Studies of the elderly in Boston. I. The effects of iron fortification on moderately anemic peole.

It has been reported that large numbers of elderly Americans are moderately anemic because of iron deficiency anemia. In the present study, information has been obtained concerning blood composition, health, and nutritional habits of 779 people over 60 years of age, institutionalized or free-living in the Boston area. This paper presents the results of their blood examinations. Two hundred twenty-one of the free-living people examined who showed hemoglobin levels between 9 and 12.9 g/dl agreed to participate in an iron fortification study. Two-thirds of them received iron-fortified grain products daily for 6 to 8 months. The rest received the same foods without added iron. At the end of the experimental period a marked increase in hemoglobin levels averaging 1.4 g/dl was observed in both groups. This appeared to be attributable to an undefined intervention effect; no measurable effects attributable to the iron fortification were observed. Three months of daily ferrous sulfate administration to those whose hemoglobin levels remained below 13 g/dl was without effect. Examination of the data obtained suggests that the cause of the moderately low hemoglobin levels initially observed was not occult bleeding or folic acid or iron deficiency.

Some aspects of specimen collection and stability in trace element analysis of body fluids.

Analyses for trace elements in biological fluids are uniquely susceptible to extreme errors unless special precautions are taken during collection, storage, and analysis. The integrity of the specimen may be compromised before it is analyzed, by contamination during collection and processing or by attenuation of the analyte concentration during storage. If this happens, determined values are not valid even though the method of analysis is extremely sensitive and highly accurate. Obstacles to obtaining precise and accurate analytical data arising from these factors are discussed. We consider control procedures applicable at all stages for ascertaining the sources of error and eliminating them.

Erythrocyte protoporphyrin in the detection of iron deficiency.

Any decrease in the availability of iron for incorporation into the heme moieties of hemoglobin results in an increase in the erythrocyte protoporphyrin concentration. Our aim was to compare protoporphyrin concentrations, determined spectrophotometrically, with body iron stores, as assessed from the amount of iron demonstrable by Prussian blue staining of bone marrow aspirates. The mean protoporphyrin concentration (175 mu-g/dl) in the erythrocytes of a group of patients with markedly decreased stainable marrow iron or no iron was significantly greater (P less than .001) than the mean concentration (76 mu-g/dl) in a comparable group with adequate bone marrow iron stores, except in the presence of certain interfering conditions. These results suggest that the erythrocyte protoporphyrin test may be a useful addition to the methods now available for assessing disorders of heme synthesis, the most common of which is iron deficiency.