Железодефицитные новости

[Dr.Vad]

железо, витамины Д и В12 у спортсменов
Life (Basel). 2023 Oct; 13(10): 2007.
Iron Status and Physical Performance in Athletes.
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[Dr.Vad]

в/в железо у детей с СБН и другими похожими нарушениями (sleep-related movement disorders), последняя публикация в полной версии:

Treatment of childhood-onset restless legs syndrome and periodic limb movement disorder using intravenous iron sucrose.
Grim K, Lee B, Sung AY, Kotagal S. Sleep Med. 2013 Nov;14(11):1100-4.

Clinical efficacy and safety of intravenous ferric carboxymaltose treatment of pediatric restless legs syndrome and periodic limb movement disorder.
DelRosso LM, Ferri R, Chen ML, Kapoor V, Allen RP, Mogavero MP, Picchietti DL. Sleep Med. 2021 Nov;87:114-118.

Clinical efficacy and safety of intravenous ferric carboxymaltose treatment for restless legs symptoms and low serum ferritin in children with autism spectrum disorder.
DelRosso LM, Reuter-Yuill LM, Cho Y, Ferri R, Mogavero MP, Picchietti DL. Sleep Med. 2022 Dec;100:488-493.

J Clin Sleep Med. 2022 Nov 1;18(11):2545-2551.
Intravenous iron therapy in the pediatric sleep clinic: a single institution experience
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[Dr.Vad]

Identification of women and girls with iron deficiency in the reproductive years

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[Dr.Vad]

дефицит железа у вегетарианцев/веганцев ассоциируется с низким витамином Д, повышением парат-гормона и повышенной резорбцией костей:

High bone remodeling was observed in the high-PTH group, with significantly higher NTx and marginally higher BAP compared to the normal-PTH group. Hematocrit and ferritin were significantly lower in the high-PTH compared to the normal-PTH group. However, serum iron was higher in the high-PTH group, which was only observed for the lacto-ovo vegetarian and vegan subjects. It is concluded that both low vitamin D and low iron status are associated with elevated PTH and bone resorption, more in vegetarians than omnivores, which is in line with the hypothesis that chronic iron deficiency in adulthood mainly predisposes to osteoporosis in postmenopausal women and the elderly.
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Int J Mol Sci. 2024 Sep 24;25(19):10290.
Iron Deficiency Is Associated with Elevated Parathormone Levels, Low Vitamin D Status, and Risk of Bone Loss in Omnivores and Plant-Based Diet Consumers

[Dr.Vad]

еще одна детализированная публикация, когда подозревать и как лечить запущенный годами дефицит железа

Infrequent symptoms in non-anemic patients with iron deficiency

Exceptional fatigue lasting several days after mild to moderate physical activity
Severe headache and treatment-resistant migraine
Severe memory lapses forcing the patient to take rigorous written notes of everything
Weight loss (About 10% of patients lose weight, 60% gain weight and in 30% the weight remains stable)
Muscle tension and cramps unresponsive to muscle relaxants and massage
Therapy-resistant heavy menstruation
Snoring and sleep apnea, both of which resolve when iron deficiency is corrected
Inability to get sun tanning which is reversed when iron stores have been repleted
Nausea and loss of appetite
Plantar fasciitis
Bruxism

Numbness or dysesthesia (pins and needles) of the extremities on one side of face or body, which may require ruling out of multiple sclerosis
Color vision disturbances and blurred vision/inability to focus
Childlessness and recurrent miscarriages
Objectively detected hot/burning skin without fever
Severe heart rate disturbances leading even to syncope at rest or during exercise
Hypokalemia, not associated with high blood pressure or hormonal changes and unresponsive to potassium substitution and spironolactone
Tongue pain
Urticaria
Severe sleeping disturbances / insomnia, which may lead to psychiatric care
Severe depression resistant to treatment including electroconvulsive therapy
Transient swelling of joints without inflammation

Iron Deficiency in the Absence of Anemia - A Common, Complex and Challenging Disease to Treat
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[Dr.Vad]

еще одна публикация в полной версии от техасских специалистов о коррекции жд или жда у подростков, включая когда можно назначать в/в железо без пробного назначения железа внутрь:

Although oral iron supplementation remains the mainstay of therapy for most adolescents with ID, in those who have an incomplete response (persistent ID), intravenous (IV) iron therapy is increasingly being used. The benefits of IV iron include the rapid repletion of iron stores in addition to the resolution of anemia, fewer gastrointestinal side effects, and relief for individuals struggling with long-term iron supplementation. Indications for IV iron as upfront therapy – without a trial of oral iron – are limited to adolescents with severe anemia and/or chronic conditions [77].

Nutritional Strategies for Managing Iron Deficiency in Adolescents: Approaches to a Challenging but Common Problem
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[Dr.Vad]

среди госпитализированных, только ферритин мог выявить дефицит железа как отсутствие железа в костном мозге: ферритин менее 80 указывал на жд без воспаления; с воспалением СРБ более 5 - ферритин менее 200 и железо/ожсс менее 13%; данная работа выполнена на реагентах Рош, поэтому ферритин 80 = еквивалентен 50, а 200 = ~ 125

The study included 139 patients. 42 had BM ID, with a median serum ferritin (SF) of 48.5 μg/L. 96 of 134 (72%) had inflammation with a CRP >5 mg/L. An SF of <80 μg/L had optimal sensitivity (69%) and specificity (94%) for ID diagnosis in the whole group (odds ratio 23.5; 95% confidence interval 4.3-129). In patients without inflammation, an SF cut-off of 80 μg/L had high sensitivity (93%) and specificity (96%). An SF <200 μg/L indicated ID in those with inflammation (sensitivity 78%, specificity 74%). A transferrin saturation of <13% in those with inflammation increased the diagnostic specificity (92%). The reticulocyte haemoglobin was unhelpful in diagnosing ID in this setting. In this hospital population, SF was the best parameter to diagnose ID, even in the presence of inflammation.
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Pathology. 2024 Sep 18:S0031-3025(24)00232-0.
From the marrow to the blood: optimising the diagnosis of iron deficiency in the setting of inflammation.

[Dr.Vad]

дефицит железа и алопеция - результаты из Испании показывают, что у 30% женщин ферритин менее 30, тогда как у мужчин жд как причина алопеции значительно реже 6.5%

Alopecia and Iron Deficiency: An Interventional Pilot Study in Primary Care to Improve the Request of Ferritin
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[Dr.Vad]

пробиотики улучшают переносимость приема железа внутрь и повышают гемоглобин и ферритин:

IRT-Pro group, when compared to IRT-only group, experienced significantly lower rates of gastrointestinal intolerance over the course of IRT (13.0% vs. 46.5%, p<0.001) and treatment discontinuation within the first 30 days (4% vs. 16%, p<0.001).

At 3rd month of therapy, IRT-Pro vs. IRT-only group had significantly higher serum levels for iron (76.0(51.0-96.0) vs. 60.0(43.0-70.0) µg/dL, p<0.001) and transferrin saturation (20.1(12.5-28.5) vs. 14.5(10.5-19.0) %, p<0.001) and higher change from baseline hemoglobin (9(3-13) vs. 4(-1-11) g/L, p<0.001) levels.

Use of Lactobacillus plantarum 299v probiotic supplementation during the first 30 days of IRT in IDA patients significantly reduces the gastrointestinal burden of IRT (particularly abdominal pain and bloating), the likelihood of intolerance development (by ∼3 times) and treatment discontinuation (by∼5 times), as accompanied with improved serum hemoglobin levels and serum iron...
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Br J Nutr. 2024 Nov 4:1-22.
Improved gastrointestinal tolerance and iron status via probiotic use in iron deficiency anemia patients initiating oral iron replacement: A randomized controlled trial

[Dr.Vad]

обзор про негативное влияние дефицита железа на спортивные достижения у спортсменок - коррекция жд ассоциируется с повышением выносливости и силы:

23 studies comprising 669 athletes (age range: 13-47 years) across 16 sports were included in the review. Iron deficiency negatively affects endurance performance by 3%-4%. However, endurance performance improved by 2%-20% when ID athletes were treated with 100 mg/day of elemental iron for up to 56 days via oral supplementation, or bi-daily via parenteral administration over 8-10 days. ID non-anemic athletes with low sFer stores may be predisposed to reduced maximal aerobic capacity. However, maximal aerobic capacity improved by 6%-15% following 16-100 mg/day of elemental iron for 36-126 days. Isokinetic strength and anaerobic power performance may be impeded (-23% to +4%) among ID athletes, but the effect of FeSup on anaerobic power varied markedly (-5% to +9%) following 100 mg/day of elemental iron over 42-56 days, or 100 mg of elemental iron bi-daily over 8-10 days. The quality of studies was moderate (77%), ranging from low (57%) to high (100%). Moststudies (n = 18) contained group sizes ≤ 20 athletes, thus limiting the likelihood of detecting significant effects (statistical power > 0.80)
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J Sport Health Sci. 2024 Nov 11:101009. doi: 10.1016/j.jshs.2024.101009
Iron deficiency, supplementation, and sports performance in female athletes: A systematic review

[Dr.Vad]

статья о высоком риске дефицита железа (53.4% (134/251)) или ЖДА (13.5% (34/251)) среди женщин с эндометриозом, но не у всех чрезмерные потери были единственной причиной ЖД и у 47% (67/142) ЖД был при нормальных потерях; у каждой третьей с ферритином более 30 жд был обнаружен как Ж/ОЖСС менее 0.2;

гемоглобин у женщин с ЖД был на 5 г/л ниже: 129 (121–136) против 134 (129–139) и у 75% женщин без дефицита железа он был 129 и выше;

ферритин был менее 55 у 75% с дефицитом железа, но более 51 у 75% без оного: 29 (21–55) против 65 (51–93)
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High prevalence of undiagnosed iron deficiency in endometriosis patients: A cross-sectional study
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[Dr.Vad]

безанемический дефицит железа и аллергия - на примере женщин с аллергическим ринитом: ln women with allergic rhinitis, dietary intestinal iron absorption and/or cellular iron release are inhibited to a greater degree than in nonallergic individuals...

Functional iron‐deficiency in women with allergic rhinitis is associated with symptoms after nasal provocation and lack of iron‐sequestering microbes.
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[Dr.Vad]

ЖД во время беременности: если ферритин менее 60 в первом триместре, то высок риск и дефицита железа в третьем триместре как ферритин менее 15, прием железа в беременность снижает риск ЖД вдвое:

The prevalence of iron deficiency (ferritin <15 μg/L) increased throughout pregnancy, at 4.5%, 13.7% and 51.2% at 15, 20, and 33 wk of gestation, respectively. Using a ferritin threshold of <30 μg/L, rates of deficiency were 20.7%, 43.7%, and 83.8% across these time points, respectively.

ferritin of <60 μg/L emerged as the ferritin threshold at 15 wk that predicted the presence of iron deficiency (ferritin <15 μg/L) at 33 wk. Iron-containing supplements (mainly multivitamins) taken prepreganancy/early pregnancy was associated with reduced risk of deficiency throughout pregnancy, including the 3rd trimester (odds ratio: 0.57; 95% confidence interval: 0.39, 0.82; P = 0.002).
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Am J Clin Nutr. 2024 Nov;120(5):1259-1268.
Longitudinal evaluation of iron status during pregnancy: a prospective cohort study in a high-resource setting.

[Dr.Vad]

дефицит железа у детей 3-7 лет с хроническим ринитом: тогда как ферритин менее 15 был у 6%, то железо/ожсс менее 0.2 было у половины из них: дефицит железа часто, но хр. воспаление ложно-повышает ферритин более 15 у 40% детей:

children aged 3 to 7 years diagnosed with chronic rhinitis. ID was defined as transferrin saturation <20%, with absolute ID being defined as ferritin <15 ng/mL. Logistic regression analyses were performed to identify factors associated with ID. Results: A total of 72 children with chronic rhinitis were included, revealing a prevalence of ID of 47%. Only 5.9% children with ID exhibited absolute ID.
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Pediatr Allergy Immunol Pulmonol. 2024 Nov 27.
Iron Deficiency in Preschool Children with Chronic Rhinitis

[Dr.Vad]

женщины с безанемичным дефицитом железа хуже/медленнее/менее аккуратно за-/вы-полняют обучающие модули, основанные на правилах:
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Cogn Affect Behav Neurosci. 2024 Dec 5.
Iron deficiency negatively affects behavioral measures of learning, indirect neural measures of dopamine, and neural efficiency