Efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia / 中国当代儿科杂志

OBJECTIVES@#To study the efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia.@*METHODS@#A total of 147 children with mild iron-deficiency anemia were enrolled in this prospective study. They were divided into an intermittent iron supplementation group (n=83) and a conventional iron supplementation group (n=64). The levels of hemoglobin were measured before treatment and after 1 and 3 months of treatment. The treat response rate and the incidence rate of adverse drug reactions were compared between the two groups.@*RESULTS@#Both groups had a significant increase in the level of hemoglobin after iron supplementation (P<0.05). After 1 month of treatment, the conventional iron supplementation group had a significantly higher treatment response rate than the intermittent iron supplementation group (61% vs 42%, P<0.05). After 3 months of treatment, there was no significant difference in the treatment response between the two groups (86% vs 78%, P>0.05). The incidence rate of adverse drug reactions in the conventional iron supplementation group was significantly higher than that in the intermittent iron supplementation group (25% vs 8%, P<0.05).@*CONCLUSIONS@#For children with mild iron-deficiency anemia, although intermittent iron supplementation is inferior to conventional iron supplementation in the short-term efficacy, there is no significant difference in the long-term efficacy between the two methods, and compared with conventional iron supplementation, intermittent iron supplementation can reduce the incidence of adverse drug reactions, alleviate family financial burdens, and improve treatment compliance of children, thus holding promise for clinical application.

Iron intake is positively associated with viral load in antiretroviral naïve Brazilian men living with HIV

BACKGROUND Iron homeostasis contribute for the human immunodeficiency virus (HIV) pathogenesis. OBJECTIVES We assessed the iron intake pattern in antiretroviral naïve Brazilian men living with HIV correlating with clinical and nutritional parameters. METHODS The iron consumption mean was estimated according to a food frequency questionnaire (FFQ), and a 3-day food record (3dFR) submitted to the patients. HIV viral load, CD4+ T cell counts, serum iron, haematological and anthropometrics parameters were recorded. FINDINGS Fifty-one HIV-infected adult men naïve for antiretroviral therapy (ART) were enrolled. The mean age of participants was 35 (SEM ± 1.28) years old, with mean time of HIV-1 infection of 1.78 (0-16.36, min-max) years. Majority (41.18%) had complete secondary, and 21.57% had tertiary educational level. The income was around 1x (54.90%) to 2x (41.18%) minimum wage. Fifty-four percent showed normal weight, while 40% were overweight. The patients showed normal mean values of haematological parameters, and mean serum iron was 14.40 µM (SEM ± 0.83). The FFQ showed moderate correlation with the 3dFR (ρ = 0.5436, p = 0.0009), and the mean values of iron intake were 10.55(± 0.92) mg/day, recorded by FFQ, and 15.75(± 1.51) mg/day, recorded by 3dFR. The iron intake, recorded by FFQ, negatively correlated with serum iron (ρ = -0.3448, p = 0.0132), and did not have influence in the CD4+ T cell counts [e.B 0.99 (0.97-1.01, 95% confidence interval (CI), p = 0.2]. However, the iron intake showed a positive effect in HIV viral load [e.B 1.12 (1.02-1.25, 95%CI), p < 0.01]. MAIN CONCLUSIONS This study draws attention for the importance of iron intake nutritional counseling in people living with HIV. However, more studies are required to clarify the association between high iron intake and HIV infection and outcome.

A suplementação de ferro na gravidez: orientações atuais / Iron supplementation in pregnancy: current guidelines

O ferro é um dos minerais mais abundantes na crosta terrestre e nos organismos. Participa da síntese da hemoglobina, mioglobina, além de ser co-fator de uma série de reações enzimáticas. Durante a gravidez, vários processos fisiológicos fazem com que a demanda desse micronutriente tenha um incremento significativo, o que torna necessárias maiores ingestão e absorção de ferro. Sabe-se que, durante a gestação, a quantidade de ferro absorvida nos intestinos aumenta, mas, mesmo assim, a maioria das gestantes não ingere quantidade satisfatória desse mineral, o que torna explicável a suplementação oral da dieta com ferro. Vários autores advogam que essa suplementação não deva ser feita de maneira rotineira, mas individualizada, devido a possíveis efeitos deletérios do ferro durante a gestação, dentre eles o aumento nas taxas de Diabetes Mellitus Gestacional e pré-eclâmpsia. O objetivo desse estudo é realizar uma revisão na literatura médica que versa sobre o assunto, criando uma análise crítica sobre a suplementação oral rotineira de ferro e seus possíveis riscos durante a gestação

Iron is one of the most abundant mineral on the Earth's crust and organisms. It is essential for the synthesis of hemoglobin and myoglobin; besides, it acts as a co-factor in a series of enzymatic reactions. During pregnancy, multiple physiological adaptations cause an increase in the demand of micro-nutrients, which makes further ingestion and absorption of iron necessary. It is known that, during pregnancy, the amount of iron absorbed in the intestines increases, but even so, most pregnant women do not have an adequate iron intake, which makes the oral supplementation of diet with iron a reasonable action. A considerable number of authors advocate that this supplementation should not be made as a routine, but individualized, due to the possible deleterious effects of iron during pregnancy, among them the increased risk of Gestational Diabetes and pre-eclampsia. The aim of this study is to perform a review in the medical literature about the subject, creating a critical analysis of routine iron supplementation and its possible risks during pregnancy

Efecto de altos niveles de hierro y molibdeno sobre la nutrición del cobre en vacas mestizas / High levels of dietary iron and molybdenum on copper nutrition in cross bred cows

Para estudiar el efecto de altos niveles de hierro (Fe) y molibdeno (Mo) sobre la nutrición del cobre (Cu), 20 vacas vacías, mestizas Bos taurus x Bos indicus, de 394 kg PV y de más de dos partos, fueron distribuidas según un diseño completamente aleatorizado en los siguientes tratamientos: (1) Testigo (T): 10 ppm Cu; (2) Mo: 10 ppm Cu y 20 ppm Mo; (3) Fe: 10 ppm Cu y 1000 ppm Fe; (4) MoFe: 10 ppm Cu y 1000 ppm Fe y 20 ppm Mo. Las vacas fueron alimentadas ad libitum con pasto de corte (Panicum maximun y Andropogun gayanus), 1,5 kg de alimento por animal día -1 (harina de maíz: 95 por ciento; urea: 5 por ciento) que contenía los minerales en las proporciones indicadas. Se tomaron muestras de suero sanguíneo para determinar Cu, Fe y la actividad de la ceruloplasmina. A través de biopsias, se tomaron muestras del tejido hepático cada 28 días, durante 192 días, para determinar la concentración de Cu, Fe y Mo. El consumo de pasto estuvo alrededor de 10 kg MS/animal día -1. El peso vivo no presentó diferencias entre tratamientos con valores de 385; 353; 396 y 382, kg para T, Mo, Fe, MoFe, respectivamente. La concentración de Cu sérico (µg ml-1) fue de 0,81; 0,67; 0,50 y 0,71, respectivamente para el mismo orden de los tratamientos, siendo Fe el más bajo (P<0,05). Para el Fe sérico, se observaron diferencias significativas entre los tratamientos (P<0,05), con valores de 1,49; 1,67; 2,08 y 1,93 µg ml -1, para el testigo, Mo, Fe y MoFe, respectivamente. Los valoresde Cp (absorbancia) fueron 0,093; 0,085; 0,084 y 0,087, para el testigo, Mo, Fe y MoFe, respectivamente, sin diferencias significativas entre tratamientos. Los niveles de Cu hepático fueron diferentes (P<0,01) entre tratamientos, con valores más altos (mg kgMS-1) para T (71,9) y más bajos para Mo (26,6), Fe (30,8) y MoFe (31,4). La concentración de Fe en el hígado registró valores (mg kgMS-1) de 559,0; 513,3; 559,8 y 797,3para T, Mo, Fe y MoFe, respectivamente, sin diferencias significativas...

To evaluate the effect of high levels of iron (Fe) and molybdenum (Mo) on copper (Cu) nutrition, 20 dry cross bred cows, Bos Taurus x Bos indicus, of 394 kg BW, with no less than two calving, were assigned to the following treatments: (1) Control (C); 10 ppm Cu(2); Mo 10 ppm + 20ppm Cu (Mo); (3) 10ppm Cu+ 1000 ppm Fe (Fe); and (4) 10 ppmCu+ 1000 ppm Fe+ 20 ppm Mo ( MoFe). Cows were fed chopped forage ad libitum (Panicum maximum and Andropogun gayanus) and 1.5 kg concentrate feed (corn meal, 95% and urea, 5%) containing minerals in the proportions as previously indicated. Serum samples were taken every 28 days for Cu, Fe and cerulopasmine (Cp) activity. Liver sample, via biopsy, at the same time intervals, were also taken to measure Cu, Fe and Mo concentrations. The experiment lasted 192 days. Body weights were not affected by treatments: 385; 353; 396 and 382 kg, respectively for T, Cu, Fe,and MoFe. Copper serum concentration values (µg ml-1) were 0.81, 0.67, 0.50 and 0.71, respectively for the same order, being Fe the lowest (P<0.05). Ceruloplasmine absorbancy values were not different among treatments. Liver copper concentration values were significantly different (P<0.05) among treatments, with higher value (mg KgMS-1) for T (71.9) and lower for Mo (26.6), Fe (30.8) and MoFe (31.4). Liver iron concentration (mg kgMS-1) values were not different among treatments, with values of 559.0, 513.3, 559.8, and 797.3 respectively for C, Mo, Fe and MoFe. Liver Mo take up (mg kgMS-1) was greater (P<0.01) for Mo treatment (19.9) and MoFe (15.8) in relation to T (1.7) and Fe (1.9). Results indicate that high levels of Mo and Fe decreased liver copper, below critical levels. However, the reduction of liver copper was no associated with clinical sign of copper efficiency. Probably lower levels of liver copper are required to show changes in ceruloplasmine and blood serum concentrations as well as other biochemical changes at tissue level...

Assessmrent of iron overload in thalassaemic patients by magnetic resonance imaging: a pilot study.

The patients of thalassaemia major need repeated blood transfusion which leads to excess iron deposition in various organs like liver, heart, pituitary etc. This iron accumulation causes various complications and ultimately organs' failure. There is no non-invasive, standard and reliable method to know the status of iron overload in various organs of the body. This paper attempts to use magnetic resonance imaging to know the liver iron overload in 8 thalassaemic patients as a pilot study. Eight children suffering with thalassaemia and 3 controls who were the normal siblings of the patient group underwent magnetic resonance imaging of the abdomen using spin-echo T, weighted sequence. Blood serum ferritin levels in the patients' group were also determined on the same day of magnetic resonance imaging examination. It was observed that the ratio of magnetic resonance imaging signal intensity (in spin-echo T1 weighted image) in paraspinous muscle to liver was significantly different in normal control (0.65) compared to that in thalassaemia patients (2.1 to 11.4 depending upon extent of iron deposition). The magnetic resonance signal intensity ratio correlated with the blood serum ferritin level of patients (p = 0.01) which is generally taken as indirect measure of body iron burden. Spin-echo sequence is the simplest imaging sequence and it increases the chance of its routine use. The study concludes that magnetic resonance imaging has good potential to quantify the liver iron deposition non-invasively and may denote the efficacy of iron-chelation therapy which is used to reduce the body iron burden in these patients.

Suplementación con hierro / Iron Supplemetation

La suplementación con hierro es una de las estrategias utilizadas en la prevención de la deficiencia de hierro, cuando la población en riesgo no tiene acceso a alimentos fortificados con hierro, o durante el embarazo debido a los elevados requerimientos de hierro que deben ser cubiertos en un período corto de tiempo. En nuestro país, basado en la prevalencia de la deficiencia de hierro, la suplementación profiláctica se ha dirigido a la mujer embarazada a partir del segundo trimestre de la gestación y al lactante que no está recibiendo alimentos fortificados con hierro. Sería de un alto interés considerar la suplementación de mujeres en edad fértil lo que permitiría que éstas abordaran el inicio del embarazo con unas reservas de hierro adecuadas y así evitar los efectos adversos de la anemia ferropriva. Se puede aumentar la efectividad de la suplementación con hierro mediante una adecuada motivación y educación, empleo de las dosis de hierro mas bajas recomendadas y utilización de preparados de hierro que presenten una baja incidencia de efectos adversos gastrointestinales.