OBJECTIVETo observe the therapeutic effect of shengxuening (SXN) in treating iron-deficiency anemia (IDA) and to explore its molecular mechanism on iron metabolism balance regulation.

METHODSPatients with IDA were randomly divided into the treated group and the control group, 50 in each group. They were treated with SXN (0.1 g, three times per day) and ferrous gluconate (0.1 g, three times per day) respectively, for 30 days. Levels of serum iron (Fe), total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF), transferrin (Tf), soluble transferrin receptor (sTfR) and blood routine test, as well as scoring of TCM qi-blood deficiency Syndrome were conducted before and after treatment.

RESULTSThe total effective rate in the treated group reached 92%, it was shown that SXN could improve the iron metabolism, increase levels of Fe, TS, SF and reduce levels of TIBC, Tf, sTfR, it has obvious effect in promoting erythrocyte generation and could promote formation of leucocytes and platelets. The total effective rate in the control group was 32%, which was significantly lower than that in the treated group (P < 0.01).

CONCLUSIONThe effect of SXN in treating IDA and qi-blood deficiency Syndrome is evident, it could improve the iron metabolism, increase levels of Fe, TS, SF and lower levels of TIBC, Tf, sTfR.

Adolescent ; Adult ; Anemia, Iron-Deficiency ; blood ; drug therapy ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ferritins ; blood ; Humans ; Iron ; blood ; Male ; Middle Aged ; Phytotherapy ; Receptors, Transferrin ; blood

OBJECTIVETo study trend of dynamic change in level of serum transferrin receptor (sTfR) in the process of iron supplementation to provide evidence for sTfR in evaluating the efficacy of iron supplementation.

METHODSTotally, 942 child-bearing-age women aged 18 to 45 years were selected from Longfang City, Hebei Province and Shunyi County, Beijing. Biochemical indicators of iron metabolism were measured for all of them, including serum levels of ferritin (SF) and zinc protoporphyrin (ZPP), and hemoglobin (Hb). According to the current criteria for assessing iron status, women were screened for iron deficiency erythropoiesis (IDE) or iron deficiency anemia (IDA). Seventy-two women agreed to participate in the study, and 59 of them finished whole dynamic observations with signed informed consent. Four capsules of ferrous L-threonate (containing 7 mg of iron element per capsule) were administered for women with IDE every other day and for women with IDA every day, respectively, for 12 weeks. Serum biochemical indicators and level of sTfR were measured in 0 wk, 3 wk, 6 wk, 9 wk and 12 wk, respectively, during the process of iron supplementation, and their dynamic changes were observed.

RESULTSLevel of sTfR in women with IDE and IDA was (26.62 +/- 10.57) nmol/L and (41.25 +/- 21.96) nmol/L, respectively, significantly higher than normal level. During the process of iron supplementation, level of sTfR changed as the following characteristics. In women with IDE, level of sTfR kept stable within the first 3 weeks of iron supplementation, then dropped gradually and progressively, reached to normal, with (17.86 +/- 5.57) nmol/L, in the 12 wk after iron supplementation. In women with IDA, level of sTfR dropped quickly within the first 3 wk of iron supplementation, then dropped slowly until the 9th wk and kept stable, and reached to normal level in the 12 wk, with (19.54 +/- 5.94) nmol/L and a ratio of sTfR/SF of 12.23 +/- 4.34. Ratio of sTfR/SF changed as level of sTfR during the process of iron supplementation. Level of sTfR correlated reversely with levels of Hb and SF and positively with level of ZPP.

CONCLUSIONSerum level of sTfR in child-bearing age women gradually decreased to normal with the restoration of their normal iron status during the process of iron supplementation and could be used as a specific indicator for assessing efficacy of iron supplementation.

Adolescent ; Adult ; Anemia, Iron-Deficiency ; blood ; drug therapy ; Biomarkers ; blood ; Dietary Supplements ; Female ; Hemoglobins ; analysis ; Humans ; Iron ; administration & dosage ; therapeutic use ; Middle Aged ; Protoporphyrins ; blood ; Receptors, Transferrin ; blood

BACKGROUND: Iron deficiency anemia is the most common form of anemia in India. Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. However, reports on the effects of iron deficiency anemia on HbA1c levels are inconsistent. We conducted a study to analyze the effects of iron deficiency anemia on HbA1c levels and to assess whether treatment of iron deficiency anemia affects HbA1c levels. METHODS: Fifty patients confirmed to have iron deficiency anemia were enrolled in this study. HbA1c and absolute HbA1c levels were measured both at baseline and at 2 months after treatment, and these values were compared with those in the control population. RESULTS: The mean baseline HbA1c level in anemic patients (4.6%) was significantly lower than that in the control group (5.5%, p<0.05). A significant increase was observed in the patients' absolute HbA1c levels at 2 months after treatment (0.29 g/dL vs. 0.73 g/dL, p<0.01). There was a significant difference between the baseline values of patients and controls (0.29 g/dL vs. 0.74 g/dL, p<0.01). CONCLUSIONS: In contrast to the observations of previous studies, ours showed that HbA1c levels and absolute HbA1c levels increased with treatment of iron deficiency anemia. This could be attributable to nutritional deficiency and/or certain unknown variables. Further studies are warranted.
Adolescent ; Adult ; Anemia, Iron-Deficiency/*blood/drug therapy ; Child ; Female ; Ferritins/blood ; Hemoglobin A, Glycosylated/*analysis ; Hemoglobins/analysis ; Humans ; Iron/therapeutic use ; Male ; Time Factors

OBJECTIVETo evaluate effect of NaFeEDTA on serum ferritin level in iron deficient epidemic population.

METHODSA comprehensive literature retrieval was performed via searching electronic databases, hand searching bibliographies of books and relevant journals, collecting grey literatures, looking into conference abstracts, contacting fields experts and reviewing references and citations. Criteria from Cochrane EPOC review group were used to assess the quality of the included studies. Generic inverse variance method was used to undertake Meta-analysis.

RESULTSThe pooled estimate for serum ferritin level (weighted mean difference) was 1.58 microg/L (95% CI 1.20-2.09; P < 0.001).

CONCLUSIONThis systematic review indicates that NaFeEDTA might improve serum ferritin concentration significantly in iron deficient epidemic population.

Anemia, Iron-Deficiency ; drug therapy ; Edetic Acid ; therapeutic use ; Ferric Compounds ; therapeutic use ; Ferritins ; blood ; Humans ; Iron, Dietary ; Randomized Controlled Trials as Topic

OBJECTIVETo evaluate the effect of NaFeEDTA on hemoglobin level in iron deficient population.

METHODSComprehensive literature retrieval was performed via searching electronic databases, hand searching bibliographies of books and relevant journals, collecting grey literatures, looking into conference abstracts, contacting fields experts and reviewing references and citations. Criteria from Cochrane EPOC review group were used to assess the quality of included studies. Generic inverse variance method was used to undertake meta-analysis.

RESULTSThe pooled estimate for hemoglobin level (weighted mean difference) was 12.14 g/L (95% CI: 5.60-18.69; P < 0.001). Subgroup analysis indicated that lower baseline hemoglobin level and higher dose for intervention were associated to greater increase in hemoglobin level.

CONCLUSIONThis systematic review indicated that NaFeEDTA improved hemoglobin significantly in iron deficient population.

Anemia, Iron-Deficiency ; blood ; drug therapy ; metabolism ; Edetic Acid ; therapeutic use ; Ferric Compounds ; therapeutic use ; Hemoglobins ; metabolism ; Humans ; Iron Chelating Agents ; therapeutic use

BACKGROUNDIron deficiency (ID) is still a great challenge to health care worldwide. Results of randomized controlled trials (RCTs) evaluating the effect of Helicobacter pylori (H. pylori) eradication on ID are contradictory. This study aimed to evaluate the effect of H. pylori eradication on ID with a meta-analysis of RCTs.

METHODSFive electronic databases were searched for RCTs evaluating the effect of H. pylori eradication on ID. Summary effects were assessed with the methods recommended by the Cochrane Collaboration.

RESULTSEight studies involving 800 participants were included in this meta-analysis. The overall analysis showed that H. pylori eradication accelerated the improvement of ferritin levels in ID people (mean difference (MD), 7.74 microg/L; 95%CI, 4.61 to 10.88; P < 0.00001). In a subgroup analysis, H. pylori eradication accelerated the improvement of ferritin levels one month (MD, 7.00 microg/L; 95%CI, 1.72 to 12.28; P = 0.009) and two months (MD, 9.80 microg/L; 95%CI, 2.22 to 17.40; P = 0.01) after the initiation of treatment. However, H. pylori eradication did not show a beneficial effect on the improvement of ferritin levels three months (MD, 7.20 microg/L; 95%CI, -3.25 to 17.65; P = 0.18), one year (MD, 10.17 microg/L; 95%CI, -1.00 to 21.34; P = 0.07) and forty months (MD, 1.00 microg/L; 95%CI, -0.57 to 2.57; P = 0.21) after the initiation of treatment. H. pylori eradication did not accelerate the improvement of hemoglobin concentrations in the overall analysis (MD, 0.38 g/dl; 95%CI, -0.45 to 1.22; P = 0.37). In a subgroup analysis, H. pylori eradication did not accelerate the improvement of hemoglobin concentrations one month (MD, -0.48 g/dl; 95%CI, -2.39 to 1.42; P = 0.62), three months (MD, -0.10 g/dl; 95%CI, -0.35 to 0.15; P = 0.44) and forty months (MD, 0.10 g/dl; 95%CI, -0.37 to 0.57; P = 0.68) after the initiation of treatment. However, H. pylori eradication accelerated the improvement of hemoglobin concentrations two months (MD, 1.96 g/dl; 95%CI, 1.48 to 2.44; P < 0.00001) and one year (MD, 0.37 g/dl; 95%CI, 0.08 to 0.65; P = 0.01) after the initiation of treatment.

CONCLUSIONSH. pylori eradication is likely to improve the absorption of oral ferrous. H. pylori infection may play some roles in the development of ID.

Anemia, Iron-Deficiency ; blood ; drug therapy ; etiology ; Animals ; Anti-Bacterial Agents ; therapeutic use ; Helicobacter Infections ; complications ; drug therapy ; microbiology ; Humans ; Randomized Controlled Trials as Topic

OBJECTIVETo understand iron nutritional status in school-age children, incidence of the sub-clinical iron deficiency (SID) and effect of iron supplementation on SID in the rural school-age children from mountainous areas of Beijing.

METHODSThe dietary survey and food frequency questionnaire survey were conducted in 1,012 school children aged 7 - 13 at rural mountainous areas of Fangshan District, Beijing, and their blood samples were collected for analyzing biochemical indicators for iron nutrition. Two hundred and sixty-seven children with IDs (iron deficiency store) and IDE (iron deficiency erythropoiesis), based on screening criteria for iron-deficiency anemia, received an iron supplementation (NaFeEDTA) capsule (containing 60 mg iron element) weekly, and those with IDA (iron deficiency anemia) received NaFeEDTA capsule thrice weekly for nine weeks. Blood biochemical indicators for iron nutrition were determined repeatedly and compared with those before and after the intervention.

RESULTSThe daily average intakes of energy, protein, iron and vitamin C in school children of all age groups reached the daily recommended criteria (> 85% of the RNIs), but the proportion of heme in dietary iron constitution was lower. The average blood biochemical indicators for iron nutrition were as follows: serum ferritin (SF) (50.83 +/- 33.09) micro g/L, free erythrocyte protoporphyrin (FEP) (489.44 +/- 219.61) micro g/L, hemoglobin (Hb) (130.57 +/- 10.82) g/L, and the ratio of FEP/Hb (3.83 +/- 1.96), respectively. Incidence of total iron deficiency in rural children was 26.5%, with proportions of iron deficiency (IDs), iron deficiency erythropoiesis (IDE), and iron deficiency anemia (IDA) of 15.5%, 7.1%, and 3.9% respectively. SID accounted for 85.4% of the total iron deficiency, which was 5.8 times as much as IDA. With iron supplementation for 9 weeks, the hematdogical index of iron increased significantly and returned to the normal level.

CONCLUSIONSThe incidence of subclinical iron deficiency in the rural school-age children was insidious and should be attached more importance, which was helpful to its early recognition and intervention. Iron supplementation is important for children with SID to prevent and decrease the occurrence of IDA.

Adolescent ; Anemia, Iron-Deficiency ; drug therapy ; prevention & control ; Child ; Diet Surveys ; Dietary Supplements ; Edetic Acid ; therapeutic use ; Female ; Ferric Compounds ; therapeutic use ; Ferritins ; blood ; Humans ; Incidence ; Iron, Dietary ; administration & dosage ; Male ; Mass Screening ; Nutritional Status ; Protoporphyrins ; blood ; Rural Health

OBJECTIVETo investigate the therapeutic effects of Angelica sinensis polysaccharide-iron complex (APIC) on rats with iron deficiency anemia (IDA).

METHODSThe IDA rat model was established by adopting low-iron forage with a small amount of regular bloodletting. The rats were randomly divided into a model group, three AIPC groups (high, middle, and low dosage), an Angelica sinensis polysaccharide (ASP) group, a mixture group (ASP+FeCl(3)) and a positive control group (Niferex). Changes in hemoglobin (Hb), red blood cell count (RBC), hematocrit (HCT) and iron content of whole blood were observed.

RESULTSThere was a significant difference before and after administration in all treated groups and all indices were restored to near-normal levels in the APIC groups and the positive control group. There was a significant difference among the changes of the indices in all the APIC groups and those of the model group but not between those of the APIC groups and the positive control group. However, the recovery of the indices in the APIC groups was superior to that in the positive control group.

CONCLUSIONAPIC not only has a superior therapeutic effect on IDA, but also has the effect of the ASP on supplementing blood and activating blood circulation. Hence, it may be used as a new iron-supplementing agent with a double therapeutic efficacy on blood supplementation for the treatment of IDA.

Anemia, Iron-Deficiency ; drug therapy ; Animals ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Iron ; blood ; chemistry ; therapeutic use ; Male ; Polysaccharides ; chemistry ; therapeutic use ; Rats ; Rats, Sprague-Dawley

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) infection appears to subvert the human iron regulatory mechanism and thus upregulates hepcidin, resulting in unexplained iron-deficiency anemia (IDA). We evaluated serum prohepcidin levels before and after eradication of H. pylori in IDA patients to assess whether it plays a role in IDA related to H. pylori infection. METHODS: Subjects diagnosed with unexplained IDA underwent upper gastrointestinal endoscopy and colonoscopy to confirm H. pylori infection and to exclude gastrointestinal bleeding. Blood was sampled before treatment to eradicate H. pylori and again 1 month later. Serum prohepcidin levels were measured using a commercial enzyme-linked immunosorbent assay kit. RESULTS: Serum prohepcidin levels decreased significantly after oral iron replacement combined with H. pylori eradication (p = 0.011). The reduction ratio of serum prohepcidin levels after the treatment did not differ among the combined oral iron replacement and H. pylori eradication groups, the H. pylori eradication only group, and the iron replacement only group (p = 0.894). CONCLUSIONS: Serum prohepcidin levels decrease after both H. pylori eradication and oral iron administration, with improvement in IDA. Serum concentration of prohepcidin is related to the anemia status, rather than to the current status of H. pylori infection, in IDA patients.
Administration, Oral ; Adult ; Aged ; Anemia, Iron-Deficiency/*blood/drug therapy/*microbiology ; Antimicrobial Cationic Peptides/*blood ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Helicobacter Infections/*blood/*complications/pathology ; *Helicobacter pylori ; Humans ; Iron/administration & dosage ; Male ; Middle Aged ; Prospective Studies ; Protein Precursors/*blood ; Severity of Illness Index

BACKGROUND/AIMS: There are few data on the effects of low hemoglobin levels on the left ventricle (LV) in patients without heart disease. The objective of this study was to document changes in the echocardiographic variables of LV structure and function after the correction of anemia without significant cardiovascular disease. METHODS: In total, 34 iron-deficiency anemia patients (35 +/- 11 years old, 32 females) without traditional cardiovascular risk factors or cardiovascular disease and 34 age- and gender-matched controls were studied. Assessments included history, physical examination, and echocardiography. Of the 34 patients with anemia enrolled, 20 were followed and underwent echocardiography after correction of the anemia. RESULTS: There were significant differences between the anemia and control groups in LV diameter, left ventricular mass index (LVMI), left atrial volume index (LAVI), peak mitral early diastolic (E) velocity, peak mitral late diastolic (A) velocity, E/A ratio, the ratio of mitral to mitral annular early diastolic velocity (E/E'), stroke volume, and cardiac index. Twenty patients underwent follow-up echocardiography after treatment of anemia. The follow-up results showed significant decreases in the LV end-diastolic and end-systolic diameters and LVMI, compared with baseline levels. LAVI, E velocity, and E/E' also decreased, suggesting a decrease in LV filling pressure. CONCLUSIONS: Low hemoglobin level was associated with larger cardiac chambers, increased LV, mass and higher LV filling pressure even in the subjects without cardiovascular risk factors or overt cardiovascular disease. Appropriate correction of anemia decreased LV mass, LA volume, and E/E'.
Adult ; Anemia, Iron-Deficiency/blood/diagnosis/*drug therapy/physiopathology ; Biological Markers/metabolism ; Case-Control Studies ; Echocardiography, Doppler ; Female ; Heart Ventricles/*physiopathology/ultrasonography ; Hematinics/*therapeutic use ; Hemoglobins/metabolism ; Humans ; Male ; Middle Aged ; Prospective Studies ; Recovery of Function ; Time Factors ; Treatment Outcome ; *Ventricular Function, Left ; *Ventricular Pressure ; *Ventricular Remodeling ; Young Adult