Hemoglobin as a predictor of response to iron therapy and its use in screening and prevalence estimates
The most common nutritional disorder in third world countries is iron deficiency. Health may be adversely affected, even if iron deficiency is not severe enough to result in anemia. Therefore, appropriate criteria are needed to diagnose iron deficiency. The level of hemoglobin in the blood has been used to define iron deficiency. This can be problematic because of a wide variation in hemoglobin among normal individuals. One study found that using a cutoff of 120 grams per liter of hemoglobin to diagnose iron deficiency led to the misclassification of 20 percent of healthy subjects as deficient and 20 percent of deficient subjects as healthy. Some have taken this evidence as a reason to abandon the use of hemoglobin, yet this may not be justified. In regions with a high prevalence of iron deficiency, hemoglobin measurement may be an sufficiently accurate indicator. In a sample of 412 pregnant women living in Ecuador, the usefulness of hemoglobin for iron deficiency screening, prevalence estimates, and prediction of response to iron therapy was assessed. About half the women took 390 mg ferrous sulfate (iron supplement) daily for two months, while the remaining women served as controls. Sixty-one percent of the treatment group was iron-deficient when the criteria based on response to iron supplementation were used; the subjects who responded to the supplements were assumed to be deficient before treatment. Evaluation was made of the sensitivity of hemoglobin to iron deficiency and its specificity for iron deficiency, as opposed to other disorders. It was concluded that hemoglobin measurement is accurate for screening and prevalence estimates in populations similar to the one studied, in which the prevalence of iron deficiency was high. Hemoglobin was also a good predictor of response to iron supplementation. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Clinical Nutrition
Is calcium the 'cure' for dilated cardiomyopathy?
More research is needed before calcium supplementation can be recommended to patients with dilated cardiomyopathy. This heart disease is caused by gene mutations that alter the cardiac myocyte cytoskeleton. This in turn reduces the amount of calcium released by the sarcoplasmic reticulum.
Publication Name: Nature Medicine
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