Lecture 20 Flashcards
Biochemical assessment of Iron status
What are some functions of iron
- oxygen carrying (haemoglobin)
- oxygen storage (myoglobin)
- oxidative production cellular energy
- glycolysis in muscles
- serotonin and norepinephrine production
- neutrophil function
What are the consequences of iron deficiency anaemia
- Decreased work capacity
- fatigue
- behavioural disturbances
- decreased cognitive function
- decreased growth
- spoon shaped nails
what are the consequences of non anaemic iron deficiency
- decreased cognitive function ?
- increased fatigue ?
-decreased mood ?
-decreased work capacity - increased risk of iron deficiency anaemia
what is the aetiology of iron deficiency
- Low intake or poor absorption
- High requirements:
- growth
- Blood loss
- pregnancy
what groups are at risk of iron deficiency
- infants (especially pre term)
- toddlers (~%30 suboptimal Fe status)
- people who are menstruating (~13%)
- pregnant people
- blood loss
- vegetarians (increased phytate intake, no intake red meat or meat, fish, poultry factor)
what is the relevance of clinical assessment of iron status
Not used in research or monitoring setting but can be used if someone is in severe iron deficiency state
What is dietary assessment used as
For sure looks at risk of looking at risk of iron deficiency
- Where some areas of weaknesses
- Can not tell you if you are deficient or not
- Overall indicator of how many people are at risk in a population
Is anthropometric assessment used as assessment of iron status
not relavent
Biochemical assessment is …
This is really important because the amount of iron you absorb is based on your status, enhancers and inhibitors
- This can tell you if you are deficient
Iron metabolism and red blood cell recycling.
step 1:
Dietary iron comes into the body and some of it is being absorbed by epithelial cells in the intestine
Iron metabolism and red blood cell recycling.
step 2:
What isn’t absorbed is going to end up going out in faeces
Iron metabolism and red blood cell recycling.
step 3:
What is absorbed is going to end up going into the body, transported on transferrin (Fe3+)
Iron metabolism and red blood cell recycling.
step 4:
Will eventually end up going to a site of erythropoiesis, and that mainly happens in the bone marrow
Erythro =means red cell
Iron metabolism and red blood cell recycling.
step 5:
We have the formation of red blood cell. There are a number of things you can measure when looking at iron status. Could look at haemoglobin concentration, and a number of other indices
Iron is an important component of Haemoglobin molecule, which enables oxygen to be carried in the blood.
Iron metabolism and red blood cell recycling.
step 6:
The haemoglobin is always being recycled. We have relatively small intake of iron compared to the amount of iron needed to replace your red blood cells every approx. 120 days.
Iron metabolism and red blood cell recycling.
step 7:
These red blood cells are being broken down all the time by RE cells, which are mainly in areas like the liver and the spleen. When they are broken down, that which is not needed is stored as ferritin which can end up in the blood etc. Others will be reused to make new Haemoglobin (the recycling)
What are the 5 red cell indices when looking at iron status
- haemoglobin
- haematocrit (packed cell volume )
- mean cell volume
- red cell distribution width
- erythrocyte protoporphyrin
What is mean cell volume
Ht / RBC
Relationship between haematocrit and red blood cell count
what is red cell distribution
the variation in the size of cells
what is erythrocyte protoporphyrin (FEP or ZPP)
the immature stage in the production of haemoglobin
zinc will be replaced by iron in this process but if you don’t have enough iron then the zinc stays and you have erythrocyte protoporphyrin instead of heme
what will happen to haemoglobin if you have iron deficiency anaemia
decrease
what will happen to hematocrit if you have iron deficiency anaemia
decrease
what will happen to mean cell volume if you have iron deficiency anaemia
decrease
what will happen to red cell distribution width if you have iron deficiency anaemia
will be greater (some are small and some are normal so there will be a greater difference in size)