1
|
Hu J, Hu XR, Li XX, Liu X, Yang XW, Guan DR, Liu JQ, Zhang FK. [Effect of iron deficiency level on oral iron absorption]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:402-406. [PMID: 34218583 PMCID: PMC8293009 DOI: 10.3760/cma.j.issn.0253-2727.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Indexed: 11/05/2022]
Abstract
Objective: To study the effect of iron deficiency level for oral iron absorption in iron deficient patients. Methods: 37 non-pregnant female patients who were diagnosed with iron deficiency and 13 healthy females who completed their physical examination at the outpatient department of the Anemia Center of the Institute of Hematology & Blood Diseases Hospital from July 2018 to June 2020 were included. Hepcidin and C2-C0 of oral iron absorption test were analyzed in different iron deficiency and serum ferritin level. Results: The median of Hepcidin in IDA, ID/IDE and healthy control group were 4.9 (2.17-32.86) , 26.98 (11.02-49.71) and 69.89 (42.23-138.96) μg/L (P<0.001) , respectively. Hepcidin level of IDA group was lower than that of ID/IDE group (adjusted P=0.005) and healthy control (adjusted P<0.001) . Hepcidin level of ID/IDE group had no significant difference compared with healthy control (adjusted P=0.22) . The mean of C2-C0 in IDA, ID/IDE and healthy control group were (35.30±21.68) , (37.90±14.06) and (23.57±10.14) μmol/L (P=0.130) , respectively. Multilinear regression analysis showed C0, SF, sTFR and HGB were independent factors for Hepcidin in iron deficient patients, with an equation of Hepcidin=-31.842-0.642*C0+2.239*SF+1.778*sTFR+0.365*HGB-0.274*RET-HB. We didn't find independent factor of C2-C0. Conclusion: The degree of iron deficiency had an effect on oral iron absorption. Patients of ID/IDE group absorbed iron more slowly than patients of IDA group. Iron deficient patients with normal gastrointestinal function absorbed more iron by oral administration when they were in a more serious iron deficient stage. Hepcidin was a better parameter to distinguish iron absorption level among different iron deficient patients than C2-C0 of oral iron absorption test.
Collapse
Affiliation(s)
- J Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X R Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X X Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X W Yang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - D R Guan
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - J Q Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - F K Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| |
Collapse
|
2
|
Talarico V, Giancotti L, Miniero R, Bertini M. Iron Deficiency Anemia Refractory to Conventional Therapy but Responsive to Feralgine ® in a Young Woman with Celiac Disease. Int Med Case Rep J 2021; 14:89-93. [PMID: 33628062 PMCID: PMC7897862 DOI: 10.2147/imcrj.s291599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023] Open
Abstract
Iron, which is an important micronutrient in the human body may be deficient in people with celiac disease (CD). Iron deficiency anemia (IDA) may be the presenting feature of celiac disease, also in the absence of diarrhea or weight loss. The treatment of IDA in patient with CD is primarily a gluten-free-diet (GFD), but it is also very important oral iron supplementation until the iron stores have been restored. However, a frequent problem in CD is the poor tolerability and poor efficacy of oral iron preparations. A new product, consisting of the combination of Ferrous Bysglicinate Chelate and Sodium Alginate (Feralgine™), has been demonstrated to be more bioavailable and well tolerated in CD. We present a case report that showed a clear efficacy of this product in a form of IDA refractory to conventional therapy in a woman with CD and we demonstrated a clear increase of serum iron after administration of this new type of ferrous.
Collapse
Affiliation(s)
| | - Laura Giancotti
- Unit of Pediatrics, University "Magna Graecia", Catanzaro, Italy
| | - Roberto Miniero
- Department of Pediatric, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Marco Bertini
- R&D Department, Laboratori Baldacci SpA, Pisa, Italy
| |
Collapse
|
3
|
Wan D, Wu Q, Ni H, Liu G, Ruan Z, Yin Y. Treatments for Iron Deficiency (ID): Prospective Organic Iron Fortification. Curr Pharm Des 2019; 25:325-332. [DOI: 10.2174/1381612825666190319111437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022]
Abstract
Iron deficiency, one of the most common nutritional deficient disorders, frequently affects infants,
adolescents and pregnant women and impairs growth, development and immune responses. Iron deficiency may
also be secondary to gastrointestinal conditions such as gastrectomy and inflammatory bowel disease, as well as
cancer and chronic uremia. Iron supplementation is the most commonly selected treatment option for iron deficiency.
This review summarizes the iron compounds currently recommended for the iron fortification of foods
and for clinical use. Additionally, this review discusses and compares the important aspects of high-quality iron
compounds/products and classes of compounds that enhance iron bioavailability. The development of efficient
iron fortification methods remains the most cost-effective and long-term approach to the treatment of iron deficiency
or related anemia. To date, no orally administered options for iron fortification can sufficiently replace the
parenteral administration of iron supplements, which includes the intramuscular injection of iron-dextran to neonatal
piglets and intravenous injection of iron supplements to patients with gastrointestinal disorders. Iron
bioavailability may be enhanced by encouraging customers to ingest iron-enriched foods together with dietary
sources of vitamin C, folic acid and/or oligosaccharides.
Collapse
Affiliation(s)
- Dan Wan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Qinghua Wu
- College of Life Science, Yangtze University, Jingzhou, China
| | - Hengjia Ni
- Academician Workstation of Hunan Baodong Farming Co. Ltd., Hunan 422001, China
| | - Gang Liu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Zheng Ruan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Yulong Yin
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| |
Collapse
|
4
|
Feralgine™ a New Approach for Iron Deficiency Anemia in Celiac Patients. Nutrients 2019; 11:nu11040887. [PMID: 31009990 PMCID: PMC6520849 DOI: 10.3390/nu11040887] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 03/26/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Celiac disease (CD) is an immunologically-mediated disorder characterized by duodenal mucosa villi atrophy. Iron absorption is usually reduced in celiac patients making every kind of oral iron treatment unhelpful because of malasorption. Feralgine™ is a new product that has been demonstrated to be more bioavailable. As such, the aim of our study was to evaluate the absorption of Feralgine™ in adult patients with CD. Methods: Twenty-six adults affected by Iron Deficiency Anemia (IDA), of which 14 were also affected by CD and 12 were not affected by CD, were enrolled. An oral iron absorption test (OIAT) was performed in each patient by administrating Feralgine™, and serum iron was evaluated at baseline (T0) and after 2 h (T1) from the oral iron ingestion. Results: The OIAT was well tolerated in all patients, and, surprisingly, an equivalent statistically significant improvement in serum iron occurred in the two groups of patients (IDA plus CD: T0 = 28.21 µg/dL vs. T1 = 94.14 µg/dL p = 0.004 and IDA without CD: T0 = 34.91 µg/dL vs. T1 = 118.83 µg/dL, p = 0.0003). Conclusions: These results demonstrated the high absorption of Feralgine™ in celiac patients, confirming our previous data obtained with Ferrous Bysglicinate in children with CD.
Collapse
|
5
|
Mazza GA, Marrazzo S, Gangemi P, Battaglia E, Giancotti L, Miniero R. Oral iron absorption test with ferrous bisglycinate chelate in children with celiac disease. Minerva Pediatr 2016; 71:139-143. [PMID: 27830928 DOI: 10.23736/s0026-4946.16.04718-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Celiac disease (CD) is an immunologically-mediated enteropathy resulting in small-bowel mucosal villous atrophy with crypt hyperplasia. Iron malabsorption is usually observed in CD. Only few studies investigated oral iron absorption in subjects with gastrointestinal diseases and Iron Deficiency Anemia (IDA), using the oral iron absorption test (OIAT). We considered useful to investigate the OIAT, using ferrous bisglycinate chelate (FBC), in patients with CD at diagnosis or on gluten free diet (GFD) from at least 1 year. METHODS A total of 25 patients with CD (3-18 years old) and iron depletion, at diagnosis of CD (N.=12) or on GFD from at least 12 months (N.=13), were considered. Serum iron was evaluated at baseline (T0) and after 3 hours (T1) from the oral iron ingestion. Statistical analyses were conducted using SPSS 21.0 software for Mac. RESULTS OIAT was well tolerated by all patients. An important increase of the serum iron at T1, of at least twice the baseline values, occurred in all patients except in one (P value <0.0005). CONCLUSIONS These results demonstrated good efficacy of the FBC, not only in patients with CD on GFD but also in children with newly diagnosed CD with the characteristic intestinal lesions.
Collapse
Affiliation(s)
- Giuseppe A Mazza
- Unit of Pediatrics, Pugliese-Ciaccio Hospital, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Santina Marrazzo
- Unit of Pediatrics, Pugliese-Ciaccio Hospital, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Pietro Gangemi
- Clinical Chemistry Laboratory, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | | | - Laura Giancotti
- Unit of Pediatrics, Pugliese-Ciaccio Hospital, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Roberto Miniero
- Unit of Pediatrics, Pugliese-Ciaccio Hospital, Magna Graecia University of Catanzaro, Catanzaro, Italy -
| |
Collapse
|
6
|
Kotkiewicz A, Donaldson K, Dye C, Rogers AM, Mauger D, Kong L, Eyster ME. Anemia and the Need for Intravenous Iron Infusion after Roux-en-Y Gastric Bypass. PLASMATOLOGY 2015; 8:9-17. [PMID: 26078589 PMCID: PMC4462165 DOI: 10.4137/cmbd.s21825] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/11/2015] [Accepted: 03/08/2015] [Indexed: 01/14/2023]
Abstract
The frequency of anemia, iron deficiency, and the long-term need for IV iron following Roux-en-y gastric bypass (RYGB) surgery has not been well characterized. Three-hundred and nineteen out of 904 consecutive subjects who underwent RYGB at Penn State Hershey Medical Center from 1999 to 2006 met the inclusion criteria for a preoperative complete blood count (CBC) and at least one CBC >6 months following surgery. Cumulative incidence of anemia 7 years post procedure was 58%. Menstruation status and presence of preoperative anemia were predictive of anemia by univariate analysis and multivariable Cox regression (P = 0.0014 and 0.044, respectively). Twenty-seven subjects, primarily premenopausal women, representing 8.5% of the cohort and 22% of the 122 anemic subjects, needed intravenous (IV) iron a mean of 51 months postoperatively for anemia unresponsive or refractory to oral iron. The risk for development of anemia necessitating IV iron therapy following RYGB is highest in menstruating women and continues to increase for many years, even in post-menopausal women. Well-designed prospective studies are needed to identify the incidence of iron deficiency anemia and the patient populations at increased risk for requiring IV iron replacement after RYGB surgery.
Collapse
Affiliation(s)
| | - Keri Donaldson
- Department of Pathology, Division of Clinical Pathology, Hershey, PA, USA
| | - Charles Dye
- Department of Medicine, Division of Gastroenterology, Hershey, PA, USA
| | - Ann M Rogers
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Hershey, PA, USA
| | - David Mauger
- Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lan Kong
- Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - M Elaine Eyster
- Division of Hematology/Oncology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| |
Collapse
|