Effects of antioxidant diet on the RBC indices in fructose-induced obesity rat model

The oxidative stress is one of the known and discussed culprits for development and progression of the disturbances in Metabolic syndrome (MetS). In our study, we are investigating the effects of antioxidant additives as additional treatment and prophylaxis in a model of MetS. We are using a fructose-induced metabolic syndrome rat model to examine the effects of antioxidant preparation ZellSchutz. Four experimental groups were formed using male Wistar rats (n = 60). The control group received standard rat chow, the other groups received either ZellSchutz (Z), fructose (F), or fructose and ZellSchutz (ZF). Our results showed an unexpected increase in the RBC indices in rats with dual treatment. There was a significant increase in hemoglobin concentration, MCHC, and MCV in those animals (p<0.001). The preliminary data shows the important role of antioxidants as supplementary therapy in metabolic syndrome. Further investigations will be carried on to reveal the molecular mechanisms of the observed changes.

Influence of red blood cell indices on HbA1c performance in detecting dysglycaemia in a Singapore preconception cohort study

Abnormalities of red blood cell (RBC) indices may affect glycated haemoglobin (HbA1c) levels. We assessed the influence of haemoglobin (Hb) and mean corpuscular volume (MCV) on the performance of HbA1c in detecting dysglycaemia among reproductive aged women planning to conceive. Women aged 18–45 years (n = 985) were classified as normal (12 ≤ Hb ≤ 16 g/dL and 80 ≤ MCV ≤ 100 fL) and abnormal (Hb < 12 g/dL and/or MCV < 80 fL). The Area Under the Receiver Operating Characteristic (AUROC) curve was used to determine the performance of HbA1c in detecting dysglycaemic status (prediabetes and diabetes). There were 771 (78.3%) women with normal RBC indices. The AUROCs for the normal and abnormal groups were 0.75 (95% confidence interval 0.69, 0.81) and 0.80 (0.70, 0.90), respectively, and were not statistically different from one another [difference 0.04 (− 0.16, 0.08)]. Further stratification by ethnicity showed no difference between the two groups among Chinese and Indian women. However, Malay women with normal RBC indices displayed lower AUROC compared to those with abnormal RBC indices (0.71 (0.55, 0.87) vs. 0.98 (0.93, 1.00), p = 0.002). The results suggest that the performance of HbA1c in detecting dysglycaemia was not influenced by abnormal RBC indices based on low Hb and/or low MCV. However, there may be ethnic variations among them.

Association between RBC Indices, Anemia, and Obesity-Related Diseases Affected by Body Mass Index in Iranian Kurdish Population: Results from a Cohort Study in Western Iran

Objective. The relationship between RBC indices and metabolic diseases remains unclear. The association between anemia and obesity is also controversial. The present study aimed to investigate the relationship between RBC indices and metabolic diseases caused by obesity and evaluate the effect of body mass index (BMI) on RBC indices on the Ravansar cohort data. Method. For the purpose of this study, 9826 participants aged 35–65 years (5158 females and 4668 males) were recruited in the analyses. A quadratic prediction fit plot investigated the association between RBC indices with BMI and lipid profile. The odds ratio of obesity-related diseases in each quartile category of RBC indices and anemia was estimated using multivariable logistic regression models. Results. Subjects in the fourth quartiles of RBC count, hematocrit (HCT), hemoglobin (HGB), and red cell distribution width (RDW) had a higher risk for obesity-related diseases compared to the first quartiles. However, individuals with the mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) in fourth quartiles had lower ORs of obesity-related diseases. While BMI reduced the effect of RBC count, HCT, HGB, and RDW on the incidence risk of obesity-related disease, it increased the impact of MCV, MCH, and MCHC. There was a negative association between BMI and RBC indices except for RDW. The BMI effect on RBC indices was different in normal and obese individuals. BMI in mild anemia lowered the risk of metabolic diseases, but it increased the risk of metabolic diseases for moderate anemia. Conclusion. A higher risk of obesity-related diseases was observed in the fourth quartiles of RBC count, HCT, HGB, and RDW compared to the first quartiles. However, the incidence risk was lower for MCV, MCH, and MCHC. BMI plays an anemia-type dependent role in the relationship. Consideration should be given to the type of anemia in the relationship between BMI and anemia.

Effect of Iron Supplementation in Anaemic Children with Breath Holding Spells at a Tertiary Care Hospital (KGH - Visakhapatnam) in Southern India

BACKGROUND Breath holding spells (BHS) are common, non-epileptic paroxysmal events that occur in children below 6 years, whose diagnosis is made many times clinically. Exact aetiology is not known, but iron deficiency was one among many proposed aetiological factors. Very few studies were published till date to determine role and effect of iron supplementation in children with breath holding spells. Hence the present study was taken up to assess the presence of iron deficiency and the effect of iron supplementation in children with breath holding spells. METHODS This prospective interventional study was performed from May 2012 to April 2017. 125 children below six years of age brought with the complaint of breath holding spells were screened for presence of anaemia and other systemic illnesses. Ten children were excluded with other organic causes and only 85 children were found to have anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months and followed up for a total period of 6 months. Response to iron supplementation was assessed in these children by measuring total number of attacks of BHS before starting iron supplementation, after supplementation of iron for three months and also at the end of follow-up period. The results were analysed by using Microsoft Office Excel. RESULTS 76.52 % (85/115) of patients had anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months. The remaining 27 cases had normal Hb % & red blood cells (RBC) indices and were not included. Response to iron therapy was assessed in anaemic children with breath holding spells and we found complete response in 78.41 %, partial response in 15.91 % and no response in 5.7 %. CONCLUSIONS This study proved the role of iron therapy in anaemic children with breath holding spells. KEYWORDS Breath Holding Spells (BHS), Iron Deficiency, Anaemia, Haemoglobin

STUDY OF CLINICALAND HAEMATOLOGICAL PROFILE OF ANEMIA IN GERIATRIC PATIENTS AT A TERTIARY LEVEL CENTRE IN HARYANA

Background: The demographic transition with ageing of population is a global phenomenon and in recent years there has been an increasing international awareness of health issues relating to aging population. Anemia represents an emerging global health problem producing a negative impact in the quality of life among the elderly and requiring greater allocation of health resources. Aims: To identify elderly patients with anemia and study the etiology, clinical parameters, laboratory parameters in these patients. Methods: A total of 100 patients were enrolled in this study. The entire medical history were obtained from each of the cases including previous medical reports and imaging studies. Complete blood counts , RBC indices,total WBC count, differential count, platelet count, haematocrit, ESR, peripheral smears ,reticulocyte count, ferritin, iron and TIBC were recorded for each patient. The data was compiled and analyzed using Statistical Package for social services (SPSS vs 20). Results: Among the etiologies, iron deciency anemia was seen in 43% of patients, anemia of chronic disease in 32%, anemia of chronic kidney disease and unexplained anemia in 11 % patients. Among clinical features the commonest symptom was easy fatiguability and commonest sign was pallor. Peripheral smear study showed that normocytic normochromic anemia was commonest type. Conclusion: This study showed that the commonest cause for anemia among elderly patients is iron deciency anemia followed by anemia due to chronic disease. Geriatric anemia is a disease that often goes unreported hence every effort should be made to identify the disease and evaluate the cause.

Hemogram components and platelets count variation in anemic patients attending Birat Medical College and Teaching Hospital, Morang, Nepal

Background: Anemia being the expression of the underlying disease is a global public health problemaffecting both developing as well as developed countries. The RBC indices and platelet count variationamong anemic patients are important to know their association for clinical implications.Materials and Methods: A hospital-based cross-sectional study among anemic patients with hemoglobin<10 gm%, attending Birat Medical College Teaching Hospital, Nepal from 15 May to 15 July 2020 wereanalyzed for RBC indices and platelet count variation. Demographic data, RBC indices, platelet countvariation, and types of anemia were evaluated. Pearson’s correlation coefficient was used for correlatingthe platelet count with RBC indices. A Chi-square test was used to know about the association betweenthe types of anemia and platelet count variation.Results: Out of 150 anemic patients, the female to male ratio was 1.5:1, with the most common agegroup between 40-49 years. There exist high differences between minimum and maximum individualRBC indices (Hb, MCV, MCH, MCH) and platelet count values. The platelet count variation with RBCvalues and MCV had a statistically significant positive and negative correlation respectively. However,the correlation between platelet count variation with hemoglobin concentration level and type of anemiawas positive but statistically not significant.Conclusion: Findings suggest that platelet count variation with RBC indices and types of anemiacorrelated well among anemic patients. Such association will enable the clinicians for diagnosing andtreatment purposes.

Association of Red Blood Cell Indices with Mild Cognitive Impairment in Chinese Elderly Individuals: a Matched Case- control Study

Background: Mild cognitive impairment (MCI) represents an intermediate and modifiable stage between normal aging and dementia. There is an urgent need for simple, non- invasive testing of MCI by blood biomarkers. Objective: This study aimed to retrospectively evaluate the association of red blood cell (RBC) indices with MCI, and select the best hematologic characteristic for detection of MCI in elderly Chinese. Methods: Matched case-control study was carried out with 85 pairs of MCI subjects and healthy controls. The matching criteria were age, gender and education attainment. All samples were analyzed for RBC indices, including hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width-standard deviation (RDW-SD). A conditional logistic regression model was used to evaluate the association between RBC indices and MCI. The diagnostic efficacy of the biomarkers was evaluated by receiver operating characteristics (ROC). Results: Among all RBC indices, there were significant differences in HGB (124.82 ± 7.89 vs. 133.93 ± 4.52, P < 0.001) and RDW-SD (45.29 ± 2.03 vs. 41.34 ± 4.41, P < 0.001) between two groups. In the logistic regression model, after adjustment for lifestyle factors and comorbidities, significant statisti- cally associations have been found between higher HGB and lower risk of MCI (adjusted OR: 0.831; 95%CI: 0.773-0.893), higher RDW-SD and a higher risk of MCI (adjusted OR: 1.575; 95%CI: 1.326- 1.872). ROC analysis suggested that the largest area under the ROC curve (AUC) was found with the combination of HGB and RDW-SD (AUC = 0.842), followed by HGB(AUC = 0.795), and finally by modest RDW-SD (AUC = 0.777). Combination of HGB <131 g/L and RDW-SD >43.4 fL yielded a sensitivity of 92% and a specificity of 89%, overall diagnosis efficiency of which were better than HBG and RDW-SD alone. Conclusion: Lower HGB and higher RDW-SD alone were significantly found to be associated with increased risk of MCI, and offered modest sensitivity and specificity as a diagnostic marker. The combination of HGB and RDW-SD was more sensitive and had higher classification accuracy for differentiating MCI from healthy controls. Further prospective research is needed to clarify whether HGB in combination with RDW-SD may be a potential diagnostic tool for early AD diagnosis.

Rapid Gardos Hereditary Xerocytosis Diagnosis in 8 Families Using Reticulocyte Indices

Gardos channelopathy (Gardos-HX) or type 2 stomatocytosis/xerocytosis is a hereditary hemolytic anemia due to mutations in the KCNN4 gene. It is rarer than inherited type 1 xerocytosis due to PIEZO1 mutations (Piezo1-HX) and its diagnosis is difficult given the absence of a specific clinical or biological phenotype. We report here that this diagnosis can be sped up using red blood cell (RBC) indices performed on an ADVIA 2120 (Siemens®) analyzer, which measures reticulocyte mean corpuscular volume (rMCV) and mean corpuscular hemoglobin concentration (rMCHC). We studied reticulocyte indices in 3 new and 12 described patients (8 families) with Gardos-HX, 11 subjects presented the recurrent p.Arg352His mutation, 4 cases (two families) carried a private KCNN4 mutation. They were compared to 79 described patients (49 families) with Piezo1-HX. Surprisingly, in Gardos-HX cases, rMCV revealed to be smaller than MCV and rMCHC higher than MCHC, in contrast with normal or Piezo1-HX RBC. Consequently, ΔMCV (rMCV-MCV) was −0.9 ± 5 fL vs. 19.8 ± 3 fL (p &lt; 0.001) in Gardos compared with Piezo1-HX and ΔMCHC (rMCHC-MCHC) was 18.7 ± 13 vs. −50 ± 8.7 g/L (p &lt; 0.001). A threshold of 8.6 fL for ΔMCV and −5.5 g/L for ΔMCHC could discriminate between Gardos and Piezo1-HX with 100% sensitivity and specificity, regardless of age, mutation or splenectomy status. Consequently, we showed that reticulocytes indices are useful to suggest Gardos-HX on blood count results, allowing to rapidly target these patients for gene analysis. In addition, these parameters may prove useful as a ‘functional tool’ in interpreting new KCNN4 variants.