ДИАГНОСТИКА И ЛЕЧЕНИЕ ДЕФИЦИТА ЖЕЛЕЗА В ПОЖИЛОМ ВОЗРАСТЕ
Аннотация
Дефицит железа имеется у 1/3 популяции и является основной причиной анемии во всех регионах мира. У пациентов пожилого возраста дефицит железа обусловливает 30% анемий. Диагностический алгоритм у больных старших возрастных групп включает исследование феррокинетики и поиск причины дефицита железа, главной из которых являются оккультные кровопотери из желудочно-кишечного тракта и снижение абсорбции железа. Для лечения используются препараты железа внутрь и парентерально под контролем клинического анализа крови и параметр овферрокинетики.
Литература
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Beyer I., Compte N., Busuioc A. et al. Anemia and transfusions in geriatric patients: a time for evaluation. Hematology. 2010; 15 (2): 116–21. DOI: 10.1179/102453310X12583347010052.
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Camaschella С. Iron deficiency. Blood. 2019; 133(1): 30–9. DOI: 10.1182/blood-2018-05-815944.
Cappellini M., Comin-Colet J., de Francisco A. et al. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. Am. J. Hematol. 2017; 92: 1068–78. DOI: 10.1002/ajh.24820.
Chapman C., Bunce J., Oliver S. et al. Service evaluation of faecal immunochemical testing and anaemia for risk stratification in the 2-week-wait pathway for colorectal cancer. BJS Open. 2019; 3: 395–402. DOI: 10.1002/bjs5.50131.
Cunin L., Khan A.A., Ibrahim M. et al. Fit negative cancers: a right-sided problem? Implications for screening and whether iron deficiency anaemia has a role to play. Surgeon. 2021; 19: 27–32. 10.1016/j.surge.2020.02.003.
Fletcher A., Forbes A., Svenson N. Guideline for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children. British Journal of Haematology. 2021; 196 (3): 523–9. http://doi.org/10.1111/bjh.17900.
Gattermann N., Muckenthaler M.U., Kulozik A.E. et al. Investigation of iron deficiency and iron overload. Dtsch Arztebl Int. 2021; 118(49): 847–56. DOI: 10.3238/arztebl.m2021.0290.
Girelli D., Marchi G., Camaschella C. Anemia in the elderly. Hemasphere.2018; 2 (3): 40. DOI: 10.1097/HS9.0000000000000040.
Gómez-Ramírez S., Brilli E., Tarantino G., Muñoz M. Sucrosomial iron: a new generation iron for improving oral supplementation.Pharmaceuticals. 2018; 11(4): 97. DOI: 10.3390/ph11040097.
Henriques C. Vifor supports efforts to make public more aware of iron deficiency and its health impact (28 November). IBD News Today 2016. Available at: https://ibdnewstoday.com/2016/11/28/vifor-pharma-supports-efforts-to-raise-awareness-of-iron-deficiency-in-ibd-patients-others. (accessed 09.003.2023).
Hershko C., Camaschella C. How I treat unexplained refractory iron-deficiency anemia. Blood. 2014; 123: 326–33. DOI: 10.1182/blood-2013-10-512624.
Johnson-Wimbley T.D. Diagnosis and management of iron deficiency anemia in the 21st century. Therap. Adv. Gastroenterol. 2011; 4 (3): 177–84. https://doi: 10.1177/1756283X11398736.
Joosten E. Iron deficiency anemia in older adults: a review. Geriatr Gerontol Int. 2018; 18: 373–9. DOI: 10.1111/ggi.13194.
Kassebaum N.J., Jasrasaria R., Naghavi M. et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014; 123(5): 615–24. https://doi: 10.1182/blood-2013-06-508325.
Lopez A., Cacoub P., Macdaugall I.C. Iron deficiency anaemia. Lancet. 2016; 387: 907–16. https://doi: 10.1016/S0140-6736(15)60865-0.
Manckoundia P., Konaté A., Hacquin A. et al. Iron in the general population and specificities in older adults: metabolism, causes and consequences of decrease or overload, and biological assessment. Clin Interv Aging. 2020; 15: 1927–38. https://doi: 10.2147/CIA.S269379.
Martín-Masot R., Nestares M.T., Diaz-Castro J. et al. Multifactorial etiology of anemia in celiac disease and effect of gluten-free diet: A comprehensive review. Nutrients. 2019; 11: 2557. DOI: 10.3390/nu11112557.
Merchant A.A., Roy C.N. Not so benign haematology: anaemia of the elderly. Br. J. Haematol. 2012; 156 (2): 173–85. DOI: 10.1111/j.1365-2141.2011.08920.
Moretti D., Goede J.S., Zeder C. et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily dosis in iron-depleted young women. Blood. 2015; 126: 1981–9. DOI: 10.1182/blood-2015-05-642223.
Nairz M., Theurl I., Wolf D. et al. Differential diagnosis and mechanisms of anemia of inflammation. Wien Med Wochenschr. 2016; 166 (13): 411–23. DOI: 10.1007/s10354-016-0505-7.
Patel K.V. Epidemiology of anemia in older adults. Semin. Hematol. 2008; 45: 210–7. DOI: 10.1053/j.seminhematol.2008.06.006.
Rockey D.C., Altayar O., Falck-Ytter Y. et al. AGA technical review on gastrointestinal evaluation of iron deficiency anemia. Gastroenterology. 2020; 159: 1097–1119. https://10.10 3/j.gastro.2020.06.045.
Röhrig G., Gütgemann I., Kolb G. et al. Anemia in the aged is not ageing related: Position paper on anemia in the aged by the “working group anemia” of the German Geriatric Society (DGG) Eur. Geriatr. Med. 2018; 9: 395–7. https://doi: 10.1007/s41999-018-0048-0.
Rohrig G., Gutgemann I., Leischker A. et al. Anemia in the aged — A geriatric syndrome? Second position paper on anemia in the aged by the working group anemia of the German Geriatric Society. Z. Gerontol. Geriatr. 2018; 51: 921–3. https://doi: 10.1007/s00391-018-1457-x.
Romano A.D., Paglia A., Bellanti F. et al. Molecular aspects and treatment of iron deficiency in the elderly. Int J Mol Sci. 2020; 21(11): 3821. https://doi: 10.3390/ijms21113821.
Serum transferrin receptor levels for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2014 (WHO/NMH/NHD/MNM/14.6; http://apps.who.int/iris/bitstream/10665/133707/1/WHO_NMH_NHD_EPG_14.6_eng. pdf?ua=1. (accessed 10.03.2023).
Snook J., Bhala N, Beales I.L. et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults.Gut. 2021; 70(11): 2030–51. DOI: 10.1136/gutjnl-2021-325210.
Soon A., Cohen B.L., Groessl E.J. et al. Long-term outcomes and prognostic factors for patients with endoscopy-negative iron deficiency. Dig Dis Sci. 2013; 58: 488–95. DOI: 10.1007/s10620-012-2368-0.
Stauder R., Valent P., Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018; 131 (5): 505–14. https://doi: 10.1182/blood-2017-07-746446.
Suchdev P.S., Williams A.M., Mei Z. et al. Assessment of iron status in settings of inflammation: challenges and potential approaches. Am. J. Clin. Nutr. 2017; 106: 1626–33. DOI: 10.3945/ajcn.117.155937.
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2). http://www.who.int/vmnis/indicators/serum_ferritin. pdf. (accessed 10.03.2023).
World Health Organisation. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011(WHO/NMH/NHD/MNM/11.1) http://www. who. int/vmnis/indicators/haemoglobin.pdf.
Yiannikourides A., Latunde-Dada G.O. A short review of iron metabolism and pathophysiology of iron disorders. Medicines (Basel). 2019; 6(3): 85. DOI: 10.3390/medicines6030085.
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Beyer I., Compte N., Busuioc A. et al. Anemia and transfusions in geriatric patients: a time for evaluation. Hematology. 2010; 15 (2): 116–21. DOI: 10.1179/102453310X12583347010052.
Burton J.K., Yates L.C., Whyte L. et al. New horizons in iron deficiency anaemia in older adults. Age and Ageing. 2020; 49 (3): 309–15. doi.org/10/1093/ageing/afz199.
Camaschella С. Iron deficiency. Blood. 2019; 133(1): 30–9. DOI: 10.1182/blood-2018-05-815944.
Cappellini M., Comin-Colet J., de Francisco A. et al. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. Am. J. Hematol. 2017; 92: 1068–78. DOI: 10.1002/ajh.24820.
Chapman C., Bunce J., Oliver S. et al. Service evaluation of faecal immunochemical testing and anaemia for risk stratification in the 2-week-wait pathway for colorectal cancer. BJS Open. 2019; 3: 395–402. DOI: 10.1002/bjs5.50131.
Cunin L., Khan A.A., Ibrahim M. et al. Fit negative cancers: a right-sided problem? Implications for screening and whether iron deficiency anaemia has a role to play. Surgeon. 2021; 19: 27–32. 10.1016/j.surge.2020.02.003.
Fletcher A., Forbes A., Svenson N. Guideline for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children. British Journal of Haematology. 2021; 196 (3): 523–9. http://doi.org/10.1111/bjh.17900.
Gattermann N., Muckenthaler M.U., Kulozik A.E. et al. Investigation of iron deficiency and iron overload. Dtsch Arztebl Int. 2021; 118(49): 847–56. DOI: 10.3238/arztebl.m2021.0290.
Girelli D., Marchi G., Camaschella C. Anemia in the elderly. Hemasphere. 2018; 2 (3): 40. DOI: 10.1097/HS9.0000000000000040.
Gómez-Ramírez S., Brilli E., Tarantino G., Muñoz M. Sucrosomial iron: a new generation iron for improving oral supplementation. Pharmaceuticals. 2018; 11(4): 97. DOI: 10.3390/ph11040097.
Henriques C. Vifor supports efforts to make public more aware of iron deficiency and its health impact (28 November). IBD News Today 2016. Available at: https://ibdnewstoday.com/2016/11/28/vifor-pharma-supports-efforts-to-raise-awareness-of-iron-deficiency-in-ibd-patients-others. (accessed 09.003.2023).
Hershko C., Camaschella C. How I treat unexplained refractory iron-deficiency anemia. Blood. 2014; 123: 326–33. DOI: 10.1182/blood-2013-10-512624.
Johnson-Wimbley T.D. Diagnosis and management of iron deficiency anemia in the 21st century. Therap. Adv. Gastroenterol. 2011; 4 (3): 177–84. https://doi: 10.1177/1756283X11398736.
Joosten E. Iron deficiency anemia in older adults: a review. Geriatr Gerontol Int. 2018; 18: 373–9. DOI: 10.1111/ggi.13194.
Kassebaum N.J., Jasrasaria R., Naghavi M. et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014; 123(5): 615–24. https://doi: 10.1182/blood-2013-06-508325.
Lopez A., Cacoub P., Macdaugall I.C. Iron deficiency anaemia. Lancet. 2016; 387: 907–16. https://doi: 10.1016/S0140-6736(15)60865-0.
Manckoundia P., Konaté A., Hacquin A. et al. Iron in the general population and specificities in older adults: metabolism, causes and consequences of decrease or overload, and biological assessment. Clin Interv Aging. 2020; 15: 1927–38. https://doi: 10.2147/CIA.S269379.
Martín-Masot R., Nestares M.T., Diaz-Castro J. et al. Multifactorial etiology of anemia in celiac disease and effect of gluten-free diet: A comprehensive review. Nutrients. 2019; 11: 2557. DOI: 10.3390/nu11112557.
Merchant A.A., Roy C.N. Not so benign haematology: anaemia of the elderly. Br. J. Haematol. 2012; 156 (2): 173–85. DOI: 10.1111/j.1365-2141.2011.08920.
Moretti D., Goede J.S., Zeder C. et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily dosis in iron-depleted young women. Blood. 2015; 126: 1981–9. DOI: 10.1182/blood-2015-05-642223.
Nairz M., Theurl I., Wolf D. et al. Differential diagnosis and mechanisms of anemia of inflammation. Wien Med Wochenschr. 2016; 166 (13): 411–23. DOI: 10.1007/s10354-016-0505-7.
Patel K.V. Epidemiology of anemia in older adults. Semin. Hematol. 2008; 45: 210–7. DOI: 10.1053/j.seminhematol.2008.06.006.
Rockey D.C., Altayar O., Falck-Ytter Y. et al. AGA technical review on gastrointestinal evaluation of iron deficiency anemia. Gastroenterology. 2020; 159: 1097–1119.https://10.10 3/j.gastro.2020.06.045.
Röhrig G., Gütgemann I., Kolb G. et al. Anemia in the aged is not ageing related: Position paper on anemia in the aged by the “working group anemia” of the German Geriatric Society (DGG) Eur. Geriatr. Med. 2018; 9: 395–7. https://doi: 10.1007/s41999-018-0048-0.
Rohrig G., Gutgemann I., Leischker A. et al. Anemia in the aged — A geriatric syndrome? Second position paper on anemia in the aged by the working group anemia of the German Geriatric Society. Z. Gerontol. Geriatr. 2018; 51: 921–3. https://doi: 10.1007/s00391-018-1457-x.
Romano A.D., Paglia A., Bellanti F. et al. Molecular aspects and treatment of iron deficiency in the elderly. Int J Mol Sci. 2020; 21(11): 3821. https://doi: 10.3390/ijms21113821.
Serum transferrin receptor levels for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2014 (WHO/NMH/NHD/MNM/14.6; http://apps.who.int/iris/ bitstream/10665/133707/1/WHO_NMH_NHD_EPG_14.6_eng. pdf?ua=1. (accessed 10.03.2023).
Snook J., Bhala N, Beales I.L. et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults.Gut. 2021; 70(11): 2030–51. DOI: 10.1136/gutjnl-2021-325210.
Soon A., Cohen B.L., Groessl E.J. et al. Long-term outcomes and prognostic factors for patients with endoscopy-negative iron deficiency. Dig Dis Sci. 2013; 58: 488–95. DOI: 10.1007/s10620-012-2368-0.
Stauder R., Valent P., Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018; 131 (5): 505–14. https://doi: 10.1182/blood-2017-07-746446.
Suchdev P.S., Williams A.M., Mei Z. et al. Assessment of iron status in settings of inflammation: challenges and potential approaches. Am. J. Clin. Nutr. 2017; 106: 1626–33. DOI: 10.3945/ajcn.117.155937.
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2). http://www.who.int/vmnis/indicators/serum_ferritin. pdf. (accessed 10.03.2023).
World Health Organisation. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011(WHO/NMH/NHD/MNM/11.1) http://www.who. int/vmnis/indicators/haemoglobin.pdf.
Yiannikourides A., Latunde-Dada G.O. A short review of iron metabolism and pathophysiology of iron disorders. Medicines (Basel). 2019; 6(3): 85. DOI: 10.3390/medicines6030085.
