Correlation of Iron Status and Micronutrients With Anaemia of Childhood Haematopoietic Malignancies: A Study From Northern India.

BACKGROUND: Most cancer patients undergoing chemotherapy develop anemia during their course of treatment. There is a need for early treatment for chemotherapy-induced anemia to prevent morbidity and mortality. MATERIAL AND METHOD: This is a hospital-based study, conducted over one year and included 59 children who are known cases of hematological malignancy aged up to 18 years. Standard methods were used to measure micronutrients and complete blood count. Statistical analysis was done using SPSS for Windows, Version 15.0 (Released 2006; SPSS Inc., Chicago, United States). RESULTS: The majority of subjects (n=21; 35.6%) were aged six to nine years with male dominance. Micronutrient deficiency and significant anemia were noted in 40-50% and 64.4% of cases, respectively. Both malignancy and blood indices showed no association with micronutrients. CONCLUSION: Anemia with micronutrient deficiency is common in children with hematopoietic malignancies receiving chemotherapy. However, no significant association was noted between red cell indices and levels of micronutrients.

Clinicopathological study on camel mastitis at Matrouh Governorate.

Objective: Camel mastitis is indeed a serious problem that can have significant impacts on animal health and production as well as pose a potential public health hazard. This work aimed to identify the bacterial species responsible for camel mastitis and evaluate the associated immunological and clinicopathological alterations in infected camels. Materials and Methods: Raw milk and blood samples were collected from 40 apparently healthy she-camels, and 40 she-camels suffered from clinical mastitis (CMG). Milk samples were subjected to bacteriological examination. Serum immunological, biochemical, and hematological parameters were estimated and statistically analyzed. Results: Similar bacterial species were obtained from the two groups with different isolation rates.Staphylococcus epidermidis and Escherichia coliwere the dominant species in the apparently healthy group, whilePseudomonas aeruginosaandBacillus cereus were the dominant species in CMG. A significant (p < 0.05) elevation of the pro-inflammatory cytokines, acute phase proteins (APPs), free radicals, total protein, Glob, kidney and liver function tests, and triglyceride concentrations were detected in CMG, and a significant (p < 0.05) decrease in the anti-inflammatory cytokine, antioxidants, Alb, glucose, and T/LDL/HDL-cholesterol concentrations was observed in CMG. Microcytic hypochromic anemia with hypoferremia, hypotransferrinemia, hyperferritinemia, and neutrophilic leukocytosis was depicted in CMG. The estimated pro-inflammatory cytokines, APPs, and total antioxidant capacity (TAC) yielded high sensitivity and specificity, but the highest likelihood ratio was for TAC, fibrinogen (Fb), and ferritin, and the highest percentages of increase were for IL-1α and IL-1ß. Conclusion: The study emphasizes the importance of hygienic preventive measures to control camel mastitis and the importance of supportive treatment to reverse the hemato-biochemicaland iron profile changes that result from the immune response in mastitic she-camels. TAC, Fb, ferritin, IL-1α, and IL-1ß are good biomarkers for camel mastitis.

Iron profile of pregnant sickle cell anemia patients in Odisha, India

ABSTRACT Introduction: During pregnancy, the iron requirement increases to meet the optimal growth of the fetus and prevent iron deficiency anemia-related complications in the mother. However, in sickle cell disease (SCD) primarily due to repeated blood transfusions and hemolysis-induced recycling of iron, its supplementation during pregnancy remains questionable and may be harmful. Methods: Twenty-five pregnant women with homozygous SCD and 25 pregnant women with normal hemoglobin variants were included as cases and control, respectively. Pregnancy and sickle cell anemia (SCA) were diagnosed using standard protocols. The serum iron, serum ferritin, total iron-binding capacity (TIBC), percentage transferrin saturation and C-reactive protein were estimated, as per the manufacturer's protocol. The complete blood count was performed. The unpaired 't-test' was performed using the SPSS v23.0 and the principal component analysis (PCA) was performed using the online software MetaboAnalyst for statistical analysis. Main Results: The studied cases had significantly lower mean hemoglobin and higher mean corpuscular volume (MCV), compared to controls. The mean serum-iron, serum-ferritin and percentage transferrin-saturation in the cases were significantly higher than that of the controls, while the TIBC was lower in the cases (p < 0.0001). The mean level of serum iron, ferritin, percentage transferrin saturation and TIBC were 309.44 ± 122.40mcg/dl, 860.36 ± 624.64ng/ml, 42.6 ± 17.30% and 241.32 ± 96.30 mcg/dl, respectively, in the cases and 95.36 ± 41.90mcg/dl, 122.28 ± 49.70ng/ml, 15.83 ± 3.10% and 492.6 ± 149.40mcg/dl in the controls, respectively. Higher MCV, mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) with lower hemoglobin (Hb) were noted in the cases. The PCA revealed that the cases were more heterogeneous in terms of the variability of the iron status and hematological indices than the controls. Conclusion: The current study shows iron sufficiency in most cases of pregnancy with SCA and suggests that evaluation of iron status must be made before initiating iron prophylaxis in pregnant women with SCA, especially in regions having a high prevalence of sickle cell hemoglobinopathy.

Studying ferroptosis and iron metabolism pre- and post-radiotherapy treatment in breast cancer patients.

BACKGROUND: Radiotherapy (RT) is an important part of the treatment of many tumors. Radiotherapy causes oxidative damage in all cellular compartments, including lipid membrane, on a random basis. Toxic lipid peroxidation accumulation has only lately been linked to a regulated type of cell death known as ferroptosis. Iron is required for ferroptosis sensitization in cells. AIM OF THE WORK: This work aimed to study ferroptosis and iron metabolism before and after RT in BC patients. SUBJECTS AND METHODS: Eighty participants were included divided into two main groups: group I: 40 BC patients treated with RT. Group II: 40 healthy volunteers' age and sex matched as control group. Venous blood samples were collected from BC patients (prior to and after RT) and healthy controls. Glutathione (GSH), malondialdehyde (MDA), serum iron levels and % of transferrin saturation were measured by colorimetric technique. Ferritin, ferroportin, and prostaglandin-endoperoxide synthase 2 (PTGS2) levels were assessed by ELISA. RESULTS: Serum ferroportin, reduced glutathione, and ferritin showed significant decrease after radiotherapy in comparison to before radiotherapy. However, there was significant increase in serum PTGS2, MDA, % of transferrin saturation and iron levels after radiotherapy in comparison to before radiotherapy. CONCLUSION: Radiotherapy induced ferroptosis in breast cancer patients as a new cell death mechanism and PTGS2 is a biomarker of ferroptosis. Iron modulation is a useful approach for the treatment of BC especially if combined with targeted therapy and immune-based therapy. Further studies are warranted to be translated into clinical compounds.

Iron profile of pregnant sickle cell anemia patients in Odisha, India.

INTRODUCTION: During pregnancy, the iron requirement increases to meet the optimal growth of the fetus and prevent iron deficiency anemia-related complications in the mother. However, in sickle cell disease (SCD) primarily due to repeated blood transfusions and hemolysis-induced recycling of iron, its supplementation during pregnancy remains questionable and may be harmful. METHODS: Twenty-five pregnant women with homozygous SCD and 25 pregnant women with normal hemoglobin variants were included as cases and control, respectively. Pregnancy and sickle cell anemia (SCA) were diagnosed using standard protocols. The serum iron, serum ferritin, total iron-binding capacity (TIBC), percentage transferrin saturation and C-reactive protein were estimated, as per the manufacturer's protocol. The complete blood count was performed. The unpaired 't-test' was performed using the SPSS v23.0 and the principal component analysis (PCA) was performed using the online software MetaboAnalyst for statistical analysis. MAIN RESULTS: The studied cases had significantly lower mean hemoglobin and higher mean corpuscular volume (MCV), compared to controls. The mean serum-iron, serum-ferritin and percentage transferrin-saturation in the cases were significantly higher than that of the controls, while the TIBC was lower in the cases (p < 0.0001). The mean level of serum iron, ferritin, percentage transferrin saturation and TIBC were 309.44 ± 122.40mcg/dl, 860.36 ± 624.64ng/ml, 42.6 ± 17.30% and 241.32 ± 96.30 mcg/dl, respectively, in the cases and 95.36 ± 41.90mcg/dl, 122.28 ± 49.70ng/ml, 15.83 ± 3.10% and 492.6 ± 149.40mcg/dl in the controls, respectively. Higher MCV, mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) with lower hemoglobin (Hb) were noted in the cases. The PCA revealed that the cases were more heterogeneous in terms of the variability of the iron status and hematological indices than the controls. CONCLUSION: The current study shows iron sufficiency in most cases of pregnancy with SCA and suggests that evaluation of iron status must be made before initiating iron prophylaxis in pregnant women with SCA, especially in regions having a high prevalence of sickle cell hemoglobinopathy.

Specific test panels for patients with heart failure: implementation and use in the Spanish National Health System.

Objectives: The use of specific test panels (STP) for heart failure (HF) could help improve the management of this condition. The purpose of this study is to gain an insight into the level of implementation of STPs in the management of HF in Spain and gather the opinions of experts, with a special focus on parameters related to iron metabolism. Methods: The opinions of experts in HF were gathered in three stages STAGE 1 as follows: level of implementation of STPs (n=40). STAGE 2: advantages and disadvantages of STPs (n=12). STAGE 3: level of agreement with the composition of three specific STPs for HF: initial evaluation panel, monitoring panel, and de novo panel (n=16). Results: In total, 62.5% of hospitals used STPs for the clinical management of HF, with no association found between the use of STPs and the level of health care (p=0.132) and location of the center (p=0.486) or the availability of a Heart Failure Unit in the center (p=0.737). According to experts, the use of STPs in clinical practice has more advantages than disadvantages (8 vs. 3), with a notable positive impact on diagnostics. Experts gave three motivations and found three limitations to the implementation of STPs. The composition of the three specific STPs for HF was viewed positively by experts. Conclusions: Although the experts interviewed advocate the use of diagnostic and monitoring STPs for HF, efforts are still necessary to achieve the standardization and homogenization of test panels for HF in Spanish hospitals.

Association between neutrophil gelatinase-associated lipocalin (NGAL) and iron profile in chronic renal disease.

NGAL, also known as lipocalin 2, is a stress protein located on the cell surface that is known for its involvement in iron transport. This study is aimed to evaluate the correlation between the iron profile and NGAL concentration in serum among chronic kidney disease patients under dialysis in order to find its diagnostic value with regards to iron deficiency anaemia (IDA). 47 patients under chronic haemodialysis in end-stage renal disease (ESRD) and 15 healthy controls were evaluated to determine the correlation between serum NGAL concentration and IDA characteristics. Our results recorded a significant correlation between IDA (TSAT < 20%) and NGAL serum concentration with a Spearman's coefficient of 0.314. Serum NGAL was also significantly related to serum ferritin, TIBC, uric acid, creatinine and blood sugar whereas, an inverse relationship with albumin, total cholesterol and LDL. Our study reports a positive correlation between IDA and serum NGAL levels in CKD patients.

Association Between Helicobacter pylori Infection and Serum Iron Profile.

INTRODUCTION: Helicobacter pylori (H. pylori) infection is reported to be the most frequent cause of morbidity and mortality in cases of upper gastrointestinal (GI) diseases. There is paucity of research between the possible association of H. pylori and iron stores and iron deficiency anemia (IDA). In this study, we will determine if there is an association between serum total iron-binding capacity (TIBC), serum iron and ferritin levels, and H. pylori infection. METHODS: This case-control study was conducted in the gastroenterology ward of a major hospital in Pakistan from December 2020 to April 2021. Three hundred patients diagnosed with H. pylori were enrolled along with 300 participants in the control group. H. pylori was confirmed or excluded with the help of Giemsa stained gastric biopsy specimens. Blood was sent to the laboratory to test for ferritin, serum iron, and TIBC. Each sample was drawn in the morning to avoid any fluctuations. RESULTS: The mean serum iron level was significantly lower in participants with H. pylori infection compared to those who did not have H. pylori infection (110.72 ± 28.38 ug/dL vs. 162.5 ± 21.18 ug/dL; p-value: <0.0001). Serum ferritin level was significantly higher in participants with H. pylori infection (536.82 ± 117.0 ng/dL vs. 391.31 ± 101.54 ng/dL; p-value: <0.0001). CONCLUSION:  In comparison with the control group, TIBC and serum iron levels were found to be lower in the case group.

Evidence-Based Discriminant Analysis: A New Insight into Iron Profile for the Diagnosis of Parkinson's Disease.

INTRODUCTION: Parkinson's disease is the second most common neurodegenerative disorder. Neurochemical studies have implicated metals in pathogenesis of PD. OBJECTIVES: To examine the association of serum iron, transferrin, ferritin, transferrin saturation and UIBC in PD patients and to derive the Discrimination Function with scores of these variables to correctly classify PD cases and healthy controls. METHODS: In the present study, identification of biomarker pool in case-control study involving 79 PD cases and 80 healthy controls were performed. RESULTS: The results of independent t-test analysis showed that PD cases presented significantly higher (P < 0.01) level of transferrin, total iron binding capacity (TIBC), unsaturated iron binding capacity (UIBC) and urea than controls. As only one-third of transferrin is saturated with iron, so the transferrin present in serum has the extra binding capacity (67%), this is called UIBC. Discriminant analysis was performed to determine the factors that best discriminate between the categories of an outcome variables (Disease status = PD and Control) and total of five biochemical independent variables (UIBC, transferrin, iron, transferrin saturation, and copper) were taken into consideration. UIBC has emerged out to be highest discriminating, powerful and independent variable among considered independent variables, which indicates iron deficiency. After development of Discriminant Function (Z) and calculation of discriminant function cut points, a cross-validation analysis of PD cases and controls were conducted. The sensitivity of the developed model was 98.73% and specificity 83.75%. Receiver operating characteristics (ROC) was plotted, and the findings of ROC curve corroborated with the results obtained from discriminant function analysis. CONCLUSION: Prospective validation of Discriminant model in large cohort is warranted in future studies.

An Evaluation of the Efficacy, Safety, and Tolerability of Abhraloha Compared With Oral Ferrous Ascorbate on Iron Deficiency Anemia in Women: A Randomized Controlled, Parallel-Group, Assessor-Blind Clinical Trial.

Background and objective Iron deficiency anemia (IDA) is a common condition in women for which ferrous ascorbate (FA) is often prescribed, which can lead to multiple side effects. Abhraloha is an Ayurvedic medicine that has been used for decades in India to treat IDA. In this study, we aimed to evaluate the efficacy and safety of Abhraloha with regard to change in hemoglobin (Hb) levels as compared to the standard treatment using FA in participants with IDA. Materials and methods We conducted a single-center, pragmatic, prospective, randomized, active-controlled, two-arm, parallel-group, assessor-blind study to evaluate the efficacy and safety of Abhraloha with regard to change in Hb levels as compared to the standard treatment using FA in participants suffering from IDA. The eligible participants were randomized and were advised to take either Abhraloha (two tablets twice a day) or FA (one tablet twice a day) for eight weeks; they were asked to follow up after 14 days for re-evaluation. On visit 1 and during the study period, the physician assessed the participants on the Pandurog scale and subjective variables. Descriptive statistics were used with unpaired T-test/Mann-Whitney U test for comparison between the groups. The Wilcoxon signed-rank test was used for within-group analysis, and the chi-square test/Fisher's exact test was employed for categorical data. Results Based on our findings, Abhraloha tablets significantly increased all the variables including the Pandurog scale after eight weeks of treatment. Abhraloha reduced total iron-binding capacity (TIBC) and peripheral smear lymphocyte (PSL), which is consistent with an improvement in IDA. There was a statistically significant increase in Hb, red blood cell (RBC) count, packed cell volume (PCV), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in the Abhraloha group as compared with the FA group at eight weeks. The Abhraloha group also exhibited a statistically significant improvement in all the subjective variables. Abhraloha was found to be safe and well-tolerated among the participants. Conclusions Abhraloha possesses hematinic activity and it improves all the blood indices. It is associated with significantly fewer adverse effects compared to oral iron therapy, which proves that it can be safely used for the treatment of IDA.

Clinical utility of serum hepcidin and iron profile measurements in Alzheimer's disease.

OBJECTIVES: There are no generally accepted serum biomarkers for Alzheimer's disease (AD). We investigated the clinical usefulness of measuring the serum hepcidin levels and iron profile in patients with AD. MATERIALS & METHODS: The iron profile and hepcidin levels were measured in patients with AD (N = 70), minimal cognitive impairment (MCI, N = 39), and vascular dementia (VD, N = 25) and normal controls (N = 124). General cognitive tests were performed, and the relationships between cognition and hepcidin levels or the iron profile were assessed. RESULTS: Patients with AD had higher hepcidin values than those with MCI and VD and normal controls (median value: 39.00 vs. 30.81, 32.52, and 5.51 ng/ml, respectively, P < 0.001), and these differences were found in both men and women. The total iron-binding capacity was significantly lower in the AD group than in any other groups (308.0 vs. 332.0, 329.0, and 330.5 µg/dl, respectively, P = 0.018), and serum iron levels were lower in the AD group than controls (79.1 vs. 107.2 µg/dl, P = 0.007). Hepcidin levels were statistically significantly correlated with the clinical dementia rating (CDR, P = 0.040) with a Pearson's correlation coefficient of 0.253, and the patients with AD with a CDR value >1 had significantly higher hepcidin values than those with a CDR value of 1 (65.26 vs. 23.49 ng/ml, P = 0.020). CONCLUSION: The measurement of serum hepcidin levels and the iron profile in patients with early manifestations of cognitive functional loss might aid in the diagnosis of AD and the assessment of disease severity when combined with other diagnostic parameters.

Association of Vitamin D and secondary hyperparathyroidism with anemia in diabetic kidney disease.

INTRODUCTION: Anemia is common in Chronic Kidney Disease (CKD) and diabetes is a major leading risk factor for it. In Diabetic Kidney Disease (DKD), it worsens more, which further increases cardiovascular morbidity and mortality. Despite of adequate iron stores anemia persist, which may be due to impaired iron release from body stores that is unable to meet the demand for erythropoiesis (also called reticuloendothelial cell iron blockade). High parathyroid hormone (PTH) along with vitamin D, may be attributable for anemia. METHODS: A cross-sectional study of 150 advanced (Stage 4 & 5) pre dialyzed DKD patients (GFR <30ml/min/1.73 m2), aged 40-70 years were included over a period of 1 year. Any other concomitant illness/ drugs leading to anemia were excluded. Serum samples were collected and urea, creatinine, hemoglobin, iron profile, vitamin D, iPTH, uric acid, calcium, phosphorous and albumin levels were measured. A data base was constructed on Microsoft Excel 2007 and statistical analyses were performed using the SPSS software version 20.0 (IBM, NY, USA). RESULTS: Stage 5 DKD had more pronounced anemia compared to stage 4 DKD (P < 0.001). Hemoglobin (Hb) was inversely correlated with iPTH (r = -0.74, P < 0.001) and was associated with vitamin D deficiency (r = 0.51, P < 0.001) but not with serum ferritin. DKD patients with low eGFR (r = -0.6, P < 0.001), vitamin D (r = -0.43, P < 0.001) and serum calcium (r = -0.37, P < 0.001) had higher iPTH. Secondary hyperparathyroidism (beta=-0.005; P < 0.001) and Vitamin D (beta=0.053; P < 0.01) were strong predictor for Hb while parameters of iron profile was not statistically significant. CONCLUSION: An efficient control of PTH hypersecretion is therefore required to achieve a better management of anemia as well as mineral metabolism in DKD patients.

Iron Profile and Inflammatory Status of Overweight and Obese Women in Sari, North of Iran.

Background: It has been suggested that inflammatory state due to obesity can lead to alteration in iron metabolism. Women in reproductive age are at higher risk of iron deficiency. In this study, we aimed to evaluate inflammatory status and iron markers in young overweight and obese women. Subjects and Methods: In this study, 120 young and healthy women with a BMI ≥ 25 kg/m2 were enrolled. Biochemical data including iron profile and inflammatory markers were analyzed using mean ± standard deviation or median (interquartile range) and multivariate multiple regression model via MANOVA. Results: Iron deficiency anemia (hemoglobin < 120 g/l) and iron deficiency without anemia (serum ferritin<30.0 mg/l) were detected in 21.67% and 33.33% of participants, respectively. Multivariate modeling showed that BMI was a significant predictor of transferrin saturation (p = 0.037), CRP (p = 0.013), soluble transferrin receptor (p=0.045), and soluble transferrin receptor/ ferritin ratio (0.015). Conclusion: The results of this study supported the positive association between obesity and inflammation and mild changes in iron markers.

Relationships between oxidative stress, haematology and iron profile in anaemic and non-anaemic calves.

The aim of this study was to investigate the relationships between oxidative stress, haematology and iron profile in neonatal dairy calves. Serum and haemolysate malondialdehyde (MDA), serum total antioxidant capacity, thiol groups, iron, total iron binding capacity, transferrin saturation and red blood cell (RBC) parameters were assessed in two groups: anaemic calves (n=14) and non-anaemic calves (n=16). Blood samples were collected from all of the calves within 24-48 hours after birth and at 7, 14, 21 and 28 days of age. A significant decrease in serum iron amount and transferrin saturation value (P<0.05) and a significant increase in haemolysate MDA concentration (P<0.05) in the anaemic calves were observed, when compared with non-anaemic calves. Total antioxidant capacity and thiol groups showed a significant positive correlation with iron profile and RBC parameters (haematocrit and haemoglobin) in the anaemic calves at day 21 (P<0.05). On the other hand, the concentration of haemolysate MDA was inversely correlated with the value of serum total antioxidant capacity (P<0.05). The results of the present study revealed that anaemic calves showed more severe oxidative stress than non-anaemic calves. In addition, iron insufficiency may be linked to the impairment of antioxidant defence system and oxidative damage of erythrocytes in the neonatal calves.

Anaemia in Systemic Lupus Erythematosus Based on Iron Studies and Soluble Transferrin Receptor Levels.

INTRODUCTION: Haematological alterations such as anaemia, neutropenia and thrombocytopenia are frequent in Systemic Lupus Erythematosus (SLE). Ferritin being an acute phase reactant can be falsely elevated in lupus cases. AIM: To evaluate the haematological alterations and to re-categorise the types of anemia by soluble transferrin receptor levels in diagnosed cases of SLE. MATERIALS AND METHODS: A sample of 30 newly diagnosed ANA positive SLE patients was taken. Complete blood counts, ESR, reticulocyte count, coagulation studies, diluted Russel Viper Venom Test (dRVVT), mixing studies, serological tests, high sensitivity CRP along with iron profile, transferrin saturation, soluble transferrin receptor (sol TFR) levels, anti-beta2 glycoprotein1, direct and indirect Coomb's test were estimated in cases diagnosed as SLE. Clinical symptoms were co-related with and Systemic Lupus Erythaematosus Disease Activity Index (SLEDAI) was estimated. RESULTS: Anaemia was the most prevalent haematological alteration followed by thrombocytopenia. Further sub typing of anaemia was done by serum ferritin levels and using sol TFR assays. Ferritin is an acute phase reactant; it underestimated iron deficiency in patients of SLE. When sol TFR was used; patients with pure Anaemia of Chronic Disease (ACD) reduced from 68% to 26%, those with pure IDA reduced from 32% to 16% and a group with co-existing IDA & ACD (58%) was defined {Agreement=53%, p=0.09} by sol TFR which co-related with clinical response to Iron therapy in these patients. CRP was significantly raised in association with disease activity. Fever (p<0.0001), arthritis (p<0.03) were significantly related and CRP was elevated (p<0.04) in cases with high SLEDAI (severe flare). CONCLUSION: Thus, in SLE, anaemia is the most frequent hematological alteration; iron deficiencies supercede in contrast to ACD and further autoimmune haemolytic anaemia. Sol TFR emerged as a better parameter to detect iron deficiency in patients of non- haemolytic anaemia in contrast to iron profile and ferritin levels.

Iron profile in Thoroughbreds during a standard training program.

OBJECTIVES: The aim of this study was to evaluate the modifications of some haematological parameters and iron profile during an 80-day training program and their relationship with athletic performance of performance horses. METHODS: During the training period, 20 Thoroughbreds were subjected to a standardised exercise test, previously standardised for gallopers to evaluate athletic performance. The test was performed immediately before the beginning of the training program (T0) and after 30 days (T30), 60 days (T60) and 90 days (T90). For each horse, their velocities at blood lactate concentrations of 2 and 4 mmol/L (V2 and V4) and a heart rate of 200 beats/min (V200) were calculated to assess the effect of the training program on athletic performance. Blood samples were collected at 20-day intervals over a period of 80 days from the beginning of the training program. RESULTS: One-way repeated measures analysis of variance (ANOVA) showed a statistically significant effect of days of training (time) on iron, ferritin, transferrin, total iron-binding capacity, transferrin saturation and unsaturated iron-binding capacity (P < 0.001 for all). CONCLUSIONS: The results showed the influence of the intensity and duration of exercise on iron metabolism. These findings may be useful for evaluating the athletic status of horses during training and to assess the degree of training adaptability, providing an opportunity to modify the training schedule to achieve the desired performance.