Iron nutrition in childhood malignancy

Undernutrition as a risk factor for cervical intraepithelial neoplasia: a case-control analysis

To evaluate the relationship between cervical intraepithelial neoplasia (CIN) and undernutrition, a pair-matched case-control study was conducted in a low-income urban population. As a broad measure of nutritional status, serum albumin, serum ferritin, hematocrit, percent desirable weight, and percent calories consumed as protein were examined. Cases (n = 102) had biopsy-confirmed CIN I, II, or III, and clinic controls (n = 102), matched on age, race, and clinic, had normal Pap smears. Survey-collected data and frozen serum were utilized to study the hypothesized association. Crude and adjusted odds ratios and 95% confidence intervals were estimated using conditional logistic regressions. Results suggest a protective role for serum ferritin for those in the highest quartile relative to those in the lowest quartile. Controlling for smoking and monthly personal income, an adjusted odds ratio of 0.2 with a corresponding 95% confidence interval of 0.1-0.7 was observed. Similar findings were noted when all other available CIN risk factors were controlled. In addition, a dose gradient was present for dietary iron intake (p = 0.01). No associations were observed between each of the other undernutrition indexes and CIN. Although only high levels of serum ferritin were associated with a protective effect against CIN, when coupled with the results from other studies that suggest carotenoids, folates, and vitamin C to be protective, the overall hypothesis that poor nutriture is associated with CIN remains viable. Lack of an association with the other nutritional indexes may reflect the relatively sufficient nutritional status of low-income individuals residing in the United States, as opposed to the undernourished population of the Third World.

Serum trace element concentrations and iron metabolism in allogeneic bone marrow transplant recipients

Serum trace element concentrations, parameters of iron metabolism and serum protein concentrations were investigated in thirteen adult recipients of bone-marrow transplants receiving total parenteral nutrition. Six of the patients died during the four weeks follow-up. Serum zinc concentrations were initially low but increased during the treatment. They also tended to be lower in dying patients than in survivors. Concentrations of serum copper and selenium remained unaltered. Serum iron started to increase during the preconditioning and remained raised for three weeks. No significant changes occurred in serum transferrin levels. Transferrin saturation increased during the preconditioning and started to return to normal after day +14. Serum ferritin was greatly raised from the start and increased further during the procedure. Routine trace element substitution seemed to be sufficient during total parenteral nutrition with the possible exception of zinc. A return to normal transferrin saturation after day +14 may be an early favourable sign that the graft is taking and hematopoietic recovery commencing.