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HUNT 242 > Lecture 20 - Biochemical Assessment of Iron Status 1 > Flashcards

Lecture 20 - Biochemical Assessment of Iron Status 1 Flashcards

(58 cards)

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1
Q

what are some functions of iron

A
  • oxygen carrying (haemoglobin)
  • oxygen storage (myoglobin)
  • oxidative production cellular energy
  • glycolysis in muscles
  • serotonin and norepinephrine production
  • neutrophil function
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2
Q

consequences of iron deficiency anaemia

A
  • decreased work capacity
  • fatigue
  • behavioural disturbances
  • decreased cognitive function
  • decreased growth
  • spoon shaped nails
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3
Q

what are the consequences of non anaemic iron deficiency

A
  • possibly decreased cognitive function
  • possibly increased fatigue
  • possibly decreased mood
  • possibly decreased work capacity
  • increased risk of iron deficiency anaemia
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4
Q

what is the aetiology of iron deficiency

A
  • low intake or poor absorption
  • high requirements : growth, blood loss, pregnancy
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5
Q

what groups are at risk of iron deficiency

A
  • 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)
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6
Q

what is the relevance of clinical assessment of iron status

A

not used in research or monitoring setting but can be used if someone is in severe iron deficiency state

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7
Q

is dietary assessment used as assessment of iron status

A

yes

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8
Q

is anthropometric assessment used as assessment of iron status

A

not relavent

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9
Q

what is the most important nutritional assessment method in the assessment of iron status and why

A

biochemical assessment

  • the amount you absorb is massively affected by what your iron stores are and by enhances + inhibitors
  • you can not tell whether someone is iron deficient from dietary assessment, you must use biochemical assessment
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10
Q

red blood cells are broken down all the time by …..

A

reticulo-epithelial cells in areas like the liver and spleen

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11
Q

what happens when red blood cells are broken down

A

some is stored as ferratin other is used to make haemoglobin again

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12
Q

what are the 5 red cell indices when looking at iron status

A
  • haemoglobin
  • haematocrit (packed cell volume )
  • mean cell volume
  • red cell distribution width
  • erythrocyte protoporphyrin
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13
Q

what is mean cell volume

A

Ht / RBC

relationship between haematocrit and red blood cell count

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14
Q

what is red cell distribution

A

the variation in the size of cells

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15
Q

what is erythrocyte protoporphyrin (FEP or ZIPP

A

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
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16
Q

what will happen to haemoglobin if you have iron deficiency anaemia

A

will decrease

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17
Q

what will happen to hematocrit if you have iron deficiency anaemia

A

decrease

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18
Q

what will happen to mean cell volume if you have iron deficiency anaemia

A

decrease

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19
Q

what will happen to red cell distribution width if you have iron deficiency anaemia

A

will be greater (some are small and some are normal so there will be a greater difference in size)

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20
Q

what will happen to eythrocyte protoporphyrin if you have iron deficiency anaemia

A

will be greater

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21
Q

what are the biochemical indices of iron status

A
  • serum ferritin
  • soluble transferrin receptor
  • serum iron
  • total iron binding capacity
  • transferrin saturation
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22
Q

what is soluble transferrin receptor

A

the receptor for pricking up the transferrin

the hungrier that a cell is for iron, the more receptors it will put on the surface to pick up more iron

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23
Q

why are we able to measure soluble transferrin receptor and ferratin in the blood

A

because some ferratin leaks out into the blood and some soluble transferrin receptor will bud off the cell into the blood

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24
Q

what is serum iron

Study These Flashcards
A

how much is being transported on transferrin

25
what is total iron binding capacity
like the number of spots on transferrin that have not been taking up by iron, each can only carry two irons
26
what is transferrin saturation
serum Fe / TIBC how saturated the transferrin is, how many of those sites are taken up with iron
27
ferratin is
how your body stores iron
28
what will happen to serum ferritin in iron deficiency
decrease
29
what will happen to soluble transferrin receptor in iron deficiency
increase
30
what will happen to serum Fe in iron deficiency
decrease
31
what will happen to total binding capacity in iron deficiency
increase (more binding sites are free)
32
what will happen to transferrin saturation in iron deficiency
decrease
33
what happens in stage 1 iron deficiency
body protects the red blood cell iron, but starting to get less in your iron stores
34
what happens to serum ferratin, transferrin saturation, erythrocyte protoporphyrin and haemoglobin in stage 1 iron deficiency
serum ferratin, = decrease transferrin saturation, = normal erythrocyte protoporphyrin = normal haemoglobin = normal
35
what happens to serum ferratin, transferrin saturation, erythrocyte protoporphyrin and haemoglobin in stage 2 iron deficiency
serum ferratin, = decrease transferrin saturation, = decrease erythrocyte protoporphyrin = increase haemoglobin = normal
36
what happens to serum ferratin, transferrin saturation, erythrocyte protoporphyrin and haemoglobin in stage 3 iron deficiency
serum ferratin, = decrease transferrin saturation, = decrease erythrocyte protoporphyrin = increase haemoglobin = decrease
37
what happens in stage 2 iron deficiency
iron deficiency erythropoisis (IDE), basically just about run out of iron stores starting to have slight impact on red blood cell iron but not to the point where your hemoglobin would be below the cut off
38
what happens in stage 3 iron deficiency
full iron deficiency anaemia, run out of stores, marked impact on your iron in red blood cells, haemoglobin dropped below the cut off
39
what do all three stages of iron deficiency represent
stage 1 = depleted iron stores stage 2 = iron deficient erythropoiesis stage 3 = iron deficiency anaemia
40
what are the three approaches to interpreting iron indices
1. cut offs and reference limits 2. multiparameter models 3. body iron model
41
what is a cut off
when you are talking about impaired function, a level of this iron index below this cut off will have functional impacts
42
most commonly we have reference limits what are these
when you take a healthy population and look at the extremes of extremely low or high
43
multi parameter models .....
combine a whole lot of these indices together
44
reference limits are quite practical to use for
an individual in health or clinical setting
45
how do reference limits differ
by gender and age
46
what is a multi-parameter model for iron
ferritin model
47
using the ferritin model, someone will have iron deficient erythropoiesis (IDE) if
SF, TS, EP = 2+ are abnormal Hb = normal
48
using the ferritin model someone will have iron deficiency anaemia (IDA) if
SF, TS, EP = 2+ are abnormal Hb = low
49
what happens if someone has low haemoglobin but only 1 of SF, TS, EP are abnormal
anaemia due to something else
50
what is the body iron model
equation based on ratio of soluble transferrin receptor and serum ferritin
51
using the body iron model what is considered iron deficiency
body iron <0mg/kg
52
using the body iron model what is considered iron deficiency anaemia
iron deficiency and low Hb
53
what are the advantages to the body iron model
- good estimate of body iron measured by phlebotomy - continuous variable - less affected by inflammation
54
why is it good that the body iron model is a continuous variable
because then you can see if they are approaching a dangerous zone in terms of iron deficiency
55
why is the body iron model less affected by inflammation
because the soluble transferrin receptor isnt considered to be much affected by inflammation
56
what are the disadvantages of body iron model
- costs soluble transferrin receptor - no standard method soluble transferrin receptor
57
prevalence of iron deficiency anaemia in 15-18 year olds NZ
5.2%
58
prevalence of iron deficiency in 15-18 year olds NZ
10.6%

HUNT 242 (23 decks)

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