Araştırma Makalesi
BibTex RIS Kaynak Göster

Demir Eksikliği Olan Üreme dönemindeki Kadınlarda Demir Replasmanının Bilişsel İşlevlere Etkisi

Yıl 2023, Cilt: 15 Sayı: 2, 175 - 181, 22.06.2023
https://doi.org/10.18521/ktd.1148337

Öz

Amaç: Demir normal beyin fonksiyonunda olduğu gibi, nörogenez, miyelinasyon, sinaptik gelişim, enerji ve nörotransmitter metabolizması dahil olmak üzere beyin gelişim süreçlerinde kilit rollere sahiptir. Bu araştırmanın amacı, demir eksikliği olan kadınlarda demir replasmanın zihinsel fonksiyonlar üzerine etkisini incelemektir.
Gereç ve Yöntem: Demir düzeyi düşük (hemoglobin >12 g/dl, ferritin <15 ng/mL) veya demir eksikliği anemisi (hemoglobin <12 g/dl, ferritin <15 ng/mL) olan 15-49 yaş arası 165 kadında müdahale çalışması yapılmıştır. 165 katılımcıya ön bilişsel işlev durumlarını belirlemek amacıyla 1. Montreal Bilişsel Değerlendirme (MoCA) ölçeği uygulandı. Kadınlara, sekiz hafta süreyle sırasıyla 100 mg/gün (DE olanlara) ve 200 mg/gün (DEA olanlara) demir glisin sülfat verildi. Sekiz hafta sonra kontrole gelen ve demir tedavisini uygun şekilde kullanan 81 hastaya 2. MoCA skalası ile kontrol hemogram ve ferritin testleri uygulandı. Bağımlı iki grubun karşılaştırılmasında Wilcoxon İşaretli Sıralar Testi, bağımsız iki grubun karşılaştırılmasında Mann-Whitney U testi, üç ve daha fazla bağımsız grubun karşılaştırılmasında ise Kruskal Wallis testi tercih edildi. Yaş ve bilişsel fonksiyon puanları arasındaki ilişki Spearman korelasyon testi ile değerlendirildi.
Bulgular: Çalışma başlangıcında DE veya DEA olan 165 kadının ilk MoCA skorları arasında anlamlı fark saptanmadı. 200 mg/gün demir replasmanı alan 81 hastanın hemogram ve ferritin düzeylerinde beklendiği gibi anlamlı artış oldu (p<0.001). Bekar, yüksek eğitim düzeyi ve düşük beden kitle indeksi olan kadınlarda bilişsel fonksiyonlar anlamlı düşük saptandı (p<0.001). Tedavi öncesi MoCA skor ortalaması 21(min:18-max:23) iken tedavi sonrası 26 (min:23-max:27) olarak saptandı (p<0,001) ve tüm fonksiyon alt grup skorlarında da tedavi sonrasında anlamlı yükselme görüldü. Bilişsel fonksiyonlardaki bu iyileşme demografik verilerden bağımsız olarak saptandı. Yaş ile toplam bilişselfonksiyon skoru arasında negatif yönde düşük düzeyde bir ilişki saptandı r:-0,335,p <0,001).
Sonuç: Bu çalışmada demir eksikliği veya anemi tanısı alan kadınlarda replasman tedavisi sonrası bilişsel işlevlere karşılık gelen toplam ve alt grup puanlarında anlamlı artış olduğunu gözlemledik. Reproduktif dönemdeki kadınlarda demir replasman tedavisi bilişsel fonksiyonlara etkisi göz önünde bulundurularak, ihmal edilmemelidir.

Proje Numarası

BAP 04.01.2018/67

Teşekkür

Aile hekimliği başta olmak üzere Türk Tıp literatürüne değerli katkılarınızdan dolayı müteşekkiriz. Değerlendirmeleriniz için şimdiden teşekkür ediyoruz.

Kaynakça

  • Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016 Feb 27;387(10021):907-16.
  • WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015. Available at https://apps.who.int › iris › 9789241564960_eng. (Accesed July 25,2022).
  • Murray-Kolb LE, Wenger MJ, Scott SP, Rhoten SE, Lung'aho MG, Haas JD. Consumption of Iron-Biofortified Beans Positively Affects Cognitive Performance in 18 to 27 Year Old Rwandan Female College Students in an 18-Week Randomized Controlled Efficacy Trial. J Nutr. 2017 Nov; 147(11): 2109–17.
  • Lane DJR, Ayton S, Bush AI. Iron and Alzheimer's Disease: An Update on Emerging Mechanisms. J Alzheimers Dis. 2018;64(s1): 379-95.
  • Greig AJ, Patterson AJ, Collins CE, Chalmers KA. Iron deficiency, cognition, mental health and fatigue in women of childbearing age: a systematic review. J Nutr Sci. 2013;2:e14.
  • Gençay-Can, A , Can S, Atagun M, Akçaer E. Is Iron Deficiency Anemia Associated with Cognitive Functions in Reproductive - Age Women? Ankara Medical Journal, 2018:18(4),470-8.
  • Selekler K, Cangöz B, Uluç S. Power of Discrimination of Montreal Cognitive Assesment (MoCA) Scale in Turkish Patients With Mild Cognitive Impairment and Alzheimer’s Disease. Turk J Geriatr 2010; 13:16671.
  • Mikami K, Okazawa H, Kimoto K, Akama F, Onishi Y, Takahashi Y,et al. Effect of Oral Iron Administration on MentalState in Children With Low Serum Ferritin Concentration Glob Pediatr Health. 2019 Oct 29;6:2333794X19884816.
  • Taylor RM, Fealy SM, Bisquera A, Smith R, Collins CE, Evans TJ, et al. Effects of Nutritional Interventions during Pregnancy on Infant and Child Cognitive Outcomes: A SystematicReviewand Meta-Analysis. Nutrients. 2017 Nov 20;9(11).
  • Bruner AB, Joffe A, Duggan AK, Casella JF, Brandt J. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls. Lancet. 1996 Oct 12;348(9033):992-6.
  • Murray-Kolb LE, Beard JL. Iron treatment normalizes cognitive functioning in young women. Am J ClinNutr. 2007;85(3):778-87.
  • Leonard AJ, Chalmers KA, Collins CE, Patterson AJ. A study of theeCects of latent iron deficiency on measures of cognition: a pilot randomised controlled trial of iron supplementation in young women. Nutrients 2014;6(6):2419-35.
  • Blanton CA, Green MW, Kretsch MJ. Body iron is associated with cognitive executive planning function in college women. Br J Nutr 2013; 109: 906–13.
  • John Wiley&Sons, Ltd. Daily iron supplementation for improving anaemia, iron status and health in menstruating women (Review). 2016. The Cochrane Collaboration. https://doi.org/10.1002/14651858.CD009747.pub2 (Accesed July 25,2022)
  • Parsons AG, Zhou SJ, Spurrier NJ, Makrides M. Effect of iron supplementation during pregnancy on the behaviour of children at early school age: long-term follow-up of a randomised controlled trial. Br J Nutr. 2008 May;99(5):1133-9.
  • Elwood PC, Hughes D.Clinical trial of iron therapy of psychomotor function in anaemic women. BrMed J. 1970 Aug 1;3(5717):254-5.
  • Scott SP, Murray-Kolb LE. Iron Status Associated with Performance on Executive Functioning Tasks in Nonanemic Young Women. J Nutr. 2016 Jan;146(1):30-7.
  • Prado EL, Dewey KG. Nutrition and brain development in early life. NutrRev. 2014;72(4):267-84.
  • Liu H, Zhang Y, Burgard SA, Needham BL. Marital status and cognitive impairment in the United States: evidence from the National Health and Aging Trends Study. Ann Epidemiol. 2019;38:28-34.e2.
  • Falkingham M, Abdelhamid A, Curtis P, Fairweather-Tait S, Dye L, Hooper L. The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis. Nutr J 2010; 9:4.
  • Verdejo-García A, Pérez-Expósito M, Schmidt-Río-Valle J, Fernández-Serrano MJ, Cruz F, Pérez-García M, et al. Selective alterations within executive functions in adolescents with excess weight. Obesity. 2010; 18 (8): 1572-1578.

The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency

Yıl 2023, Cilt: 15 Sayı: 2, 175 - 181, 22.06.2023
https://doi.org/10.18521/ktd.1148337

Öz

Objectives: Iron plays key roles in brain development including neurogenesis, myelination, synaptic development, energy and neurotransmitter metabolism as well as normal brain functioning. The aim of this study is to examine the effect of iron replacement on cognitive functions in women with iron deficiency.
Methods: An intervention study was conducted in 165 women aged 15-49 years with low iron levels (ID;hemoglobin >12 gr/dl, ferritin <15 ng/mL) or iron deficiency anemia (IDA; hemoglobin <12 gr/dl, ferritin <15 ng/mL). 165 participants were subjected to 1st Montreal Cognitive Assessment (MoCA) scale in order to determine their preliminary cognitive function status. The women were given ferrous glycine sulfate at 100 mg/day (for those with ID) and 200 mg/day (for those with IDA), respectively, for eight weeks. Eight weeks later, the 2nd MoCA scale and control hemogram and ferritin tests were administered to 81 patients who came for follow-up and used iron treatment appropriately. Wilcoxon Signed Ranks Test was preferred when two dependent groups were compared, and Mann-Whitney U test was used when two independent groups were compared, and Kruskal Wallis test was used when three or more independent groups were compared. The analyze between age and cognitive function scores was evaluated with the Spearman correlation test.
Results: There was not a significant difference between the 1st MoCA scores of patients with ID or IDA in 165 women at the onset of the study. There was a significant increase in hemogram and ferritin levels of 81 patients who received a 200 mg/day iron replacement as expected (p<0.001). Cognitive functions were found to be significantly lower in single women with a high education level and a low body mass index (p<0.001). Average pretreatment MoCA score was 21 (min: 18- max:21), whereas post treatment average score was 26 (min:23- max:27) (p<0.001). For all cognitive functions, subgroup scores significantly increased after treatment. This improvement in cognitive functions was determined independently of demographic data. A low negative correlation also was found between age and total cognitive function score (r:-0.335, p <0.001).
Conclusion: In this study, we observed that after replacement therapy there was a significant increase in total and subgroup scores corresponding to cognitive functions of women diagnosed as iron deficiency or anemia. Considering the effect of iron replacement therapy on cognitive functions in women in the reproductive period, it should not be neglected.

Proje Numarası

BAP 04.01.2018/67

Kaynakça

  • Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016 Feb 27;387(10021):907-16.
  • WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015. Available at https://apps.who.int › iris › 9789241564960_eng. (Accesed July 25,2022).
  • Murray-Kolb LE, Wenger MJ, Scott SP, Rhoten SE, Lung'aho MG, Haas JD. Consumption of Iron-Biofortified Beans Positively Affects Cognitive Performance in 18 to 27 Year Old Rwandan Female College Students in an 18-Week Randomized Controlled Efficacy Trial. J Nutr. 2017 Nov; 147(11): 2109–17.
  • Lane DJR, Ayton S, Bush AI. Iron and Alzheimer's Disease: An Update on Emerging Mechanisms. J Alzheimers Dis. 2018;64(s1): 379-95.
  • Greig AJ, Patterson AJ, Collins CE, Chalmers KA. Iron deficiency, cognition, mental health and fatigue in women of childbearing age: a systematic review. J Nutr Sci. 2013;2:e14.
  • Gençay-Can, A , Can S, Atagun M, Akçaer E. Is Iron Deficiency Anemia Associated with Cognitive Functions in Reproductive - Age Women? Ankara Medical Journal, 2018:18(4),470-8.
  • Selekler K, Cangöz B, Uluç S. Power of Discrimination of Montreal Cognitive Assesment (MoCA) Scale in Turkish Patients With Mild Cognitive Impairment and Alzheimer’s Disease. Turk J Geriatr 2010; 13:16671.
  • Mikami K, Okazawa H, Kimoto K, Akama F, Onishi Y, Takahashi Y,et al. Effect of Oral Iron Administration on MentalState in Children With Low Serum Ferritin Concentration Glob Pediatr Health. 2019 Oct 29;6:2333794X19884816.
  • Taylor RM, Fealy SM, Bisquera A, Smith R, Collins CE, Evans TJ, et al. Effects of Nutritional Interventions during Pregnancy on Infant and Child Cognitive Outcomes: A SystematicReviewand Meta-Analysis. Nutrients. 2017 Nov 20;9(11).
  • Bruner AB, Joffe A, Duggan AK, Casella JF, Brandt J. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls. Lancet. 1996 Oct 12;348(9033):992-6.
  • Murray-Kolb LE, Beard JL. Iron treatment normalizes cognitive functioning in young women. Am J ClinNutr. 2007;85(3):778-87.
  • Leonard AJ, Chalmers KA, Collins CE, Patterson AJ. A study of theeCects of latent iron deficiency on measures of cognition: a pilot randomised controlled trial of iron supplementation in young women. Nutrients 2014;6(6):2419-35.
  • Blanton CA, Green MW, Kretsch MJ. Body iron is associated with cognitive executive planning function in college women. Br J Nutr 2013; 109: 906–13.
  • John Wiley&Sons, Ltd. Daily iron supplementation for improving anaemia, iron status and health in menstruating women (Review). 2016. The Cochrane Collaboration. https://doi.org/10.1002/14651858.CD009747.pub2 (Accesed July 25,2022)
  • Parsons AG, Zhou SJ, Spurrier NJ, Makrides M. Effect of iron supplementation during pregnancy on the behaviour of children at early school age: long-term follow-up of a randomised controlled trial. Br J Nutr. 2008 May;99(5):1133-9.
  • Elwood PC, Hughes D.Clinical trial of iron therapy of psychomotor function in anaemic women. BrMed J. 1970 Aug 1;3(5717):254-5.
  • Scott SP, Murray-Kolb LE. Iron Status Associated with Performance on Executive Functioning Tasks in Nonanemic Young Women. J Nutr. 2016 Jan;146(1):30-7.
  • Prado EL, Dewey KG. Nutrition and brain development in early life. NutrRev. 2014;72(4):267-84.
  • Liu H, Zhang Y, Burgard SA, Needham BL. Marital status and cognitive impairment in the United States: evidence from the National Health and Aging Trends Study. Ann Epidemiol. 2019;38:28-34.e2.
  • Falkingham M, Abdelhamid A, Curtis P, Fairweather-Tait S, Dye L, Hooper L. The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis. Nutr J 2010; 9:4.
  • Verdejo-García A, Pérez-Expósito M, Schmidt-Río-Valle J, Fernández-Serrano MJ, Cruz F, Pérez-García M, et al. Selective alterations within executive functions in adolescents with excess weight. Obesity. 2010; 18 (8): 1572-1578.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Şükran Berkman 0000-0001-7741-5974

Özlem Suvak 0000-0001-6286-8081

Proje Numarası BAP 04.01.2018/67
Yayımlanma Tarihi 22 Haziran 2023
Kabul Tarihi 7 Mayıs 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 15 Sayı: 2

Kaynak Göster

APA Berkman, Ş., & Suvak, Ö. (2023). The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency. Konuralp Medical Journal, 15(2), 175-181. https://doi.org/10.18521/ktd.1148337
AMA Berkman Ş, Suvak Ö. The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency. Konuralp Medical Journal. Haziran 2023;15(2):175-181. doi:10.18521/ktd.1148337
Chicago Berkman, Şükran, ve Özlem Suvak. “The Effect of Iron Replacement on Cognitive Functions in Reproductive Women With Iron Deficiency”. Konuralp Medical Journal 15, sy. 2 (Haziran 2023): 175-81. https://doi.org/10.18521/ktd.1148337.
EndNote Berkman Ş, Suvak Ö (01 Haziran 2023) The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency. Konuralp Medical Journal 15 2 175–181.
IEEE Ş. Berkman ve Ö. Suvak, “The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency”, Konuralp Medical Journal, c. 15, sy. 2, ss. 175–181, 2023, doi: 10.18521/ktd.1148337.
ISNAD Berkman, Şükran - Suvak, Özlem. “The Effect of Iron Replacement on Cognitive Functions in Reproductive Women With Iron Deficiency”. Konuralp Medical Journal 15/2 (Haziran 2023), 175-181. https://doi.org/10.18521/ktd.1148337.
JAMA Berkman Ş, Suvak Ö. The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency. Konuralp Medical Journal. 2023;15:175–181.
MLA Berkman, Şükran ve Özlem Suvak. “The Effect of Iron Replacement on Cognitive Functions in Reproductive Women With Iron Deficiency”. Konuralp Medical Journal, c. 15, sy. 2, 2023, ss. 175-81, doi:10.18521/ktd.1148337.
Vancouver Berkman Ş, Suvak Ö. The Effect of Iron Replacement on Cognitive Functions in Reproductive Women with Iron Deficiency. Konuralp Medical Journal. 2023;15(2):175-81.