliation(s)
- Therese A O'Sullivan
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | | | - Natalie Tsalis
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nina Calogero
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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13
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Li C, Feng Q, Zhang J, Xie X. A multivariate analysis of the risk of iron deficiency in plateletpheresis donors based on logistic regression. Transfus Apher Sci 2023; 62:103522. [PMID: 35985968 DOI: 10.1016/j.transci.2022.103522] [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: 02/15/2022] [Revised: 07/28/2022] [Accepted: 08/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to analyze the application of individual factors, blood cell related indicators, and blood donation frequency in predicting the risk of iron deficiency of plateletpheresis donors. METHODS A total of 801 plateletpheresis donors were included in this study. The relationship between risk factors and iron deficiency was retrospectively analyzed by univariate analysis and logistic regression analysis. The application of Hb, MCHC, RDW-CV and blood donation frequency combined prediction of iron deficiency risk among plateletpheresis donors was evaluated. RESULT The rate of iron deficiency in this study was 31.5 % (241/766). The age, gender (the ratio of male donors), red blood cell related indicators, blood donation frequency were statistically different between the normal and iron deficiency group (all P < 0.05). Age, gender, the reciprocal of Hb and MCHC, RDW-CV, total number of blood donation and number of plateletpheresis donation in the past year, these indicators to predict the risk of iron deficiency area under the curve (AUC) were 0.558, 0.672, 0.785, 0.717, 0.599, 0.621, 0.646, respectively. The AUC of these indicators combined to predict the risk of iron deficiency was 0.877, higher than all single indicators. The sensitivity and specificity of these indicators combined in prediction of iron deficiency were 88.89 % and 81.57 %, respectively. CONCLUSION Age, gender, the reciprocal of Hb and MCHC, RDV-CV, blood donation frequency are associated with the risk of iron deficiency in plateletpheresis donors. The combination of these indicators has high value in predicting the risk of iron deficiency.
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Affiliation(s)
- Chunyan Li
- Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Blood Center of Zhejiang Province, Hangzhou, Zhejiang 310052, China; Key Laboratory of Blood Safety Research, Hangzhou, Zhejiang Province 310052, China
| | - Qing Feng
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang 310052, China; Key Laboratory of Blood Safety Research, Hangzhou, Zhejiang Province 310052, China
| | - Jun Zhang
- Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Xinyou Xie
- Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China.
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14
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Raz S, Koren A, Levin C. Associations between red blood cell indices and iron status and neurocognitive function in young adults: Evidence from memory and executive function tests and event-related potentials. Ann N Y Acad Sci 2022; 1517:300-313. [PMID: 35976740 PMCID: PMC9804398 DOI: 10.1111/nyas.14877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cognitive impairment has been associated with anemia and iron deficiency; however, brain electrophysiological studies correlating red blood cell (RBC) indices and iron status to cognition in adulthood are scarce. We aimed to assess neurocognitive function in young adults of the general population and its correlation with RBC indices and iron status. Neurocognitive function was investigated using scalp-recorded event-related potentials (ERPs) within the context of a task-switching paradigm. ERPs and test performance were also compared across groups of "high"/"low" RBC and iron indices. Working memory was examined using the digit span test, in which mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), and ferritin were found to be significant predictors of test performance, with higher MCH/MCV/ferritin being associated with better test scores. In the switching task, MCH, MCV, and ferritin were found to be significant predictors of task performance, with higher MCH/MCV/ferritin levels associated with a lower percentage of errors. Electrophysiological results showed that MCH and MCV were significant predictors of ERPs amplitude, with lower MCH/MCV levels associated with greater amplitude, which may reflect compensatory processes. P1, N1, P2, and P3 were greater for the low MCH/MCV groups. This is the first evidence of association between levels of MCH/MCV and brain function while engaged in an executive function task; possibly reflecting brain iron availability.
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Affiliation(s)
- Sivan Raz
- Department of Behavioral Sciences, The Center for Psychobiological ResearchThe Max Stern Yezreel Valley CollegeJezreel ValleyIsrael,Department of PsychologyTel Hai CollegeTel HaiIsrael
| | - Ariel Koren
- Pediatric Hematology UnitEmek Medical CenterAfulaIsrael,The Ruth and Bruce Rappaport Faculty of Medicine, TechnionIsrael Institute of TechnologyHaifaIsrael
| | - Carina Levin
- Pediatric Hematology UnitEmek Medical CenterAfulaIsrael,The Ruth and Bruce Rappaport Faculty of Medicine, TechnionIsrael Institute of TechnologyHaifaIsrael
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15
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Diet, Polyphenols, and Human Evolution. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although diet has contributed significantly to the evolution of human beings, the composition of the diet that has most affected this phenomenon is still an open issue. Diet has undoubtedly participated in the acquisition of the skills that underlie the differentiation of humans from other animal species and in this context the development of the nervous system has played a primary role. This paper aimed to: (1) outline the relationship between diet and human evolution; (2) evaluate how a variation in food consumption may have contributed to the enhancement of cognitive and adaptive capacities. The most widespread diet among the ancient populations that showed the highest levels of civilization (that is well-organized societies, using advanced technical tools, and promoting art and science) was very close to what is now defined as the Mediterranean diet. This suggests that a dietary approach typical of the Mediterranean basin (little meat and some fish; abundant cereals, legumes, fruit, vegetables and wine) significantly increased the intake of antioxidant molecules, including polyphenols, which along with other factors may have modulated the cognitive evolution of humans.
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16
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Wenger MJ, Murray Kolb LE, Scott SP, Boy E, Haas JD. Modeling relationships between iron status, behavior, and brain electrophysiology: evidence from a randomized study involving a biofortified grain in Indian adolescents. BMC Public Health 2022; 22:1299. [PMID: 35794587 PMCID: PMC9260997 DOI: 10.1186/s12889-022-13612-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Iron deficiency (ID) and iron deficiency anemia (IDA) are highly-prevalent nutrient deficiencies and have been shown to have a range of negative effects on cognition and brain function. Human intervention studies including measures at three levels—blood, brain, and behavior—are rare and our objective was to model the relationships among measures at these three levels in school-going Indian adolescents. Methods Male and female adolescents in rural India were screened for ID/IDA. Subjects consumed 2 meals/day for 6 months; half were randomly assigned to consume meals made from a standard grain (pearl millet) and half consumed meals made from an iron biofortified pearl millet (BPM). Prior to and then at the conclusion of the feeding trial, they completed a set of cognitive tests with concurrent electroencephalography (EEG). Results Overall, serum ferritin (sFt) levels improved over the course of the study. Ten of 21 possible measures of cognition showed improvements from baseline (BL) to endline (EL) that were larger for those consuming BPM than for those consuming the comparison pearl millet (CPM). Critically, the best model for the relationship between change in iron status and change in cognition had change in brain measures as a mediating factor, with both change in serum ferritin as a primary predictor and change in hemoglobin as a moderator. Conclusions A dietary intervention involving a biofortified staple grain was shown to be efficacious in improving blood iron biomarkers, behavioral measures of cognition, and EEG measures of brain function. Modeling the relationships among these variables strongly suggests multiple mechanisms by which blood iron level affects brain function and cognition. Trial registration Registered at ClinicalTrials.gov, NCT02152150, 02 June 2014. Supplementary Information The online version contains supplementary material available at (10.1186/s12889-022-13612-z).
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Affiliation(s)
- Michael J Wenger
- Department of Psychology, Cellular and Behavioral Neurobiology, The University of Oklahoma, Norman, OK, USA. .,Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
| | | | - Samuel P Scott
- Poverty Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
| | - Erick Boy
- HarvestPlus, International Food Policy Research Institute, Washington, DC, USA
| | - Jere D Haas
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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17
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Ketogenic and Modified Mediterranean Diet as a Tool to Counteract Neuroinflammation in Multiple Sclerosis: Nutritional Suggestions. Nutrients 2022; 14:nu14122384. [PMID: 35745113 PMCID: PMC9229939 DOI: 10.3390/nu14122384] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022] Open
Abstract
Ketogenic Diet is a nutritional pattern often used as dietotherapy in inflammatory diseases, including neurological disorders. Applied on epileptic children since 1920, in recent years it has been taken into account again as a tool to both reduce inflammatory burdens and ameliorate the nutritional status of patients affected by different pathologies. Multiple sclerosis (MS) is considered an immune-mediated neuro-inflammatory disease and diet is a possible factor in its pathogenesis. The aim of this work is to investigate the main potential targets of MS-related impairments, in particular the cognitive deficits, focusing on the alteration of biomarkers such as the Brain Derived-Neurotrophic Factor and the Tryptophan/Kynurenine ratio that could play a role on neuroprotection and thus on MS progression. Furthermore, we here propose nutritional suggestions which are useful in the development of a ketogenic diet protocol that takes advantage of the anti-inflammatory properties of low-carbohydrate foods from the Mediterranean diet to be applied to subjects with MS. In conclusion, this approach will allow one to develop the ketogenic diet combined with a modified Mediterranean diet as a possible tool to improve neuroinflammation in multiple sclerosis.
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18
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Finkelstein JL, Fothergill A, Guetterman HM, Johnson CB, Bose B, Qi YP, Rose CE, Williams JL, Mehta S, Kuriyan R, Bonam W, Crider KS. Iron status and inflammation in women of reproductive age: A population-based biomarker survey and clinical study. Clin Nutr ESPEN 2022; 49:483-494. [PMID: 35623855 PMCID: PMC10878764 DOI: 10.1016/j.clnesp.2022.02.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/18/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Women of reproductive age (WRA) are at increased risk for anemia and iron deficiency. However, there is limited population-level data in India, which could help inform evidence-based recommendations and policy. AIMS To conduct a population-based biomarker survey of anemia, iron deficiency, and inflammation in WRA in Southern India. METHODS Participants were WRA (15-40 y) who were not pregnant or lactating. Blood samples (n = 979) were collected and analyzed for hemoglobin (Hb), serum ferritin (SF), soluble transferrin receptor (sTfR), C-reactive protein (CRP), and alpha-1 acid glycoprotein (AGP). Anemia and severe anemia were defined as Hb < 12.0 and < 8.0 g/dL. Serum ferritin was adjusted for inflammation using BRINDA methods. Iron deficiency was defined as SF <15.0 μg/L, iron insufficiency was defined as SF < 20.0 and < 25.0 μg/L, and iron deficiency anemia was defined as Hb < 12.0 g/dL and SF < 15.0 μg/L. Inflammation was defined as CRP > 5.0 mg/L or AGP > 1.0 g/L. Restricted cubic spline regression models were also used to determine if alternative SF thresholds should be used t to classify iron deficiency. RESULTS A total of 41.5% of WRA had anemia, and 3.0% had severe anemia. Findings from spline analyses suggested a SF cut-off of < 15.0 μg/L, consistent with conventional cut-offs for iron deficiency. 46.3% of WRA had SF < 15.0 μg/L (BRINDA-adjusted: 61.5%), 55.0% had SF < 20.0 μg/L (72.7%), 61.8% had SF < 25.0 μg/L (81.0%), and 30.0% had IDA (34.5%). 17.3% of WRA had CRP > 5.0 mg/L and 22.2% had AGP > 1.0 g/L. The prevalence of ID (rural vs. urban: 49.1% vs. 34.9%; p = 0.0004), iron insufficiency (57.8% vs. 43.8%; p = 0.0005), and IDA (31.8% vs. 22.4%; p = 0.01) were significantly higher in rural areas, although CRP levels were lower and there were no differences in elevated CRP or AGP. CONCLUSIONS The burden of anemia and iron deficiency in this population was substantial, and increased after adjusting for inflammation, suggesting potential to benefit from screening and interventions. REGISTRATION NUMBER NCT04048330.
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Affiliation(s)
- Julia L Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca NY, USA; Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, NY, USA; St. John's Research Institute, Bangalore, Karnataka, India.
| | - Amy Fothergill
- Division of Nutritional Sciences, Cornell University, Ithaca NY, USA
| | | | | | - Beena Bose
- St. John's Research Institute, Bangalore, Karnataka, India
| | - Yan Ping Qi
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charles E Rose
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer L Williams
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca NY, USA; Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, NY, USA
| | | | - Wesley Bonam
- Arogyavaram Medical Centre, Andhra Pradesh, India
| | - Krista S Crider
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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19
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Cichoń J, Ostapiuk-Karolczuk J, Cieślicka M, Dziewiecka H, Marcinkiewicz A, Tafil-Klawe M, Basta P, Maciejewski D, Skarpańska-Stejnborn A. Effect of an acute exercise on early responses of iron and iron regulatory proteins in young female basketball players. BMC Sports Sci Med Rehabil 2022; 14:69. [PMID: 35428332 PMCID: PMC9013050 DOI: 10.1186/s13102-022-00465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
Background The accumulation of physiological stress and the presence of inflammation disturb iron management in athletes during intense training. However, little is known about the mechanisms regulating iron levels in athletes during training periods with low training loads. In the current study, we analyzed the effect of an acute exercise on early responses of iron and iron regulatory proteins at the end of such training periods. Methods The study was performed at the end of competitive phase of training. A total of 27 trained female basketball players were included in the study after application of the inclusion/exclusion criteria. The participants performed an incremental exercise on a treadmill. Blood samples were taken before the test, immediately after exercise, and after 3 h of restitution. Parameters, such as interleukin (IL) 6, hepcidin, ferritin, transferrin, hemopexin, and lactoferrin levels, total iron-biding capacity (TIBC), unsaturated iron-biding capacity (UIBC) were determined by using appropriate biochemical tests. Results The level of iron increased significantly after exercise, and then decreased within next 3 h restitution. Except for iron levels, only TIBC levels significantly increased after exercise and decreased to baseline level during rest period. No significant changes in the levels of hepcidin, IL-6, and other proteins related to the iron homeostasis were observed. Conclusions The increases in iron level after acute exercise is short-term and transient and appear to have been insufficient to induce the acute systemic effects in rested athletes.
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Affiliation(s)
- Justyna Cichoń
- Department of Biological Sciences, Faculty of Physical Culture in Gorzow Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland
| | - Joanna Ostapiuk-Karolczuk
- Department of Biological Sciences, Faculty of Physical Culture in Gorzow Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland
| | - Mirosława Cieślicka
- Department of Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Hanna Dziewiecka
- Department of Biological Sciences, Faculty of Physical Culture in Gorzow Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland
| | - Anita Marcinkiewicz
- Department of Biological Sciences, Faculty of Physical Culture in Gorzow Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland
| | - Małgorzata Tafil-Klawe
- Department of Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Piotr Basta
- Department of Physical Education and Sport, Poznań University of Physical Education, Faculty of Physical Culture in Gorzów Wielkopolski, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland
| | - Dariusz Maciejewski
- Department of Physical Education and Sport, Poznań University of Physical Education, Faculty of Physical Culture in Gorzów Wielkopolski, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland
| | - Anna Skarpańska-Stejnborn
- Department of Biological Sciences, Faculty of Physical Culture in Gorzow Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400, Gorzów, Wielkopolski, Poland.
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20
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Mehta S, Huey SL, Ghugre PS, Potdar RD, Venkatramanan S, Krisher JT, Ruth CJ, Chopra HV, Thorat A, Thakker V, Johnson L, Powis L, Raveendran Y, Haas JD, Finkelstein JL, Udipi SA. A randomized trial of iron- and zinc-biofortified pearl millet-based complementary feeding in children aged 12 to 18 months living in urban slums. Clin Nutr 2022; 41:937-947. [PMID: 35299084 DOI: 10.1016/j.clnu.2022.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Biofortification of staple crops with higher levels of micronutrients via traditional breeding methods is a sustainable strategy and can possibly complement fortification and other interventions to target micronutrient deficiencies in low resource settings, particularly among vulnerable populations such as children. We aimed to determine if iron- and zinc-biofortified pearl millet (FeZnPM, Dhanashakti, ICTP-8203Fe)-based complementary feeding improves nutritional status, including iron biomarkers and growth, in children living in urban slums of Mumbai. METHODS We conducted a randomized controlled trial of FeZnPM among 223 children aged 12-18 months who were not severely anemic at baseline (hemoglobin ≥9.0 g/dL). Children were randomized to receive either FeZnPM or conventional non-biofortified pearl millet (CPM) daily for 9 months. Iron status (hemoglobin, serum ferritin), plasma zinc, and anthropometric indicators (length, weight, mid-upper arm circumference, triceps and subscapular skinfolds) were evaluated at enrollment and throughout the trial. World Health Organization (WHO) anthropometric z-scores were calculated using WHO growth standards. Primary outcomes were hemoglobin and serum ferritin concentrations, and growth, defined as WHO z-scores. An intent to treat approach was used for analyses. We used the Hodges-Lehmann-Sen test to assess the change in primary outcomes between baseline and the last visit and report corresponding 95% confidence intervals. RESULTS At baseline, 67.7% of children were anemic (hemoglobin <11.0 g/dL) and 59.6% were iron deficient (serum ferritin <12.0 μg/L). FeZnPM did not significantly increase iron biomarkers or improve growth, compared to CPM. In subgroup analyses, FeZnPM improved hemoglobin concentrations in male children, and in children with iron deficiency or iron depletion (serum ferritin <25.0 μg/L) at baseline, relative to CPM. CONCLUSIONS Daily consumption of FeZnPM-based complementary foods did not significantly impact iron and zinc status or growth in children living in Mumbai's urban slums. However, the intervention significantly improved hemoglobin concentrations among male children and among individuals who were iron-deficient or iron-depleted at baseline. TRIAL REGISTRATION This trial is registered with Clinicaltrials.gov (ID: NCT02233764), and Clinical Trials Registry of India (ID: REF/2014/10/007731).
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Affiliation(s)
- Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, NY, USA.
| | - Samantha L Huey
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Padmini S Ghugre
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | | | | | - Jesse T Krisher
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Harsha V Chopra
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Aparna Thorat
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Varsha Thakker
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Lynn Johnson
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | - Laura Powis
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Jere D Haas
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Shobha A Udipi
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
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21
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Harrabi MA, Fendri T, Ayed R, Rebai H, Chaari F, Turki M, Ayadi F, Sahli S. Iron deficiency anemia induces postural control disorders in young women. J Trace Elem Med Biol 2021; 68:126868. [PMID: 34597961 DOI: 10.1016/j.jtemb.2021.126868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/05/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Due to menstruation and restrictive dietary practices, women are at a particular risk of iron deficiency anemia (IDA). This hematologic manifestation could impair postural control as it induces fatigue, muscle weakness, cognitive and neurological functions alteration. AIM This study aimed to investigate IDA effects on postural control in young women in comparison to healthy counterparts. MATERIAL AND METHODS Twenty-four young women with IDA and twenty-four controls participated in this study. Center of pressure (CoP) excursions, in the bipedal and semi-tandem postures on the firm and foam surfaces in the eyes opened (EO) and closed (EC), were recorded, and Romberg index was calculated to evaluate postural control. Besides physical performance, attentional capacity, fatigue, and heart and respiratory rates were assessed. RESULTS Young women with IDA had significantly higher CoP velocity (CoPv) values in the bipedal posture in both vision and surface conditions (EO [firm: P < 0.001 and foam: P < 0.01]; EC: P < 0.001), as well as in the semi-tandem posture (EO [firm: P < 0.01 and foam: P < 0.001]; EC: P < 0.001) compared to controls indicating that they had worse postural control than their peers. In addition, values of the respiratory rate (P < 0.001), attentional capacity (P < 0.001), physical performance (P < 0.001), fatigue (P < 0.001), and Romberg index on the foam surface in both postures (P < 0.05) were significantly higher in young women with IDA compared to controls. CONCLUSIONS Physical performance, fatigue, tachypnea and attentional capacity resulting from IDA may explain postural control disorder in young women.
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Affiliation(s)
- Mohammed A Harrabi
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia.
| | - Thouraya Fendri
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
| | - Rahma Ayed
- Laboratory of Biochemistry, CHU Habib Bourguiba, University of Sfax, 3000, Tunisia
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
| | - Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
| | - Mouna Turki
- Laboratory of Biochemistry, CHU Habib Bourguiba, University of Sfax, 3000, Tunisia
| | - Fatma Ayadi
- Laboratory of Biochemistry, CHU Habib Bourguiba, University of Sfax, 3000, Tunisia
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
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22
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Beatrix J, Piales C, Berland P, Marchiset E, Gerbaud L, Ruivard M. Non-anemic iron deficiency: correlations between symptoms and iron status parameters. Eur J Clin Nutr 2021; 76:835-840. [PMID: 34811510 DOI: 10.1038/s41430-021-01047-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/02/2021] [Accepted: 11/01/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To register all symptoms reported by non-anemic menstruating women, and examine the links between these symptoms and iron status parameters available including serum ferritin (SF) in primary care. SUBJECTS AND METHODS In this cross-sectional study, we collected clinical and biological data from 780 French menstruating women aged 18-50 years. The data included an anonymous questionnaire (biometric information, physical and cognitive symptoms, reduction in physical performance, current quality of life with SF-36 questionnaire) and seven biological parameters available in primary care. We excluded women with anemia (hemoglobin < 12 g/dl) or chronic disease. Correlations were studied for 554 participants in bivariate analysis (BVA) and multivariate analysis (MVA), with adjusted odds ratio (OR). Receiver operating characteristic (ROC) curves were established for significant correlations in MVA (p < 0.05). RESULTS Among these 554 non-anemic women included, 304 (54.9%) had SF level below 50 µg/l, 103 (18.6%) had SF level below 20 µg/l, and 60 (10.8%) had SF level below 15 µg/l. Iron deficiency was significantly correlated with recent hair loss for SF ≤ 15 µg/l (OR = 2.19 with p = 0.02 in MVA) and SF ≤ 20 µg/l (OR = 2.26 with p < 0.01 in MVA). SF ≤ 20 µg/l was also correlated with limitations due to emotional problems according to SF-36 questionnaire (p = 0.01 in MVA). SF ≤ 50 µg/l was significantly correlated with restless legs syndrome (OR = 2.82 with p = 0.01 in MVA). Only one ROC curve for restless legs syndrome could suggest an optimal SF cut-off point at 39 µg/l (sensitivity 73%, specificity 61%). CONCLUSION We identified two symptoms significantly more reported by non-anemic iron-deficient menstruating women: recent hair loss for serum ferritin (SF) ≤ 20 µg/l and restless legs syndrome for SF ≤ 50 µg/l. Non-anemic iron deficiency may also impact their quality of life, but further investigation is needed. If one of these symptoms is reported in primary care, the possibility of a symptomatic iron deficiency cannot be ruled out, and iron supplementation should be considered.
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Affiliation(s)
- Julien Beatrix
- Service Médecine Interne, CHU Estaing, Clermont-Ferrand, France.
| | - Claire Piales
- Service Hématologie, Gen-Bio, Clermont-Ferrand, France
| | - Pauline Berland
- Service Santé Publique, CHU Gabriel Montpied, Clermont-Ferrand, France
| | | | - Laurent Gerbaud
- Service Santé Publique, CHU Gabriel Montpied, Clermont-Ferrand, France.,UMR 6602 UCA/CNRS/SIGMA - T.G.I., Université Clermont Auvergne, Clermont-Ferrand, France
| | - Marc Ruivard
- Service Médecine Interne, CHU Estaing, Clermont-Ferrand, France.,UMR 6602 UCA/CNRS/SIGMA - T.G.I., Université Clermont Auvergne, Clermont-Ferrand, France
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23
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Ryan BJ, Charkoudian N, McClung JP. Consider iron status when making sex comparisons in human physiology. J Appl Physiol (1985) 2021; 132:699-702. [PMID: 34792406 DOI: 10.1152/japplphysiol.00582.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Benjamin J Ryan
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - James P McClung
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States
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24
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Bardestani A, Ebrahimpour S, Esmaeili A, Esmaeili A. Quercetin attenuates neurotoxicity induced by iron oxide nanoparticles. J Nanobiotechnology 2021; 19:327. [PMID: 34663344 PMCID: PMC8522232 DOI: 10.1186/s12951-021-01059-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/24/2021] [Indexed: 01/19/2023] Open
Abstract
Iron oxide nanoparticles (IONPs) have been proposed as targeted carriers to deliver therapeutic molecules in the central nervous system (CNS). However, IONPs may damage neural tissue via free iron accumulation, protein aggregation, and oxidative stress. Neuroprotective effects of quercetin (QC) have been proven due to its antioxidant and anti-inflammatory properties. However, poor solubility and low bioavailability of QC have also led researchers to make various QC-involved nanoparticles to overcome these limitations. We wondered how high doses or prolonged treatment with quercetin conjugated superparamagnetic iron oxide nanoparticles (QCSPIONs) could improve cognitive dysfunction and promote neurogenesis without any toxicity. It can be explained that the QC inhibits protein aggregation and acts against iron overload via iron-chelating activity, iron homeostasis genes regulation, radical scavenging, and attenuation of Fenton/Haber-Weiss reaction. In this review, first, we present brain iron homeostasis, molecular mechanisms of iron overload that induced neurotoxicity, and the role of iron in dementia-associated diseases. Then by providing evidence of IONPs neurotoxicity, we discuss how QC neutralizes IONPs neurotoxicity, and finally, we make a brief comparison between QC and conventional iron chelators. In this review, we highlight that QC as supplementation and especially in conjugated form reduces iron oxide nanoparticles neurotoxicity in clinical application.
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Affiliation(s)
- Akram Bardestani
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, P.O. Box: 8174673441, Isfahan, Iran
| | - Shiva Ebrahimpour
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, P.O. Box: 8174673441, Isfahan, Iran
| | - Ali Esmaeili
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abolghasem Esmaeili
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, P.O. Box: 8174673441, Isfahan, Iran.
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25
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France JL, France CR, Rebosa M, Shaz BH, Kessler DA. Promoting awareness of donation-related iron depletion among high risk blood donors. Transfusion 2021; 61:3353-3360. [PMID: 34605554 DOI: 10.1111/trf.16694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The potential for iron deficiency is a known blood donor health concern and suggests the need to inform donors about the potential risks of low iron levels as well as strategies to address these risks. STUDY DESIGN AND METHODS Frequent (n = 904) and young (n = 629) donors were randomly assigned within risk group to either a control (n = 548) or an intervention (n = 985) group. The control group answered questions at baseline and 6-month follow-up regarding their awareness of the risk of donation-related iron depletion and whether they were taking actions to address their iron status. The intervention group answered the same questions at baseline and follow-up, but after completing the baseline survey, they received information regarding their risk of iron depletion and behaviors they could adopt to mitigate this risk. Intervention group participants were also offered the opportunity to develop an action plan to help them supplement their iron intake. RESULTS The intervention enhanced overall awareness of donation-related iron loss (OR = 1.5, 95% CI 1.171-1.864, p = .001), with no negative impact on retention. Reported iron health behaviors (iron supplementation, speaking with a doctor) showed significant increases when action planning was paired with the educational information. CONCLUSION These findings suggest that it is possible to increase awareness of donation-related risk for iron depletion without negatively influencing retention, and combining education with encouragement to develop an action plan may increase the likelihood of both retention and behavioral changes to promote healthy iron levels.
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Affiliation(s)
- Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | - Mark Rebosa
- New York Blood Center, New York, New York, USA
| | - Beth H Shaz
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
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26
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Ishfaq M, Wakeel A, Shahzad MN, Kiran A, Li X. Severity of zinc and iron malnutrition linked to low intake through a staple crop: a case study in east-central Pakistan. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4219-4233. [PMID: 33830390 DOI: 10.1007/s10653-021-00912-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/26/2021] [Indexed: 05/24/2023]
Abstract
Micronutrients deficiency in soil-plant and human is well-addressed; however, little is known about their spatial distribution, magnitude of deficiency and biological nexus. Zinc deficiency (ZnD) and iron-deficiency anemia (FeD) are two serious nutritional concerns which are negatively affecting human health. Herein, a survey-based case study was conducted in major wheat-based cropping system of east-central Pakistan. Soil and grain samples were collected from 125 field-grown wheat from 25 distinct sites/villages and GPS coordinates were taken for mapping. The collected samples were tags according to the names of 25 sites, i.e., UCs (union councils; an administrative unit). The quantified amount of zinc (Zn) or iron (Fe) in soil-wheat grains was compared with their recommended concentrations (RCZn, RCFe) for human nutrition. Additionally, clinical features of ZnD and FeD were diagnosed among local farmers who used to consume these grains, throughout the year, cultivated on their farm, and quantified their deficiency prevalence (ZnDP, FeDP). Results revealed, the collected 64% (0.54 to 5.25 mg kg-1) soils, and 96% (1.4 to 31 mg kg-1) grain samples are Zn-deficient (RCZn) along with ZnDP recorded among 68% of population. Meanwhile, FeD is quantified in 76% (1.86 to 15 mg kg-1) soil, 72% grain (2.1 to 134 mg kg-1) samples, and FeDP is found among 84% of studied population. A strong and positive correlation is developed in the Zn-or FeDP with their deficiencies in soil and grain by plotting multivariate analysis. In line with spatial distribution pattern, the UCs, namely, 141, 151, 159 and 132 are quantified severe deficient in Zn and Fe, and others are marginal or approaching to deficient level. Our findings rationalize the biological nexus of Zn and Fe, and accordingly, draw attention in the biofortification of staple crop as a win-win approach to combat the rising malnutrition concerns.
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Affiliation(s)
- Muhammad Ishfaq
- Department of Plant Nutrition, The Key Laboratory of Plant-Soil Interactions, Ministry of Education, China Agricultural University, Beijing, 100193, China.
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan.
| | - Abdul Wakeel
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Muhammad Nadeem Shahzad
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Aysha Kiran
- Department of Botany, University of Agriculture, Faisalabad, 38040, Pakistan.
| | - Xuexian Li
- Department of Plant Nutrition, The Key Laboratory of Plant-Soil Interactions, Ministry of Education, China Agricultural University, Beijing, 100193, China
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27
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Portugal-Nunes C, Castanho TC, Amorim L, Moreira PS, Mariz J, Marques F, Sousa N, Santos NC, Palha JA. Iron Status is Associated with Mood, Cognition, and Functional Ability in Older Adults: A Cross-Sectional Study. Nutrients 2020; 12:E3594. [PMID: 33238615 PMCID: PMC7700455 DOI: 10.3390/nu12113594] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/02/2020] [Accepted: 11/19/2020] [Indexed: 01/04/2023] Open
Abstract
Several conditions are risk factors for iron deficiency (ID), some of which are highly prevalent in older individuals. Despite the amount of evidence pointing for a role of ID in cognition, mood and physical functional ability, the research addressing these associations in older individuals is still scarce. In the present study, 162 older community-dwelling individuals (29.53% classified as ID) were enrolled in a cross-sectional analysis and characterized regarding cognition, mood, functional ability, general nutritional intake and iron status. Assessment of iron status was performed using several blood biomarkers. Storage and erythropoiesis dimensions were positively associated with memory, along with an interaction (moderator effect) between iron storage and nutritional status. A more depressed mood was negatively associated with (iron) transport, transport saturation and erythropoiesis dimensions, and functional tiredness was positively associated with the erythropoiesis dimension. These observations indicate that lower iron status is associated with depressive mood, functional tiredness and poorer memory ability, with the latter moderated by nutritional status. These findings suggest that using iron as a continuous variable may be useful in finding associations with iron homeostasis, eventually missed when iron levels are considered within the usual classification groups.
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Affiliation(s)
- Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Clinical Academic Center—Braga, 4710-243 Braga, Portugal
| | - Teresa Costa Castanho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Clinical Academic Center—Braga, 4710-243 Braga, Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Associação Centro de Medicina P5 (ACMP5), 4710-057 Braga, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Clinical Academic Center—Braga, 4710-243 Braga, Portugal
| | - José Mariz
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Clinical Academic Center—Braga, 4710-243 Braga, Portugal
- Emergency Department, Intermediate Care Unit (EDIMCU), Hospital de Braga, 4710-243 Braga, Portugal
| | - Fernanda Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Clinical Academic Center—Braga, 4710-243 Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Associação Centro de Medicina P5 (ACMP5), 4710-057 Braga, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (C.P.-N.); (T.C.C.); (L.A.); (P.S.M.); (J.M.); (F.M.); (N.S.); (N.C.S.)
- ICVS/3B′s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- Clinical Academic Center—Braga, 4710-243 Braga, Portugal
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Gong A, Wan D, Liang H, Yan L, Yu Z, Zhang H, Wang Q, Dou M. Joint replenishment of zinc and folic acid enhances the anti-depressive effect of paroxetine via increasing serum calcium and copper and decreasing serum arsenic. Neurosci Lett 2020; 737:135270. [PMID: 32777348 DOI: 10.1016/j.neulet.2020.135270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/23/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
Insufficient zinc and folic acid levels are associated with depression and poor response to antidepressants. This study aimed to investigate the influences of combined zinc and folic acid replenishment on the anti-depressive effect of paroxetine. Male rats were randomly divided into five groups: control (C), model (M), paroxetine (MP), zinc + folic acid (MZnF), and zinc + folic acid + paroxetine (MZnFP) groups. Rats were exposed to mild unpredictable stress for 3 weeks as a depression model. The combinations of drug and supplements were applied via daily gavage for 4 weeks. The open field test was conducted to observe behavioral changes. A chemiluminescence method was used to detect folacin, and inductively coupled plasma mass spectrometry was used to detect serum elements. Supplementation of zinc and folic acid significantly improved behavior responses to paroxetine, including movement speed, total distance, and central zone frequency. In addition, higher calcium and copper levels and a lower arsenic level were found in the serum of the MZnFP group. Thus, supplementation of zinc and folacin can enhance the anti-depressive effect of paroxetine, and the mechanism is potentially related to the improved levels of calcium and copper and a reduced level of arsenic.
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Affiliation(s)
- Anjing Gong
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Dehong Wan
- Department of Operating Room, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Hui Liang
- Department of Human Nutrition, College of Public Health, Qingdao University, Qingdao 266000, China
| | - Liping Yan
- Department of Laboratory Medicine, Qingdao Central Hospital, Qingdao 266042, China
| | - Zhou Yu
- Research Center, Qingdao Supervision and Testing Center of Product Quality, Qingdao, 266000, China
| | - Huizhen Zhang
- Department of Food Inspection, Qingdao Food and Drug Inspection Institute, Qingdao, 266071, China
| | - Qiuzhen Wang
- Department of Human Nutrition, College of Public Health, Qingdao University, Qingdao 266000, China
| | - Mei Dou
- Department of Human Nutrition, College of Public Health, Qingdao University, Qingdao 266000, China.
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29
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France JL, Hod EA, Caccappolo EA, Suhr JA, France CR, Kessler DA, Shaz BH. Examination of the relationship between iron status and cognitive function among healthy young women with and without a recent history of blood donation. Transfusion 2020; 60:2886-2895. [PMID: 32920826 DOI: 10.1111/trf.16069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND With growing awareness of the prevalence of nonanemic iron deficiency among blood donors, there is a need to explore the extent of potential negative consequences. This study examined the relationship between various measures of iron status, blood donation history, and neuropsychological and psychosocial functioning in healthy young women. STUDY DESIGN AND METHODS Using a cross-sectional design, 160 female undergraduates completed neuropsychology tests and measures of sleep, fatigue, quality of life, and depression before providing a blood sample. Correlational analyses examined the relationship between iron status (ferritin, iron, hemoglobin, and zinc protoporphyrin) and cognitive and psychosocial functioning. Performance on these measures was also examined as a function of recent blood donation history (zero, one, more than one donation in the past year). RESULTS Iron status (low ferritin, iron, or hemoglobin or high zinc protoporphyrin) was not associated with poorer performance on the cognitive tasks. Further, participants who reported donating once in the previous year performed better, rather than worse, than those with no recent donation history on several measures of executive function, even when controlling for ferritin levels. Although there was some evidence of greater fatigue among those who had donated more than once in the past year, this effect was not accounted for by ferritin levels. CONCLUSION The present findings are consistent with prior evidence that nonanemic iron deficiency is not associated with cognitive impairment or psychosocial dysfunction in healthy young females. Because these results are based on cross-sectional evidence, further study using longitudinal research is needed to confirm these findings.
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Affiliation(s)
- Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Eldad A Hod
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Elise A Caccappolo
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Julie A Suhr
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Christopher R France
- Department of Psychology, Ohio University, Athens, Ohio, USA.,Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, Ohio, USA
| | | | - Beth H Shaz
- New York Blood Center Enterprises, New York, New York, USA
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Keller P, von Känel R, Hincapié CA, da Costa BR, Jüni P, Erlanger TE, Andina N, Niederhauser C, Lämmle B, Fontana S. The effects of intravenous iron supplementation on fatigue and general health in non-anemic blood donors with iron deficiency: a randomized placebo-controlled superiority trial. Sci Rep 2020; 10:14219. [PMID: 32848185 PMCID: PMC7449957 DOI: 10.1038/s41598-020-71048-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/31/2020] [Indexed: 12/20/2022] Open
Abstract
We investigated whether intravenous iron supplementation improves fatigue and general health in non-anemic repeat adult blood donors with iron deficiency (ferritin ≤ 50 µg/L). Of 1,487 potentially eligible participants, 203 were randomly assigned to a single intravenous dose of 800 mg iron-carboxymaltose and 202 to placebo; 393 participants completed the trial. At 6 to 8 weeks after intervention, self-rated mean fatigue scores (numeric rating scale from 1-10, primary outcome) were 3.9 ± 1.8 in the iron supplementation group and 4.0 ± 2.2 in the placebo group, showing no group difference (p = 0.819). Pre-specified subgroup analyses of gender, ferritin < 25 µg/L and fatigue ≥ 4 points, as well as exploratory analyses of lower ferritin cut-offs did not reveal any between-group differences. In terms of secondary outcomes, the mean differences were 114.2 µg/L for ferritin (95% CI 103.1-125.3) and 5.7 g/L for hemoglobin (95% CI 4.3-7.2) with significantly higher values in the iron supplementation group. No group differences were observed for different measures of general well-being and other clinical and safety outcomes. Intravenous iron supplementation compared with placebo resulted in increase of ferritin and hemoglobin levels in repeat blood donors with low iron stores, yet had no effect on fatigue and general well-being.
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Affiliation(s)
- Peter Keller
- Division of Hematology, Department of Internal Medicine, SRO AG Spital Langenthal, Langenthal, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091, Zurich, Switzerland.
| | - Cesar A Hincapié
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Chiropractic Medicine, Faculty of Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Bruno R da Costa
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Peter Jüni
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tobias E Erlanger
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Nicola Andina
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland.,Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Christoph Niederhauser
- Interregional Blood Transfusion SRC, Bern, Switzerland.,University of Lausanne, Lausanne, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland.,Faculty of Biology and Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Bernhard Lämmle
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.,Haemostasis Research Unit, University College London, London, UK
| | - Stefano Fontana
- Interregional Blood Transfusion SRC, Bern, Switzerland.,University of Lausanne, Lausanne, Switzerland
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Demaret P, Karam O, Labreuche Bst J, Chiusolo F, Mayordomo Colunga J, Erickson S, Nellis ME, Perez MH, Ray S, Tucci M, Willems A, Duhamel A, Lebrun F, Loeckx I, Mulder A, Leteurtre S. How 217 Pediatric Intensivists Manage Anemia at PICU Discharge: Online Responses to an International Survey. Pediatr Crit Care Med 2020; 21:e342-e353. [PMID: 32217901 DOI: 10.1097/pcc.0000000000002307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the management of anemia at PICU discharge by pediatric intensivists. DESIGN Self-administered, online, scenario-based survey. SETTING PICUs in Australia/New Zealand, Europe, and North America. SUBJECTS Pediatric intensivists. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Respondents were asked to report their decisions regarding RBC transfusions, iron, and erythropoietin prescription to children ready to be discharged from PICU, who had been admitted for hemorrhagic shock, cardiac surgery, craniofacial surgery, and polytrauma. Clinical and biological variables were altered separately in order to assess their effect on the management of anemia. Two-hundred seventeen responses were analyzed. They reported that the mean (± SEM) transfusion threshold was a hemoglobin level of 6.9 ± 0.09 g/dL after hemorrhagic shock, 7.6 ± 0.10 g/dL after cardiac surgery, 7.0 ± 0.10 g/dL after craniofacial surgery, and 7.0 ± 0.10 g/dL after polytrauma (p < 0.001). The most important increase in transfusion threshold was observed in the presence of a cyanotic heart disease (mean increase ranging from 1.80 to 2.30 g/dL when compared with baseline scenario) or left ventricular dysfunction (mean increase, 1.41-2.15 g/dL). One third of respondents stated that they would not prescribe iron at PICU discharge, regardless of the hemoglobin level or the baseline scenario. Most respondents (69.4-75.0%, depending on the scenario) did not prescribe erythropoietin. CONCLUSIONS Pediatric intensivists state that they use restrictive transfusion strategies at PICU discharge similar to those they use during the acute phase of critical illness. Supplemental iron is less frequently prescribed than RBCs, and prescription of erythropoietin is uncommon. Optimal management of post-PICU anemia is currently unknown. Further studies are required to highlight the consequences of this anemia and to determine appropriate management.
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Affiliation(s)
- Pierre Demaret
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHC, Liège, Belgium.,Univ. Lille, EA 2694 - Santé Publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - Oliver Karam
- Division of Pediatric Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, VA
| | - Julien Labreuche Bst
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - Fabrizio Chiusolo
- Anesthesia and Critical Care, Bambino Gesù Children's Hospital, Rome, Italy
| | - Juan Mayordomo Colunga
- Sección de Cuidados Intensivos Pediátricos, Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain.,CIBER-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Simon Erickson
- Division of Pediatric Critical Care, Princess Margaret Hospital, Perth, WA, Australia
| | - Marianne E Nellis
- Pediatric Critical Care Medicine, Department of Pediatrics, NY Presbyterian Hospital - Weill Cornell Medicine, New York, NY
| | - Marie-Hélène Perez
- Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital of Lausanne, Lausanne, Switzerland
| | - Samiran Ray
- Pediatric Intensive Care Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Marisa Tucci
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Sainte-Justine Hospital and Université de Montréal, Montreal, QC, Canada
| | - Ariane Willems
- Pediatric Intensive Care Unit, Department of Intensive Care, Leiden Universitair Medisch Centrum, Leiden, The Netherlands
| | - Alain Duhamel
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - Frédéric Lebrun
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHC, Liège, Belgium
| | - Isabelle Loeckx
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHC, Liège, Belgium
| | - André Mulder
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHC, Liège, Belgium
| | - Stéphane Leteurtre
- Univ. Lille, EA 2694 - Santé Publique: épidémiologie et qualité des soins, F-59000 Lille, France.,CHU Lille, Pediatric Intensive Care Unit, CHU Lille, F-59000 Lille, France
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Caré W, Hénard J, Gillard J, Cremades S, Ceppa F, Vest P, Foissaud V, Hejl C. Evaluation of Systematic Blood Testing at the Time of Recruitment to the Armed Forces: Retrospective Monocentric Study Among 726 French Army Soldiers. Mil Med 2020; 185:346-353. [PMID: 31665403 DOI: 10.1093/milmed/usz368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION In the French armed forces, the biological checkup required during the recruitment process comprises a urinalysis (urinary dipstick), a complete blood count (CBC), and measurement of serum levels of aspartate aminotransferase, alanine aminotransferase, fasting blood glucose, and creatinine. This study aimed to evaluate the benefits of this biological checkup and to determine the most relevant parameters. MATERIALS AND METHODS We conducted a monocentric retrospective study of all standardized and systematically conducted blood tests (CBC and measurement of aspartate aminotransferase, alanine aminotransferase, fasting blood glucose, and creatinine) over a 15-month period among 726 French Army recruits. RESULTS The population included mainly young males (85.4%, mean age 21.6 years). More than half (54.1%) of the blood tests had at least one abnormal parameter, most often concerning the CBC. Anemia occurred in 5.3% of the population and was mostly normocytic. Microcytosis was mostly not associated with anemia (72.3% of cases). Lymphopenia occurred in 20.1% of the population and was mostly mild. Eosinophilia was present in 5.1% of the population and was never severe. Thrombocytopenia occurred in 0.7% of the population and was never severe. Serum levels of aminotransferases were elevated in 8.1% of the population. Fasting plasma glucose averaged 84 mg/dL (SD: 0.07) ranging from 64 to 123 mg/dL, was abnormal in 0.4% of the population, and one case of diabetes was diagnosed. Serum creatinine concentration was elevated in 0.7% of the population. CONCLUSION CBCs gave useful information but iron deficiency was common and insufficiently detected by this single analysis. Assessing aminotransferase levels without screening for viral hepatitis and systematic measurement of fasting plasma glucose levels did not appear to be efficient. In addition, the only interest in systematic measurement of creatinine serum levels was to obtain a reference level for long-term follow-up. In addition to the urinary dipstick, the systematic biological checkup at recruitment could be limited to a CBC with measurement of plasma ferritin levels and Hepatitis B virus serology, providing that any CBC abnormalities, in particular cytopenia, eosinophilia, and microcytosis, are systematically investigated. For a public health approach, systematic screening for other sexually transmitted infections could be proposed.
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Affiliation(s)
- Weniko Caré
- Department of Internal Medicine, Percy Military Teaching Hospital, 101 Boulevard Henri Barbusse, 92140 Clamart, France
| | - Jessica Hénard
- Third Military Medical Center, Quartier Saint Ruth, Rue de la Porte d'Ypres, 59000 Lille, France
| | - Jonathan Gillard
- Surgeon General Office, Operations Division, Fort Neuf de Vincennes, Cours des Maréchaux, 75614 Paris Cedex 12, France
| | - Serge Cremades
- Department of Internal Medicine, Bégin Military Teaching Hospital, 69 Avenue de Paris, 94160 Saint-Mandé, France.,Val-de-Grâce School, 1 Place Alphonse Laveran, 75005 Paris, France
| | - Franck Ceppa
- Val-de-Grâce School, 1 Place Alphonse Laveran, 75005 Paris, France.,Department of Biology, Bégin Military Teaching Hospital, 69 Avenue de Paris, 94160 Saint-Mandé, France
| | - Philippe Vest
- Department of Biology, Percy Military Teaching Hospital, 101 Avenue Henri Barbusse, 92140 Clamart, France
| | - Vincent Foissaud
- Department of Biology, Percy Military Teaching Hospital, 101 Avenue Henri Barbusse, 92140 Clamart, France
| | - Carine Hejl
- Department of Biology, Percy Military Teaching Hospital, 101 Avenue Henri Barbusse, 92140 Clamart, France
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Drexler C, Macher S, Lindenau I, Holter M, Moritz M, Stojakovic T, Pieber TR, Schlenke P, Amrein K. High-dose intravenous versus oral iron in blood donors with iron deficiency: The IronWoMan randomized, controlled clinical trial. Clin Nutr 2020; 39:737-745. [DOI: 10.1016/j.clnu.2019.03.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/01/2019] [Accepted: 03/18/2019] [Indexed: 01/01/2023]
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Association Between School Performance and Anemia in Adolescents in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051466. [PMID: 32106470 PMCID: PMC7084426 DOI: 10.3390/ijerph17051466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/20/2020] [Indexed: 12/02/2022]
Abstract
In school age children and adolescents, anemia might cause lower cognitive function and attention span, which in turn could diminish human capital accumulation. As children born in low-income households are more likely to be anemic, this may prevent many individuals from overcoming the intergenerational poverty traps. In this paper, we used data from the Mexican National Health and Nutrition Survey 2012 and focused on a sample of adolescents between 12 and 19 years of age to study the relationship between attending school without delay—our proxy for school performance—and anemia. We found a statistically significant association between the two variables. If this relationship is causal, the economic burden linked to the loss of school years could well exceed the costs associated with programs aimed at reducing the prevalence of anemia in vulnerable populations. Our results provide additional support to the existing literature on anemia as a significant barrier to school achievement.
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Mariño MM, Grijota FJ, Bartolomé I, Siquier-Coll J, Román VT, Muñoz D. Influence of physical training on erythrocyte concentrations of iron, phosphorus and magnesium. J Int Soc Sports Nutr 2020; 17:8. [PMID: 31996219 PMCID: PMC6988285 DOI: 10.1186/s12970-020-0339-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/20/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The present study aimed to determine changes occurring in the erythrocyte concentrations of Iron (Fe), Magnesium (Mg) and Phosphorous (P) of subjects with different levels of physical training living in the same area of Extremadura (Spain). METHODS Thirty sedentary subjects (24.34 ± 3.02 years) without sports practice and a less active lifestyle, formed the control group (CG); 24 non-professional subjects (23.53 ± 1.85 years), who perform between 4 and 6 h/week of moderate sports practice without any performance objective and without following systematic training formed the group of subjects with a moderate level of training (MTG), and 22 professional cyclists (23.29 ± 2.73 years) at the beginning of their sports season, who performed more than 20 h/week of training, formed the high-level training group (HTG). Erythrocyte samples from all subjects were collected and frozen at - 80 °C until analysis. Erythrocyte analysis of Fe, Mg and P was performed by inductively coupled plasma mass spectrometry (ICP-MS). All results are expressed in μg/g Hb. RESULTS The results showed that there were statistically significant lower concentrations of erythrocyte Fe, Mg and P in MTG and HTG than CG. All parameters (Fe, Mg and P concentrations in erythrocytes) correlated inversely with physical training. CONCLUSIONS Physical exercise produces a decrease in erythrocyte concentrations of Fe, Mg and P. This situation could cause alterations in the performance of athletes given the importance of these elements. For this reason, we recommend an erythrocyte control at the beginning, and during the training period, to avoid harmful deficits.
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Affiliation(s)
- Marcos Maynar Mariño
- Sport Sciences Faculty, University of Extremadura, Avenida de la Universidad s/n 10003, Cáceres, Spain
| | - Francisco Javier Grijota
- Education Faculty, University of Extremadura, Avenida de la Universidad s/n 10003, Cáceres, Spain
| | - Ignacio Bartolomé
- Sport Sciences Faculty, University of Extremadura, Avenida de la Universidad s/n 10003, Cáceres, Spain
| | - Jesús Siquier-Coll
- Sport Sciences Faculty, University of Extremadura, Avenida de la Universidad s/n 10003, Cáceres, Spain
| | - Victor Toro Román
- Sport Sciences Faculty, University of Extremadura, Avenida de la Universidad s/n 10003, Cáceres, Spain
| | - Diego Muñoz
- Sport Sciences Faculty, University of Extremadura, Avenida de la Universidad s/n 10003, Cáceres, Spain
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Bayen S, Le Grand C, Bayen M, Richard F, Messaadi N. Anemia management in non-menopausal women in a primary care setting: a prospective evaluation of clinical practice. BMC FAMILY PRACTICE 2020; 21:13. [PMID: 31964335 PMCID: PMC6971881 DOI: 10.1186/s12875-020-1086-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The study aimed to analyze anemia management in non-pregnant, and non-menopausal women aged from 18 to 50 years old, in a French primary care setting. METHODS An observational descriptive prospective study was conducted between November 2018 and February 2019. Inclusion criteria were as followed: anemia diagnosed in women aged from 18 to 50, not pregnant and not menopausal. Quantitative and qualitative data were anonymized and collected through an electronic survey. Investigating general practitioners completed the questionnaire for each newly diagnosed woman. Mean values and medians were calculated for the quantitative data. Answers to the open questions were encoded manually and proportions of the different modalities have been calculated. RESULTS Altogether, 43 women with anemia were ascertained. Moderate microcytic anemia, due to an iron deficiency in a context of menorrhagia, was the most observed anemia profile. The mean value of hemoglobin was 10.5 ± 1 g/dl. Among these women: 32 (74%) presented an iron deficiency, 17 (53%) had inappropriate intakes, and 9 (28%) reported menorrhagia. For 17 (40%) women, unnecessary or inappropriate exams were prescribed. The investigations did not allow to establish a differential diagnosis for 12 women (28%). Even for similar clinical situations, anemia management was variable. Among the women who presented iron deficiency, 15 (47%) were informed about an iron-rich diet and received a daily iron supplementation of ferrous sulfate between 80 mg and 160 mg. CONCLUSIONS Our study highlights that, in the absence of specific national guidelines for anemia management in non-pregnant, non-menopausal women in primary care settings, French GPs undergo various clinical management strategies leading to a heterogeneous, sometimes inappropriate follow-up. Women with iron deficiency were prescribed higher daily iron supplementation than recommended, according to new evidence, suggesting a maximal daily dose of 50 mg of elementary iron in a context of Hepcidin up-regulation in the case of an iron overload. Additional longitudinal studies with a bigger sample size and randomized controlled trials are needed to confirm our results and to elaborate national guidelines.
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Affiliation(s)
- Sabine Bayen
- Department of General Practice, University of Lille (F), Pôle formation Faculté de médecine Henri Warembourg, 59045 Lille CEDEX 1, France
- Department of Medical Pharmacology & Neurology, INSERM UMRS 1171, University of Lille (F), Lille, France
| | - Charline Le Grand
- Department of General Practice, University of Lille (F), Pôle formation Faculté de médecine Henri Warembourg, 59045 Lille CEDEX 1, France
| | - Marc Bayen
- Department of General Practice, University of Lille (F), Pôle formation Faculté de médecine Henri Warembourg, 59045 Lille CEDEX 1, France
| | - Florence Richard
- Department of Epidemiology and Public Health, INSERM UMRS 1167, University of Lille (F), Lille, France
| | - Nassir Messaadi
- Department of General Practice, University of Lille (F), Pôle formation Faculté de médecine Henri Warembourg, 59045 Lille CEDEX 1, France
- SCALab CNRS UMR 9193, University of Lille, Lille, France
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Affiliation(s)
- Laura A Douglass
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
| | - Andrew M Davis
- Department of Medicine, University of Chicago, Chicago, Illinois
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Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence. Nutrients 2020; 12:nu12010228. [PMID: 31963141 PMCID: PMC7019700 DOI: 10.3390/nu12010228] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamins and minerals are essential to humans as they play essential roles in a variety of basic metabolic pathways that support fundamental cellular functions. In particular, their involvement in energy-yielding metabolism, DNA synthesis, oxygen transport, and neuronal functions makes them critical for brain and muscular function. These, in turn, translate into effects on cognitive and psychological processes, including mental and physical fatigue. This review is focused on B vitamins (B1, B2, B3, B5, B6, B8, B9 and B12), vitamin C, iron, magnesium and zinc, which have recognized roles in these outcomes. It summarizes the biochemical bases and actions of these micronutrients at both the molecular and cellular levels and connects them with cognitive and psychological symptoms, as well as manifestations of fatigue that may occur when status or supplies of these micronutrients are not adequate.
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Sawada T, Konomi A, Yokoi K. Serum lipid profiles of young Japanese women with iron deficiency without anemia. J Trace Elem Med Biol 2020; 57:126408. [PMID: 31587838 DOI: 10.1016/j.jtemb.2019.126408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/28/2019] [Accepted: 09/18/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE We aimed to evaluate the association between iron deficiency without anemia (IDNA) and serum lipid profiles in young women of around 20 years of age. METHODS This study included non-anemic (hemoglobin ≥ 12 g/dL) female volunteers aged 18 to 22 years who were not taking mineral/vitamin supplements and living in the metropolitan area of Tokyo, Japan. These volunteers were classified into two groups based on their sFer (serum ferritin) levels: normal group (sFer ≥ 20 ng/mL, n = 36) and IDNA group (sFer < 20 ng/mL, n = 29). Venous blood samples were obtained from the antecubital veins of these volunteers after 10-12-h fasting to measure the hematological and biochemical parameters, including lipid levels and iron status. The results of each group were compared using Student's t-test or the Mann-Whitney U test (for inhomogeneous variance). RESULTS The serum cholesterol levels varied depending on the iron status in the women. Serum high-density lipoprotein cholesterol (HDL-C) levels in the IDNA group were significantly higher (P = 0.006) than that in the normal group. However, the levels of total cholesterol (T-CHO), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) were not significantly different between the groups. Serum LDL-C levels were positively and significantly correlated with sFer levels in the IDNA group (Kendall's rank correlation 0.264, P = 0.044), but not in the normal group. The sFer level was not correlated with serum HDL-C in both groups. The reason for the high serum HDL-C levels in young women with IDNA is not yet clear. Compared to the normal group, the frequency of eating bread containing bran was significantly higher (P = 0.031) and that for yogurt was significantly lower (P = 0.040) in the IDNA group. The proportion of the women who were susceptible to infection, which was measured using the Cornell Medical Index, was significantly higher in the IDNA group than in the normal group. Among those susceptible to infection, the serum HDL-C level of the volunteers in the IDNA group was significantly higher than that of the volunteers in the normal group (P = 0.024). CONCLUSIONS Our findings suggest that lipid parameters may be associated with IDNA and susceptibility to infection. Further research is needed to elucidate the mechanisms underlying the changes in the serum cholesterol levels in individuals with IDNA and the clinical significance of these findings.
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Affiliation(s)
- Takako Sawada
- Department of Nutritional Sciences, Tohto University, 4-2-7 Kamishibachonishi, Fukaya, Saitama 366-0052, Japan
| | - Aki Konomi
- Department of Nutritional Sciences, Faculty of Human Ecology, Yasuda Women's University, Hiroshima 731-0153, Japan
| | - Katsuhiko Yokoi
- Department of Human Nutrition, Seitoku University Graduate School, Matsudo, Chiba 271-8555, Japan.
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Abstract
Celiac disease is a common form of enteropathy with frequent extraintestinal manifestations (EIM). Misrecognition of these presentations may lead to significant delays in diagnosis. Any organ may be involved, either through an immune/inflammatory phenomenon, or nutritional deficiencies. Some EIM, such as gluten ataxia, may be irreversible if left untreated, but most will improve with a gluten-free diet. Knowledge of the various EIM, as well as the associated conditions which do not improve on a gluten-free diet, will avoid delays in the diagnosis and management of celiac disease and associated manifestations.
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Bries AE, Wang C, Agbemafle I, Wels B, Reddy MB. Assessment of Acute Serum Iron, Non-Transferrin-Bound Iron, and Gastrointestinal Symptoms with 3-Week Consumption of Iron-Enriched Aspergillus oryzae Compared with Ferrous Sulfate. Curr Dev Nutr 2019; 3:nzz127. [PMID: 32154497 PMCID: PMC7053575 DOI: 10.1093/cdn/nzz127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/23/2019] [Accepted: 11/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is a widespread nutritional deficiency, and iron supplementation, especially with ferrous sulfate (FeSO4), is the most common strategy to treat IDA; however, compliance is often poor with daily FeSO4 owing to negative side effects. In a previous study, iron from iron-enriched Aspergillus oryzae [Ultimine® Koji Iron (ULT)] was absorbed similarly to FeSO4. OBJECTIVES The main objective of this study was to assess the safety of consuming ULT in terms of increasing non-transferrin-bound iron (NTBI) and gastrointestinal distress. METHODS Young female participants (n = 16) with serum ferritin <40 μg/L were randomly assigned to a double-blind, 9-wk crossover study with a 3-wk placebo/washout period between treatments. Oral FeSO 4 and ULT supplements containing 65 mg Fe were administered daily for 21 consecutive days. On day 1, serum iron (SI), percentage transferrin saturation (%TS), and NTBI were measured for 8 h on the first day of iron consumption. Changes in biochemical indicators were evaluated after 3 wk consumption. Side effects questionnaires were completed weekly on 2 randomly selected weekdays and 1 weekend day for the entire study. RESULTS SI, %TS, and NTBI were all markedly higher during hours 2-8 (P < 0.001) with FeSO4 than with ULT. Oxidative stress, inflammatory, and kidney and liver function markers remained unchanged with both supplementations compared with placebo. Changes in iron status markers were not significantly different among the 3 treatments. Individual or global side effects were not significantly different among all treatments. Even when common side effects of nausea, constipation, and diarrhea were combined, FeSO4 treatment had a significantly higher effect than ULT (P = 0.04) and placebo (P = 0.004) only at week 3, but the difference was not significant between ULT and placebo. CONCLUSIONS Low NTBI production and fewer common gastrointestinal side effects with ULT suggest that it is a safe oral iron supplement to treat IDA. This trial was registered at clinicaltrials.gov as NCT04018300.
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Affiliation(s)
- Amanda E Bries
- Department of Food Sciences and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Chong Wang
- Department of Statistics, Iowa State University, Ames, IA, USA
| | - Isaac Agbemafle
- Department of Food Sciences and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Brian Wels
- State Hygienic Laboratory, University of Iowa, Ankeny, IA, USA
| | - Manju B Reddy
- Department of Food Sciences and Human Nutrition, Iowa State University, Ames, IA, USA
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Famitafreshi H, Karimian M. Paradoxical regulation of iron in hippocampus and prefrontal cortex induces schizophrenic-like symptoms in male rats. Int J Neurosci 2019; 130:384-390. [PMID: 31714862 DOI: 10.1080/00207454.2019.1692832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Introduction: Social isolation induces schizophrenic-like symptoms. Iron is an essential element for brain functions. The aim of this study is to investigate if the emergence of schizophrenia after social isolation is the result of impaired iron metabolism in the hippocampus and in the prefrontal cortex.Methods and materials: In this study, 42 male Sprague-Dawley rats were randomly divided into six groups: 1) grouped housed (GH), 2) socially isolated (SI), 3) grouped housed + vehicle, 4) grouped housed + morphine, 5) socially isolated + vehicle and 6) socially isolated + morphine. After 14 days of social isolation and group housing, behavioral experiments were performed. Then, the iron in the hippocampus, prefrontal cortex, and serum was assessed.Results: SI rats were more anxious in compared to GH rats. Memory was better in GH rats compared to SI rats. SI rats had more locomotor activity compared to GH rats. Iron was higher in the hippocampus in GH rats compared to SI rats. Paradoxically iron was higher in the prefrontal cortex in SI rats compared to GH rats. In serum, iron was higher in GH rats compared to SI rats.Conclusion: Emergence of schizophrenic-like symptoms is associated with the paradoxical concentration of iron in hippocampus and prefrontal cortex in the isolation period. Further studies are recommended to investigate the possible specific changes in ion transporters and the metabolism of the neurotransmitter that occurs as the result of this paradoxical regulation.
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Affiliation(s)
- Hamidreza Famitafreshi
- Department of Physiology, Tehran University of Medical Science-International Campus, Tehran, Iran
| | - Morteza Karimian
- Department of Physiology, Tehran University of Medical Science, Tehran, Iran
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The effects of plant-based diets on the body and the brain: a systematic review. Transl Psychiatry 2019; 9:226. [PMID: 31515473 PMCID: PMC6742661 DOI: 10.1038/s41398-019-0552-0] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/22/2019] [Accepted: 07/17/2019] [Indexed: 12/15/2022] Open
Abstract
Western societies notice an increasing interest in plant-based eating patterns such as vegetarian and vegan, yet potential effects on the body and brain are a matter of debate. Therefore, we systematically reviewed existing human interventional studies on putative effects of a plant-based diet on the metabolism and cognition, and what is known about the underlying mechanisms. Using the search terms "plant-based OR vegan OR vegetarian AND diet AND intervention" in PubMed filtered for clinical trials in humans retrieved 205 studies out of which 27, plus an additional search extending the selection to another five studies, were eligible for inclusion based on three independent ratings. We found robust evidence for short- to moderate-term beneficial effects of plant-based diets versus conventional diets (duration ≤ 24 months) on weight status, energy metabolism and systemic inflammation in healthy participants, obese and type-2 diabetes patients. Initial experimental studies proposed novel microbiome-related pathways, by which plant-based diets modulate the gut microbiome towards a favorable diversity of bacteria species, yet a functional "bottom up" signaling of plant-based diet-induced microbial changes remains highly speculative. In addition, little is known, based on interventional studies about cognitive effects linked to plant-based diets. Thus, a causal impact of plant-based diets on cognitive functions, mental and neurological health and respective underlying mechanisms has yet to be demonstrated. In sum, the increasing interest for plant-based diets raises the opportunity for developing novel preventive and therapeutic strategies against obesity, eating disorders and related comorbidities. Still, putative effects of plant-based diets on brain health and cognitive functions as well as the underlying mechanisms remain largely unexplored and new studies need to address these questions.
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Joshee P, Wood AG, Wood ER, Grunfeld EA. Meta-analysis of cognitive functioning in patients following kidney transplantation. Nephrol Dial Transplant 2019; 33:1268-1277. [PMID: 28992229 PMCID: PMC6031036 DOI: 10.1093/ndt/gfx240] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/14/2017] [Indexed: 12/20/2022] Open
Abstract
Background There is mixed evidence regarding the nature of cognitive function in patients who have undergone renal transplantation. The aim of this meta-analysis was to examine which cognitive domains are impacted following kidney transplantation and how performance compares with non-transplanted patients or healthy controls/normative data. Method A systematic search was conducted using keywords within three databases (Embase, MEDLINE and PsychINFO), yielding 458 unique studies, 10 of which met the inclusion criteria. Neuropsychological tests were grouped into nine cognitive domains and three separate analyses were undertaken within each domain: (i) within subjects pre- versus post-transplant, (ii) transplanted versus non-transplanted patients and (iii) transplanted versus healthy matched controls and standardized normative data. Results Transplanted patients showed moderate to large improvements in the domains of general cognitive status (g = 0.526), information and motor speed (g = 0.558), spatial reasoning (g = 0.376), verbal memory (g = 0.759) and visual memory (g = 0.690) when compared with their pre-operative scores. Test scores in the same five domains were significantly better in post-transplanted patients when compared with dialysis-dependant or conservatively managed chronic kidney disease patients. However, post-transplanted patients’ performance was significantly low compared with that of healthy controls (and standardized normative data) in the domains of executive functioning (g = −0.283), verbal fluency (g = −0.657) and language (g = −0.573). Conclusions Two key issues arise from this review. First, domain-specific cognitive improvement occurs in patients after successful transplantation. Nevertheless, transplanted patients still performed significantly below healthy controls in some domains. Second, there are important shortcomings in existing studies; the length of follow-up is typically short and only limited neuropsychological test batteries are employed. These factors are important in order to support the recovery of cognitive function among patients following renal transplant.
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Affiliation(s)
- Paras Joshee
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Amanda G Wood
- School Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK.,Murdoch Childrens Research Institute, Clinical Sciences, Flemington Road, Parkville, VIC, Australia
| | | | - Elizabeth A Grunfeld
- Centre for Technology Enabled Health Research, Coventry University, Coventry, UK.,School of Psychological Sciences, Birkbeck, University of London, UK
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Spencer BR. Iron Depletion in Adult and Teenage Blood Donors: Prevalence, Clinical Impact, and Options for Mitigation. Hematol Oncol Clin North Am 2019; 33:781-796. [PMID: 31466604 DOI: 10.1016/j.hoc.2019.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Iron depletion is a known risk for adult blood donors, but recent studies indicate the prevalence of iron depletion is higher in teenage blood donors. Teenage donors account for more than 10% of the blood collected in the United States and are important for maintaining component availability. Evidence of harm from iron depletion has not been demonstrated, but the area would benefit from further scientific inquiry. Options to protect against iron depletion exist, but each has limitations including cost, logistics, and potential negative impact on blood supply. Blood centers should communicate with donors and make efforts to mitigate these risks.
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Affiliation(s)
- Bryan R Spencer
- Scientific Affairs, American Red Cross, 180 Rustcraft Road, Dedham, MA 02026, USA.
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LaVallee C, Cronin P, Bansal I, Kwong WJ, Boccia R. Importance of Initial Complete Parenteral Iron Repletion on Hemoglobin Level Normalization and Health Care Resource Utilization: A Retrospective Analysis. Pharmacotherapy 2019; 39:983-993. [PMID: 31411763 DOI: 10.1002/phar.2319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVE Iron deficiency anemia is the most common form of anemia, and parenteral iron therapy is necessary in select patients. The objective of this analysis was to assess the impact of initial complete parenteral iron repletion on serum hemoglobin (Hgb) level normalization and on health care resource utilization in real-world practice. DESIGN Retrospective observational study. DATA SOURCE Decision Resources Group Real-World Data Repository (United States databases). PATIENTS A total of 2966 patients who had a baseline Hgb level below normal (< 12 g/dl for females and < 13.5 g/dl for males) and were treated with parenteral iron between March 2015 and February 2017. MEASUREMENTS AND MAIN RESULTS The effect of receiving the required parenteral iron dose to replete the deficit, calculated by a modified Ganzoni formula, within 3 weeks of the first parenteral iron therapy claim (index date) on the likelihood of Hgb level normalization, was estimated by using logistic regression. All analyses were adjusted for sex, age, comorbidities, and use of prescription oral iron therapy. The adjusted mean numbers of all-cause inpatient admissions, outpatient visits, and emergency department (ED) visits within 6 months and 1 year after the index date were compared between patients with and without normalized Hgb levels by using negative binomial regression. Of the 2966 included patients, 33.9% received the required iron dose within 3 weeks of the index date, and 19.6%, 48.2%, and 53.9% had a normalized Hgb level within 8 weeks of the index date, within 1 year of the index date, and until the end of data availability, respectively. Patients who received the required iron dose within 3 weeks of the index date were significantly more likely to have a normalized Hgb level within 8 weeks of the index date and at any time during the study period than those who did not: adjusted odds ratio (OR) (95% confidence interval [CI]) 2.67 (2.20, 3.24) and 2.33 (1.96, 2.77), respectively. Hgb level normalization within 1 year of the index date was associated with fewer inpatient admissions and outpatient visits and a similar number of ED visits compared with no Hgb level normalization 1 year after the index date. CONCLUSION The results of these analyses underscore the importance of initial complete parenteral iron repletion for rapidly improving clinical outcomes. Prompt achievement of a normalized Hgb level may also provide an opportunity to reduce health care resource utilization in patients with iron deficiency anemia receiving parenteral iron therapy.
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Affiliation(s)
- Chris LaVallee
- Health Outcomes Research, Decision Resources Group, Boston, Massachusetts
| | - Patrick Cronin
- Analytics, Decision Resources Group, Boston, Massachusetts
| | - Isha Bansal
- Analytics, Decision Resources Group, Boston, Massachusetts
| | | | - Ralph Boccia
- Center for Cancer and Blood Disorders, Bethesda, Maryland
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Anaemia and iron deficiency in pregnancy and adverse perinatal outcomes in Southern India. Eur J Clin Nutr 2019; 74:112-125. [PMID: 31296936 PMCID: PMC10122513 DOI: 10.1038/s41430-019-0464-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES We examined the prevalence of anaemia, iron deficiency, and inflammation during pregnancy and their associations with adverse pregnancy and infant outcomes in India. SUBJECTS/METHODS Three hundred and sixty-six women participating in a randomised trial of vitamin B12 supplementation were monitored to assess haemoglobin (Hb), serum ferritin (SF), hepcidin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) during pregnancy. Women received vitamin B12 supplementation (50 µg per day) or placebo daily; all women received daily prenatal iron-folic acid supplementation. Binomial and linear regression models were used to examine the associations of maternal iron biomarkers with pregnancy and infant outcomes. RESULTS Thirty percent of women were anaemic (Hb < 11.0 g/dl), 48% were iron deficient (SF < 15.0 µg/l), and 23% had iron deficiency anaemia at their first prenatal visit. The prevalence of inflammation (CRP > 5.0 mg/l: 17%; AGP > 1.0 g/l: 11%) and anaemia of inflammation (Hb < 11.0 g/dl, SF > 15.0 µg/l, plus CRP > 5.0 mg/l or AGP > 1.0 g/l: 2%) were low. Infants born to anaemic women had a twofold higher risk of low birth weight (<2500 g; risk ratio [RR]: 2.15, 95%CI: 1.20-3.84, p = 0.01), preterm delivery (RR: 2.67 (1.43-5.00); p = 0.002), underweight (WAZ < -2; RR: 2.20, 95%CI: 1.16-4.15, p = 0.02), and lower MUAC (β(SE): -0.94 (0.45)cm, p = 0.03). Similarly, maternal Hb concentrations predicted higher infant birth weight (p = 0.02) and greater gestational age at delivery (β(SE): 0.28 (0.08) weeks, p = 0.001), lower risk of preterm delivery (<37 weeks; RR: 0.76, 95%CI: 0.66-86, p < 0.0001); and higher infant MUAC (β(SE): 0.36 (0.13) cm, p = 0.006). Maternal SF concentrations were associated with greater birth length (β(SE): 0.44 (0.20) cm, p < 0.03). Findings were similar after adjusting SF concentrations for inflammation. IDA was associated with higher risk of low birth weight (RR: 1.99 (1.08-3.68); p = 0.03) and preterm birth (RR: 3.46 (1.81-6.61); p = 0.0002); and lower birth weight (p = 0.02), gestational age at birth (p = 0.0002), and infant WAZ scores (p = 0.02). CONCLUSIONS The prevalence of anaemia and iron deficiency was high early in pregnancy and associated with increased risk of adverse pregnancy and infant outcomes. A comprehensive approach to prevent anaemia is needed in women of reproductive age, to enhance haematological status and improve maternal and child health outcomes.
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Gorlin JB. Iron replacement: precautionary principle versus risk-based decision making. Transfusion 2019; 59:1613-1615. [PMID: 31050828 DOI: 10.1111/trf.15274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 03/09/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Jed B Gorlin
- Innovative Blood Resources, Saint Paul, Minnesota
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Sayers MH. Iron supplementation? Ferritin screening? Why questions persist. Transfusion 2019; 59:1616-1619. [DOI: 10.1111/trf.15303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Merlyn H. Sayers
- Carter BloodCare Bedford Texas
- Department of PathologyUniversity of Texas Southwestern Medical Center Dallas Texas
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Goodman SP, Moreland AT, Marino FE. The effect of active hypohydration on cognitive function: A systematic review and meta-analysis. Physiol Behav 2019; 204:297-308. [DOI: 10.1016/j.physbeh.2019.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/12/2019] [Accepted: 03/11/2019] [Indexed: 12/14/2022]
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