Gastric Function and Structure in Iron Deficiency

Shearman, D. J. C.; Delamore, I. W.; Gardner, David L.

doi:10.1016/s0140-6736(66)90185-1

Cited by 32 publications

(28 citation statements)

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“…Reduction of iron is necessary because most dietary iron is found in the ferric form and is poorly absorbed. Decreased gastric acidity resulting from overconsumption of antacids or achlorhydria in atrophic gastritis may lead to impaired iron absorption (8)(9)(10)(11)(12). Type 1 diabetic patients show a high prevalence of PCAs (2-4) that target the H ϩ /K ϩ ATPase (7) and thus result in a compromised gastric acid production (8)(9)(10)(11)(12).…”

Section: De Block and Associatesmentioning

confidence: 99%

“…Moreover, PCAs target the gastric proton pump (7), which results in decreased gastric acid secretion and decreased iron absorption. This may cause iron deficiency anemia, which is a common (although frequently overlooked) manifestation of autoimmune gastritis (8)(9)(10)(11)(12). On the other hand, iron deficiency anemia can also arise by malignant or inflammatory diseases, especially from the gastrointestinal tract (13,14), and atrophic gastritis predisposes patients to gastric carcinoma and carcinoid tumors (15,16).…”

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Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

et al. 2000

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Abbreviations: ANOVA, analysis of variance; AUC ROC , area under the curve for receiver operating characteristics; CV, coefficient of variation; Nl, normal range; PCA, parietal cell antibody; sTfR, soluble transferrin receptor.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Soluble Transferrin Receptor LevelA new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetesOBJECTIVE -A total of 15-20% of type 1 diabetic patients have parietal cell antibodies (PCAs). PCA ϩ subjects are at increased risk for iron deficiency anemia and atrophic gastritis. Recently, soluble transferrin receptor (sTfR) levels have proven to be a sensitive indicator for iron deficiency. They are, in contrast with ferritin levels, independent of inflammation, liver and hormonal status, and sex. We are the first to evaluate sTfR levels in type 1 diabetes and tested the hypothesis of higher sTfR levels in patients with PCAs and/or autoimmune gastritis.RESEARCH DESIGN AND METHODS -We examined 148 type 1 diabetic patients (85 men and 63 women; 50 were PCA ϩ ) and 59 sex-and age-matched control subjects (30 men and 29 women). The main outcome measures were sTfR levels, iron deficiency anemia, and atrophic gastritis. Logistical regression analysis tested risk factors for iron deficiency.RESULTS -Iron deficiency was present in 38 subjects. Iron (P Ͻ 0.0001) and ferritin (P Ͻ 0.0001) levels but not sTfR levels were lower in women. sTfR levels were similar in diabetic and control subjects but were higher in PCA ϩ subjects (P = 0.015). In diabetic subjects, iron deficiency anemia was more prevalent in PCA ϩ than in PCA -patients (odds ratio 3.07, P = 0.013) and was associated with sex (P = 0.0001), age (P = 0.046), and sTfR (P = 0.0008) levels. Atrophic gastritis was present in 15 of 28 PCA ϩ and in 1 of 11 PCA -diabetic subjects (P = 0.014). sTfR levels tended to be higher in patients with atrophic gastritis (P = 0.062).CONCLUSIONS -In type 1 diabetes, sTfR levels can be used to diagnose iron deficiency anemia, which is more prevalent in PCA ϩ subjects. sTfR levels are higher in PCA ϩ individuals who are at risk for developing atrophic gastritis.

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Section: De Block and Associatesmentioning

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Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

et al. 2000

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“…Abnormal histological structure of the gastric mucosa is frequently found in chronically iron-deficient adults (2,8,12,14,28) and children (10,21,24). Koyanagi et al (5) and Shearman et al (29) observed histological changes in the gastric mucosa of iron-deficient rats, though Valberg et al (22) and Sharma et al (26) did not.…”

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“…Since maximal acid output is related to the parietal cell mass in the gastric mucosa (4), one possible cause of this decreased acid secretion is a decrease in the number of acid-secreting parietal cells in the gastric mucosa of iron deficient human beings (2,28) and rats (9,15,29). Another possible cause for the decreased gastric acid secretion is a decreased enzyme activity of the gastric mucosa in iron deficiency (29,32).…”

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Utilization of Dietary Calcium by Iron-Deficient Rats

Mahoney¹,

Hendricks²

1975

Ann Nutr Metab

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Iron deficiency causes cytological and enzymic changes in the gastrointestinal mucosa of animals and man that can be expected to impair the digestion and absorption of other nutrients. In experiment 1, healthy, weanling, female rats were grouped into pair-mates and pair-fed either an iron-deficient or an iron-supplemented diet for 19 weeks. In experiment 2, iron-deficient offspring reared by iron-deficient females were grouped into pair-mates and pair-fed either an iron-deficient or an iron-supplemented diet for 15 weeks. In experiment 1, apparent absorption of calcium was significantly depressed in week 9 (p < 0.001) and slightly depressed in weeks 10 and 11. In experiment 2, the apparent absorption of calcium was significantly (p < 0.001) depressed in weeks 6, 13, and 14. Absorption was not measured in other weeks in these experiments. The concentrations of calcium and magnesium were consistently higher in the fecal dry matter of the iron deficient rats in both experiments. It was concluded that any defects in digestion and absorption by the iron-deficient rats was confined primarily to the mineral nutrients because in both experiments apparent absorption of dry matter was consistently higher in these animals compared to their iron-supplemented pair-mates.

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“…Iron deficiency can produce a low serum vitamin B12 level, which returns to normal after adequate treatment with iron (Cox et al, 1959). This effect is probably mediated by a reduction in secretion of intrinsic factor in iron deficiency (Biggs et al, 1962), although the relationship between iron deficiency and atrophic gastritis is probably more complex in many patients (Shearman et al, 1966). Chronic renal failure (defined as a blood urea persistently above 45 mg%) causes the serum vitamin B12 level to be Dawson and D onald, The Serum Vitamin B12 in the Elderly 221 higher than in normal subjects (Matthews and Beckett, 1962), probably because of reduced vitamin B12 excretion, and minor azotaemia is common in the elderly.…”

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