DOCSLIB.ORG

Evaluation of Serum Iron Overload, AST:ALT Ratio and Log10ferritin:AST Ratio Among Schizophrenia Patients in the Kumasi Metropolis, Ghana: a Case-Control Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Evaluation of Serum Iron Overload, AST:ALT Ratio and Log10ferritin:AST Ratio Among Schizophrenia Patients in the Kumasi Metropolis, Ghana: a Case-Control Study View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Research Online @ ECU Edith Cowan University Research Online ECU Publications Post 2013 1-1-2019 Evaluation of serum iron overload, AST:ALT ratio and log10ferritin:AST ratio among schizophrenia patients in the Kumasi Metropolis, Ghana: A case-control study W. K. B. A. Owiredu Peter Kojo Brenya Yaw Osei Edwin Ferguson Laing Clement Opoku Okrah See next page for additional authors Follow this and additional works at: https://ro.ecu.edu.au/ecuworkspost2013 Part of the Medicine and Health Sciences Commons 10.1186/s13104-019-4847-2 Owiredu, W. K. B. A., Brenya, P. K., Osei, Y., Laing, E. F., Okrah, C. O., Obirikorang, C., ... Donkor, S. (2019). Evaluation of serum iron overload, AST: ALT ratio and log 10 ferritin: AST ratio among schizophrenia patients in the Kumasi Metropolis, Ghana: a case–control study. BMC Research Notes, 12, Article 802. Available here This Journal Article is posted at Research Online. https://ro.ecu.edu.au/ecuworkspost2013/7327 Authors W. K. B. A. Owiredu, Peter Kojo Brenya, Yaw Osei, Edwin Ferguson Laing, Clement Opoku Okrah, Christian Obirikorang, Enoch Odame Anto, Emmanuel Acheampong, and Sampson Donkor This journal article is available at Research Online: https://ro.ecu.edu.au/ecuworkspost2013/7327 Owiredu et al. BMC Res Notes (2019) 12:802 https://doi.org/10.1186/s13104-019-4847-2 BMC Research Notes RESEARCH NOTE Open Access Evaluation of serum iron overload, AST:ALT ratio and log10ferritin:AST ratio among schizophrenia patients in the Kumasi Metropolis, Ghana: a case–control study W. K. B. A. Owiredu1, Peter Kojo Brenya1, Yaw Osei3, Edwin Ferguson Laing1, Clement Opoku Okrah4, Christian Obirikorang1, Enoch Odame Anto1,2, Emmanuel Acheampong1,2 and Sampson Donkor1* Abstract Objective: The association between unbalanced iron indices and the conditions of schizophrenia are not well under- stood. Liver dysfunction which has been linked to iron metabolism might be a contributing factor. This case–control study evaluated serum iron indices and liver function in treatment-naïve schizophrenia patients and those already on treatment at the Psychiatric Department of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Results: The mean age of the respondents was 39.6 0.8 years. Increased levels of serum iron, TS, AST, ALT and AST:ALT ratio and lower levels of UIBC, TIBC, Transferrin,± and log Ferritin:AST ratio levels were observed among the treatment-naïve group compared to the control. The treatment-naïve and treatment groups showed signifcantly higher serum AST:ALT ratio, and lower log10ferrtin:AST ratio than the healthy controls. There was a signifcant correla- tion between log10ferritin and AST, and log10ferritin and GGT in both treatments (r 0.343; p 0.003, and r 0.502; p 0.001 respectively) and treatment-naïve groups (r 0.348; p 0.002, and r 0.614;= p < 0.001= respectively).= Percent- age= transferrin saturation correlated signifcantly with =GGT only, =in the treatment-naïve= group (r 0.667; p < 0.001), and ALT and GGT in the treatment group (r 0.252; p 0.030 and r 0.646; p 0.014 respectively).= = = = = Keywords: Iron overload, Schizophrenia, AST:ALT ratio, log10ferritin:AST Introduction of the adult population sufer from some form of mental According to the World Health Organization (WHO) disorder [2]. [1], mental disorders account for fve of the ten leading Studies in Ghana have indicated that schizophrenia is causes of disability and premature death worldwide, of the leading psychiatric condition [3, 4]. Owiredu et al. [5] which neuropsychiatric condition accounts for 13% of in their study in Ghana reported a prevalence of 59% for the total disability adjusted life years [1]. A prevalence schizophrenia compared to other psychiatric conditions [5]. based rate report from the World Mental Health Survey Serious mental illness is accompanied by higher morbidity 2004, undertaken by WHO in Ghana estimated that, 13% and mortality rates of chronic diseases such as lung disease, diabetes and liver problems [6]. A previous study found that liver dysfunction is particularly elevated in adults with men- tal illness [7]. Iron overload has been reported to be signif- *Correspondence: [email protected] 1 Department of Molecular Medicine, KNUST School of Medicine cantly associated with liver damage [8]. and Dentistry, Kwame Nkrumah University of Science and Technology Iron overload (IO) has been reported to be associated with (KNUST), Kumasi, Ghana parenchymal and organ dysfunction following abnormal Full list of author information is available at the end of the article © The Author(s) 2019. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creat iveco mmons .org/publi cdoma in/ zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Owiredu et al. BMC Res Notes (2019) 12:802 Page 2 of 6 deposition of tissue iron [9, 10]. Dangers of IO in several illness were included in the study. All respondents disease conditions over the years including coronary disease were ≥ 18 years. [10–12], diabetes mellitus [10, 13], sexual impotence [9, 10], cerebral ischemic disease [10, 14] and neurologic or psychi- Exclusion criteria atric alterations [10, 15] has been noted. Schizophrenia patients already on iron therapy, non-ste- Te manifestations of neuropsychiatric efects of roidal anti-infammatory agents, antacids, alcohol con- chronic iron overload have been observed in depressives, sumption, pain killers such as paracetamol etc., multiple memory loss, paranoia, visual hallucination, lethargy, blood transfusions and androgen/oestrogen therapy were disorientation, dementia, and anxiety symptoms [16, 17]. all excluded from the study. However, the pathophysiology of iron metabolism in psy- chiatric illnesses still remains unclear, albeit several stud- Questionnaire administration and sample collection ies have suggested a possible link between serum iron A validated questionnaire was administered to all and some variables in psychiatric conditions [16, 18]. respondents by qualifed nurses to collect demographic Tere is dearth of data on serum iron indices among data including age and gender. About 4 ml of venous psychiatric patients in Ghana, and the association blood sample was collected from the antecubital fosa of between iron overload and primary psychiatric illness. the study participants after an overnight fast, and sera Also, little is known about the liver function of psychi- were obtained after centrifugation.Assayparameters atric patients in Ghana. Tis study therefore evaluated included: serum iron, unsaturated iron binding capacity serum iron indices and liver function among schizophre- (UIBC), total iron binding capacity (TIBC), transferrin, nia patients in a Ghanaian population. ferritin, percentage transferrin saturation, aspartate ami- notransferase (AST), gamma glutamyl transferase (GGT) Main text and alanine aminotransferase (ALT). AST, GGT and ALT Methods were performed on a fully automated Mindray BS-380 Study population and setting auto-analyzer (Shenzhen Mindray Bio-medical electron- Tis case–control study was carried out at the Psychiat- ics Co., Ltd, China). Ferritin was performed on Mindray ® ric department of the Komfo Anokye Teaching Hospital, microplate reader MR 96 A. Te assay for UIBC and Kumasi-Ghana. Qualifying patients attending the psychi- iron were performed on the Mindray BA-88A Biochem- atric department were recruited into the study using Inter- istry auto-analyzer. Transferrin concentration was esti- national classifcation of Diseases (ICD-10). Healthy control mated according to Vernet [19] and Gambino et al. [20] participants were recruited from a keep ft club. A total of equation. 200 participants comprising 75 treatment-naïve schizophre- nia patients, 75 schizophrenia patients on treatment and 50 Statistical analysis healthy controls were recruited via purposive sampling. Results are presented as mean ± SD. Analysis of variance (ANOVA) coupled with Tukey’s post hoc multiple com- Ethical consideration parisons was used to compare more than two means of Te study was approved by the Committee on Human continuous variables. Unpaired t-test was used to com- Research, Publications and Ethics (CHRPE), and the pare the means of two continuous variables. Chi-square Research and Development Unit of the Komfo Anokye test was used to assess the associations between cat- Teaching Hospital (KATH). Written informed consent egorized variables. Partial Pearson correlation was per- was obtained from each participant through their legally formed to test for associations between iron indices and authorised family
Load more

Recommended publications
  • Evaluation of Iron Profile in Type II Diabetes Mellitus Cases
    International Journal of Biotechnology and Biochemistry ISSN 0973-2691 Volume 15, Number 1 (2019) pp. 27-37 © Research India Publications http://www.ripublication.com Evaluation of Iron Profile in Type II Diabetes Mellitus Cases Dr. Sayantaann Saha*, Dr. Roopa Murgod Department of Biochemistry Vydehi Institute of Medical Sciences and Research Centre, EPIP Area, Whitefield, Bangalore 560066, India. ABSTRACT Introduction: Type 2 diabetes mellitus is the most common metabolic disorder, characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Iron, a transitional metal has been shown to play a major role in pathogenesis of T2DM with a bi-directional relationship where iron affects glucose metabolism, and glucose metabolism in turn impinges on several iron metabolic pathways. Aims or Objectives: To estimate and compare the parameters related to iron metabolism viz. Serum Iron (Fe), Serum Ferritin, Serum TIBC (Total Iron Binding Capacity), Serum Transferrin and Transferrin Saturation with Fasting Blood Sugar (FBS) between T2DM patients and healthy controls and correlation of FBS with the above iron parameters. Material and methods: A case control study was conducted between 41 cases of confirmed T2DM patients and 40 age & sex matched healthy controls. Iron profile parameters & FBS were estimated in both the groups and compared. Iron parameters were also correlated with FBS. * Corresponding author(Dr. Sayantaann Saha), Email id: [email protected] 28 Dr. Sayantaann Saha, Dr. Roopa Murgod Results: Serum ferritin, Serum iron & serum transferrin saturation were found to be significantly higher in patients with T2DM compared to control group (P<0.001). Serum transferrin & serum TIBC were found to be slightly lower in cases as compared to controls (P<0.001).
    [Show full text]
  • K392-100 Total Iron-Binding Capacity (TIBC) and Serum Iron Assay Kit (Colorimetric)
    FOR RESEARCH USE ONLY! Total Iron-Binding Capacity (TIBC) and Serum Iron Assay Kit (Colorimetric) rev 08/19 (Catalog # K392-100; 100 assays; Store at -20°C) I. Introduction: BioVision’s TIBC and Serum Iron Assay Kit measures both Total iron-binding capacity (TIBC) and Serum iron. Those values indicate the requisite iron for transferrin saturation and Serum Iron respectively. In humans, Transferrin is a blood protein that binds and transports iron throughout the body. Iron bound to transferrin and not bound are reflected in the following: 1) Total Iron Binding Capacity, 2) Unbound Iron, 3) Transferrin Saturation Bound Iron, and 4) Free Iron. Those measurements can be used for to detect and monito transferrin saturation and also iron-deficiency anemia and chronic inflammatory diseases. Part A: TIBC Part B: Serum Iron 1 1 2 2 3 3 4 II. Application: Determination of TIBC, Unbound Iron, Transferrin Saturation, Serum Iron III. Sample Type: Serum or plasma. Serum-off-the clot is preferable to normal serum. IV. Kit Contents: Components K392-100 Cap Code Part Number TIBC Assay Buffer 25 ml WM K392-100-1 Iron Solution 100 µl Blue K392-100-2 TIBC Detector 2 x 1.5 ml Brown K392-100-3 TIBC Developer 5 ml NM K392-100-4 Iron Standard (100 mM) 100 µl Yellow K392-100-5 V. User Supplied Reagents and Equipment: • 96-well plate clear plate with flat bottom • Microplate reader capable of absorbance reading VI. Storage Conditions and Reagent Preparation: Store kit at -20°C, protected from light. Briefly centrifuge small vials prior to opening.
    [Show full text]
  • Gamma-Glutamyltransferase: a Predictive Biomarker of Cellular Antioxidant Inadequacy and Disease Risk
    Hindawi Publishing Corporation Disease Markers Volume 2015, Article ID 818570, 18 pages http://dx.doi.org/10.1155/2015/818570 Review Article Gamma-Glutamyltransferase: A Predictive Biomarker of Cellular Antioxidant Inadequacy and Disease Risk Gerald Koenig1,2 and Stephanie Seneff3 1 Health-e-Iron, LLC, 2800 Waymaker Way, No. 12, Austin, TX 78746, USA 2Iron Disorders Institute, Greenville, SC 29615, USA 3Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA 02139, USA Correspondence should be addressed to Gerald Koenig; [email protected] Received 2 July 2015; Accepted 20 September 2015 Academic Editor: Ralf Lichtinghagen Copyright © 2015 G. Koenig and S. Seneff. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Gamma-glutamyltransferase (GGT) is a well-established serum marker for alcohol-related liver disease. However, GGT’s predictive utility applies well beyond liver disease: elevated GGT is linked to increased risk to a multitude of diseases and conditions, including cardiovascular disease, diabetes, metabolic syndrome (MetS), and all-cause mortality. The literature from multiple population groups worldwide consistently shows strong predictive power for GGT, even across different gender and ethnic categories. Here, we examine the relationship of GGT to other serum markers such as serum ferritin (SF) levels, and we suggest a link to exposure to environmental and endogenous toxins, resulting in oxidative and nitrosative stress. We observe a general upward trend in population levels of GGT over time, particularly in the US and Korea. Since the late 1970s, both GGT and incident MetS and its related disorders have risen in virtual lockstep.
    [Show full text]
  • Iron Deficiency Anemia: Evaluation and Management MATTHEW W
    Iron Deficiency Anemia: Evaluation and Management MATTHEW W. SHORT, LTC, MC, USA, and JASON E. DOMAGALSKI, MAJ, MC, USA Madigan Healthcare System, Tacoma, Washington Iron deficiency is the most common nutritional disorder worldwide and accounts for approxi- mately one-half of anemia cases. The diagnosis of iron deficiency anemia is confirmed by the findings of low iron stores and a hemoglobin level two standard deviations below normal. Women should be screened during pregnancy, and children screened at one year of age. Supple- mental iron may be given initially, followed by further workup if the patient is not responsive to therapy. Men and postmenopausal women should not be screened, but should be evaluated with gastrointestinal endoscopy if diagnosed with iron deficiency anemia. The underlying cause should be treated, and oral iron therapy can be initiated to replenish iron stores. Paren- teral therapy may be used in patients who cannot tolerate or absorb oral preparations. (Am Fam Physician. 2013;87(2):98-104. Copyright © 2013 American Academy of Family Physicians.) ▲ Patient information: ron deficiency anemia is diminished red causes of microcytosis include chronic A handout on iron defi- blood cell production due to low iron inflammatory states, lead poisoning, thalas- ciency anemia, written by 1 the authors of this article, stores in the body. It is the most com- semia, and sideroblastic anemia. is available at http://www. mon nutritional disorder worldwide The following diagnostic approach is rec- aafp.org/afp/2013/0115/ I and accounts for approximately one-half of ommended in patients with anemia and is p98-s1.html. Access to anemia cases.1,2 Iron deficiency anemia can outlined in Figure 1.2,6-11 A serum ferritin level the handout is free and unrestricted.
    [Show full text]
  • Correlation Between Serum Bilirubin and Serum Ferritin Level in Thalassaemia Patients N Sultana1, S Sadiya2, MH Rahman1 1Dept
    ORIGINAL ARTICLE Correlation between serum bilirubin and serum ferritin Level in thalassaemia patients N Sultana1, S Sadiya2, MH Rahman1 1Dept. of Biochemistry, Dhaka Medical College, Dhaka 2Dept. of Biochemistry, Dhaka Shishu Hospital, Dhak ABSTRACT Thalassaemia is the most common hereditary disorder in the world including Bangladesh. Beta thalassaemia major and Hb-E thalassaemia both are common in our country. Iron overload causes most of the mortality and morbidity associate with thalassaemia. To assess the iron over load and liver function a cross sectional comparative study was carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka in collaboration with Thalassaemia Center and Department of Pathology, Dhaka Shishu Hospital, Dhaka during the period of July 2006 to June 2007. The study was carried out with the patients who visited regularly in Dhaka Shishu Hospital Thalassaemia Centre (DSHTC) and had multiple transfusions (more than five) and age more than 2 years. To compare the state of liver function with normal healthy individuals' normal healthy persons were also included. Total 70 subjects were included in this study. The study subjects were distributed into two groups, the group - A (cases, n=40) and group - B (healthy controls, n=30). According to the major types of thalassaemia present in our country, group -A again divided into two, group - AI β-thalassaemia major (n=12) and group - AII of Hemoglobin E β-thalassaemia (n=28). The mean of serum Bilirubin in group - A and group - B were (2.04 ±0.70) mg/dl and (0.67±0.15) mg/dl respectively. Group - A had higher serum bilirubin than group -B in p value <0.001.The mean level of serum bilirubin in group - AI was (1.70±0.70)mg/dl and the mean of bilirubin in group AII was (2.18±0.66) mg/dl.
    [Show full text]
  • Influence of Iron on Bone Homeostasis
    pharmaceuticals Review Influence of Iron on Bone Homeostasis Enik˝oBalogh 1, György Paragh 2 and Viktória Jeney 1,* 1 Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, 4012 Debrecen, Hungary; [email protected] 2 Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4012 Debrecen, Hungary; [email protected] * Correspondence: [email protected]; Tel.: +36-70-217-1676 Received: 1 September 2018; Accepted: 12 October 2018; Published: 18 October 2018 Abstract: Bone homeostasis is a complex process, wherein osteoclasts resorb bone and osteoblasts produce new bone tissue. For the maintenance of skeletal integrity, this sequence has to be tightly regulated and orchestrated. Iron overload as well as iron deficiency disrupt the delicate balance between bone destruction and production, via influencing osteoclast and osteoblast differentiation as well as activity. Iron overload as well as iron deficiency are accompanied by weakened bones, suggesting that balanced bone homeostasis requires optimal—not too low, not too high—iron levels. The goal of this review is to summarize our current knowledge about how imbalanced iron influence skeletal health. Better understanding of this complex process may help the development of novel therapeutic approaches to deal with the pathologic effects of altered iron levels on bone. Keywords: bone homeostasis; iron overload; iron deficiency; osteoclast; osteoblast; osteoporosis 1. Introduction Bone is a metabolically active tissue that is continuously being remodeled, which enables growth in childhood, as well as repair and adaptation of the skeleton in adults. During bone remodeling, the adult skeleton is renewed approximately once every ten years. The two major cell types involved in bone remodeling are the osteoclasts, with a function of resorption of bone tissue and osteoblasts, with a role of new bone tissue formation.
    [Show full text]
  • GGT) Activity and Indices of Iron Metabolism with Bone-Mineral Parameters in Orthogeriatric Patients Leon Fisher1 and Alexander Fisher2
    Research iMedPub Journals Journal of Biomedical Sciences 2016 http://www.imedpub.com/ Vol.5 No.4:26 ISSN 2254-609X DOI: 10.21767/2254-609X.100040 Relationship between Serum Gamma-Glutamyltransferase (GGT) Activity and Indices of Iron Metabolism with Bone-Mineral Parameters in Orthogeriatric Patients Leon Fisher1 and Alexander Fisher2 1Department of Gastroenterology, The Canberra Hospital, Canberra, ACT, Australia 2Department of Geriatric Medicine, The Canberra Hospital, and Australian National University Medical School, Canberra, ACT, Australia Corresponding author: Leon Fisher, Department of Gastroenterology, The Canberra Hospital, and Australian National University Medical School, Canberra, ACT, Australia, Tel: +61-2-62443738; Fax: +61-2-62444036; E-mail: [email protected] Rec Date: Jun 21, 2016; Acc Date: Jul 18, 2016; Pub Date: Jul 25, 2016 Copyright: © 2016 Fisher L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Citation: Fisher L, Fisher A. Relationship between serum gamma-glutamyltransferase (GGT) activity and indices of iron metabolism with bone- mineral parameters in orthogeriatric patients. J Biomedical Sci. 2016, 5:4. Keywords: Bone turnover markers; GGT; Iron metabolism; Abstract Fracture; Elderly Purpose: To examine serum levels of GGT activity and Introduction biomarkers of iron metabolism in relation to parameters of bone and mineral metabolism in elderly patients with and The interest in gamma-glutamyltransferase (GGT; E.C.2.3.2.2), without osteoporotic bone fractures in the absence of overt a heterodimeric glycosylated protein embedded into outer liver diseases.
    [Show full text]
  • Anaemia and Serum Protein Alteration in Patients with Pressure Ulcers
    Spinal Cord (1997) 35, 58 ± 60 1997 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/97 $12.00 Anaemia and serum protein alteration in patients with pressure ulcers U Fuoco, G Scivoletto, A Pace, VU Vona and V Castellano IRCCS, Ospedale S. Lucia-Rome, Italy The presence of anaemia and serum protein alteration frequently makes the treatment of pressure ulcers more dicult. Several haemato-chemical parameters were observed in 40 patients with sacral pressure ulcers in order to determine the pathogenesis of these complications. All of the patients showed mild-moderate anaemia with low serum iron and normal or increased ferritin and hypoproteinemia with hypoalbuminemia. Our results suggest that both anaemia and serum protein alteration depend on the chronic in¯ammatory state due to the presence of pressure ulcers. Both anaemia and hypoproteinemia disappeared after pressure ulcer healing. A correct diagnosis is important for the treatment. Iron therapy is useless and potentially dangerous (iatrogenic haemochromatosis) since anaemia is the result of the inability to use iron stores and not iron de®ciency. The treatment of serum protein alterations should be based on a dietary therapy rich in protein and calories; the administration of albumin should be reduced, since albumin is low in essential amino-acids and too expensive; albumin administration should be limited to cases with severe hypoproteinemia and oedema. Keywords: pressure ulcers; anaemia; serum protein alteration; chronic in¯ammatory state Introduction Pressure ulcers are complications which frequently femur. All suered from a sacral pressure ulcer which occur in patients who have been bedridden for a long had persisted for more than 30 days (from 30 days to 6 time.
    [Show full text]
  • A Case of a 15-Month-Old with Periorbital Edema and Severe Anemia Audrey D
    A Case of a 15-Month-Old With Periorbital Edema and Severe Anemia Audrey D. Kamzan, MD, Charles A. Newcomer, MD, Laura J. Wozniak, MD, MSHS, Noah C. Federman, MD, Lydia S. Kim, MD, MPH This is the case of a previously healthy 15-month-old girl who initially abstract presented to her primary pediatrician with a 2-week history of intermittent periorbital edema. The edema had improved by the time of the visit, and a urine specimen was unable to be obtained in the clinic. A routine fingerstick demonstrated anemia to 8.8 mg/dL, so the patient was started on ferrous sulfate. She then returned to the emergency department 1 month later with severe periorbital edema and pallor but no other significant symptoms. On physical examination, she was tachycardic with striking periorbital edema and an otherwise normal physical examination. She was noted to have a severe microcytic anemia (hemoglobin of 3.9 mg/dL and mean corpuscular Mattel Children’s Hospital and University of California, Los Angeles, Los Angeles, California volume of 53.1 fL) and hypoalbuminemia (albumin of 1.9 g/dL and total protein of 3.3 g/dL). The remainder of her electrolytes and liver function test Drs Kamzan, Newcomer, and Kim conceptualized this diagnostic dilemma and drafted the initial results were within normal limits. A urinalysis was sent, which was negative manuscript; Drs Wozniak and Federman contributed for protein. Our panel of experts reviews her case to determine a unifying to drafting the initial manuscript; and all authors diagnosis for both her severe anemia and her hypoalbuminemia.
    [Show full text]
  • Guidelines for the Use of Serum Tests for Iron Deficiency (CLP 002)
    Guidelines for the Use of Serum Tests for Iron Deficiency (CLP 002) Revised February, 2012 1. Purpose To provide clinicians with a concise reference document describing the appropriate laboratory tests for assessing patients of all ages suspected of having iron deficiency. Investigation of the underlying cause of iron deficiency is beyond the scope of this guideline. Iron overload will be covered in a separate OAML guideline. Readers are reminded that OAML Guidelines will not apply to every clinical situation, nor can they serve as a substitute for sound clinical judgment. 2. Causes of Iron Deficiency: Table 1: Causes of Iron Deficiency Increased Menstruating females Requirements Pregnancy Lactation Growing infants and children Erythropoietin treatment Increased Loss GI bleeding Menorrhagia Persistent hematuria Intravascular hemolytic anemias Regular blood donors Parasitic infections Decreased Intake Vegetarian diet Socioeconomic factors Decreased Upper GI pathology (eg: Celiac and Crohn’s disease) Absorption Gastrectomy Medications (antacids, Zantac) Page 1 of 5 3. Indications for Testing Screening of the general population for iron deficiency is not indicated. At-risk populations as defined in Table 1 with clinical signs and symptoms and patients with microcytic anemia should be considered for screening. It should be noted that although microcytic anemia is often due to iron deficiency, it can also be caused by hemoglobinopathies and anemia of chronic disease. The latter disorders are beyond the scope of this guideline, but should be considered in the differential diagnosis and management. Failure to identify these other causes may result in unnecessary iron replacement. 4. Testing for Iron Deficiency A low serum ferritin result indicates that iron stores are depleted, making serum ferritin the most specific test for iron deficiency and the only test that should be used for screening.
    [Show full text]
  • Serum Iron and Risk of Diabetic Retinopathy
    nutrients Article Serum Iron and Risk of Diabetic Retinopathy Ying-Jen Chen 1, Jiann-Torng Chen 1, Ming-Cheng Tai 1, Chang-Min Liang 1, Yuan-Yuei Chen 2,3 and Wei-Liang Chen 4,5,6,* 1 Department of Ophthalmology, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei 114, Taiwan; [email protected] (Y.-J.C.); [email protected] (J.-T.C.); [email protected] (M.-C.T.); [email protected] (C.-M.L.) 2 Department of Pathology, Tri-Service General Hospital Songshan Branch, and School of Medicine, National Defense Medical Center, Taipei 114, Taiwan; [email protected] 3 Department of Pathology, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei 114, Taiwan 4 Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei 114, Taiwan 5 Division of Environmental Health & Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan 6 Department of Biochemistry, National Defense Medical Center, Taipei 114, Taiwan * Correspondence: [email protected]; Tel.: +886-2-87923311 (ext. 16567); Fax: +886-2-87927057 Received: 2 July 2020; Accepted: 29 July 2020; Published: 31 July 2020 Abstract: Background: Diabetic retinopathy (DR) is indicated as a major cause of blindness in the world. Emerging evidence supports the interaction of iron metabolism with diabetes. However, little research is available concerning the relationship between iron metabolism and DR. The intent of this paper is to describe the correlation between serum iron and the occurrence of DR.
    [Show full text]
  • Serum Iron and Risk of Nonalcoholic Fatty Liver Disease and Advanced Hepatic Fibrosis in US Adults
    www.nature.com/scientificreports OPEN Serum iron and risk of nonalcoholic fatty liver disease and advanced hepatic fbrosis in US adults Huan‑Huan Yang1, Guo‑Chong Chen2, De‑Ming Li1, Lei Lan3, Li‑Hua Chen4, Jia‑Ying Xu5 & Li‑Qiang Qin1* Epidemiological evidence on the relationship between serum iron and liver diseases is limited. This study aims to investigate whether serum iron is associated with nonalcoholic fatty liver disease (NAFLD) and advanced hepatic fbrosis (AHF). Cross‑sectional data for adults aged ≥ 18 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were analyzed. Odds ratio (ORs) and 95% confdence intervals (CIs) of NAFLD and AHF associated with serum iron were estimated using multivariable logistic regression models. A total of 18,031 males and 18,989 females were included in the analysis. After multivariable adjustment for potential confounders, serum iron was signifcantly and inversely associated with NAFLD in both genders (P-trend < 0.001) and AHF in females (P-trend = 0.018). Compared to the bottom quartile, those in higher quartiles of serum iron had no signifcant ORs for AHF in males, but the trend across the quartiles was signifcant (P-trend = 0.046). In conclusion, higher serum iron level was associated with lower risk of NAFLD in males and females, and with lower risk of AHF in females but not in males. No signifcant racial/ethnical diferences in these associations were observed. Iron is an essential nutrient integral to various metabolic processes1. Serum iron (i.e., transferrin bound iron) can be delivered to cells or organ where needed, and can recycle back to the blood, and thus acts as a clearing house in regulating iron distribution in the body1.
    [Show full text]