Examination of serum ferritin and erythrocyte ferritin--its role in the blood transfusion service.

Blood donors were examined for serum ferritin values and concentration of ferritin in the erythrocytes. The group of male and female donors without previous donations showed average values of 102.27 ng and 51.75 ng of ferritin per one ml of serum, respectively. Males with over 20 donations had 68.04 ng ferritin per one ml, females 37.14 ng of ferritin per one ml. The reduced serum ferritin values in multiple male and female donors is statistically significant. Serum ferritin values in women of the two groups are lower than those of males, the difference also being statistically significant. In male and female blood donors, irrespective of the number of donations, average values of 13.74 ag and 12.07 ag of ferritin per erythrocyte, respectively, were established. The difference in ferritin concentration in the erythrocytes between males and females is statistically insignificant. The correlation coefficient failed to demonstrate any dependence between erythrocyte ferritin concentration and concentration of ferritin in the serum. The object of serum ferritin determination in blood donors is to detect the earliest stage of storage iron deficiency in the organism. For the latter purpose, the determination of erythrocyte ferritin is ineffective.     

Serum ferritin estimation in blood donors subject to apheresis on IBM 2997 cell separator

The serum ferritin concentration was tested in blood donors selected for apheresis on IBM Cell Separator. Of 41 donors, 28 were males and 13 females. All donors exhibited normal hemoglobin and RBC. The mean value of serum ferritin was 90.93 ng/ml in males and 48.38 ng/ml in females. In males--often with repeated blood donations--a low value of serum ferritin suggesting reduced Fe stores in organism was found in one individual only. In contrast, reduced serum ferritin levels were observed in 4 females who, before apheresis, regularly donated blood or had several pregnancies in their anamnesis. The obtained results point to prelatent or latent sideropenia. Serum ferritin concentration was measured in 18 donors selected for apheresis. The examination of ferritin was performed prior to, immediately after, and one week post separation. No significant changes in serum ferritin concentrations due to the separation procedure were observed. Preventive tests of serum ferritin in multiple blood donations and in women with previous pregnancies are recommended.     

Iron stores in female blood donors evaluated by serum ferritin

Iron stores were evaluated by serum ferritin determinations in 948 menstruating and 141 non-menstruating female blood donors. Blood donation was associated with a decrease in ferritin. First-time donors (n = 163) had a geometric mean ferritin of 24 micrograms/l and multiple-time donors a value of 19 micrograms/l (p less than 0.01). In the donating population 31.5% had ferritin values less than 15 micrograms/l (i.e. depleted iron stores). Menstruating donors had lower mean serum ferritin than non-menstruating donors (p less than 0.001), and a higher frequency of ferritin values less than 15 micrograms/l (p less than 0.05). There was no relationship between ferritin levels and the number of pregnancies. The frequency of donations was more predictive of ferritin levels than the number of donations. Mean ferritin displayed a moderate fall up to the 2nd donation, and was hereafter relatively constant, whereas an increase in donation frequency was accompanied by a significant decrease in ferritin. Female donors, especially when phlebotomised greater than or equal to 3 times per year, should have their iron status checked at appropriate intervals by measurement of serum ferritin and should be advised regular iron supplementation.     

Serum ferritin and the iron status of Canadians.

Serum ferritin concentration was determined in 1105 Canadians aged 1 to 90 years. Geometric mean values (ng/ml) were as follows: children 1 to 4 years old, 12; children 5 to 9 years old, 15; adolescent girls, 17; adolescent boys, 18; women 20 to 39 years, 23; women 65 years and older, 52; men 20 to 39 years, 93; and men 40 and older, 92. Ranges were side in all age groups, reflecting variations in size of body iron stores. From analysis of the ferritin values it is highly probably that iron stores were greatly reduced in approximately 25% of children, 30% of adolescents, 30% of menstruating women, 60% of pregnant women and 3% of men. Iron-deficiency anemia was noted in only 2% of subjects. If "normality" requires more than small amounts of storage iron to meet physiologic demands, the study results suggest a high probability of iron deficiency in 60% of the pregnant women and in 19% of the other subjects; but if normality is defined as maintenance of adequate iron stores for erythropoiesis, the prevalence of iron deficiency was zero in the pregnant women and 2% in the other subjects.     

Social structure of the donor sample of a district blood donation and transfusion institute

The change from paid blood donation to that made within the Red Cross Organization at the Erfurt District Institute for Blood Donation and Transfusion Service is reflected in the altered composition of the donor population. Team A (n = 4903) consists of "traditional" paid blood donors and Red Cross blood donors. It is characterized as follows: - approximately equal percentage of men and women, - high percentage of working class people with skilled worker's certificate. Women are relatively less frequent among blood donors than men, they are more frequently represented, however, as Red Cross blood donors. Team B (n = 759) covers all new blood donors since 1986, exclusively Red Cross blood donors. It is characterized as follows: - women are represented by 69% (predominantly female students), - the highest percentage (42%) of the team is made up of students. The percentage of blood donors from working class people with a skilled worker's certificate correspond to GDR average. Among the donors graduates from technical colleges and universities are overrepresented, whereas trained working class people with a skilled worker's certificate and those without it are underrepresented. Members of the staff of the municipal health service and Medical Academy as well as students of medicine and education made up the highest percentage of blood donors. About 17% of all members of the medical health service are blood donors, far more than in other branches of Erfurt.     

Seroprevalence of Fecal-Oral Transmitted Hepatitis A and E Virus Antibodies in Burkina Faso

Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections occur chiefly as a result of unhygienic conditions. The purpose of this study was to assess the seroprevalence of antibodies to both viruses in central Burkina Faso in the absence of a recorded hepatitis epidemic. Serum samples from 178 blood donors (131 males and 47 females) and from 189 pregnant women were collected from November 2010 to March 2012, at blood banks and medical centers in Burkina Faso. An immunochromatography test was used to screen for Anti-HAV IgM and IgG in a subgroup of 91 blood donors and 100 pregnant women. The seroprevalence of anti-HAV IgG was 14.3% [CI95, 7.1–21.4%] for all blood donors and 23% [CI95, 14.8–31.2%] for pregnant women. Anti-HEV IgG were detected using the ELISA kits Dia.pro and Wantai and were found in 19.1% [CI95, 13.3–24.9%] of the blood donors and 11.6% [CI95, 7.1–16.2%] of the pregnant women. The seroprevalences of anti-HAV and anti-HEV IgGs did not differ significantly between men and women blood donors. Anti-HAV IgM was detected in 3.3% of the blood donors and in 2% of the pregnant women. These findings for asymptomatic individuals indicate that the HAV and HEV circulate at low but significant levels. This is the first evaluation of the acute hepatitis virus burden in Burkina Faso and the underlying epidemiologic status of the population.     

High-titered anti-HBs plasma donors--another form of post-hepatitic immunopathy syndrome

In the population of 55 high-titered anti-HBs donors only 23 tolerated plasmapheretic collections without intermittent elevations or ALT activity. In 4 persons a RIA-detected HBsAg circulated along with high-titered anti-HBs. In 73.8% of donors anti-HBs was accompanied by an anti-HBe antibody which also appeared in the HBIG preparation HEPAGA and can perhaps participate on its protective influence. Circulating immune complexes (CIC) were detected in 89.1%. No HBsAg, HBeAg, or albumin were detected in CIC isolated from anti-HBs sera in spite of their content in CIC isolated from HBsAg carriers. Thus, CIC carriers found in normal population with a prevalence of 1.0% can be divided into 0.6% of HHsAg-containing CIC and 0.4% of HBsAg-lacking CIC carriers with anti-HBs attesting the hepatitic origin in a considerable part of them. The continuing production of alienated CIC-forming antigens and a common origin combine these two forms of post-hepatitic development to a syndrome of post-hepatitic immunopathy which seems to be the most frequent source of CIC in a normal population. All the donors and HEPAGA were anti-HBc positive, as well, but this antibody possessed the IgM character only in 4.3% of the donors. Mean serum ferritin levels in the anti-HBs donors were distinctly higher than those found in normal populations of both men and women but the differences were statistically not significant due to high variability.     

Association Between Serum Magnesium and Anemia: China Health and Nutrition Survey

The role of magnesium in anemia remains unclear. We aimed to investigate the prevalence of anemia and its association with serum magnesium in a nationally representative sample. A total of 8,511 participants aged 18 years and over were recruited in this cross-sectional survey in 2009. Anemia was defined as hemoglobin concentration less than 130 g/l for men and less than 120 g/l for women. Multiple logistic regression models were applied to explore the association of magnesium and anemia. The prevalence of anemia in total was 14.0 % with 8.8 % for men and 18.5 % for women (P?<?0.0001), respectively. The interaction terms between magnesium and gender and ferritin were significant (P?<?0.001). In men with serum ferritin ≥15 ng/ml, compared with the first quartile of magnesium, the odds ratios (ORs) and 95 % confidence intervals (CIs) for those in the second, third, and fourth quartile of magnesium were 0.65 (0.46, 0.91), 0.77 (0.55, 1.09), and 0.63 (0.45, 0.89), respectively, after adjusting multiple confounders. Likewise, in women with serum ferritin ≥15 ng/ml, the corresponding ORs (95 % CIs) were 0.71 (0.56, 0.91), 0.64 (0.49, 0.84), and 0.53 (0.40, 0.71). The associations between magnesium and anemia were not significant in neither men nor women with serum ferritin <15 ng/ml. Serum magnesium was inversely associated with anemia in both men and women, in particular among adults with high serum ferritin levels.     

Isotopic evidence of unaccounted for Fe and Cu erythropoietic pathways

Despite its potential importance for understanding perturbations in the Fe-Cu homeostatic pathways, the natural isotopic variability of these metals in the human body remains unexplored. We measured the Fe, Cu, and Zn isotope compositions of total blood, serum, and red blood cells of ~50 young blood donors by multiple-collector ICP-MS after separation and purification by anion exchange chromatography. Zinc shows much less overall isotopic variability than Fe and Cu, which indicates that isotope fractionation depends more on redox conditions than on ligand coordination. On average, Fe in erythrocytes is isotopically light with respect to serum, whereas Cu is heavy. Iron and Cu isotope compositions clearly separate erythrocytes of men and women. Fe and Cu from B-type men erythrocytes are visibly more fractionated than all the other blood types. Isotope compositions provide an original method for evaluating metal mass balance and homeostasis. Natural isotope variability shows that the current models of Fe and Cu erythropoiesis violate mass balance requirements. It unveils unsuspected major pathways for Fe, with erythropoietic production of isotopically heavy ferritin and hemosiderin, and for Cu, with isotopically light Cu being largely channeled into blood and lymphatic circulation rather than into superoxide dismutase-laden erythrocytes. Iron isotopes provide an intrinsic measuring rod of the erythropoietic yield, while Cu isotopes seem to gauge the relative activity of erythropoiesis and lymphatics.     

Effects of HFE C282Y and H63D polymorphisms and polygenic background on iron stores in a large community sample of twins

The aim of this study was to assess and to compare the role of HFE polymorphisms and other genetic factors in variation in iron stores. Blood samples were obtained from 3,375 adult male and female twins (age range 29-82 years) recruited from the Australian Twin Registry. There were 1,233 complete pairs (562 monozygotic and 571 dizygotic twins). Serum iron, transferrin, transferrin saturation with iron, and ferritin were measured, and the HFE C282Y and H63D genotypes were determined. The frequency of the C282Y allele was.072, and that of the H63D allele was.141. Significant sources of variation in the indices of iron status included age, sex, age-sex interaction, body-mass index, and both the C282Y and H63D genotypes. The iron, transferrin, and saturation values of CC and CY subjects differed significantly, but the ferritin values did not. After correction for age and body-mass index, 23% and 31% of the variance in iron, 66% and 49% of the variance in transferrin, 33% and 47% of the variance in transferrin saturation, and 47% and 47% of the variance in ferritin could be explained by additive genetic factors, for men and women, respectively. HFE C282Y and H63D variation accounted for <5% of the corrected phenotypic variance, except for saturation (12% in women and 5% in men). We conclude that HFE CY and HD heterozygotes differ in iron status from the CC and HH homozygotes and that serum transferrin saturation is more affected than is serum ferritin. There are highly significant effects of other as-yet-unidentified genes on iron stores, in addition to HFE genotype.     

The course of serum ferritin in blood donors

In the course of 18 months there occurred a decrease in the serum ferritin concentration from 58 +/- 2 micrograms/l to 32 +/- 1 micrograms/l in male donors after 5-6 donations of 400 ml of blood each. Female permanent donors showed a constantly lowered content of an average of 15 +/- 1 micrograms/l. Female first donors attained the serum ferritin level of permanent female donors with the fourth donation, whereas it was not until the fifth donation that male first donors declined to the level of permanent donors. This decrease of serum ferritin content in blood donors points to a depletion of iron stores. This process should be counteracted by exerting an increased influence on nutritional habits supported by oral iron substitution and diminishing the frequency of donation, particularly for female blood donors.     

Estimation of Dietary Iron Bioavailability from Food Iron Intake and Iron Status

Currently there are no satisfactory methods for estimating dietary iron absorption (bioavailability) at a population level, but this is essential for deriving dietary reference values using the factorial approach. The aim of this work was to develop a novel approach for estimating dietary iron absorption using a population sample from a sub-section of the UK National Diet and Nutrition Survey (NDNS). Data were analyzed in 873 subjects from the 2000–2001 adult cohort of the NDNS, for whom both dietary intake data and hematological measures (hemoglobin and serum ferritin (SF) concentrations) were available. There were 495 men aged 19–64 y (mean age 42.7±12.1 y) and 378 pre-menopausal women (mean age 35.7±8.2 y). Individual dietary iron requirements were estimated using the Institute of Medicine calculations. A full probability approach was then applied to estimate the prevalence of dietary intakes that were insufficient to meet the needs of the men and women separately, based on their estimated daily iron intake and a series of absorption values ranging from 1–40%. The prevalence of SF concentrations below selected cut-off values (indicating that absorption was not high enough to maintain iron stores) was derived from individual SF concentrations. An estimate of dietary iron absorption required to maintain specified SF values was then calculated by matching the observed prevalence of insufficiency with the prevalence predicted for the series of absorption estimates. Mean daily dietary iron intakes were 13.5 mg for men and 9.8 mg for women. Mean calculated dietary absorption was 8% in men (50^th percentile for SF 85 µg/L) and 17% in women (50^th percentile for SF 38 µg/L). At a ferritin level of 45 µg/L estimated absorption was similar in men (14%) and women (13%). This new method can be used to calculate dietary iron absorption at a population level using data describing total iron intake and SF concentration.     

Are our blood donors in danger of iron deficiency?]

In blood donors the question arises for eventual endangering by iron deficiency. The results of this work show that ferritin determinations for blood donors will indicate a latent, in some cases a manifest iron deficiency. The examination of testing components such as PVC, MCH, Fe i. S., transferrin and transferrin saturation produced no special advantages concerning sensitivity and specificity, in terms of ferritin determination. It is indispensable, however, to know the ferritin value because the control of the Hb value prior to blood donation will usually characterize the blood donor's situation in a sufficient manner. For control purposes it is possible to use capillary or venous blood. It is only in general, but particularly in special clinical situations that you have to be aware of the blood donor's condition concerning his/her Fe-metabolism.     

Molecular analysis of homeostatic iron regulator,transmembrane protease serine-6, and BTB domain-containing protein-9 variants and iron parameters in blood donors

Genetic variants associated with iron homeostasis have been identified, but their association with iron-related indices and variables among different ethnic populations remains controversial. We aimed to explore the genotype frequency and allelic distribution of three iron-metabolism related variants in homeostatic iron regulator gene (HFE; rs1800562 G/A), transmembrane protease, Serine-6 gene (TMPRSS6; rs855791 A/G), and BTB domain-containing protein-9 gene (BTBD9; rs9357271 C/T) among a sample of the Middle Eastern blood donors and to detect the association of these variants on blood indices, and serum hepcidin/ferritin levels. Real-Time TaqMan genotyping assay for the specified variants was applied for 197 unrelated blood donors. Complete blood picture and serum hepcidin/ferritin levels were assessed. All participants were carriers of rs1800562*G/G genotype for HFE. The frequency of A/A and A/G genotypes of TMPRSS6 rs855791 variant was 55% and 45%, and for C/C, C/T, and T/T of BTBD9 rs9357271, were 15%, 43%, and 42%, respectively. Minor allele frequencies of rs855791*G and rs9357271*C were 0.23 and 0.37. The GGC genotype combination (for HFE/TMPRSS6/BTBD9, respectively) was more frequent in male participants. Higher serum hepcidin and hepcidin/ferritin ratio were observed in TMPRSS6 (A/G) carriers. While subjects with BTBD9 C/T and TT genotypes had lower serum ferritin values and higher levels of hepcidin and hepcidin/ferritin ratio compared with C/C genotype. No significant associations were found with any other blood parameters.In conclusion, TMPRSS6 rs855791 (A/G) and BTBD9 rs9357271 (C/T) variants were prevalent in the present blood donor population and may influence the serum hepcidin and/or ferritin levels.     

Levels of Circulating DNA in Blood Serum and DNA Damage in Leukocytes of Healthy Donors of Different Genders and Ages

We studied the levels of extracellular nuclear and mitochondrial DNA of blood serum and DNA damage in leukocytes of healthy donors of different sex and age groups. The baseline levels of DNA damage in leukocytes and serum DNA levels were shown to vary greatly among different donors. The baseline level of DNA damage in leukocytes was not associated with the presence of chronic deceases or an occupational health risk for elderly donors. It was found that extracellular DNA concentrations were generally higher in men than in women. There is a tendency towards an increase in the relative mitochondrial DNA copy number determined by ΔCt in women but not in men: the relative mtDNA copy number in elderly individuals varies significantly in both sexes, possibly due to age-related physiological changes. It is necessary to consider the gender and age of patients when using an indicator such as the level of extracellular DNA of blood serum for diagnosis and monitoring.

     

Serum ferritin in colorectal cancer patients and its prognostic evaluation

The aim of this study was to investigate the relationship between preoperative serum ferritin levels, clinico-pathological parameters and survival analysis of patients with colorectal cancer. Ninety-four patients (57 males) with a mean age of 65 years (39-87 years) underwent 63 curative and 31 palliative operations. Follow-up was at least 5 years. Patients were categorized with normal (30-215 ng/mL in men and 11-148 ng/mL in women), low, or high serum ferritin levels. Prognostic evaluation was undertaken with stratified survival analysis and Cox's regression model. Twenty-nine of the patients (30.9%) had raised ferritin levels and 14 (14.9%) had low values. Comparisons of the survival curves showed significant differences in stage C disease; specifically, patients with either low or high ferritin levels had a shorter survival than patients with normal levels. Patients who underwent palliative surgery and had high ferritin serum values also had a shorter survival. In multivariate analysis, the variables with a negative effect on survival were stage, serum ferritin levels and age. Our data suggest that patients with advanced colorectal cancer having normal preoperative serum ferritin levels may have a better prognosis, although the prognostic value related to this association requires further investigation.     

Comprehensive Reference Ranges for Hematology and Clinical Chemistry Laboratory Parameters Derived from Normal Nigerian Adults

Background

Interpretation of laboratory test results with appropriate diagnostic accuracy requires reference or cutoff values. This study is a comprehensive determination of reference values for hematology and clinical chemistry in apparently healthy voluntary non-remunerated blood donors and pregnant women.

Methods and findings

Consented clients were clinically screened and counseled before testing for HIV, Hepatitis B, Hepatitis C and Syphilis. Standard national blood donors’ questionnaire was administered to consented blood donors. Blood from qualified volunteers was used for measurement of complete hematology and chemistry parameters. Blood samples were analyzed from a total of 383 participants, 124 (32.4%) males, 125 (32.6%) non-pregnant females and 134 pregnant females (35.2%) with a mean age of 31 years. Our results showed that the red blood cells count (RBC), Hemoglobin (HB) and Hematocrit (HCT) had significant gender difference (p = 0.000) but not for total white blood count (p>0.05) which was only significantly higher in pregnant verses non-pregnant women (p = 0.000). Hemoglobin and Hematocrit values were lower in pregnancy (P = 0.000). Platelets were significantly higher in females than men (p = 0.001) but lower in pregnant women (p = 0.001) with marked difference in gestational period. For clinical chemistry parameters, there was no significant difference for sodium, potassium and chloride (p>0.05) but gender difference exists for Bicarbonate (HCO3), Urea nitrogen, Creatinine as well as the lipids (p<0.05). Total bilirubin was significantly higher in males than females (p = 0.000). Significant differences exist for all chemistry parameters between pregnant and non-pregnant women in this study (p<0.05), except Amylase and total cholesterol (p>0.05).

Conclusions

Hematological and Clinical Chemistry reference ranges established in this study showed significant gender differences. Pregnant women also differed from non-pregnant females and during pregnancy. This is the first of such comprehensive study to establish reference values among adult Nigerians and difference observed underscore the need to establish reference values for different populations.     

Iron deficiency and smoking. Comparative criteria for buccal mucosa keratinization in menstruating and postmenopausal women

OBJECTIVE: To compare the degree of keratinization of buccal mucosa between nonsmoking menstruating and postmenopausal women without oral complaints whose iron status was established. STUDY DESIGN: Samples collected from 26 nonsmoking, regularly menstruating women (mean age, 26 years) and 18 nonsmoking, postmenopausal women without oral complaints (mean age, 57 years) were stained according to the method of Papanicolaou. Keratinization was evaluated by the karyopyknotic index (KI). Iron status was assessed with blood ferritin levels. RESULTS: Mean ferritin values of menstruating and postmenopausal women were statistically significantly different (mean ferritin value = 28.97 micrograms/L and 103.69 micrograms/L, respectively). The difference in the degree of keratinization of buccal mucosa between menstruating women (mean KI = 16.03%) and postmenopausal women (mean KI = 13.16) was statistically nonsignificant. CONCLUSION: Our results indicate that the degree of keratinization of buccal mucosa does not show any alteration after menopause.     

Blood flow response to a postural challenge in older men and women

BACKGROUND: The purpose of this study was to measure blood flow in the carotid and femoral arteries, heart rate and blood pressure in response to postural challenge in older adults. A second purpose was to determine if older men and women have different cardiovascular responses to a postural challenge such as tilt. METHODS: Thirty-seven healthy elderly men and women participated in this study (69-82 years old). All subjects had similar physical activity levels. Postural challenge was induced by a 60 degrees tilt at the level of the waist. Continuous carotid blood flow and femoral blood flow was measured with Doppler ultrasound. RESULTS: Carotid blood flow was significantly reduced 17% in both men and women immediately after tilt (p < 0.001), and by 3.2% two minutes after tilt (p < 0.001). Femoral blood flow decreased 59.4% in men and 61% in women immediately after tilt (p < 0.001), and remained significantly decreased two minutes after tilt by 21% (p <0.001). Heart rate increased by 15% in men (p < 0.001), and 26% in women immediately after the tilt (p < 0.001). Heart rate returned to resting values within two minutes in both men and women. Response to tilt was not significantly related to self-report physical activity levels or to six-minute walk time. CONCLUSION: A postural challenge induced larger changes in the femoral artery compared to the carotid artery. There were no differences between men and women to a tilt table test except for differences in heart rate response. There was no difference in the blood flow responses to postural challenge with physical activity level or between healthy older men and women.     

Menopause effect on blood Fe and Cu isotope compositions

Iron (δ⁵⁶Fe) and copper (δ⁶⁵Cu) stable isotope compositions in blood of adult human include a sex effect, which still awaits a biological explanation. Here, we investigate the effect of menopause by measuring blood δ⁵⁶Fe and δ⁶⁵Cu values of aging men and women. The results show that, while the Fe and Cu isotope compositions of blood of men are steady throughout their lifetime, postmenopausal women exhibit blood δ⁶⁵Cu values similar to men, and δ⁵⁶Fe values intermediate between men and premenopausal women. The residence time of Cu and Fe in the body likely explains why the blood δ⁶⁵Cu values, but not the δ⁵⁶Fe values, of postmenopausal women resemble that of men. We suggest that the Cu and Fe isotopic fractionation between blood and liver resides in the redox reaction occurring during hepatic solicitation of Fe stores. This reaction affects the Cu speciation, which explains why blood Cu isotope composition is impacted by the cessation of menstruations. Considering that Fe and Cu sex differences are recorded in bones, we believe this work has important implications for their use as a proxy of sex or age at menopause in past populations. Am J Phys Anthropol 153:280–285, 2014. © 2013 Wiley Periodicals, Inc.