Perspectives on anemia and iron deficiency from the cystic fibrosis care community

Garlow, Gretchen M; Gettle, L.; Felicetti, Nicola J; Polineni, Deepika; Gifford, Alex H.

doi:10.1002/ppul.24323

Cited by 6 publications

(8 citation statements)

References 5 publications

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“…According to a recent survey of CF clinicians, 38% had concerns about supplemental iron, and the most common concern was the possibility that iron could enhance growth of lung bacteria. 22 Iron has been implicated as a tool for pathogens, notably Pseudomonas aeruginosa, to enhance biofilm formation, which makes eradication more difficult. 23 A number of studies [24][25][26] have found that CF airways contain substantially higher amounts of iron than those of healthy controls, and it has been proposed that this higher amount of iron provides the fuel for pathogens to proliferate.…”

Section: Introductionmentioning

confidence: 99%

“…Another complicating factor is the uncertainty regarding whether iron supplementation in CF is of benefit or harm. According to a recent survey of CF clinicians, 38% had concerns about supplemental iron, and the most common concern was the possibility that iron could enhance growth of lung bacteria 22 . Iron has been implicated as a tool for pathogens, notably Pseudomonas aeruginosa , to enhance biofilm formation, which makes eradication more difficult 23 .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Risk Factors for Iron Deficiency in Adults With Cystic Fibrosis

et al. 2020

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Background: Iron deficiency is common in cystic fibrosis (CF), but previous prevalence studies often reported results confounded by acute exacerbations. This single-center retrospective study aimed to identify the prevalence of iron deficiency in a stable adult CF population, identify the risk factors associated with iron deficiency, and compare common laboratory indicators of iron status. Methods: Medical charts of 105 patients aged 18-67 were reviewed to determine the prevalence of anemia. Of these patients, a subgroup of 67 were included in analyses of iron deficiency, defined as serum ferritin < 12 ng/mL and/or percent transferrin saturation (TSAT) < 16%. Data on sex, age, body mass index, anemia status, vitamin deficiencies, presence of comorbidities, colonization with Pseudomonas aeruginosa, and use of acid blockers and CF transmembrane conductance regulator modulators were collected to evaluate relationship of iron deficiency with these clinical factors. κ agreements between serum iron, ferritin, transferrin, and TSAT were compared. Results: In this stable CF population, the prevalence of iron deficiency was 41.8% (n = 67), and the prevalence of anemia was 33.3% (n = 105). Iron deficiency was associated with presence of anemia (P < .001), vitamin A deficiency (P = .012), and moderate (P = .047) and severe lung disease (P = .045) compared with mild lung disease. Transferrin agreed poorly with other iron status indicators. Conclusion: Iron deficiency is common in CF, although prevalence rates can vary widely depending on the laboratory parameters used. CF centers should consider routine screening for iron deficiency.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and Risk Factors for Iron Deficiency in Adults With Cystic Fibrosis

et al. 2020

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“…When surveyed, about a quarter of CF clinicians reported concern that supplemental iron could enhance the growth of lung bacteria despite lack of evidence between iron supplementation and pulmonary status. 105,109 Because iron studies are affected by inflammation, it is best to use multiple laboratory values to assess iron status, including serum iron, transferrin saturation, and soluble transferrin receptor. Checking C-reactive protein may help improve the interpretation of results.…”

Section: Ironmentioning

confidence: 99%

Update on the management of vitamins and minerals in cystic fibrosis

2022

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Advancements in respiratory and nutrition management have significantly improved the survival of patients with cystic fibrosis (CF). With the availability of several nutrition interventions such as oral/enteral nutrition supplements, enteric‐coated pancreatic enzymes, and water‐miscible CF‐specific vitamin supplements, frank vitamin deficiencies—with the exception of vitamin D—are rarely encountered in current clinical practice. Whereas they were previously considered as micronutrients, our current understanding of fat‐soluble vitamins and minerals as antioxidants, immunomodulators, and disease biomarkers has been evolving. The impact of highly effective modulators on the micronutrient status of patients with CF remains elusive. This narrative review focuses on the updates on the management of fat‐soluble vitamins and other micronutrients in CF in the current era and identifies the gaps in our knowledge.

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“…The treatment of ID is controversial and no recommendations are available [ 35 ]. Iron supplementation has been suspected to enhance bacterial growth.…”

Section: Discussionmentioning

confidence: 99%

Iron Deficiency in Cystic Fibrosis: A Cross-Sectional Single-Centre Study in a Referral Adult Centre

et al. 2022

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Iron deficiency (ID) diagnosis in cystic fibrosis (CF) is challenging because of frequent systemic inflammation. We aimed to determine the prevalence and risk factors of ID in adult patients with CF. We conducted a single-centre prospective study in a referral centre. ID was defined by transferrin saturation ≤ 16% or ferritin ≤ 20 (women) or 30 (men) µg/L, or ≤ 100 µg/L in the case of systemic inflammation. Apparent exacerbation was an exclusion criterion. We included 165 patients (78 women), mean age—31.1 ± 8.9 years. ID prevalence was 44.2%. ID was significantly associated with female gender (58.9% vs. 38%), lower age (29.4 ± 8.5 vs. 32.5 ± 9.1), lower body mass index (20.5 ± 2.2 vs. 21.3 ± 2.5), and Pseudomonas aeruginosa colonization (70.8% vs. 55.1%). Diabetes mellitus, antiacid drug use and low pulmonary function were more frequent in patients with ID with no statistical significance. The use of CFTR correctors was not associated with ID. In the multivariate analysis, ID was associated with female gender (OR 2.64, CI95% 1.31–5.31), age < 30 years (OR 2.30, CI95% 1.16–4.56), and P. aeruginosa (OR 2.09, CI95% 1.04–4.19).

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Perspectives on anemia and iron deficiency from the cystic fibrosis care community

Cited by 6 publications

References 5 publications

Prevalence and Risk Factors for Iron Deficiency in Adults With Cystic Fibrosis

Prevalence and Risk Factors for Iron Deficiency in Adults With Cystic Fibrosis

Update on the management of vitamins and minerals in cystic fibrosis

Iron Deficiency in Cystic Fibrosis: A Cross-Sectional Single-Centre Study in a Referral Adult Centre

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