Relationship of Iron Status to Urinary Norepinephrine Excretion in Children 7–12 Years of Age

Te, Webb; Ce, Krill; Fa, Oski; Kc, Tsou

doi:10.1097/00005176-198201020-00009

Cited by 6 publications

(7 citation statements)

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“…This is plausible given that ID enhances circulating catecholamine levels that promote congestion partly by activating the renin-angiotensinaldosterone cascade. 6,7,20 This direct mode of action appears more credible given that 4 weeks is conventionally too short for any agent to significantly remodel the failing myocardium, and IV iron repletion in CHF has yet to be shown to improve LVEF on echocardiography. 2,8 Irrespective of the underlying mechanism(s), changes in PVS over time correlated to alterations in other indices of CHF status.…”

Section: Discussionmentioning

confidence: 99%

“…In experimental animals and humans, ID has been shown to elevate circulating catecholamine levels that promote congestion in CHF, 6,7 and in the small FERRIC-HF trial, intravenous (IV) iron sucrose significantly reduced body weight compared with placebo. Because congestion drives dyspnoea, exercise intolerance, and hospital admissions in CHF, 4,5 ID might be detrimental by directly or indirectly augmenting fluid retention.…”

Section: Introductionmentioning

confidence: 99%

“…Because congestion drives dyspnoea, exercise intolerance, and hospital admissions in CHF, 4,5 ID might be detrimental by directly or indirectly augmenting fluid retention. In experimental animals and humans, ID has been shown to elevate circulating catecholamine levels that promote congestion in CHF, 6,7 and in the small FERRIC-HF trial, intravenous (IV) iron sucrose significantly reduced body weight compared with placebo. 8 To date, no study has appraised the impact of iron therapy on clinical congestion in a large CHF population, and none have addressed this interaction using newer and potentially more reliable metrics of fluid overload.…”

Section: Introductionmentioning

confidence: 99%

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Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR‐HF substudy

et al. 2019

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Aims Iron deficiency worsens symptoms, quality of life, and exercise capacity in chronic heart failure (CHF) and might do so by promoting fluid retention. We assessed whether iron repletion improved congestion in CHF and appraised the prognostic utility of calculated plasma volume status (PVS), a novel index of congestion, in the FAIR‐HF data set. Methods and results In FAIR‐HF, 459 iron deficient CHF patients were randomized to intravenous ferric carboxymaltose (FCM) or saline and assessed at 4, 12, and 24 weeks. Using weight and haematocrit, we calculated PVS in 436 patients. At baseline, PVS and weight were −5.5 ± 7.7% and 76.9 ± 14.3 kg, with peripheral oedema evident in 35% of subjects. Higher PVS values correlated to other congestion surrogates such as lower serum albumin. At 4 weeks, FCM was associated with greater reductions in weight (0.02) and PVS (P < 0.0001), and a trend for improved peripheral oedema at 24 weeks (0.07). Irrespective of treatment allocation, patients with a decrease in PVS from baseline to week 24 had higher increments in 6 min walking distance (61.4 m vs. 43.5 m, 0.02) and were more likely to improve their NYHA class (33.3% vs. 15.5%, 0.001). A PVS > −4% at baseline predicted worse outcomes even after adjustment for treatment assignment (hazard ratio 1.88, 95% confidence interval 1.01–3.51, 0.046). Conclusions Intravenous iron therapy with FCM is associated with early reductions in PVS and weight, implying that decongestion might be one mechanism via which iron repletion aids CHF patients. Calculated PVS is of prognostic utility in this cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR‐HF substudy

et al. 2019

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“…The latter effect does appear to concur with older papers on changes in the peripheral physiology of anemic individuals. Increased NE was found in the blood and urine of anemic children, which was interpreted as indicative of greater sympathetic activity, perhaps to assist with thermoregulation in the face of a lower oxygen-carrying capacity by their red blood cells (Dillmann, Johnson, Martin, Mackler, & Finch, 1979; Voorhees et al 1975; Webb et al, 1982). In addition, when rats are ID, they have an increased level of extracellular NE and higher NE turnover in their brains, as well as lower brain levels of MHPG, the primary NE metabolite, all of which could contribute to the diffusion of more NE into the intrathecal compartment (Burhans, Daily, Beard, Wiesinger, Murray-Kolb, Jones, & Beard, 2005; Erikson et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…Our a priori hypothesis was that the ID infants would have lower DA levels. Effects on serotonin (5HT) and NE were not as easy to predict, although one can find reports in the older pediatric literature of increased NE in the plasma and urine of anemic children (Voorhees, Stuart, Stockman, & Oski, 1975; Webb, Krill, Oski, & Tsou, 1982). In addition, when women are ID, they have higher plasma NE, which can be corrected with iron treatment, suggesting that it too is affected by iron biology (Borel, Smith, Derr, & Beard, 1991).…”

Section: Introductionmentioning

confidence: 99%

A history of iron deficiency anemia during infancy alters brain monoamine activity later in juvenile monkeys

Coe

Lubach

Bianco

et al. 2009

Developmental Psychobiology

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Both during and after a period of iron deficiency (ID), iron-dependent neural processes are affected, which raises the potential concern that the anemia commonly experienced by many growing infants could have a protracted effect on the developing brain. To further investigate the effects of ID on the immature brain, 49 infant rhesus monkeys were evaluated across the first year of life. The mothers, and subsequently the infants after weaning, were maintained on a standardized diet containing 180 mg/kg of iron and were not provided other iron-rich foods as treats or supplements. As the infants grew, they were all screened with hematological tests, which documented that 16 (33.3%) became markedly ID between 4-to-8 months of age. During this anemic period and subsequently at one year of age, cerebrospinal fluid (CSF) specimens were collected to compare monoamine activity in the ID and iron-sufficient infants. Monoamine neurotransmitters and metabolite levels were normal at 4 and 8 months of age, but by one year the formerly anemic monkeys had significantly lower dopamine and significantly higher norepinephrine levels. These findings indicate that ID can affect the developmental trajectory of these two important neurotransmitter systems, which are associated with emotionality and behavioral performance, and further that the impact in the young monkey was most evident during the period of recovery.

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Biochemical and genetic analyses of childhood attention deficit/hyperactivity disorder

Çaylak

2012

American J of Med Genetics Pt B

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Attention deficit/hyperactivity disorder (ADHD) in children is a neurobehavioral disorder characterized by inattention, hyperactivity, and/or impulsivity. The biochemical abnormalities and genetic factors play significant roles in the etiology of ADHD. These symptoms affect the behavior performance and social relationships of children in school and at home. Recently, many studies about biochemical abnormalities in ADHD have been published. Several research groups have also suggested the genetic contribution to ADHD, and attempted to identify susceptibility and candidate genes for this disorder through the genetic linkage and association studies. To date, these studies have reported substantial evidence implicating several genes (dopaminergic: DRD4, DAT1, DRD5, COMT; noradrenergic: DBH, ADRA2A; serotonergic: 5-HTT, HTR1B, HTR2A; cholinergic: CHRNA4, and central nervous system development pathway: SNAP25, BDNF) in the etiology of ADHD. Understanding the biochemistry and genetics of ADHD will allow us to provide a useful addition with other treatment procedures for ADHD.

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Relationship of Iron Status to Urinary Norepinephrine Excretion in Children 7–12 Years of Age

Cited by 6 publications

References 0 publications

Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR‐HF substudy

Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR‐HF substudy

A history of iron deficiency anemia during infancy alters brain monoamine activity later in juvenile monkeys

Biochemical and genetic analyses of childhood attention deficit/hyperactivity disorder

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