The effect of donation activity dwarfs the effect of lifestyle, diet and targeted iron supplementation on blood donor iron stores

Abstract

The iron status of blood donors is a subject of concern for blood establishments. The Finnish Red Cross Blood Service addresses iron loss in blood donors by proposing systematic iron supplementation for demographic at-risk donor groups. We measured blood count, ferritin and soluble transferrin receptor (sTfR) and acquired lifestyle and health information from 2200 blood donors of the FinDonor 10000 cohort. We used modern data analysis methods to estimate iron status and factors affecting it with a special focus on the effects of the blood service’s iron supplementation policy. Low ferritin (< 15 μg/L), an indicator of low iron stores, was present in 20.6% of pre-menopausal women, 10.6% of post-menopausal women and 6% of men. Anemia co-occurred with iron deficiency more frequently in pre-menopausal women (21 out of 25 cases) than in men (3/6) or post-menopausal women (1/2). In multivariable regression analyses, lifestyle, dietary, and blood donation factors explained up to 38% of the variance in ferritin levels but only ~10% of the variance in sTfR levels. Days since previous donation were positively associated with ferritin levels in all groups while the number of donations during the past 2 years was negatively associated with ferritin levels in pre-menopausal women and men. FRCBS-provided iron supplementation was negatively associated with ferritin levels in men only. Relative importance analyses showed that donation activity accounted for most of the explained variance in ferritin levels while iron supplementation explained less than 1%. Variation in ferritin levels was not significantly associated with variation in self-reported health. Donation activity was the most important factor affecting blood donor iron levels, far ahead of e.g. red-meat consumption or iron supplementation. Importantly, self-reported health of donors with lower iron stores was not lower than self-reported health of donors with higher iron stores.

FinDonor 10 000 study: a cohort to identify iron depletion and factors affecting it in Finnish blood donors

“…In this paper, we address goal (1) and give general description of the cohort, and in consecutive publications, we will analyse distributions of iron biomarkers and estimate their determinants with multivariate regression (goal 2) . We will subsequently carry out genome‐wide association analysis for iron biomarkers.…”

Low ferritin levels appear to be associated with worsened health in male repeat blood donors

“…Our primary goal was to test whether blood donation‐related factors could explain worsened self‐rated health between the two questionnaires. To this end, we selected from the literature plausible donation‐related factors [11, 35] and constructed logistic multivariate regression models to test the specific hypothesis of whether these factors could be associated with worsened donor health.…”

“…Recently, iron supplementation was found to reduce iron deficiency‐related symptoms in non‐anaemic Swiss blood donors [10]. Iron levels of Finnish blood donor population are mostly affected by blood donation activity [11]. Importantly, iron supplementation for at‐risk groups has been in place since the 1980s in Finland.…”

“…The Finnish Red Cross Blood Service (FRCBS) set up the FinDonor 10 000 study in 2015 [21] to investigate the health effects of blood donation with a specific focus on iron status [11]. In the present study, we test if worsening of self‐rated health of blood donors during the study period was associated with donation activity, biomarkers for iron levels or self‐reported changes in lifestyle.…”

La Donación de Sangre

“…3,24 Se sabe que los niveles de hemoglobina y hematocrito no sirven para la detección de depleción de hierro en pacientes con hemoglobina en niveles relativamente normales, lo que sugiere que estos casos pueden tener una deficiencia de hierro subclínica. 25,26 Además se ha observado en algunos estudios que 42% de los pacientes presentan bajos niveles de ferritina, cifra que aumenta con la frecuencia de las donaciones. 27 Según Bitan y col. 28 la sangre de donadores frecuentes con ferropenia puede tener eritrocitos con componentes celulares alterados (25% a 35%), observando también que por el bajo nivel de hierro son más propensos a la hemólisis invitro debido a defectos de la hemoglobina.…”