Serum iron concentration as a tool to measure relative iron absorption from elemental iron powders in man

Objective: To present a new method for measuring the relative bioavailability (RBV) of commercial elemental iron powders by investigating induced changes of serum iron concentration (S‐Fe) in relation to ferrous sulphate (FeSO₄). Earlier studies have shown that in a group of subjects there is good agreement between the increase in S‐Fe and the amount of iron absorbed from a simple iron salt as FeSO₄. Methods: The study included two groups of male blood donors (n=2×16 subjects) who were served three meals with an interval of approximately nine weeks between each one. In one group the meal was fortified with reduced iron, ferrous sulphate or no iron at all. In the other group the meal was fortified with electrolytic iron, ferrous sulphate or no iron. The S‐Fe increase was followed for 6?h. Studying the non‐iron meals was necessary so that the basal diurnal variation in the S‐Fe during the six hours could be measured and subtracted. Results: The mean S‐Fe increase calculated as the area under the curve (AUC) from the reduced iron (RBV=0.43) and the electrolytic iron (RBV=0.73) differed significantly from the AUC following FeSO₄ (p=0.002 and p=0.021, respectively). The difference between the reduced and the electrolytic iron was also statistically significant (p=0.036). Conclusion: Measuring increases in S‐Fe could be a reliable and simple method to determine the RBV in comparative studies of elemental iron powders in relation to FeSO₄.     

骨髓铁与常用血清铁指标的相关性研究

目的 探讨血清铁(SI)、血清铁蛋白(SF)、总铁结合力(TIBC)、不饱和铁结合能力(UIBC)、转铁蛋白(TRF)等血清铁指标和骨髓内、外铁的相关性.方法 对112例贫血患者进行骨髓铁染色及血清常用铁指标的检测.将骨髓内、外铁与常用铁指标进行等级相关统计分析.按骨髓内、外铁变化的情况将病例分组:骨髓内、外铁均下降为...     

Thrombocytopenia secondary to iron deficiency anemia responding to iron therapy

A broad spectrum of diseases can cause anemia and thrombocytopenia. Some of these diseases are a hematological emergency; others are benign diseases, so early and accurate diagnosis is crucial in managing such patients. Usually, IDA is associated with thrombocytosis or normal platelets; however, in rare cases, IDA can be associated with thrombocytopenia; even though, thrombocytopenia that occurs with IDA responds to iron therapy. Iron therapy rarely causes transient thrombocytopenia per se. We are reporting an African female patient who is found to have thrombocytopenia secondary to iron deficiency anemia (IDA), and she responded to iron replacement therapy initially with a transient drop in platelets, followed by a rapid rise in platelets till platelets reached the normal level.     

98例血小板增多症患者血象、骨髓铁染色及铁代谢分析

目的 通过对98例血小板增多症患者血象、骨髓铁染色及铁代谢结果的回顾性分析,了解血小板增多患者在确立诊断时机体的含铁状况,协助鉴别诊断.结果 血小板＜800×109/L的患者中缺铁性贫血占40.8%;而血小板≥800×109/L的患者中原发性血小板增多症占81.5%,其中有2例患者铁蛋白水平低于正常值(占9.1%),而血清铁水平正常.结论 对于血小板数在(400～800)×109/L的患者,继发性血小板增多的可能性更大;血小板计数≥800×109/L的患者中绝大部分可以诊断为原发性血小板增多症,但仍需要排除可伴有血小板增多的其他骨髓增殖性疾病(如慢性粒细胞白血病、真性红细胞增多症等)以及同时合并反应性血小板增多的情况.     

The iron hypothesis of atherosclerosis and its clinical impact

The iron hypothesis as an alternative explanation for the gender difference in the incidence and mortality of atherosclerosis has provoked increased debates and public health concerns. In this review we summarize the historical and recent literature on the iron hypothesis and discuss several related clinical issues and their implications. Apart from misconstruction of study populations, lack of a good method to reflect the iron contents of tissues may be the major factor for causing inconsistent results from epidemi‐ological studies. Published data from 11 countries clearly indicate that the mortality from cardiovascular diseases is correlated with liver iron. We propose that redox‐active iron in tissue is the atherogenic portion of total iron stores. Recently developed magnetic resonance imaging techniques in combination with Fe chelators may allow future studies to examine this component of body iron in lesions and the whole body. Several clinical situations characterized by increased iron stores have been proposed as ‘human models’ suitable for further tests of the iron hypothesis. Patients with end‐stage renal disease may be the most unique cohort, having significant increases in their iron stores, low‐density lipoprotein (LDL) oxidation, and cardiovascular events. Other patient groups may be well suited for specific studies of different atherogenic events. With a better understanding of iron‐driven oxidative damage, well controlled and effectively designed studies on these models will finally bring us to the truth of the iron hypothesis.     

维生素AD联合铁剂治疗婴幼儿缺铁性贫血的效果

目的:观察维生素AD滴剂联合蛋白琥珀酸铁口服液治疗婴幼儿缺铁性贫血的临床效果。方法:选取安徽省庐江县人民医院儿童保健门诊缺铁性贫血患儿102例,性别不限,采用随机数字表法分为观察组(n=52)和对照组(n=50)。观察组治疗采用蛋白琥珀酸铁口服液联合维生素AD滴剂口服,对照组治疗仅采用蛋白琥珀酸铁口服液口服。治疗前分析缺铁性贫血患儿维生素A和25-羟维生素D缺乏情况,于治疗1个月后对2组治疗效果进行比较并对贫血相关指标进行分析。结果:治疗前两组缺铁性贫血患儿维生素A和25-羟维生素D缺乏严重。治疗后,观察组的显效率为61.54%,明显高于对照组的44%(P<0.05);总有效率为94.23%,也明显高于对照组的84%(P<0.05);观察组血红蛋白、血清铁和血清铁蛋白较对照组明显改善(P<0.05)。结论:维生素AD滴剂联合蛋白琥珀酸铁口服液用于婴幼儿缺铁性贫血治疗时可有效改善患儿相关的贫血指标,显著提高临床治疗效果。     

Non-transferrin-bound iron is present in serum of hereditary haemochromatosis heterozygotes

BACKGROUND: Hereditary haemochromatosis (HH) is a common autosomal recessive disease. Recently, HH heterozygosity has been identified as an independent risk factor for myocardial infarction and cardiovascular mortality. Iron may play an important role in atherogenesis by catalyzing peroxidation of low-density-lipoprotein (LDL), an essential step in atherogenesis. In iron overload conditions, non-transferrin-bound iron (NTBI) is found in serum, which can catalyze lipid peroxidation. We investigated whether sera of HH heterozygotes contain more NTBI than sera of normal controls. METHODS: In 27 treated HH homozygotes, 22 HH heterozygotes and 17 healthy control subjects, conventional parameters of iron status (serum iron, transferrin saturation, serum ferritin) were measured. NTBI was detected using HPLC after addition of nitrilotriacetic acid and pretreatment with cobalt. RESULTS: The conventional parameters of iron status were similar in the HH heterozygous group and the control group. NTBI was significantly higher in homozygotes compared to heterozygotes (1.79 micromol L-1 vs. 0.51 micromol L-1, 95% CI of the difference = 0.6-1.95, P < 0.001), and controls (1.79 micromol L-1 vs. - 0.3 micromol L-1, 95% CI of the difference = 1.36-2.81, P < 0.001). The difference in NTBI between the heterozygous subjects and control subjects was also significant (0.51 micromol L-1 vs. - 0. 3 micromol L-1, 95% CI of the difference = 0.05-1.57, P < 0.05). CONCLUSION: Phlebotomy treated HH homozygotes maintain a high and potentially harmful serum NTBI. HH heterozygotes have a higher serum NTBI than normal controls. The reported increased risk of cardiovascular events in heterozygous haemochromatosis may be explained by NTBI-catalyzed LDL peroxidation.     

网织红细胞血红蛋白含量在铁缺乏诊断中的应用研究

目的研究网织红细胞血红蛋白含量(CHr)对铁缺乏的诊断价值。方法用ADVIA120血细胞分析仪检测常用血液学指标,包括CH(单个红细胞血红蛋白含量)、MCH、HGB、MCV、RDW和CHr。同时测定血清铁代谢指标,包括血清铁(SI)、血清总铁结合力(TIBC),血清转铁蛋白饱和度(TfS)、血清铁蛋白(SF)。以SF为“金标准”,统计分析CHr的对铁缺乏的诊断效率。结果518例病人和141例健康人的CH均低于CHr,二者有良好的相关性(P<0001)。铁缺乏病人的CHr(265±44pg)显著减低,与铁正常病人(332±39pg)和健康人(331±14pg)的CHr有显著差异(P<00001),缺铁性贫血病人的CHr降至最低(252±35pg)。当临界值为285pg时,CHr诊断铁缺乏的灵敏度和特异性分别为857%和913%。结论CHr优于传统的血液学指标,可准确地诊断铁缺乏和缺铁性贫血,而且简便、快速、价廉,可广泛用于铁缺乏的筛查。     

献血者铁缺乏:现状与管理

随着全球无偿献血的发展,人们对献血者铁缺乏风险的认识也在不断提高.目前已知献血的唯一明显缺点就是潜在的铁缺乏风险.因此,预防献血者铁缺乏的发生十分必要.近20年内,在输血医学伦理规范的大背景下,遵循对献血者的尊重和无伤害原则,促成了基于国家和地区层面针对献血者铁代谢管理实施干预的发展.近10年美国血库联合会(AABB)...     

健脾生血颗粒联合多糖铁复合物胶囊治疗妊娠期缺铁性贫血的效果

目的分析健脾生血颗粒联合多糖铁复合物胶囊治疗妊娠期缺铁性贫血(IDA)的效果。方法选取2018年11月至2020年3月在我院产科定期产检的IDA孕妇90例,将其随机分为A组(45例,多糖铁复合物胶囊)和B组(45例,健脾生血颗粒联合多糖铁复合物胶囊)。比较两组的治疗效果。结果治疗后,B组的Hb水平、MCV、MCHC显著高于A组(P<0.05)。治疗后,B组的SI、TSAT、Hepc水平显著高于A组,TRF水平显著低于A组(P<0.05)。B组的治疗总有效率显著高于A组(P<0.05)。结论健脾生血颗粒联合多糖铁复合物胶囊治疗妊娠期IDA可有效改善患者的血常规指标和铁代谢指标水平,提高临床治疗效果,且安全可靠。     

Non-haem iron transport in the rat proximal colon

BACKGROUND: Only 10% of dietary iron is absorbed in the duodenum which implies that 90% (approximately 9 mg day(-1)) reaches the lower small intestine and colon. Therefore the purpose of this study was to assess the iron transport capacity of the rat proximal colon and to determine whether iron absorption is regulated by changes in dietary iron content. MATERIALS AND METHODS: Rats were fed for 14 days on either iron adequate (44 mg Fe kg(-1) diet) or iron-deficient (< 0.5 mg Fe kg(-1) diet) diets. The 59Fe transport across the colonic epithelium and its subsequent appearance in the blood were measured in vivo. In separate studies the colon was excised and used to measure divalent metal transporter expression. RESULTS: Divalent metal transporter (DMT1) was expressed at the apical membrane of the surface epithelium in rat proximal colon. In animals fed an iron-deficient diet, DMT1 mRNA and protein expression were increased. This was accompanied by a significant increase in tissue 59Fe uptake. CONCLUSIONS: The proximal colon can absorb non-haem iron from the intestinal lumen. The purpose of this mechanism remains to be elucidated.     

多糖铁复合物胶囊和硫酸亚铁片治疗缺铁性贫血的疗效比较

目的：观察多糖铁复合物胶囊和硫酸亚铁片治疗缺铁性贫血的临床疗效。方法：选择2012年10月-2013年10月确诊的缺铁性贫血患者190例,随机分为两组,各95例。对照组口服硫酸亚铁片,每次2片,每日3次,治疗组口服多糖铁复合物胶囊,每次2粒,每日1次。治疗14周,观察两组患者治疗前后血常规各项指标变化情况以及临床疗效。结果：两组患者治疗后血常规红细胞指标均有所改善,治疗组与对照组比较差异有统计学意义（ P 〈0.05）,白细胞和血小板指标变化比较差异无统计学意义（P〉0.05）。治疗组治疗后和对照组治疗后总有效率比较,差异有统计学意义（P 〈0.05）。结论：口服多糖铁复合物胶囊改善缺铁性贫血的效果优于硫酸亚铁片,是一种安全有效的补铁制剂。