Железодефицитные новости

[Dr.Vad]

впервые опубликованы результаты исследования, где пациентам с ожирением и функциональным дефицитом железа (как ферритин менее 50) в/в введение железа повышало гемоглобин на 10 г/л в среднем, показывая, что нормальные цифры гемоглобина до лечения были для них легкой анемизацией, похожий эффект, но менее выраженный эффект был у пациентов с избыточным весом (ИМТ 25-30) = повышение на 5 г/л, но не было у пациентов с нормальным весом:
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Impact of obesity on iron metabolism and the effect of intravenous iron supplementation in obese patients with absolute iron deficiency
Sci Rep. 2025 Jan 8;15(1):1343
[Ссылки доступны только зарегистрированным пользователям ]

[Dr.Vad]

риск инфекций верхних дыхательных путей и мочевыводящих путей выше у женщин-доноров крови с дефицитом железа:

Iron deficiency was associated with an overall increased risk of infection (defined as prescriptions of antibiotics) for women (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.02-1.15). Subgroup analyses showed an increased risk of respiratory tract infections (HR 1.16, 95% CI 1.05-1.28) and urinary tract infections (HR 1.16, 95% CI 1.04-1.29).
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Transfusion. 2025 Jan 14.
Iron deficiency and infection risk in Danish blood donors

[Dr.Vad]

еще одна публикация о жд и фертильности из Хельсинки, которая показала, что у женщин с дефицитом железа (ферритин менее 30) введение 500 мг фериндзжекта повысило шансы на зачатие с 65% до 77%, в 3 раза снизило прерывание беременности и в 3 раза (до 51%) шансы на рождение ребенка:

In the model adjusted for age, use of preimplantation genetic testing for aneuploidy, and repeated iron infusions, treatment of iron deficiency with iron infusion was associated with a higher live birth rate (OR = 3.19; 95% CI = 2.21-4.66; p < 0.001).
In the model adjusted for age, reason for infertility, and total number of pregnancies, treatment of iron deficiency was associated with lower miscarriage rates (OR = 0.32; 95% Cl = 0.20-0.52; p < 0.001).

Conclusions: Filling of depleted iron stores was positively associated with conception results (higher number of pregnancies) and pregnancy outcomes (higher live birth rates and lower miscarriage rates), regardless of the assisted reproductive technology method used. Screening of iron status seems to be important in patients seeking help for infertility problems.
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Acta Obstet Gynecol Scand. 2025 Jan 16.
Association between iron deficiency and fertility

[Dr.Vad]

дети с ожирением и дефицит железа без анемии: повышает риск в 1.6 раз; и частота жд у детей с ожирением 20%, тогда как у детей с норм. весом в 16%

The pooled OR (95% CI) for ID was 1.6 (1.2, 2.2), 16 studies, 20,949 children. The pooled prevalence of ID was 20.1% (14.98, 25.16) among children living with obesity (16 studies, 3147 children), compared to 16.1% (11.82, 20.38) in children without obesity.

Children living with obesity had significantly lower levels of hemoglobin, iron, % transferrin saturation, and higher levels of ferritin and hepcidin than children without obesity.
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Obes Rev. 2025 Jan 22:e13892.
Association of iron deficiency and anemia with obesity among children: A systematic review and meta-analysis

[Dr.Vad]

Дефицит железа в КМ у пожилых - лучше всего ферритин: цифра менее 30 у женщин и менее 51 у мужчин с 95% точностью подтвержает диагноз

Using a ferritin cut-off 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. With 50% pre-probability for reduced iron stores, a ferritin of 30 µg/L (females) and 51 µg/L (males) had 95% positive predictive value for reduced iron stores.
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Blood Adv. 2025 Jan 22:bloodadvances.2024014283.
Ferritin Outperforms Other Biomarkers in Predicting Bone Marrow Iron Stores in Hematological Patients

[Dr.Vad]

обзор негативного влияния жд на детей в первые 2.5-3 года жизни на когнитивные функции, моторное развитие и поведение ребенка:

ID in early childhood disrupts neurodevelopmental processes, leading to long-term effects on cognition, motor skills, behavior,
and neuroendocrine function. Children with a history of childhood ID were reported to have lower cognitive, motor, behavior, and
neuroendocrine functions compared to those without a history of ID. Our study emphasizes the importance of the neurodevelopmental
process, as disturbances during this phase, particularly ID, can result in long-term neurological impairments. Therefore, we stress
the importance of preventing ID, especially during the first 1,000 days of life, as it can lead to irreversible deficits in motor function,
cognitive ability, and behavior.
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Neurodevelopmental Impairments as Long-term Effects of Iron Deficiency in Early Childhood: A Systematic Review
[Ссылки доступны только зарегистрированным пользователям ]

[Dr.Vad]

систематический обзор публикаций показывает, что у детей с жд или жда повышен риск инфекций:

Iron deficiency anemia is common among children between 6 months and
3 years of age. This age group can be considered a highly susceptible age for
contraction of ARTI and AGE. Children below 5 years suffer 5 to 6 episodes of
acute ARTI per year on average, and pneumonia accounts for the highest number of
deaths, which is around 1.1 million each year. When considered, the odds ratio of
anemia to increase the susceptibility of contracting lower ARTI would range from 2 to
5.7. Also, anemic children were 10 times more susceptible to developing acute
recurrent ARTI and 4 times more susceptible to contracting pneumonia. Respiratory
syncytial virus is the commonest viral etiology. Anemia would increase the risk of
diarrhea by 2.9-fold in toddlers, while mild anemia, moderate anemia, and severe
anemia would increase the susceptibility to contract AGE by 1.6, 1.6, and 8.9 times,
respectively. Rotavirus is the commonest etiology.
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Childhood Anemia and Risk for Acute Respiratory Infection, Gastroenteritis, and Urinary Tract Infection: A Systematic Review
J Pediatr Infect Dis 2023;18:61–70.

[Dr.Vad]

дефицит железа без анемии - показатели крови до и после лечения, симптоматика и ее улучшение на фоне лечения

24 patients with Hb above 12 g/dL were found, 16.7% (4/24) were male, 83.3% (18/24) were female. The most common age groups were 30-40 at 33.3% (8/24) and 40-50 at 20.8% (5/24). The mean Hb for this group of patients was 13.4 ± 1 g/dL, MCV 83 ± 7 fL, and the mean ferritin was 16 ± 10 ng/mL. 87.5% (21/24) of patients reported symptoms, with fatigue being reported by 83.3% (20/24) of patients. Pica was reported by 8.3% (2/24), restless leg syndrome by 12.5% (3/24), cold intolerance by 12.5% (3/24), and hair and/or nail changes by 25% (6/24) of patients. 70.8% (17/24) of patients received IV iron treatment, 16.7% (4/24) received oral iron treatment. Iron dextran was the most frequently used preparation at 76.5% (13/17). Mean post-treatment Hb was 13.9 ± 0.8 g/dL, MCV 88.5 ± 5.2 fL, and mean post-treatment ferritin 135.6 ± 99.7 ng/mL. In our study, 62.5% (15/24) of patients stated their symptoms improved, 4.17% (1/24) of patients stated their symptoms did not improve, 33% (8/24) of patients could not be evaluated at a subsequent visit for symptoms.

Iron deficiency without anemia can be a significant contributor to patient morbidity, and patients are not routinely assessed for iron deficiency in the absence of anemia. A recent study (Weyand et al. JAMA 2023) suggests up to 40% of females can have iron deficiency when defined by a ferritin level of 15 ng/mL, and up to 80% of females when a less stringent cut-off of 50 ng/mL is used. Our study suggests both male and female patients can report symptoms of iron deficiency without the presence of anemia and subjective improvement following iron replacement without significant changes in Hb. The high prevalence of iron deficiency indicates a greater need for screening for this underrecognized phenomenon. We recommend considering ferritin and iron panel evaluation while assessing patients for symptoms such as those seen in iron deficiency anemia, even without the presence of low Hb.
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Symptomatic Iron Deficiency without Anemia: An Underrecognized Phenomenon.
Blood (2023) 142(Suppl. 1):1092.

[Dr.Vad]

ЖД анемия у беременной повышает риск ЖД анемии у новорожденных: в 1.5 раз при лёгкой анемии, и в 3 раза при анемии средней тяжести или тяжелой:

maternal anemia significantly increases the rate of anemia in offsprings, with ORs being 1.5 (1.0 ~ 2.1) for mild anemia, and 3.0 (1.2 ~ 7.1) for moderate or severe anemia, respectively.
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Front Nutr. 2025 Jan 27:12:1535226.
Detection of postpartum women anemia and its impact on their offspring in Zhejiang Province, China

[Dr.Vad]

ЖДА и головная боль - мета-анализ:

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 1.8-higher risk of developing chronic headaches compared to nonanemic individuals (RR: 1.76; 95% CI: 1.22-2.52).
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Anemia. 2025 Feb 7:2025:5695022.
The Bidirectional Relationship Between Iron Deficiency Anemia and Chronic Headache Disorders: A Systematic Review and Meta-Analysis

[Dr.Vad]

Витамин Д в крови и риск ЖДА: более высокие цифры его в крови предупреждают развитие ЖДА у женщин:

The risk of developing IDA was significantly lower for participants in the highest quartile subgroup with vitamin D levels ≥ 78.1 nmol/L (> 31 нг/мл) compared to those in the lowest quartile with vitamin D levels ≤ 42.8 nmol/L (< 17.1 нг/мл). In terms of gender, serum vitamin D primarily exhibited a protective effect against IDA in females...
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Food Sci Nutr. 2025 Feb 24;13(3):e4746.
Serum Vitamin D Levels and Risk of Iron Deficiency Anemia in Adults: A Cross-Sectional Study and Mendelian Randomization Analysis

[Dr.Vad]

Should Iron Deficiency Be Treated With Oral or IV Iron?

[Ссылки доступны только зарегистрированным пользователям ]

[Dr.Vad]

дженерики венофера могут хуже переноситься (повышение частоты поб. эффектов в 6-8 раз) или давать худший ответ при лечении, несмотря на одинаковые дозы:

Iron Sucrose: A Wealth of Experience in Treating Iron Deficiency
[Ссылки доступны только зарегистрированным пользователям ]

[Dr.Vad]

повышение СРБ и снижение усвоения железа у пожилых если СРБ более 50 мг/Л, то ожидать ответа на прием железа внутрь не приходится:

Serum iron and CRP levels were measured before breakfast and two- and four-hours after ingestion of two iron capsules. Intestinal iron absorption was calculated by subtracting baseline values from those obtained after the test, with an increase of 100 ug/dl indicating sufficient absorption. Patients were categorized into six CRP groups: ≤0.50, 0.51-2.50, 2.51-5.0, 5.1-7.50, 7.51-10.0, and ≥10.1 mg/dl.

Results: The study included 59 participants (73% females, age range 71-99). Iron absorption was highest in groups with lower CRP levels ≤0.50 to 2.5 mg/dl) and declined significantly as CRP increased, particularly beyond 5 mg/dl. The most significant decline was noted in patients with CRP ≥ 10.1 mg/dl. A negative correlation between inflammation, as measured by CRP, and iron absorption was found. As CRP levels escalate, there is a significant reduction in the increase of serum iron levels after 2 h. A regression analysis showed that only elevated CRP levels significantly reduced serum iron increments post-iron supplementation (P = 0.004), while other factors such as age, sex, body mass index, frailty, weight loss, hemoglobin and nutritional status had no significant impact.

Conclusion: A CRP level above 5 mg/dl is indicative of significantly impaired intestinal iron absorption in older patients...
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Eur J Clin Nutr. 2025 Mar 27.
Impact of inflammatory status on intestinal iron absorption in older hospitalized patients.

[Dr.Vad]

сравнение лечения железа сульфатом 60 мг ежедневно или 120 мг железа через день у женщин с анемией (гемоглобин менее 100 г/л) показало, что прием через день (ADA) больше повышает гемоглобин и побочного действия в 5 раз реже:

Hb change at Day-28 was significantly higher in the ADA compared to DA (mean change: +22 ± 13 vs. +13 ± 11 g/L, p = 0.003)...Significantly higher proportion in the DA had AEs compared to ADA (45% vs. 9%, p < 0.005).
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Indian J Hematol Blood Transfus. 2025 Apr;41(2):245-251.
Daily Versus Alternate Day Oral Iron Replacement for Women with Iron Deficiency Anaemia: A Randomized Controlled Trial