Iron deficiency

Iron deficiency and anemia affect a substantial portion of the world’s population, provoking severe health problems to the people suffering these conditions, as well as important economic losses to the regions in which this nutritional deficiency is significant. In this work, the principal causes and consequences produced by this deficiency are discussed, as well as the different strategies that can be applied in order to prevent and solve this nutritional problem.     

Malnutrition,anemia, micronutrient deficiency and parasitic infections among schoolchildren in rural Tanzania

BackgroundMalnutrition, anemia, micronutrient deficiency and parasitic infections continue to impact the nutritional status and health of children in lower-income countries. However, not enough data concerning this issue is available. The aim of this study was to assess the distribution of nutritional indicators, anemia and micronutrient deficiency and their underlying risk factors among schoolchildren in south-eastern Tanzania.Methodology/Principal findingsThis cross-sectional study enrolled primary schoolchildren aged 6–12 years from Kikwawila and Kiberege wards, Tanzania. In total, 471 schoolchildren underwent a physical examination and provided blood, stool and urine samples for an assessment of the levels of different micronutrients, nutritional and anemia status, and parasitic infection status. We employed bivariate and multivariate logistic regression to determine the association between nutritional statuses, anemia, micronutrient deficiency and parasitic infections. We found that 23.90%, 12.60% and 16.20% of schoolchildren were stunted, underweight and wasted, respectively. About 14.0% of schoolchildren were found to be anemic. Children diagnosed with Plasmodium falciparum infection were more likely to have low levels of ferritin (aOR: 10.40, 95% CI: 2.88-40.53) and elevated levels of serum soluble transferrin receptor (aOR: 3.59, 95% CI: 1.27-11.23), respectively. Vitamin A (34.71%) and vitamin B12 (8.79%) were the most prevalent micronutrients found to be deficient in diagnosed children. Finally, we found that schoolchildren attending the most rural schools were five times more likely to be diagnosed with at least one micronutrient deficiency (aOR: 5.04, 95% CI: 2.38–11.44).Conclusions/SignificanceMalnutrition, anemia and micronutrient deficiency still pose a significant health burden among schoolchildren living in rural Tanzania. To effectively tackle this burden, health interventions such as deworming, micronutrient supplementation, vector control, health education and access to clean water and improved sanitation should be strengthened and made sustainable.     

Iron deficiency in obese postmenopausal women

Objective: This study evaluates whether the iron deficiency suggested in children and adolescents with overweight is also present with increasing age. Research Methods and Procedures: We examined 50 consecutive postmenopausal nondiabetic white women with a BMI ≥30 kg/m² and 50 non‐obese seemingly healthy women as a control group. In addition to the traditional indices of iron status, we measured the soluble transferrin receptor (sTfR) levels, a sensitive and highly quantitative indicator of early iron deficiency not influenced by the acute phase response. Results: Obese women have higher serum sTfR levels than control subjects [1.38 (range, 0.89 to 2.39) vs. 1.16 mg/dL (range, 0.69 to 2.03 mg/dL); p < 0.001]. However, no difference in ferritin concentration was observed between the groups [70.50 (range, 18 to 219) vs. 69.50 ng/mL (range, 24 to 270 ng/mL); p = not significant]. A positive correlation between BMI and sTfR concentration was detected. On multiple regression analyses, BMI (positively) and ferritin (inversely) were independent predictors accounting for sTfR. Discussion: These results suggest that a moderate degree of iron deficiency is also present among adult women with obesity. The determination of sTfR is useful in the evaluation of iron status in this condition. Further studies with a greater number of patients are required to investigate the relationship between tissue iron concentrations and obesity.     

Iron deficiency on neuronal function

Because of the intrinsic ability of iron to catalyze the formation of reactive oxygen species, it has been associated with oxidative stress and neurodegenerative diseases. However, iron deficiency (ID) also negatively impacts various functions of the brain, suggesting that iron plays an important physiological role in neuronal processes such as myelination, synaptogenesis, behavior and synaptic plasticity (SP). ID not only produces changes in the hippocampus, striatum, amygdale or prefrontal cortex, it also affects the interaction among these systems. In both humans and rodents, the perturbations of these structures are associated to cognitive deficits. These cognitive alterations have been well correlated with changes in neural plasticity, the possible cellular substrate of memory and learning. Given that SP is strongly affected by early ID and the lasting-neurological consequences remain even after ID has been corrected, it is important to prevent ID as well as to seek effective therapeutic interventions that reduce or reverse the long-term effects of the ID in the nervous system. This review will give an overview of the literature on the effects of iron deficit in neuronal functions such as behavior, neurotransmission and SP. We also discuss our recent data about the possible oxidative effect of iron on the mechanisms involved in neural plasticity.     

Glucose-6-phosphate dehydrogenase deficiency in Kuwait, Syria, Egypt, Iran, Jordan and Lebanon

A total of 3,501 male subjects from six Arab countries living in Kuwait were investigated for quantitative and phenotypic distribution of red cell glucose-6-phosphate dehydrogenase (G6PD). The ethnic origins of those investigated were Kuwait, Egypt, Iran, Syria, Lebanon and Jordan. The distribution of G6PD deficiency among the different ethnic groups varied widely, ranging from 1.00% for Egyptians to 11.55% for Iranians. The activity of the normal enzyme was remarkably similar, with values ranging from 6.1 +/- 0.8 to 6.5 +/- 1.1 IU/g Hb. A low frequency of the Gd(A) allele was found in two ethnic groups, Egyptians (0.019) and Iranians (0.014). Gd(A-) was present at the very low frequency of 0.006 in another two ethnic groups, Kuwaitis and Jordanians.     

Brassiodol, a new iodised oil for goitrous patients

A new iodised oil, called Brassiodol, is proposed to prevent or eradicate 127I-deficiency disorders. Its original synthesis utilises rapeseed oil as vehicle of iodination, allowing the covalent binding of 127I atoms to all olefin groups of fatty acids (FAs). The final product contains 376 mg 127I/mL, manifests high refractoriness to degradative processes and is well tolerated by goitrous patients. The proposed dosage is 1 mL/year in adults owing to the rapid deiodination and massive 127I leakage of larger amounts in the urinary output. About 300-350 mg 127I may undergo tissue sequestration, insuring appropriate iodine coverage during 9-12 months. Clinical follow-up, hormonal data, and 127I excretory kinetics point to the normalisation of thyroid function within 3 months is stages I and II of the goitrous disease. This iodised oil, characterised by low cost, easy handling and high nutritional efficiency, seems ideally suited to meet public health and economical problems in countries facing severe goitrous areas.     

Iron deficiency decreases gluconeogenesis in isolated rat hepatocytes

Dietary iron deficiency in rats results in increased blood glucose turnover and recycling. We measured the rates of glucose production in isolated hepatocytes from iron-sufficient (Fe+) and iron-deficient (Fe-) rats to assess the intrinsic capacity of the Fe- liver to carry out gluconeogenesis. Low-iron and control diets were given to 21-day-old female rats. After 4-5 wk, hemoglobin concentrations averaged 4.1 g/dl in the Fe- and 14.3 g/dl in the Fe+ animals. In the hepatocytes from Fe- rats, there was a 35% decrease in the rate of glucose production from 1 mM pyruvate + 10 mM lactate, a 48% decrease from 0.1 mM pyruvate + 1 mM lactate, a 39% decrease from 1 mM alanine, and a 48% decrease from 1 mM glycerol. The addition of 5 microM norepinephrine or 0.5 microM glucagon to the incubation media produced stimulatory effects on hepatocytes from both Fe- and Fe+ rats, resulting in the maintenance of an average difference of 38% in the rates of gluconeogenesis between the two groups. Studies on isolated liver mitochondria and cytosol revealed alpha-glycerophosphate-cytochrome c reductase and phospho(enol)pyruvate carboxykinase activities to be decreased by 27% in Fe- rats. We conclude that because severe dietary iron deficiency decreases gluconeogenesis in isolated rat hepatocytes, the increased gluconeogenesis demonstrated by Fe- rats in vivo is attributable to increased availability of gluconeogenic substrates and upregulation of the pathway.     

Iron deficiency differently affects peroxidase isoforms in sunflower

The response of both specific (ascorbate peroxidase, APX) and unspecific (POD) peroxidases and H(2)O(2) content of sunflower plants (Helianthus annuus L. cv. Hor) grown hydroponically with (C) or without (-Fe) iron in the nutrient solution were analysed to verify whether iron deficiency led to cell oxidative status. In -Fe leaves a significant increase of H(2)O(2) content was detected, a result confirmed by electron microscopy analysis. As regards extracellular peroxidases, while APX activity significantly decreased, no change was observed in either soluble guaiacol or syringaldazine-dependent POD activity following iron starvation. Moreover, guaiacol-dependent POD activity was found to decrease in both ionically and covalently-cell-wall bound fractions, while syringaldazine-POD activity decreased only in the covalently-bound fraction. At the intracellular level both guaiacol-POD and APX activities underwent a significant decrease. The overall reduction of peroxidase activity was confirmed by the electrophoretic separation of POD isoforms and, at the extracellular level, by cytochemical localization of peroxidases by diaminobenzidine staining. The electrophoretic separation, besides quantitative differences, also revealed quantitative changes, particularly evident for ionically and covalently-bound fractions. Therefore, in sunflower plants, iron deficiency seems to affect the different peroxidase isoenzymes to different extents and to induce a secondary oxidative stress, as indicated by the increased levels of H(2)O(2). However, owing to the almost completely lack of catalytic iron capable of triggering the Fenton reaction, iron-deficient sunflower plants are probably still sufficiently protected against oxidative stress.     

Iron deficiency in pea plants effect on catalase,peroxidase, chlorophyll and proteins of leaves

Summary Pea plants (Pisum sativum L., var. Lincoln) were grown in nutrient cultures at 4 levels of iron, 0.60 ppm (low), 0.96 ppm (low), 3.0 ppm (normal) and 30 ppm (excess) for 45 days.Leaf extracts were assayed for chlorophyll, proteins, catalase and peroxidase activities. Catalase and chlorophyll were closely related to iron supply. An inverse relationship was observed between peroxidase and catalase activities. Peroxidase was increased both at dificiency and excess iron levels, but was depressed at normal iron supply. The peroxidase/catalase ratio varied with iron supply and showed a minimum value of about 39 at 15 and 30 days growth, at adequate iron supplies.Measurement of catalase activity and the use of peroxidase/catalase ratios appear to be helpful in identifying iron deficiencies in peas.     

The proportion of tetrahydrobiopterin deficiency and PAH gene deficiency variants among cases with hyperphenyalaninemia in Western Iran

BACKGROUND:

Defects either in phenylalanine hydroxylase (PheOH) or in the production and recycling of its cofactor (tetrahydrobiopterin [BH4]) are the causes of primary hyperphenylalaninemia (HPA). The aim of our study was to investigate the current status of different variants of HPA Kurdish patients in Kermanshah province, Iran.

MATERIALS AND METHODS:

From 33 cases enrolled in our study, 32 were identified as HPA patients. Reassessing of pre-treatment phenylalanine concentrations and the analysis of urinary pterins was done by high-performance liquid chromatography method.

RESULTS:

A total of 30 patients showed PAH deficiency and two patients were diagnosed with BH4 deficiency (BH4/HPA ratio = 6.25%). Both of these two BH4-deficient patients were assigned to severe variant of dihydropteridine reductase (DHPR) deficiency. More than 75% of patients with PAH deficiency classified as classic phenylketonuria (PKU) according their levels of pre-treatment phenylalanine concentrations.

CONCLUSION:

Based on the performed study, we think that the frequency of milder forms of PKU is higher than those was estimated before and/or our findings here. Furthermore, the frequency of DHPR deficiency seems to be relatively high in our province. Since the clinical symptoms of DHPR deficiency are confusingly similar to that of classic PKU and its prognosis are much worse than classical PKU and cannot be solely treated with the PKU regime, our pilot study support that it is crucial to set up screening for BH4 deficiency, along with PAH deficiency, among all HPA patients diagnosed with HPA.     

Association Between Zinc, Copper, and Iron Concentrations in Breast Milk and Growth of Healthy Infants in Tabriz, Iran

The aims of this study were to determine the effect of breast milk zinc, copper, and iron concentrations on infants’ growth and their possible correlations with maternal dietary intake. Milk samples and information on food intake were collected from 182 lactating women. Concentrations of zinc, copper, and iron in milk were analyzed using atomic absorption spectrophotometry. The infant’s weight for age Z-score (WAZ) and height for age Z-score (HAZ) were calculated. The mean milk zinc, copper, and iron concentrations were 1.85?±?0.5, 0.53?±?0.3, and 0.85?±?0.2 mg/l, respectively. Only zinc mean level was lower than the recommended range. Association between zinc, copper, and iron concentrations of milk and WAZ or HAZ of infants were not significant. However, the WAZ of infants whose mothers' milk zinc was more than 2 mg/l was significantly (P?<?0.039) higher than for others. The mean dietary zinc (5.31?±?2.3 mg/day) and copper (1.16?±?0.7 mg/day) intake of mothers was significantly less than the required daily intake (RDA) recommendations (P?<?0.05). The mean dietary iron intake (11.8?±?8.2 mg/day) was significantly higher than RDA recommendation (P?<?0.001). No significant association was found between maternal mean dietary zinc, copper, and iron intakes with their concentrations in milk. Dietary consultation or/and zinc supplementation is suggested for lactating women and infants.     

Iron overload can induce mild copper deficiency

Dietary copper in the U.S. often is lower than that proved insufficient for men and women under controlled conditions. Iron overload can have adverse effects on copper nutriture and can produce cardiac disease in people. The hypothesis that iron can interfere with copper utilization to produce adverse effects related to cardiovascular function was tested.

Rats were fed a diet high in iron and marginal, but not deficient in copper for comparison with similar diets containing iron at the recommended amount. Copper and iron were measured by atomic absorption spectroscopy; cholesterol was measured by fluorescence, ceruloplasmin was measured by oxidase activity and hematology was done by an automated cell counter. When dietary copper was 2.0 mg/kg of diet, high iron decreased (p<0.008) cardiac and hepatic copper, plasma copper and ceruloplasmin, and increased (p<0.02) cardiac weight, hepatic iron and plasma cholesterol. When dietary copper was increased to 2.5 mg/kg, copper in heart and plasma decreased (p<0.04) and hepatic iron increased (p=0.001) with high iron but other effects disappeared. No harmful changes in hematology, such as hematocrit, mean corpuscular volume, etc. were found. High iron increased the dietary copper requirement of the animals. People with iron overload may benefit from copper supplementation, particularly if they habitually consume a diet low in copper.     

Iron deficiency in pasture species on coralline rubble soils

Summary Iron deficiency was diagnosed in some pasture species growing on a coralline rubble soil (Troporthent) of high pH in the Solomon Islands. A comparative study of the response of a selection of pasture species to additions of iron indicated differential species tolerance to iron deficiency particularly among legumes.Macroptilium atropurpureum andM. lathyroides produced good yields on this soil without additions of iron while other legume species,Centrosema pubescens, Pueraria phaseoloides andStylosanthes guianensis either grew poorly or failed to survive.