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BACKGROUND: Different laboratory methods are used to quantify ferritin concentrations as a marker of iron status. A systematic review was undertaken to assess the accuracy and comparability of the most used methods for ferritin detection. METHODS AND FINDINGS: National and regional databases were searched for prospective, retrospective, sectional, longitudinal and case-control studies containing the characteristics and performance of at least one method for serum/plasma ferritin determinations in humans published to date. The analysis included the comparison between at least 2 methods detailing: sensitivity, precision, accuracy, predictive values, inter-methods adjustment, and use of international reference materials. Pooled method performance was analyzed for each method and across methods. OUTCOMES: Search strategy identified 11893 records. After de-duplication and screening 252 studies were assessed, including 187 studies in the qualitative analysis and 148 in the meta-analysis. The most used methods included radiometric, nonradiometric and agglutination assays. The overall within-run imprecision for the most reported ferritin methods was 6.2±3.4% (CI 5.69-6.70%; n = 171), between-run imprecision 8.9±8.7% (CI 7.44-10.35%; n = 136), and recovery rate 95.6% (CI 91.5-99.7%; n = 94). The pooled regression coefficient was 0.985 among all methods analyzed, and 0.984 when comparing nonradiometric and radiometric methods, without statistical differences in ferritin concentration ranging from 2.3 to 1454 µµg/L. CONCLUSION: The laboratory methods most used to determine ferritin concentrations have comparable accuracy and performance. Registered in PROSPERO CRD42016036222.

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La prevalencia de diabetes mellitus continúa aumentandoen proporciones de epidemia, y para el año2010 se estima que a nivel mundial se dupliquen loscasos nuevos a 270 millones. Desde el descubrimientode la insulina, las recomendaciones del aporte decarbohidratos en la dieta de los diabéticos ha variadoconsiderablemente, pasando de la restricción severa decarbohidratos a un aporte entre un 60% a 75% de laenergía total, y la inclusión de polisacáridos altos en fibra.El papel de la fibra en el diabético está dirigido especialmentea mejorar el control glucémico, modificando lospicos postprandiales hiperglucémicos, y mejorando el perfillipídico. En esta revisión se discuten las recomendacionesnutricionales actuales en el manejo de la diabetes mellitus,los beneficios de la fibra dietética en el control glucémico ysus efectos en el metabolismo de carbohidratos y lípidos(AU)

The prevalence of diabetes mellitus is still on the rise, tothe point of currently being considered an epidemic. It isestimated that the number of new cases will duplicate upto 270 million cases by year 2010. Since the discoveryof insulin, the recommendation on the contribution ofcarbohydrates to the diet of diabetic patients has variedconsiderably, from a severe restriction of carbohydratesto a intake ranging from 60% to 75% of the total caloricintake, and the addition of high-fiber polysaccharides.The role of dietary fiber in the diabetic is specially aimedto improve the glycemic control, by modifying thepostprandial hyperglycemic peaks and improving thelipidic profile. In this review, the current dietary recommendationsin the management of diabetes mellitus arediscussed, as well as the benefits of the dietary fiber inthe glycemic control and its effects in the metabolism ofcarbohydrates and lipids(AU)

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Daily iron supplementation programs for pregnant women recommend amounts of iron that are considered by some to be excessive, and either lower-dose or less frequent iron supplementation regimens have been proposed. A randomized, placebo-controlled study was performed to assess and compare the relative effectiveness of a weekly (WS) or twice weekly (TW) iron supplementation schedule in maintaining or achieving hemoglobin (Hb) levels at term considered to carry minimal maternal and fetal risk (90-130 g/L). Pregnant women (n = 116) at wk 10-30 of gestation (63 WS and 53 TW) were enrolled in the study (52 in WS and 44 TW completed the study). Women were randomly allocated to receive a 120-mg oral dose of iron as ferrous sulfate and 0.5 mg of folic acid weekly (n = 52) or 60 mg iron and 0.25 mg folic acid and a placebo twice weekly (n = 44). Hb, hematocrit, serum ferritin, and transferrin saturation were estimated at baseline and at 36-39 wk of gestation. Baseline dietary data and the presence and intensity of intestinal helminthic infections were assessed. The duration of supplementation was 14 +/- 4 wk and the median level of adherence was 60.5%. Hb concentrations improved in women following the TW regimen and in women following WS who had low baseline Hb levels. About 89% of WS women and 95% of TW women maintained Hb levels at term (between 90 g/L and 130 g/L), a range associated with optimal pregnancy outcomes. One woman in the TW group exhibited higher Hb levels that potentially carried perinatal risk (>130 g/L). Intermittent iron and folic acid supplementation may be a valid strategy when used as a preventive intervention in prenatal care settings.

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