Iolascon Achille, Andolfo Immacolata, Russo Roberta, Sanchez Mayka, Busti Fabiana, Swinkels Dorine, Aguilar Martinez Patricia, Bou-Fakhredin Rayan, Muckenthaler Martina U, Unal Sule, Porto Graça, Ganz Tomas, Kattamis Antonis, De Franceschi Lucia, Cappellini Maria Domenica, Munro Malcolm G, Taher Ali
Dipartimento di Medicina Molecolare e Biotecnologie Mediche Università degli Studi di Napoli Federico II Napoli Italy.
CEINGE Biotecnologie Avanzate Franco Salvatore Napoli Italy.
Hemasphere. 2024 Jul 15;8(7):e108. doi: 10.1002/hem3.108. eCollection 2024 Jul.
Iron is an essential nutrient and a constituent of ferroproteins and enzymes crucial for human life. Generally, nonmenstruating individuals preserve iron very efficiently, losing less than 0.1% of their body iron content each day, an amount that is replaced through dietary iron absorption. Most of the iron is in the hemoglobin (Hb) of red blood cells (RBCs); thus, blood loss is the most common cause of acute iron depletion and anemia worldwide, and reduced hemoglobin synthesis and anemia are the most common consequences of low plasma iron concentrations. The term iron deficiency (ID) refers to the reduction of total body iron stores due to impaired nutrition, reduced absorption secondary to gastrointestinal conditions, increased blood loss, and increased needs as in pregnancy. Iron deficiency anemia (IDA) is defined as low Hb or hematocrit associated with microcytic and hypochromic erythrocytes and low RBC count due to iron deficiency. IDA most commonly affects women of reproductive age, the developing fetus, children, patients with chronic and inflammatory diseases, and the elderly. IDA is the most frequent hematological disorder in children, with an incidence in industrialized countries of 20.1% between 0 and 4 years of age and 5.9% between 5 and 14 years (39% and 48.1% in developing countries). The diagnosis, management, and treatment of patients with ID and IDA change depending on age and gender and during pregnancy. We herein summarize what is known about the diagnosis, treatment, and prevention of ID and IDA and formulate a specific set of recommendations on this topic.
铁是一种必需营养素,是对人类生命至关重要的铁蛋白和酶的组成成分。一般来说,非经期个体能非常有效地保存铁,每天丢失的身体铁含量不到0.1%,这一量可通过膳食铁吸收来补充。大部分铁存在于红细胞(RBC)的血红蛋白(Hb)中;因此,失血是全球急性铁缺乏和贫血的最常见原因,而血红蛋白合成减少和贫血是血浆铁浓度低的最常见后果。缺铁(ID)一词指由于营养受损、胃肠道疾病继发吸收减少、失血增加以及怀孕等需求增加导致全身铁储存减少。缺铁性贫血(IDA)定义为由于缺铁导致的低血红蛋白或血细胞比容,伴有小红细胞和低色素红细胞以及低红细胞计数。IDA最常影响育龄妇女、发育中的胎儿、儿童、慢性和炎症性疾病患者以及老年人。IDA是儿童中最常见的血液系统疾病,在工业化国家0至4岁儿童中的发病率为20.1%,5至14岁儿童中的发病率为5.9%(发展中国家分别为39%和48.1%)。ID和IDA患者的诊断、管理和治疗因年龄、性别以及孕期而异。我们在此总结关于ID和IDA的诊断、治疗及预防的已知信息,并就该主题制定一套具体建议。