OBJECTIVE: To observe and compare the therapeutic effects of hydroxypropyl chitosan ferrous ion complex solution and ferrous sulfate solution in iron deficiency anemia rats and their effects on gastric mucosa. METHODS: Seven rats were randomly selected from thirty five SPF grade SD rats as control group, and were fed with normal diet, distilled water (E). The rest of SD rats were fed with low iron feed and distilled water plus continuous tail vein bloodletting to establish the iron deficiency anemia model. After the model was established successfully, the rats were randomly divided into four groups: blank control group (A), iron deficiency anemia control group (B), ferrous sulfate group (C), hydroxypropyl chitosan ferrous ion complex (HPCTS-Fe RESULTS: After modeling, except the normal control group, the hair color of the rats in the four groups showed dark yellow and the belly of the toes became white gradually. HGB, HCT, Ret%, MCV, MCH, MCHC and SF decreased significantly (P < 0.05). After treatment, the rats with dark yellow hair in group C and D were improved, and the toe abdomen turned pink gradually. RBC, HGB, HCT, Ret%, MCV, MCH, MCHC and SF in rats in group C and D increased, which were higher than those in group B (P < 0.05). The HGB of the rats in group D was higher than that of group C in day 28th during treatment and the Ret% was higher than that in group C at day 10th (P<0.05).After treatment, the liver and spleen of the rats in group C and D were lighter than those in group B (P<0.05).The gastric mucosa in group A, B, D and E was not damaged obviously, while it was slightly irritated and damaged in group C. CONCLUSION Hydroxypropyl chitosan ferrous complex solution can improve the hemoglobin level of SD rats with iron deficiency anemia, which is stronger than ferrous sulfate solution and shows no damage to gastric mucosa.
Anemia, Iron-Deficiency/drug therapy* ; Animals ; Chitosan ; Ferrous Compounds ; Hemoglobins ; Iron ; Rats ; Rats, Sprague-Dawley

OBJECTIVES: We attempt to find out the decremental character of serum vitamin B12 level and features of patients with vitamin B12 deficiency anemia occurring earlier than 4 years after total gastrectomy. Methods: We studied 91 patients who underwent total gastrectomy and select 59 patients who evaluate serum vitamin B12 level within 4 years after total gastrectomy to characterize the features of vitamin B12 deficiency anemia group occurring earlier than 4 years after the operation. RESULTS: 1) In 91 patients, the mean postoperative duration is 31.9(range: 0-135) months and mean serum vitamin B12 level 158.9(total 159 times, range: 20.0-806.2) pg/mL. Correlation equation is y=403.30 x e-0.09x+175.93 x e-0.02 x (r2=0.804). The postoperation duration that serum vitamin B12 level falls below 200 pg/mL is 20 months. 2) Among 59 patients, there were 20 cases of vitamin B12 deficiency anemia group(Group I), 21 cases of vitamin B12 deficiency(Group II) and 39 cases of non-vitamin B12 deficiency group(Group III). Preoperation symptom dura tion in Group I was longer than that in Group II(18.2 vs 9.6 weeks, p<0.01). Group I and Group II showed lower serum vitamin B12 level than Group III(126.7 & 96.0 pg/mL vs 330.4 pg/mL, p<0.01). 3) Eleven cases had associated diseases(9 alcoholics and 2 liver cirrhosis) with vitamin B12 deficiency anemia and these disease had significant influence on the incidence of vitamin B12 deficiency anemia(p<0.01) within 4 years. Among the 30 cases who could measure iron profile, 10 patients had an iron deficiency anemia. There was a higher incidence of vitamin B12 deficiency anemia in iron deficiency anemia group(7/10, 70%) than that in non iron deficiency anemia group(7/20, 35%) but no sta tistical significance(p=0.12). 4) Although anti-cancer chemotherapy did not have a significant influence on the incidence of vitamin B12 defi ciency anemia, vitamin B12 level in anti-cancer chemo therapy group was higher than that in non-chemotherapy group(201.83 vs 127.66 pg/mL, p=0.01) at similar mean postoperation duration(27.8 vs 27.7 months, p=0.97). 5) The independent predictor of vitamin B12 deficiency anemia within 4 years were associated disease(p=0.002) and preoperation symptom duration(p=0.004). CONCLUSION: Red cell indices such as Hb or MCV did not have any clinical significances in predicting the development of vitamin B12 deficiency. To prevent vitamin B12 deficiency anemia and promote better quality of life in total gastrectomized patients with stomach can cer, careful monitoring of serum vitamin B12 level and re placement therapy should be necessary at least 20 months after operation, especially in patients with associated disease and longer preoperation symptom duration.
Alcoholics ; Anemia ; Anemia, Iron-Deficiency ; Drug Therapy ; Erythrocyte Indices ; Gastrectomy* ; Humans ; Incidence ; Iron ; Liver ; Quality of Life ; Stomach Neoplasms* ; Stomach* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

OBJECTIVE: To compare the clinical efficacy and safety of oral administration of Buxue Yimu Pills (BYP, ), ferrous sulfate (FS), and the combination of BYP and FS on gynecological anemia, and investigate the mechanisms using network pharmacology. METHODS: A randomized, controlled, multi-center clinical trial was conducted. Totally 150 patients with hemoglobin of 70-110 g/L due to gynecological conditions were recruited and randomized (using the block randomization method) into Buxue Yimu Pills group (24 g/d), oral iron group (FS Tablets, 0.9 g/d), and combined treatment group (BYP, 24 g/d plus FS Tablets, 0.9 g/d), 50 patients in each group. At the enrollment and 4-week treatment, complete blood count, serum iron indexes were evaluated. Adverse events, liver and renal functions, as well as blood coagulation were observed. Network pharmacology was conducted to identify the active ingredients and explore the potential mechanisms of BYP. RESULTS: Ten (20%) and 7 (14%) participants discontinued the therapy due to gastrointestinal symptoms in oral iron and combination treatment groups. All 3 groups showed elevated hemoglobin. The patients in the iron group exhibited typically elevated in serum iron and ferritin and decreased in total iron-binding capacity. No change in iron indexes was observed in BYP group. The patients in the combination treatment group neither showed significant changes in serum ferritin nor total iron-binding capacity. No significant adverse reactions were observed in the BYP group. The network pharmacology identified 27 bioactive compounds and 145 targets of BYP on gynecological anemia. Biological processes and pathways including regulation of inflammation, hormone, angiogenesis and hemostasis, response to decreased oxygen levels, effects on myeloma cell, and response to metal ions were identified. CONCLUSION BYP contributes to the practical improvement on gynecological anemia potentially through multi-target mechanisms and optimized iron re-distribution. (Trial registration: No. NCT03232554).
Humans ; Anemia/drug therapy* ; Anemia, Iron-Deficiency/drug therapy* ; Ferritins/therapeutic use* ; Hemoglobins ; Iron/therapeutic use* ; Network Pharmacology ; Drugs, Chinese Herbal

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

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

Iron deficiency anemia is one of the most common micronutrient deficient conditions around the globe with various consequences, including the weakened immune system. Quercetin is widely distributed bioflavonoid; it has been debated for its dual roles in iron regulation. Quercetin-iron interaction in the body is a complex mechanism which has not been completely understood. The present study aimed to investigate the effect of quercetin on iron supplementation in iron deficiency anemia and on iNOS expression in splenic macrophages. The rat model of iron deficiency anemia was induced by feeding low iron diet to weanling rats for 20 days. The animals were then administered with ferrous sulfate, quercetin, and their combination for 30 days. Blood parameters, histopathological analysis, iron storage, CD68, iNOS and SLC40 expression in rat spleen were investigated. Our results showed that quercetin regulated iron absorption, despite SLC40 down-expression, indicating possible alternate route of iron transport, and that quercetin modulated iNOS production in splenic macrophages.
Anemia, Iron-Deficiency ; drug therapy ; genetics ; metabolism ; Animals ; Dietary Supplements ; analysis ; Female ; Homeostasis ; drug effects ; Humans ; Iron ; deficiency ; Macrophages ; drug effects ; metabolism ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; Quercetin ; administration & dosage ; Rats ; Rats, Sprague-Dawley ; Spleen ; drug effects ; enzymology

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