Introduction: Pre-eclampsia is a serious complication of pregnancy and is associated with increased maternal and perinatal morbidity and mortality. Increased iron and ferritin concentration is associated to a higher risk of pre-eclampsia and prophylactic iron supplementation can sometimes be harmful to pregnant women who are otherwise not iron deficient. Aim: To analyse serum iron, serum ferritin, serum Transferrin Receptor (sTFR) levels, Total Iron Binding Capacity (TIBC) among iron supplemented pre-eclamptic cases and normotensive pregnant controls. Materials and Methods: This prospective, observational, case- control study was conducted in Jaipur National University Institute of Medical Sciences and Research Centre (JNUIMSRC), Jaipur, Rajasthan, India for a period of one year from (February 2019-January 2020). A total of 200 pregnant females, all on iron supplementation during the course of their pregnancy, 100 in pre-eclampsia group (case group); 100 in normotensive group (control group), in third trimester and between 18- 45 years of age were enrolled in the study. Serum iron, serum ferritin, sTFR and TIBC were estimated using fully automated analysers. Results: Median Interquartile Range (IQR) of serum ferritin levels in cases were higher than the controls [41 (30-70) vs 24 (17-44); p<0.001]. Serum ferritin in cases were also found to correlate positively with systolic (r=0.37, p=0.001) Blood Pressure (BP) whereas TIBC correlated negatively with diastolic BP (r=-0.238, p-value=0.017). The median IQR differences of TIBC values among cases and controls were insignificant {485 (404-523) vs 493 (448- 544)} and differences of median IQR of sTFR values among cases and controls were significant {8.5 (7-9) vs 8.9 (8-10)}. Subjects with serum feritin levels >40 ng/mL had three times increased risk of PE (Odds ratio=3, 95% Cl=1.571-5.157). Conclusion: Elevated serum ferritin, decreased sTFR levels and correlation of Ferritin and TIBC to BP in pre-eclampsia compels us to put cautionary remarks over testing these parameters before continuing with iron supplements. This may prevent a possible iron related added complications in pre-eclampsia and help clinicians decide about restricting/lowering iron supplement doses in case a situation of iron overload arise.

No abstract

Introduction: Lead (Pb) is one of the major occupational pollutants present in the developed and developing countries including India. In humans, Pb can cause a wide range of biological effects depending upon the level and duration of exposure. The goal of this study was to evaluate the blood lead levels (BLLs) and its associated effects on vitamin D and calcium metabolism, among the workers occupationally exposed to Pb. Materials and Methods: This cross-sectional, case-control study was conducted for a period of 18 months (January 2017 to July 2018). A total of 160 subjects were included in the study (80 in each, Pb-exposed group and control group). The blood Pb levels were quantified by using an inductively coupled plasma mass spectrometry with triple quadrupole technology (iCAP™ TQ ICP-MS). Other biochemical parameters were estimated using fully automatic analyzer by RANDOX, RX-imola, Crumlin, UK and Johnson and Johnson, VITROS® ECiQ, Immunodiagnostic system, Ortho Clinical Diagnostics, New Jersey, USA. Results: Upon analysis it was observed that serum calcium, phosphorous, and vitamin D levels were significantly decreased (8.35 ± 0.42 mg/dl, 3.07 ± 0.34 mg/dl, and 28.82 ± 10.81 ng/ml respectively; P < 0.001), whereas the BLL and serum iPTH levels were significantly increased (38.02 ± 19.92 μg/dl and 116.78 ± 19.93 pg/ml respectively; P < 0.001) in Pb exposed subjects as compared to control subjects. Conclusion: Our study results demonstrated that high BLL significantly alter vitamin D and calcium metabolism. The data extrapolated from our study emphasizes the necessity of surveillance in exposed workers. As the associated deleterious effects of Pb-exposure can be serious, we propose that a routine-periodical screening of the workers exposed to lead should be conducted.