Ferritin, commonly used for diagnosing iron deficiency (ID) in pregnancy, is limited by high cost and false elevations during inflammation. Reticulocyte hemoglobin equivalent (Ret-He), an alternative marker for ID, is unaffected by inflammation and analyzed on the same collection tube as the standard complete blood count (CBC). We aimed to determine the accuracy of Ret-He in detecting ID in pregnancy compared to ferritin in a U.S. cohort.This prospective cohort study enrolled 200 pregnant participants, recruited in any trimester if a CBC was drawn as part of routine prenatal care. For those who agreed to participate, Ret-He and ferritin were collected concurrently with the CBC. ID was defined as ferritin level below 30 ng/mL. Patients were classified into three groups based on hemoglobin and ferritin results to determine the severity of ID: no ID, ID alone, and ID anemia (IDA). Four participants with anemia but normal ferritin were excluded. Receiver operating curve analysis, including the area under the curve (AUC), was performed to assess the accuracy of Ret-He in detecting ID. A one-way ANOVA (analysis of variance) with post-hoc analysis was used to compare differences in Ret-He between the three groups of ID severity.The prevalence of ID in our cohort was 82% (161/196). The AUC for Ret-He was 0.65 (95% confidence interval: 0.55-0.75), indicating suboptimal discrimination between patients with and without ID. Ret-He was significantly different among the three groups (p < 0.001). In post-hoc analysis, Ret-He was significantly lower in the IDA group compared to the ID group (p < 0.001) but there was only a trend of lower Ret-He in the ID group compared to the non-ID group (p = 0.38).Ret-He has low accuracy in diagnosing ID in pregnancy. It may be useful in detecting severe ID resulting in anemia but not a mild iron-deficient state resulting in ID only. · The prevalence of ID in our cohort was 82%.. · Ret-He has low accuracy in diagnosing ID in pregnancy.. · Ferritin is preferable when readily available..

Treatment interruptions due to adverse drug reactions (ADRs) are common in iron deficiency anemia (IDA). We evaluated medication completion rates and quality of life (QoL) changes in patients with IDA after starting ferric citrate hydrate (FCH) treatment.

This multicenter, open-label, uncontrolled, single-arm comparative study included 30 Japanese female patients with IDA who experienced nausea and/or vomiting (N/V) with previous oral iron preparations. Patients received FCH 500 mg orally daily (< 1000 mg/day). Those with hemoglobin levels ≥ 11.0 g/dl completed the study at week 4; others continued until week 8. The primary endpoint was medication completion rate. Secondary endpoints included medication compliance rate, treatment satisfaction scores, and QoL scores and changes.

Thirty patients initiated and completed treatment; 24 reached ≥ 11.0 g/dl hemoglobin at week 4 and ended treatment, while 6 continued until week 8. The medication compliance rate was 93.92% ± 8.11% (mean ± standard deviation [SD]), and the completion rate was 100.0% (95% confidence interval 88.4-100.0%). Questionnaire findings revealed that the most severe nausea score decreased from 5.7 ± 2.4 to 1.7 ± 2.1 (mean ± SD), N/V incidence decreased from 100.0 to 63.3%, and patients reporting that N/V did not interfere with daily life increased from 6.7 to 52.6% following the switch to FCH. Twenty-four patients (80.0%) reported a satisfactory experience with FCH versus their previous oral iron preparation. Scores for all eight subscales of the Short-Form 36-Item Health Survey v2 improved, with significant increases in six. Nine ADR events occurred in six patients (20.0%), including nausea in three (10.0%); none were serious or resulted in treatment discontinuation.

FCH treatment exhibited a satisfactory medication completion rate in patients with IDA. Switching to FCH reduced N/V incidence and improved N/V and QoL severity compared with previous oral iron preparations.

jRCTs031210634. Registration date: March 01, 2022.

Pediatric anemia is a pervasive public health issue in Asia, significantly impairing children's growth, cognitive development, and future potential. This study evaluates trends, prevalence, and socio-economic disparities of pediatric anemia across Asia from 1990 to 2021, leveraging data from the Global Burden of Disease Study (GBD) 2021 study.

Using estimated annual percentage change (EAPC) and Pearson's correlation coefficient, geographic variations and temporal trends were analysed alongside associations between prevalence, years lived with disability (YLDs), and Socio-demographic index (SDI).

The study reveals a modest overall decline in anemia prevalence by 11.9%, from 464.53 million cases in 1990 to 409.07 million in 2021. High-SDI regions such as East Asia achieved significant reductions (- 71.36%), with countries like Singapore, the Republic of Korea, Seychelles, Qatar, and the United Arab Emirates (UAE) showing substantial progress. In stark contrast, low-SDI countries, including Yemen (108.34%) and Afghanistan (130.28%), along with Cambodia, India, and Pakistan, experienced alarming increases. Dietary iron deficiency was the dominant cause, followed by hemoglobinopathies and neglected tropical diseases. Females, particularly adolescents, and children under five faced disproportionate burdens, with prevalence rates in low-SDI regions exceeding 47,000 per 100,000 compared to < 10,000 per 100,000 in high-SDI areas.

These findings emphasize profound regional and socio-economic inequalities in anemia burden. Urgent, evidence-based interventions are imperative, focusing on enhancing nutrition, expanding healthcare access, and integrating sex-sensitive strategies to address this multifaceted issue. Strengthened policies and targeted actions are critical to mitigating the burden and fostering health equity, particularly in vulnerable low-SDI regions.

Major gynaecological surgery is a significant risk factor for intra and postoperative blood loss. Effective iron deficiency (ID) and anaemia management is critical for ensuring patient safety. The aim of this update, was to take an in-depth look at two recently published studies focusing on the assessment and management of ID and anaemia in subgroups of patients undergoing gynaecological surgery from the CARENFER PBM (2023) and PERIOPES (2023 and 2024) studies. Among the 6999 patients included in the three studies, 354 involved gynaecological procedures. Within this cohort, the prevalence of preoperative ID ranged from 70% to 78%, with 88% considered absolute ID, while preoperative anaemia affected 28% to 59% of women. Indeed, several gynaecological conditions that require surgery (e.g., uterine fibroids and gynaecological malignancies) are frequently associated with significant blood loss. Nonetheless, pre-operative iron workup was only performed in 5% to 33% of the patients. Furthermore, anaemia and/or ID were only treated in 12.5%-24% pre-operatively and 25% postoperatively. In conclusion, there seems to be a need to optimise peri-operative ID and anaemia management in gynaecologic surgery by ensuring systematic preoperative screening and treatment for anaemia and/or ID and, wherever feasible, postponing surgery if restoration of the blood mass and iron stores is considered necessary prior to surgery.

Although iron-deficiency anemia is common, interpreting iron laboratory test results can be challenging in patients with comorbidities. We aimed to study the accuracy of common iron biomarkers compared with bone marrow iron staining in a large retrospective data set of patients with hematologic disorders. We collected from 6610 patients (median age, 66 years) results of iron staining, with their concurrent ferritin, transferrin saturation, soluble transferrin receptor, transferrin, hemoglobin, and mean red blood cell volume results from Helsinki University Hospital electronic health records. In receiver operating characteristics analysis, ferritin had the highest area under the curve (AUC) with 88% (95% confidence interval [CI], 86-90) for females and 89% (95% CI, 87-91) for males in predicting reduced bone marrow iron. Using a ferritin cutoff of 30 μg/L resulted in high specificity rates of 97% in females and 99% in males. However, sensitivity rates were only 54% and 35%, respectively. Other studied biomarkers had inferior AUCs. Multivariate logistic regression models did not significantly perform better in prediction than ferritin alone. With 50% preprobability for reduced iron stores, a ferritin of 30 μg/L (females) and 51 μg/L (males) had a 95% positive predictive value for reduced iron stores. A 95% negative predictive value was achieved at 1750 μg/L (females) and 4967 μg/L (males). In our large population study, ferritin was the best single biomarker for iron deficiency in secondary care. Adding other blood tests in a multivariate model did not improve performance. However, in these patients with hematologic disorders, even a high ferritin did not rule out iron deficiency with 95% certainty.

Segmental testicular infarction (STI) is an idiopathic testicular disease with a low incidence. Accurately diagnosing and treating this disease presents a challenge for clinicians. Iron deficiency anemia (IDA) is a relatively common blood disorder and is generally accompanied by thrombocytosis, which increases the risk of thrombosis. In the present study, we report a 38-year-old man who suffered from a rare bilateral STI, which may be related to IDA. After conservative treatment and timely administration of iron supplementation, we observed an improvement in the patient's IDA and bilateral STI. Ultrasound, magnetic resonance imaging, and laboratory tests helped us to accurately diagnose the disease and avoid unnecessary surgery. Following a month of follow-up, continuous ultrasound monitoring showed that the patient's lesions had completely disappeared, with no indications of recurrence. Therefore, ultrasound is a useful tool for the diagnosis and continuous monitoring of this type of disease.

Our previous study found that 60 of 588 oral lichen planus (OLP) patients have vitamin B12 deficiency. This study assessed whether the vitamin B12-deficient OLP (B12D/OLP) patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects and evaluated whether all B12D/OLP patients had pernicious anemia (PA).

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 60 B12D/OLP patients and 588 healthy control subjects were measured and compared.

We found that 60 B12D/OLP patients had significantly lower mean blood Hb and serum iron, vitamin B12, and folic acid levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than 588 healthy control subjects (all P-values <0.01). Moreover, 60 B12D/OLP patients had significantly higher frequencies of macrocytosis (55.0 %), blood Hb (68.3 %) and serum iron (31.7 %) and vitamin B12 (100.0 %) deficiencies, hyperhomocysteinemia (91.7 %), and serum GPCA positivity (66.7 %) than 588 healthy control subjects (all P-values <0.001). The four most common types of anemia in 41 anemic B12D/OLP patients were PA (17 patients, 41.5 %), normocytic anemia (12 patients, 29.3 %), iron deficiency anemia (6 patients, 14.6 %), and macrocytic anemia other than PA (5 patients, 12.2 %).

The B12D/OLP patients have significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Only 17 (28.3 %) of 60 B12D/OLP patients have PA.

Our previous study found that 99 of 588 oral lichen planus (OLP) patients have iron deficiency (ID). This study assessed whether all OLP patients with ID (so-called ID/OLP patients) had iron deficiency anemia (IDA) and evaluated whether the ID/OLP patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects.

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 99 ID/OLP patients and 588 healthy control subjects were measured and compared.

We found that 99 ID/OLP patients had significantly lower mean blood Hb and serum iron, vitamin B12, folic acid levels as well as significantly higher mean serum homocysteine level than 588 healthy control subjects (all P-values <0.001). Moreover, 99 ID/OLP patients had significantly higher frequencies of blood Hb (64.7 %) and serum vitamin B12 (19.2 %), and folic acid (2.0 %) deficiencies, hyperhomocysteinemia (34.3 %), and serum GPCA positivity (33.3 %) than 588 healthy control subjects (all P-values <0.05). Furthermore, of 64 anemic ID/OLP patients, 2 (3.1 %) had pernicious anemia, 30 (46.9 %) had normocytic anemia, and 32 (50.0 %) had IDA.

ID/OLP patients have significantly higher frequencies of blood Hb and serum vitamin B12 and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Although the IDA (50.0 %) is the most common type of anemia in our 64 anemic ID/OLP patients, there are still 46.9 % of the 64 anemic ID/OLP patients who had the normocytic anemia.

We investigated the cost-effectiveness of treating iron deficiency anemia (IDA) with ferric citrate hydrate (FC) in Japan. We employed four treatment strategies: switching from sodium ferrous citrate (SF) to FC at (1) 500 mg (approximately 120 mg of iron) per day or (2) 1000 mg (approximately 240 mg of iron) per day in patients with SF-induced nausea/vomiting, or starting treatment with FC at (3) 500 mg/day or (4) 1000 mg/day. We evaluated the cost-effectiveness of these strategies compared with SF 100 mg (100 mg of iron) per day. Incremental effects over 26 weeks relative to SF 100 mg were 0.0052 quality-adjusted life years (QALYs) for (1) and (2), and 0.0044 QALYs for (3) and (4). From the payer's perspective, incremental cost-effectiveness ratios (ICERs: JPY/QALY) against SF 100 mg were: (1) 1,107,780, (2) 2,257,477, (3) 5,588,430, and (4) 11,544,816. All four FC strategies were dominant (less costly and more effective) from a limited societal perspective. Treatment with FC for IDA was cost-effective (ICER ≤ JPY 5,000,000/QALY) when switching strategies from the payer perspective, and cost-saving (all FC strategies) from limited societal perspectives. Individual patients' characteristics and cost-effectiveness should be considered in treatment selection.

Autoimmune gastritis (AIG) was previously considered a rare disease in China, and its clinical characteristics were not fully understood. This study aimed to demonstrate the characteristics of AIG in China and evaluate gastric oxyntic mucosal atrophy using a modified AIG-atrophic staging.

This was a single-center retrospective observational real-world study. The diagnosis of AIG was based on pathological results combined with parietal cell antibody (PCA) and intrinsic factor antibody (IFA) results, and endoscopic findings.

A total of 745 patients were enrolled, the median age at diagnosis was 58 years old, and 69.9 % were female. The symptoms of AIG patients were nonspecific, and about 2/5 of the cases were asymptomatic. The proportions of cases from modified AIG-atrophic stage 1 to 4 were 0.8 %, 14.1 %, 73.8 %, and 11.3 %, respectively. Approximately 1/5 had autoimmune thyroiditis (AITD). Near 1/2 had one or more comorbidities: iron-deficiency anemia (IDA), pernicious anemia (PA), neuropathy, gastric hyperplastic polyps (GHP), gastric intraepithelial neoplasia (GIN), type 1 gastric neuroendocrine tumors (g-NET), or gastric adenocarcinoma (GAC). There was a high risk of type 1 g-NET (7.0 %) and GAC (9.1 %) in AIG patients.

AIG is not rare in China, and its early diagnosis is challenging, accompanied by a high risk of GAC. The modified four-stage AIG-atrophic staging can effectively represent the extent of oxyntic mucosal atrophy and the progression in AIG.

Iron deficiency (ID) is a prevalent complication of chronic kidney disease (CKD), often managed reactively when associated with anaemia. This scoping review evaluates the evidence supporting intravenous (IV) iron therapy in non-anaemic individuals with CKD and ID, focusing on safety, efficacy, and emerging therapeutic implications. Current diagnostic markers, including serum ferritin, transferrin saturation, and reticulocyte haemoglobin content, are reviewed alongside their limitations in the context of inflammation and variability. The pathophysiology of ID in CKD is explored, highlighting the roles of hepcidin, hypoxia-inducible factor pathways, and uraemic toxins. Comparative studies reveal that IV iron offers a more rapid correction of iron stores, improved compliance, and fewer gastrointestinal side effects compared to oral iron. Evidence from trials such as "iron and heart" and "iron and muscle" suggests potential benefits of IV iron on functional capacity and fatigue, though findings were statistically non-significant. Insights from heart failure trials support the safety and efficacy of IV iron in improving quality of life and reducing hospitalizations, with newer formulations like ferric derisomaltose demonstrating favourable safety profiles. This review underscores the need for standardized screening protocols for ID in CKD, even in the absence of anaemia, to facilitate earlier intervention. Future research should prioritise robust outcome measures, larger sample sizes, and person-specific treatment strategies to optimise dosing and administration frequency. Tailored approaches to IV iron therapy have the potential to significantly improve functional outcomes, quality of life, and long-term health in people with CKD.

Few studies report about management of iron deficiency anemia after a severe, acute gastrointestinal bleed. Most include good risk patients with upper gastrointestinal bleeds and report only laboratory improvements but not clinical outcomes.

To assess management of iron deficiency anemia and clinical outcomes of patients after a severe, acute gastrointestinal bleed from either upper or lower sources in an unselected group of patients.

Retrospective analysis of adult patients hospitalized with severe gastrointestinal bleeding in two referral centers. They had endoscopic diagnoses of lesions including non-variceal upper, variceal, and lower sites (diverticulosis or other colon sources). Analyses were of rates of iron studies ordered and iron treatments up to 4 months post-discharge. Composite clinical outcomes were also assessed and analyzed.

For 337 patients studied, iron studies were ordered in only 50%. When tested, iron deficiency was diagnosed in 75% of anemias. Intravenous iron or oral iron was prescribed in only 7.1% and 26.7% of patients, respectively. By 4 months, 94% of patients treated with intravenous iron and 80% treated with oral iron achieved ≥ 2 g/dL increase in hemoglobin level. Patients with high rates of severe co-morbidities and severe anemia had poor clinical outcomes although most were not treated for IDA.

Despite significant anemia after a severe gastrointestinal bleed from common diagnoses, iron studies were not routinely ordered. Iron deficiency anemia was infrequently recognized or treated with iron therapies. Patients with severe co-morbidities and anemia after an acute gastrointestinal bleed had poor clinical outcomes.

Iron deficiency anaemia develops when there is not enough iron in the body to sustain normal red blood cell production. It is a major cause of morbidity worldwide and is linked to a range of comorbid conditions, including gastrointestinal cancer. In the UK, iron deficiency anaemia is the most common cause of anaemia identified in primary care and is estimated to affect 3% of men and 8% of women. Nurses can support the management of iron deficiency anaemia by identifying possible causes, ordering blood tests, advising on diet and iron supplementation, and referring patients for additional investigations as required. This article provides an overview of the pathophysiology, identification and diagnosis of iron deficiency anaemia, describes sources of dietary iron and factors influencing dietary iron absorption, and discusses patient management.

Seaweed plays an essential role in the survival of marine life, provides habitats and helps in nutrient recycling. It is rich in valuable nutritious compounds such as pigments, proteins, polysaccharides, minerals, vitamins, omega-rich oils, secondary metabolites, fibers and sterols. Pigments like fucoxanthin and astaxanthin and polysaccharides like laminarin, fucoidan, galactan and ulvan possess immune-modulatory and immune-enhancing properties. Moreover, they show antioxidative, antidiabetic, anticancer, anti-inflammatory, antiproliferative, anti-obesity, antimicrobial, anticoagulation and anti-aging properties and can prevent diseases such as Alzheimer's and Parkinson's and cardiovascular diseases. Though seaweed is frequently consumed by Eastern Asian countries like China, Japan, and Korea and has gained the attention of Western countries in recent years due to its nutritional properties, its consumption on a global scale is very limited because of a lack of awareness. Thus, to incorporate seaweed into the global diet and to make it familiar as a functional food, issues such as large-scale cultivation, processing, consumer acceptance and the development of seaweed-based food products need to be addressed. This review is intended to give a brief overview of the present status of seaweed, its nutritional value and its bioactive metabolites as functional foods for human health and diseases owing to its immunity-boosting potential. Further, seaweed as a source of sustainable food and its prospects along with its issues are discussed in this review.

Non-anaemic iron deficiency (IDNA) is highly prevalent in exercising females. Although iron therapy can be used to correct this issue, its impact on exercise performance is equivocal. Our aim was to assess the efficacy of intravenous iron therapy on exercise performance, fatigue, mood states, and quality of life in recreationally active IDNA females of reproductive age.

Twenty-six recreationally active IDNA females were randomised to either an intravenous iron treatment (IRON) group or placebo (PLA). Prior to, 4 days and 4 weeks following intervention, participants completed a variety of assessments to determine changes in exercise performance, haemoglobin mass, blood iron status and haematology, fatigue levels, mood states and quality of life.

Intravenous iron therapy significantly improved serum ferritin, serum iron and transferrin saturation (p<0.05), with a highly variable individual response. No differences were observed between groups' peak oxygen consumption (V̇O2Peak), lactate threshold or haemoglobin mass. Running economy improved in IRON from baseline to 4 weeks (p<0.05), which was also different to PLA at 4 weeks (p<0.05). Fatigue scores improved in IRON but not PLA after 4 weeks (p<0.05). Mood states and quality of life remained unchanged in both groups over the trial.

In recreationally active IDNA females, intravenous iron therapy corrects iron status and improves both exercise economy and fatigue scores after 4 weeks.

ACTRN12620001357943.

This study aimed to explore the effect of 8-week oral supplementation on postural control in young women with iron deficiency anemia (IDA).

This study involved 15 women with IDA who received 160 mg of elemental iron daily in the form of dried ferrous sulfate capsules (80 mg twice daily) taken in two divided doses for 8 weeks. The mean velocity of oscillations of the center of pressure (CoPv) was recorded to evaluate postural control pre- and post-supplementation. In addition, simple reaction time (SRT) and weight discrimination tests were performed to assess attentional capacity and proprioceptive acuity, respectively.

This study revealed significant increases (P < 0.001, mean difference = 1.83, 95% CI: -17.25; -9.42) in proprioceptive acuity values, as well as decreases in CoPv [firm (EO (P < 0.01, mean difference = 0.52, 95% CI: 0.69; 2.92), EC (P < 0.05, mean difference = 0.75, 95% CI: 0.24; 3.45)) and foam (EO (P < 0.001, mean difference = 0.64, 95% CI: 1.71; 4.44) ; EC (P < 0.001, mean difference = 1.04, 95% CI: 3.51; 7.97))] and SRT (P < 0.001, mean difference = 59.31, 95% CI: 103.02; 168.71) values post-supplementation compared to pre-supplementation.

This study showed significant improvements in postural control in young women with IDA after 8 weeks of oral iron supplementation. These improvements were probably related to the enhanced bioavailability of iron, which may have influenced neural processes inducing improvements in attention capacity and proprioceptive acuity.

Iron is an essential micronutrient for abounding physiological processes in the body, and its deficiency can be caused by various factors, such as low iron intake due to economic difficulties or loss of appetite, decreased iron absorption due to gastrointestinal issues, or increased iron loss due to hemorrhages or proteinuria. Iron deficiency is a prevalent issue among heart failure (HF) patients and is a significant contributor to anemia, affecting 30-50% of patients regardless of their gender, ethnicity, or left ventricular ejection fraction. Individuals with HF have high levels of pro-inflammatory cytokines, which can inhibit erythropoiesis by degrading the membrane iron exporter ferroportin, mediated by an increased release of hepcidin. In addition, elevated sympathetic and renin-angiotensin-aldosterone system activity retains salt and water, resulting in high cardiac output HF in people with normal left ventricular function. This review provides an overview of iron deficiency and HF.

Hyperglycemia and hyperlipidemia increase the risk for diabetes and its complications, atherosclerosis, heart failure, and stroke. Identification of safe and cost-effective means to reduce risk factors is needed. Herbal teas may be a vehicle to deliver antioxidants and polyphenols for prevention of complications.

This systematic review and meta-analysis were conducted to evaluate and summarize the impact of herbal tea (non-Camellia sinensis) on glucose homeostasis and serum lipids in individuals with type 2 diabetes (T2D).

PubMed, FSTA, Web of Science, CINAHL, MEDLINE, and Cochrane Library databases were searched from inception through February 2023 using relevant keyword proxy terms for diabetes, serum lipids, and "non-Camellia sinensis" or "tea."

Data from 14 randomized controlled trials, totaling 551 participants, were included in the meta-analysis of glycemic and serum lipid profile end points.

Meta-analysis suggested a significant association between drinking herbal tea (prepared with 2-20 g d-1 plant ingredients) and reduction in fasting blood glucose (FBG) (P = .0034) and glycated hemoglobin (HbA1c; P = .045). In subgroup analysis based on studies using water or placebo as the control, significant reductions were found in serum total cholesterol (TC; P = .024), low-density lipoprotein cholesterol (LDL-C; P = .037), and triglyceride (TG; P = .043) levels with a medium effect size. Meta-regression analysis suggested that study characteristics, including the ratio of male participants, trial duration, and region, were significant sources of FBG and HbA1c effect size heterogeneity; type of control intervention was a significant source of TC and LDL-C effect size heterogeneity.

Herbal tea consumption significantly affected glycemic profiles in individuals with T2D, lowering FBG levels and HbA1c. Significance was seen in improved lipid profiles (TC, TG, and LDL-C levels) through herbal tea treatments when water or placebo was the control. This suggests water or placebo may be a more suitable control when examining antidiabetic properties of beverages. Additional research is needed to corroborate these findings, given the limited number of studies.

Herein, in this report we are introducing newly synthesized chalcone derivative, "(E)-1-phenyl-3-(4-((5-(((Z)-thiophen-2-ylmethylene)amino)-1,3,4-thiadiazol-2-yl)thio)phenyl)prop-2-en-1-one" (5), as a chemosensor to detect Fe2+ metal ions in HEPES buffer solution of pH 7.5. Spectroscopic techniques were used to confirm the synthesized sensor. To determine the chemical reactivity and molecular stability of the probe, a frontier molecular orbitals investigation was carried out. A molecular electrostatic potential map was investigated to know the binding site of 5 for metal ion coordination. The theoretical absorption and fluorescence emission properties were estimated and correlated with the experimental observations. The sensor showed excellent selectivity for Fe2+ compared to all other studied metal ions. The fluorescence binding studies were carried out by adding different amounts of Fe2+ ions for a fixed concentration of probe 5. The inclusion of Fe2+ ions resulted in a decrease in fluorescence intensity with a bathochromic shift of emission wavelength of 5 due to the 5-Fe2+ complexation. The binding affinity value for the probe was found to be 576.2 M-1 with the help of the Stern-Volmer plot. The Job's plot and mass spectra supported the 2:1 (5: Fe2+) stoichiometry of complex formation. The detection limit and limit of quantification of 5 for Fe2+ were calculated to be 4.79 × 10-5 M and 14.54 × 10-5 M. Further, in addition to this, the photophysical parameters such as fluorescence lifetime of 5 and 5-Fe2+ complex measured to be 0.1439 and 0.1574 ns. The quantum yield of 5 and 5-Fe2+ was found to be 0.0398 and 0.0376. All these experimental findings revealed that probe 5 has excellent selectivity and sensitivity for Fe2+ ions.

Iron deficiency anemia (IDA) is a significant global health problem affecting close to 2 billion people worldwide. The prevalence of IDA is higher among children younger than five years and women of reproductive age, indicating an intergenerational correlation between maternal and child anemia. This study aims to analyze the association between maternal and child anemia in The Gambia.

A nationally representative dataset comprising 3249 children under the age of five, obtained from The Gambia Demographic and Health Survey (2019-2020), was utilized for empirical analyses. Multivariate linear regression models were employed to assess the association between maternal and child anemia. The multivariate models were adjusted for various confounding variables, including birth order, age, and the gender of the child, as well as maternal education, religion, wealth quintiles, rural residence, and region-fixed effects.

Fifty-three percent of children and 52% of mothers are anemic. Children from poorer households show a higher rate of anemia compared to those from wealthier households. Maternal anemia was significantly associated with the anemia status of the children. Children born to anemic mothers were 13.5% more likely to be also anemic (p < 0.001). The correlation coefficient between mother and child hemoglobin levels is 0.165 (p < 0.001). The correlation coefficient between maternal and child anemia is higher among the bottom three wealth quintiles than the top two wealth quintiles.

The significant intergenerational association between maternal and child anemia status highlights the need for targeted, multi-pronged strategies to combat the adverse impacts of anemia. Maternal anemia, in general, appears to influence childhood anemia beyond just the pregnancy period. Shared socioeconomic environment, dietary patterns, and exposure to infections likely contribute to this intergenerational association.

The first period of military service consists of a physically and mentally challenging basic combat training (BCT) program. Factors like demanding physical exercise, limited recovery time, and restricted diet choice and food intake may challenge iron intake and homeostasis in recruits undergoing BCT. Iron-deficient individuals may experience reduced work capacity, fatigue, weakness, frequent infections, and increased injury risk. Limited knowledge is available on the extent of this potential health risk among military recruits. The aim of the present study was to systematically review published studies on the prevalence and change in prevalence of anemia, iron deficiency (ID), and ID anemia (IDA) among recruits undergoing BCT.

Electronic searches were conducted in the databases Medline (Ovid), Embase (Embase.com), and Web of Science (Clarivate Analytics) from database inception up until April 16, 2024. Inclusion criteria were observational studies with both cross-sectional and observational longitudinal designs that examined the effects of BCT (intervention) on iron status (outcome) in military recruits (population). Extracted data were the number of participants (n), age, sex, country/population, BCT duration, and relevant measures of prevalence and changes in prevalence of anemia, ID, and IDA (primary outcome) and physical performance, mood state, stress fractures, attrition rate, and nutritional supplements (secondary outcomes). The study quality and risk of bias were assessed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and The National Institutes of Health Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. Meta-analyses were performed using restricted maximum-likelihood models, and the effect size was calculated as Cohen's h with 95% CI.

Twenty-two articles were systematically reviewed (n = 111,764 men and 12,650 women), and six of these papers (n = 388 men and 773 women) were included in the meta-analysis. There was a varying prevalence of anemia, ID, and IDA among military recruits at the start of BCT. Results from meta-analyses showed negligible and nonsignificant effects of BCT on the prevalence of anemia, ID, and IDA. The quality of the included cross-sectional studies ranging from fair to good, whereas a large proportion of the included longitudinal studies were classified as poor. No sign of publication bias was found.

The prevalence of anemia, ID, and IDA in military recruits seems not to be affected by the completion of BCT shorter than 16 weeks, whereas the effects of longer BCT durations remain unclear. Even though body iron homeostasis seems unaffected, adequate energy and nutritional intake should remain a priority. Future research could focus on dietary interventions to determine the optimal diet among female recruits in specifically exposed populations.

Previous studies have suggested a link between gut microbiota and iron-deficiency anemia (IDA). However, interpreting these findings is difficult due to various factors that influence microbiome composition and the limitations of observational studies, such as confounding variables and reverse causation. This study aims to explore the causal relationship between gut microbiota and IDA using Mendelian randomization (MR) to overcome these limitations. We conducted a 2-sample MR analysis using data from genome-wide association studies from the MiBioGen Consortium and the UK Biobank. The gut microbiome data included 211 genus-level microbes linked to single-nucleotide polymorphisms from 18,340 participants in the MiBioGen Consortium. The outcome data for IDA were obtained from 484,598 participants in the UK Biobank, with 2941 cases and 481,657 controls. We assessed causal relationships using various MR techniques, primarily inverse variance weighting, and performed sensitivity analyses to confirm the robustness of our results. Nine genus-level gut microbes were significantly associated with IDA (P < .05). Protective factors included Clostridia, Actinomycetaceae, Pasteurellaceae, Oscillospira, Prevotella, and Roseburia, while risk factors included Ruminococcus gnavus group, Hungatella, and Parasutterella. Sensitivity analyses showed the reliability of these findings without significant variability. This study provides evidence for a causal relationship between specific gut bacteria and IDA risk, identifying potential targets for therapies aimed at improving outcomes for those with IDA. Further research is needed to clarify the bacteria involved.

Iron deficiency anaemia (IDA) accounts for nearly two-thirds of all anaemia cases globally. Despite the widespread use of iron supplementation, the optimal dose and duration for treating IDA remain unclear. In this study, we aimed to determine the most effective dose and duration of iron supplementation for improving haemoglobin (Hb) levels in children and adolescents (≤19 years) with IDA.

A systematic review and meta-analysis were conducted. We searched MEDLINE, Embase, CINAHL, and the Cochrane Library for peer-reviewed studies published between 2013 and 2024. The interventions included iron supplementation with a defined dose and duration of at least 30 days. Comparators were placebo, no treatment, or alternative regimens. The outcome was the change in Hb levels. Eligible studies included IDA cases diagnosed through ferritin level measurements in healthy individuals. Studies involving pregnant women or children with underlying conditions were excluded. A meta-analysis was performed using standardized mean differences to pool effect sizes for Hb improvement with 95% confidence intervals (CIs). Subgroup analyses were performed for different treatment durations (<3 months, 3-6 months, >6 months) and dosage categories (<5 mg/kg/day, 5-10 mg/kg/day, >10 mg/kg/day). A random-effects meta-regression model was used to determine the optimal dose and duration, accounting for known covariates affecting Hb improvement.

A total of 28 studies with 8,829 participants from 16 countries were included. The pooled effect size for Hb improvement was 2.01 gm/dL (95% CI: 1.48-2.54, p < 0.001). Iron supplementation for less than 3 months showed the highest significant effect size (2.39 gm/dL, 95% CI: 0.72-4.07), followed by treatments exceeding 6 months (1.93 gm/dL, 95% CI: 0.09-3.77). The lowest effect size was observed in treatments lasting 3-6 months (1.58 gm/dL, 95% CI: 0.93-2.23). Low-dose iron supplementation (<5 mg/kg/day) demonstrated favourable trends in Hb improvement, particularly in individuals with lower baseline Hb levels. Oral ferrous sulphate had a significant effect (2.03 gm/dL, 95% CI: 1.24-2.82), while parenteral ferric Carboxymaltose showed consistent efficacy.

Low-dose iron supplementation (<5 mg/kg/day) combined with treatment durations of either less than 3 months or more than 6 months, is optimal for improving Hb levels in children and adolescents with IDA. Tailoring treatment based on baseline Hb levels and anaemia severity is essential. These findings provide evidence to support updated guidelines on iron supplementation in paediatric and adolescent populations and inform national anaemia management programmes.

Prospero registration number: This study was registered with PROSPERO (CRD42024541773).

To analyze the burden of dietary iron deficiency in China from 1990 to 2021.

Using the results of the 2021 Global Burden of Disease (GBD 2021) study, this study analyzed the prevalence and disability adjusted life years (DALY) of dietary iron deficiency in China from 1990 to 2021.

In 2021, the prevalence number of dietary iron deficiency was 795,910,75 (76,187,661-82,382,158), which decreased by 40.86% compared to that in 1990. The number of DALY were 1,689,209 (1,119,315-2,445,991), which decreased by 47.15% compared to that in 1990. The age-standardized prevalence rate (ASPR) and age-standardized DALY rate (ASDR) of dietary iron deficiency showed a downward trend from 1990 to 2021 (P < 0.05).

From 1990 to 2021, the burden of dietary iron deficiency in China showed a downward trend, with the burden of females having a significantly higher than males, and the burden in females aged 20 to 49 years old increases significantly.

Iron (Fe) is present in foods and food supplements in a wide variety of Fe species. Caution needs to be paid in the case of overdosing on this essential trace element as adverse effects like neurodegenerative diseases are associated with increased iron levels in the brain. However, knowledge regarding the species-specific effects of nutritionally relevant Fe species is limited. Therefore, we treated the nematode Caenorhabditis elegans (C. elegans) with an overdose of the Fe species iron(III) ammonium citrate (FAC), iron(II) gluconate (FeGlu), and iron(II) chloride (FeCl2) for 5 and 24 h. While the bioavailability of Fe was highest with FeCl2 and lowest with FAC, the effects on tested endpoints, such as superoxide dismutase activity, translocation of the transcription factor daf-16 (human FOXO3), mitochondrial reactive oxygen and nitrogen species, and apoptotic cells were similar. This study provides further insights into Fe-species-specific effects on genes related to Fe homeostasis of C. elegans by studying gene expression and investigating C. elegans mutants lacking smf-3, ftn-1, ftn-2, dcytb (f55h2.5), and cp (f21d5.3). Thus, these findings underline the significance of the oxidation state and ligand of Fe species with respect to bioavailability while also identifying the key genes involved in Fe homeostasis in C. elegans.

Background and Objective: IDA and chronic headache disorders such as migraines and tension-type headaches are common conditions that significantly affect quality of life. Emerging evidence suggests a bidirectional relationship between these two conditions. This systematic review and meta-analysis aimed to explore and quantify the association between iron deficiency anemia (IDA) and chronic headache disorders, with a focus on understanding the bidirectional nature of this relationship. Methods: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science to identify relevant studies published up until August 10, 2024. Observational studies examining the prevalence, incidence, or association between IDA and chronic headache disorders were included. Data were extracted and assessed for quality using the Newcastle-Ottawa Scale. Meta-analyses were performed using a random-effects model to calculate pooled prevalence rates and risk ratios (RRs), with heterogeneity assessed via the I 2 statistic and meta-regression. A sensitivity analysis was conducted using the leave-one-out approach, and publication bias was evaluated through a funnel plot. Results: The meta-analysis included 13 studies: five studies examined chronic headaches among patients with IDA, and eight studies examined IDA among patients with chronic headaches. The pooled prevalence of chronic headaches among patients with IDA was 38% (95% CI: 15%-69%). In addition, 20% (95% CI: 10%-35%) of patients with chronic headaches were found to have IDA. Anemic patients were found to have a 76% higher risk of developing chronic headaches compared to nonanemic individuals (RR: 1.76; 95% CI: 1.22-2.52). Significant heterogeneity was observed across the studies. Conclusion: This meta-analysis demonstrates a significant association between IDA and chronic headache disorders, with a pooled prevalence of 38% for chronic headaches in IDA patients and 20% for IDA in chronic headache patients. IDA was associated with a 76% higher risk of chronic headaches. Routine screening for IDA in high-risk populations may improve headache outcomes, but further longitudinal studies are needed to establish causality and refine management strategies.

Intravenous iron supplementation is increasingly used to safely and effectively correct iron deficiency anemia, but some formulations are linked to a renal phosphate wasting syndrome which is mediated by fibroblast growth factor 23. Unawareness among prescribers and the nonspecific clinical symptoms of hypophosphatemia result in underreporting of this complication. Even though it is often an asymptomatic and self-limiting condition, accumulating evidence from case reports and dedicated randomized controlled trials show that IV iron induced hypophosphatemia may be associated with clinical symptoms. If hypophosphatemia is not recognized and treated, a metabolic bone disease phenotype may develop, pathophysiologically reminiscent of hypophosphatemic rickets as seen in X-linked hypophosphatemic rickets or oncogenic osteomalacia. This syndrome is particularly, but not uniquely, associated with formulations containing ferric carboxymaltose, probably due to specific chemical characteristics of its carbohydrate moiety. Risk factors include repeated infusion, severity of iron deficiency, as well as normal kidney function. Coexisting vitamin D deficiency or hyperparathyroidism increase the risk of metabolic bone disease. Complications can be easily prevented by an early diagnosis and switching to another IV iron formulation. In this review, we describe the epidemiology and pathophysiology of this condition, to raise awareness among prescribing clinicians.

The differential diagnosis between iron deficiency anemia (IDA) and thalassemia trait (TT) remains a significant clinical challenge. This study aimed to develop a machine learning-based multi-class model to differentiate among Microcytic-TT(TT with low mean corpuscular volume), Normocytic-TT (TT with normal mean corpuscular volume), IDA, and healthy individuals.

A comprehensive dataset comprising 1,819 individuals was analyzed using six distinct machine learning algorithms. The eXtreme Gradient Boosting (XGBoost) algorithm was ultimately selected to construct the MultiThal-Classifier (M-THAL) model. SMOTENC (Synthetic Minority Over-sampling Technique for Nominal and Continuous features) was employed to address data imbalance. Model performance was evaluated using various metrics, and SHAP values were applied to interpret the model's predictions.Additionally, external validation was conducted to assess the model's robustness and generalizability.

After performing 1000 bootstrap resamples of the test set, the average performance metrics of M-THAL and the 95 % confidence interval(CI) were as follows, sensitivity 90.27 % (95 % CI: 84.88-95.26), specificity 97.87 % (95% CI: 97.10-98.55), PPV 93.42 % (95 % CI: 89.34-96.48), NPV 97.82% (95 % CI: 97.00-98.53), F1-score 91.50 % (95% CI: 87.29-95.34), Youden's index 88.15 % (95 % CI: 82.33-93.70), accuracy 97.06 % (95% CI: 96.06-97.99), and AUC 94.07 % (95 % CI: 91.17-96.84).Feature importance analysis identified mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), red cell distribution width - standard deviation(RDW-SD), and hemoglobin (HGB) were identified as the most important features. External validation confirmed the model's robustness and generalizability.

The M-THAL effectively distinguishes Normocytic-TT, Microcytic-TT, IDA, and healthy individuals using hematological parameters, offers a rapid and cost-effective screening tool that can be readily implemented in diverse healthcare settings.

Iron deficiency (ID) is a common condition with readily available treatment but can be challenging to diagnose. Traditional biomarkers of ID are acute-phase reactants, which complicate diagnosis in patients with co-existent inflammation. This study aimed to establish optimal biomarker diagnostic thresholds for ID diagnosis using bone marrow (BM) iron stores as the gold standard and the C-reactive protein (CRP) as an inflammatory marker. A cross-sectional study was carried out in the haematology department of a tertiary academic hospital. Patients undergoing BM biopsies for any reason were recruited for inclusion. Retrospective case finding was used to enrich the data for cases with confirmed BM ID. Laboratory markers including red cell indices, reticulocyte haemoglobin and iron studies were evaluated to establish optimal cut-offs for ID diagnosis. A CRP of >5 mg/L was used as a marker of inflammation. The study included 139 patients. Forty-two had BM ID, with a median serum ferritin (SF) of 48.5 μg/L. Ninety-six 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. The CRP was useful to identify populations with inflammation in whom higher SF thresholds could be used together with the transferrin saturation to accurately diagnose ID.

Anemia in pregnancy has been a topic of interest for researchers due to its potential impact on various adverse pregnancy outcomes. This study aims to explore the relationship between anemia and adverse pregnancy outcomes such as preterm birth, low birth weight, and maternal mortality.

We conducted both a systematic review and a meta-analysis on the associations between anemia during pregnancy and adverse pregnancy outcomes. We searched Chinese databases (CNKI, Wanfang, CBM, VIP) and English ones (Cochrane Library, PubMed, Embase, Web of Science). Two researcher-authors independently assessed study quality with the Newcastle-Ottawa Scale. After extracting data, we analyzed heterogeneity and used a random-effects model for higher heterogeneity and a fixed-effects model for low heterogeneity in the meta-analysis while also systematically synthesizing and narratively describing findings in the systematic review.

A total of 31 cohort studies were included. Meta-analysis showed that the risk of postpartum hemorrhage [RR [95% CI], 2.76 [1.63, 4.66]], premature rupture of membranes (PROM) [1.94 (1.26, 3.00)], preterm delivery [1.51 (1.33, 1.72)], low birth weight (LBW) [1.40 (1.19, 1.63)], cesarean section[1.33 (1.02, 1.74)], gestational hypertension[1.28 (1.14, 1.44)] and neonatal asphyxia[1.21 (1.07, 1.37)] was higher in the group of anemia in pregnancy than in the control group.

Maternal anemia is associated with an increased risk of seven adverse pregnancy outcomes: postpartum hemorrhage, PROM, preterm delivery, LBW, cesarean section, gestational hypertension and neonatal asphyxia. Appropriate nutritional supplementation and screening for anemia before and during pregnancy are recommended to improve maternal health and manage adverse pregnancy outcomes.

Ferritin is found in all cells of the body, serving as a reservoir of iron and protecting against damage to the molecules that make up cellular structures. It has emerged as a biomarker not only for iron-related disorders but also for inflammatory diseases and conditions in which inflammation plays a key role, including cancer, neurodegeneration, and infection. Oxidative stress, which can cause cellular damage, is induced by reactive oxygen species generated during the Fenton reaction, activating signaling pathways associated with tumor growth and proliferation. This review primarily emphasizes basic studies on the identification and function of ferritin, its essential role in iron metabolism, its involvement in inflammatory diseases, and its potential as an important prognostic factor and biomarker for cancer detection.

Hereditary haemorrhagic telangiectasia (HHT) is a vascular dysplasia inherited as an autosomal dominant trait and caused by loss-of-function pathogenic variants in genes encoding proteins of the BMP signalling pathway. Up to 90% of disease-causal variants are observed in ENG and ACVRL1, with SMAD4 and GDF2 less frequently responsible for HHT. In adults, the most frequent HHT manifestations relate to iron deficiency and anaemia owing to recurrent epistaxis (nosebleeds) or bleeding from gastrointestinal telangiectases. Arteriovenous malformations (AVMs) in the lungs, liver and the central nervous system cause additional major complications and often complex symptoms, primarily due to vascular shunting, which is right-to-left through pulmonary AVMs (causing ischaemic stroke or cerebral abscess) and left-to-right through systemic AVMs (causing high cardiac output). Children usually experience isolated epistaxis; in rare cases, childhood complications occur from large AVMs in the lungs or central nervous system. Management goals encompass control of epistaxis and intestinal bleeding from telangiectases, screening for and treatment of iron deficiency (with or without anaemia) and AVMs, genetic counselling and evaluation of at-risk family members. Novel therapeutics, such as systemic antiangiogenic therapies, are actively being investigated. Although HHT is associated with increased morbidity, the appropriate screening and treatment of visceral AVMs, and the effective management of bleeding and anaemia, improves quality of life and overall survival.

Children are among the most vulnerable groups for Helicobacter pylori (H. pylori) infection, which was linked with an increased risk of anemia. H. pylori infection may cause the development of anemia through affecting the absorption of different micronutrients and increasing hepcidin production from hepatocytes. This study aimed to assess the effect of H. pylori infection on the occurrence of anemia in children.

Previously published articles were systematically searched on major databases including Science Direct, PubMed, Embase, Scopus, Cochrane Library, and Science Citation Index using search terms. The search results were imported into EndNote X9 to organize and remove duplicates. Then, relevant data was extracted and analyzed using STATA version 16.0. The pooled odds ratio (OR) was calculated to evaluate the associations of H. pylori infection with Anemia. Moreover, pooled standardized mean difference (SMD) of Hemoglobin (Hgb) and Serum ferritin (SF) levels between cases and controls were calculated for group comparisons.

A total of nine published articles were included in this study. The result showed that H. pylori-infected children had 2.68 times more risk of developing anemia compared to H. pylori-negative children (OR: 2.68:95% CI:1.44-4.99, p = 0.002). Subgroup analyses based on study design showed an increased significant association between H. pylori infection and anemia among case-control studies (OR:3.792:95%CI;1.767, 8.142, p = 0.001). Subgroup analyses based on the H. pylori detection method indicated an increased significant association between H. pylori infection and anemia when the stool antigen test method was used (OR:3.801;95%CI:1.090,13.250, p = 0.036). Moreover, there was a significant decrement of Hgb and SF levels in the H. pylori positive group compared to the negative group with SMD of -0.54(95%CI: -0.65, -0.42, p < 0.001) and - 0.49(95% CI: -0.91, -0.08, p < 0.020), respectively.

This study revealed that children with H. pylori infection are at a higher risk of developing anemia as compared to non-infected children. Moreover, the observed decrease in Hgb and SF levels in infected children suggests that H. pylori may contribute to the development of anemia. Future research need to focus on the mechanisms by which H. pylori infection contributes to anemia, as well as the potential benefits of targeted interventions in reducing both H. pylori prevalence and anemia rates in children.

Heavy menstrual bleeding (HMB) associated with iron deficiency anemia (IDA) negatively affects quality of life (QoL). Management of IDA usually begins with oral iron supplementation or, if ineffective/poorly tolerated, then intravenous iron (IVI) is given; however, no guidance exists on transitioning from oral to IVI in patients with HMB. While various IVI products exist, safety profiles and distinct properties affecting treatment logistics make product choice important.

Assess the IVI treatment journey for patients with HMB and IDA.

A survey was designed to assess multiple aspects of IVI treatment to evaluate patient perspectives.

Patients (⩾18 years) from the United States with IDA currently prescribed IVI completed a survey conducted by The Harris Poll in 2023. Questions covered symptoms, time to diagnosis/treatment, IVI appointment logistics, IVI infusion experience, impact on daily activities, and patient preferences.

Of 323 respondents, 71 (22.0%) were prescribed IVI for HMB and received ⩾2 IVI infusions monthly. The mean age for these patients was 33.5 years; they experienced a mean of 2.9 years from symptom onset until IDA diagnosis, and 1.4 years between diagnosis and IVI treatment. Most patients agreed that navigating IVI treatment logistics interfered with productivity and social commitments, and felt they must schedule their life around treatment. Patients who were also diagnosed with hypophosphatemia following IVI (12/71; 16.9%) reported a mean of 8.2 additional hospital visits. Furthermore, 36.6% of patients missed an IVI dose; of these, 80.8% preferred single-dose IVI.

Patients with IDA and HMB experienced substantial delays from symptom onset to subsequent IVI treatment, demonstrating a gap in management. Therefore, oral iron may not be an appropriate first-line treatment for some of these patients. Multiple-dose IVI and associated appointment logistics can negatively impact patients' perspectives on treatment. Single-dose IVI preferences should be considered to improve patients' adherence and QoL.

Anemia is a common global health problem, particularly in impoverished regions, with a high incidence rate. The condition is multifactorial, with iron deficiency being one of the most prevalent causes. Current treatment for anemia often relies on iron supplements or erythropoiesis-stimulating agents, although these therapies may show limited efficacy for some patients. Recent evidence suggests that probiotics, prebiotics, and synbiotics, as microbiome modulators, hold significant potential in the treatment of anemia. These interventions may enhance iron absorption and improve overall blood health through their impact on gut microbiota, thus providing an alternative or complementary approach to conventional treatments.

Six databases, including the Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), and WangFang data library, were searched up to November 20, 2024. Studies published in English and Chinese were included. We included randomized controlled trials (RCTs) evaluating the effects of probiotics, prebiotics, or synbiotics in treating anemia. The experimental groups received probiotics, prebiotics, or synbiotics, while the control groups received placebo, alternative treatments, or no treatment. The primary outcome was hemoglobin (Hb) levels. Secondary outcomes included serum iron (SI) and serum ferritin (SF). A descriptive analysis was conducted for studies where meta-analysis was not feasible. The GRADE tool was used to assess the quality of evidence, and the Cochrane guidelines were employed to evaluate the risk of bias in each study.

Seven studies were included comprising a total of eight RCTs, with the main types of anemia being iron deficiency anemia (IDA) and anemia of chronic kidney disease (CKD), involving 632 patients. The analysis revealed that probiotics, prebiotics, or synbiotics significantly improved Hb levels in patients with anemia (WMD = 10.760, 95% CI: 4.593 to 16.747, p = 0.001), though heterogeneity was high (I² = 96.5%). Two RCTs (n = 120 participants) reported significant increases in serum iron levels in the probiotic group (WMD = 3.835, 95% CI: 3.271 to 4.400), with moderate heterogeneity (I² = 38.7%). Two RCTs (n = 192 participants) reported no significant differences were observed between the groups in serum ferritin levels (WMD = 8.048, p = 0.115), and heterogeneity remained high (I² = 62.6%). Subgroup analyses revealed that probiotics improved Hb levels in renal and iron-deficiency anemia, as well as across different doses. The synbiotic group showed consistent efficacy (I² = 0%), while the prebiotic group did not exhibit significant effects, with extremely high heterogeneity (I² = 99.3%). This indicates that heterogeneity may stem from variations in intervention types, and the results should be interpreted with caution.

There is moderate-quality evidence suggesting that probiotics, prebiotics, and synbiotics may improve anemia management, particularly by enhancing Hb levels. Further high-quality RCTs are required to explore the specific role of synbiotics in anemia management, including their comparative efficacy against probiotics and prebiotics alone, and their impact on gastrointestinal factors such as gut microbiota modulation and inflammation reduction.

PROSPERO CRD42024590073.

Iron homoeostasis is tightly regulated, with hepcidin and soluble transferrin receptor (sTfR) playing significant roles. However, the genetic determinants of these traits and the biomedical consequences of iron homoeostasis variation are unclear. In a meta-analysis of 12 cohorts involving 91,675 participants, we found 43 genomic loci associated with either hepcidin or sTfR concentration, of which 15 previously unreported. Mapping to putative genes indicated involvement in iron-trait expression, erythropoiesis, immune response and cellular trafficking. Mendelian randomisation of 292 disease outcomes in 1,492,717 participants revealed associations of iron-related loci and iron status with selected health outcomes across multiple domains. These associations were largely driven by HFE, which was associated with the largest iron variation. Our findings enhance understanding of iron homoeostasis and its biomedical consequences, suggesting that lifelong exposure to higher iron levels is likely associated with lower risk of anaemia-related disorders and higher risk of genitourinary, musculoskeletal, infectious and neoplastic diseases.

Anaemia occurs due to an imbalance between erythrocyte production and loss. This imbalance can be due to ineffective erythropoiesis, blood loss or haemolysis. Whilst there are many causes for anaemia, iron deficiency anaemia (IDA) remains the predominant cause worldwide.

There have been many updated guidelines on the management of IDA in the past few years. As the reasons for IDA are many, evaluation requires thorough analysis and focused investigations. As an asymptomatic disease in the early stages, IDA can lead to many mistakes in its management. This review highlights potential mistakes in assessing and managing IDA and recommendations to avoid them.

The effective management of IDA necessitates a comprehensive and multidisciplinary approach. By recognising and addressing the common mistakes highlighted in this narrative review, healthcare professionals can improve patient outcomes, minimise complications, and enhance the overall quality of care.

Phosphate dysregulation is often associated with chronic kidney disease (CKD), and recent studies suggest that it may also be present in non-CKD patients with systemic conditions including iron deficiency anemia. This study aimed to evaluate the relationship between iron deficiency parameters (total iron-binding capacity {TIBC}, hemoglobin, and serum ferritin) and markers of proximal tubular dysfunction (the maximal tubular reabsorption of phosphate normalized to glomerular filtration rate {TmP/GFR} and tubular reabsorption of phosphate {TRP}) in non-CKD patients with iron deficiency anemia.

This was a hospital-based analytical cross-sectional study conducted in the outpatient department and/or inpatient wards of the Department of Internal Medicine, Swaroop Rani Nehru (SRN) Hospital associated with Moti Lal Nehru (MLN) Medical College, Prayagraj, Uttar Pradesh, India, between July 2023 and August 2024.

This study analyzed 40 anemic patients without CKD, with a mean age of 33.9 years. Most participants (n=24, 60%) were aged 18-35 years, and the majority (n=27, 67.5%) were female. Peripheral smear analysis revealed that 72.5% (n=29) had microcytic hypochromic anemia. Hemoglobin levels averaged 7.7 g/dL, serum iron was 91.0 µg/dL, total iron-binding capacity (TIBC) was 316.3 µg/dL, and serum ferritin was 199.7 ng/mL. Phosphate handling was assessed with TmP/GFR and tubular reabsorption of phosphate (TRP) showing mean values of 4.1 mg/dL and 99.2%, respectively. This study found that TmP/GFR had a significant positive correlation with TIBC (r=0.402, p=0.010), but non-significant negative correlations with hemoglobin and serum iron. TRP was negatively correlated with hemoglobin and serum ferritin, but not significantly. Among patients with microcytic hypochromic anemia, 55.2% (n=16) had increased TmP/GFR, and 61.1% (n=20) of patients with iron deficiency anemia exhibited increased TmP/GFR. Regression analysis revealed that TIBC significantly predicted TmP/GFR (p=0.022), indicating that higher TIBC values are associated with increased TmP/GFR, suggesting a potential link between iron metabolism and renal phosphate handling.

Higher TIBC levels were associated with increased TmP/GFR, suggesting that iron deficiency anemia may influence proximal tubular function. The findings emphasize the importance of considering renal phosphate handling in patients with iron deficiency anemia.