Estimates of total body iron indicate 19 mg and 38 mg oral iron are equivalent for the mitigation of iron deficiency in individuals experiencing repeated phlebotomy.
Estimates of total body iron indicate 19 mg and 38 mg oral iron are equivalent for the mitigation of iron deficiency in individuals experiencing repeated phlebotomy.
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DOI：
10.1002/ajh.24784
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发表时间：
2017-09
影响因子：
12.8
通讯作者：
Mast AE
中科院分区：
文献类型：
--
作者：
Bialkowski W;Kiss JE;Wright DJ;Cable R;Birch R;D'Andrea P;Bryant BJ;Spencer BR;Mast AE
缺铁性贫血是一种常见的临床病症，通常用含有65毫克元素铁的片剂治疗。这样的剂量可引起胃肠道副作用，降低患者依从性。口服铁补充剂也增加铁调素的产生，导致后续剂量的吸收分数降低。经常献血的人往往会缺铁。因此，他们参加了一项为期两年的研究，包括持续献血和随机接受60天的无药丸，安慰剂，19或38 mg葡萄糖酸亚铁。对于完成入组和最终访视的无药丸组和安慰剂组的供体亚组，全身铁（TBI）没有变化（分别为p=0.21和p=0.28）。然而，对完整数据集的重复测量回归分析估计，安慰剂组和无药丸组的TBI显著降低52 mg/年（p=0.001）。19和38毫克铁补充剂对TBI的影响是不可区分的（p=0.54）。在最初60天的铁补充后，TBI增加了229 mg（p<0.0001），并且在每次后续捐赠后继续补充铁时保持在这个较高水平。TBI增加的51 mg分配给红细胞铁（p<0.0001），174 mg分配给储存铁（p<0.0001）。由于同时使用抗酸剂，57 mg对储存铁的变化产生了负面影响（p=0.04）。在献血者中的这些发现表明，比目前使用的低得多的铁剂量将有效用于缺铁性贫血的临床治疗。
Iron deficiency anemia is a common clinical condition often treated with tablets containing 65 mg of elemental iron. Such doses can elicit gastrointestinal side effects lowering patient compliance. Oral iron supplements also increase hepcidin production causing decreased fractional absorption of subsequent doses. Frequent blood donors often become iron deficient. Therefore, they were enrolled in a two-year study involving continued blood donations and randomization to receive no pill, placebo, 19, or 38 mg ferrous gluconate for 60 days. Total body iron (TBI) did not change for the subset of donors in the no pill and placebo groups who completed both enrollment and final visits (p=0.21 and p=0.28, respectively). However, repeated measures regression analysis on the complete dataset estimated a significant decrease in TBI of 52 mg/year for the placebo and no pill groups (p=0.001). The effects of 19 and 38 mg iron supplementation on TBI were indistinguishable (p=0.54). TBI increased by 229 mg after the initial 60 days of iron supplementation (p<0.0001) and was maintained at this higher level with continued iron supplementation following each subsequent donation. The TBI increase was apportioned 51 mg to red cell iron (p<0.0001) and 174 mg to storage iron (p<0.0001). Changes in storage iron were negatively impacted by 57 mg due to concurrent antacid use (p=0.04). These findings in blood donors suggest that much lower doses of iron than are currently used will be effective for clinical treatment of iron deficiency anemia.
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影响因子：
2.9
作者：
Bryant, Barbara J.;Yau, Yu Ying;Leitman, Susan F.
通讯作者：
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影响因子：
7.1
作者：
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影响因子：
3.6
作者：
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通讯作者：
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影响因子：
6.5
作者：
Mast, Alan E.;Lee, Tzong-Hae;Busch, Michael P.
通讯作者：
Busch, Michael P.
DOI：
10.1001/jama.2015.13766
发表时间：
2015-11-03
期刊：
JAMA
影响因子：
--
作者：
Kantor ED;Rehm CD;Haas JS;Chan AT;Giovannucci EL
通讯作者：
Giovannucci EL