Assessment of the Association Between Complete Blood Cell Parameters, Levels of Vitamin B12 and Folate, Decreased Iron Storage and Recurrent Vasovagal Syncope Episodes
Öz
Objective: To evaluate the relationship between recurrent vasovagal syncope (VVS) and complete blood cell parameters, serum levels of ferritin, vitamin B12, and folate.
Materials and Methods: This retrospective study included patients with recurrent VVS and healthy controls. Children and adolescents presenting with at least two VVS episodes were included. Exclusion criteria were as follows; having an electrocardiogram abnormality, patients without an evident trigger before fainting, having an infection, having a history of chronic disease, and taking any medications or vitamin supplements, including folate, vitamin B12, and iron.
Results: A total of 44 patients and 66 healthy controls were included. There were no significant differences between the groups in terms of age and gender. Mean corpuscular hemoglobin concentration (MCHC) (p=0.014), mean platelet volume (MPV) (p=0.020), and levels of ferritin (p<0.0001) were significantly lower in the patient group. No significant differences were found between the groups with respect to other laboratory parameters. Binary logistic regression analysis showed that every 1-unit decrease in serum ferritin constitutes a 0.972 [95% confidence interval (CI)= 0.954-0.990] fold risk. Also, every 1-unit decrease in MPV constitutes a 0.453 (95% CI=0.275-0.745) fold risk of VVS.
Conclusion: This study showed lower levels of serum ferritin, smaller platelet sizes, and lower levels of MCHC. Additionally, smaller platelet sizes and lower levels of ferritin were independent risk factors.
Anahtar Kelimeler
Vasovagal syncope fainting serum ferritin complete blood count mean platelet volume mean corpuscular hemoglobin concentration
Kaynakça
- 1. Ganzeboom KS, Mairuhu G, Reitsma JB, Linzer M, Wieling W, Van Dijk N. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35–60 years. J Cardiovasc Electrophysiol 2006; 17: 1172-6.
- 2. Furlan R, Piazza S, Dell’Orto S, Barbic F, Bianchi A, Mainardi L, et al. Cardiac autonomic patterns preceding occasional vasovagal reactions in healthy humans. Circulation 1998; 98: 1756-61.
- 3. Brignole M. Diagnosis and treatment of syncope. Heart 2007; 93: 130-6.
- 4. Aminorroaya A, Tajdini M, Yunesian M, Boroumand M, Tavolinejad H, Yadangi S, et al. Association of folate and vitamin B12 deficiency with vasovagal syncope: a case-control study. European Heart Journal 2021; 42: ehab724. 0621.
- 5. Symes AL, Missala K, Sourkes TL. Iron-and riboflavin-dependent metabolism of a monoamine in the rat in vivo. Science 1971; 174: 153-5.
- 6. Calderón‐Ospina CA, Nava‐Mesa MO. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neurosci Ther 2020; 26: 5-13.
- 7. Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull 2008; 29: S126-S31.
- 8. Pushpakumar S, Kundu S, Sen U. Endothelial dysfunction: the link between homocysteine and hydrogen sulfide. Curr Med Chem 2014; 21: 3662-72.
- 9. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations \[Internet]. Geneva: World Health Organization; 2020.
- 10. Green R, Mitra AD. Megaloblastic anemias: nutritional and other causes. Med Clin Nort Am 2017; 101: 297-317.
- 11. Steinberg LA, Knilans TK. Syncope in children: diagnostic tests have a high cost and low yield. J Pediatr 2005; 146: 355-8.
- 12. Task Force for the Diagnosis and Management of Syncope; European Society of Cardiology (ESC); European Heart Rhythm Association (EHRA); Heart Failure Association (HFA); Heart Rhythm Society (HRS), Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009; 30: 2631-71.
- 13. Vaddadi G, Esler MD, Dawood T, Lambert E. Persistence of muscle sympathetic nerve activity during vasovagal syncope. Eur Heart J 2010; 31: 2027-33.
- 14. Peatfield R, Gawel M, Clifford-Rose F, Guthrie D, Pearson T. The effects of exercise on platelet numbers and size. Med Lab Sci 1985; 42: 40-3.
- 15. Kabul H, Celik M, Yuksel U, Yalcinkaya E, Gokoglan Y, Bugan B, et al. Increased sympathetic activation in patients with vasovagal syncope is associated with higher mean platelet volume levels. Eur Rev Med Pharmacol Sci 2014; 18: 235-41.
- 16. Gökoğlan Y, Yıldırım E. Relationship between the mean platelet volume values and tilt-table test results in patients with vasovagal syncope. Med-Science 2018; 7: 110-3.
- 17. Yalçin M, Aparci M, Işilak Z, Uz Ö, Atalay M, Erdal E, et al. Gender and age effects on the type of result of head-up tilt-table test: A retrospective study. Gulhane Med J 2015; 57: 21-5.
- 18. Jarjour IT, Jarjour LK. Low iron storage in children and adolescents with neurally mediated syncope. J Pediat 2008; 153: 40-4.
- 19. Guven B, Oner T, Tavli V, Yilmazer MM, Demirpence S, Mese T. Low iron storage in children with tilt positive neurally mediated syncope. World J Pediatr 2013; 9: 146-51.
- 20. Kikushima S, Kobayashi Y, Nakagawa H, Katagiri T. Triggering mechanism for neurally mediated syncope induced by head-up tilt test: role of catecholamines and response to propranolol. J A Coll Cardiol 1999; 33: 350-7.
- 21. Keramati MR, Manavifar L, Badiee Z, Sadeghian MH, Farhangi H, Mood MB. Correlation between blood lead concentration and iron deficiency in Iranian children. Niger Med J 2013; 54: 325-8.
- 22. Malczewska-Lenczowska J, Orysiak J, Szczepańska B, Turowski D, Burkhard-Jagodzińska K, Gajewski J. Reticulocyte and erythrocyte hypochromia markers in detection of iron deficiency in adolescent female athletes. Biol Sport 2017; 34: 111-8.
- 23. Kovalchuk T, Boyarchuk O. Serum pyridoxine, folate, cobalamin, and homocysteine levels in children presenting with vasovagal syncope. Cardiol Young 2021; 32: 1-7.
- 24. Öner T, Guven B, Tavli V, Mese T, Yılmazer MM, Demirpence S. Postural orthostatic tachycardia syndrome (POTS) and vitamin B12 deficiency in adolescents. Pediatrics 2014; 133: e138-e42.
Öz
Kaynakça
- 1. Ganzeboom KS, Mairuhu G, Reitsma JB, Linzer M, Wieling W, Van Dijk N. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35–60 years. J Cardiovasc Electrophysiol 2006; 17: 1172-6.
- 2. Furlan R, Piazza S, Dell’Orto S, Barbic F, Bianchi A, Mainardi L, et al. Cardiac autonomic patterns preceding occasional vasovagal reactions in healthy humans. Circulation 1998; 98: 1756-61.
- 3. Brignole M. Diagnosis and treatment of syncope. Heart 2007; 93: 130-6.
- 4. Aminorroaya A, Tajdini M, Yunesian M, Boroumand M, Tavolinejad H, Yadangi S, et al. Association of folate and vitamin B12 deficiency with vasovagal syncope: a case-control study. European Heart Journal 2021; 42: ehab724. 0621.
- 5. Symes AL, Missala K, Sourkes TL. Iron-and riboflavin-dependent metabolism of a monoamine in the rat in vivo. Science 1971; 174: 153-5.
- 6. Calderón‐Ospina CA, Nava‐Mesa MO. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neurosci Ther 2020; 26: 5-13.
- 7. Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull 2008; 29: S126-S31.
- 8. Pushpakumar S, Kundu S, Sen U. Endothelial dysfunction: the link between homocysteine and hydrogen sulfide. Curr Med Chem 2014; 21: 3662-72.
- 9. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations \[Internet]. Geneva: World Health Organization; 2020.
- 10. Green R, Mitra AD. Megaloblastic anemias: nutritional and other causes. Med Clin Nort Am 2017; 101: 297-317.
- 11. Steinberg LA, Knilans TK. Syncope in children: diagnostic tests have a high cost and low yield. J Pediatr 2005; 146: 355-8.
- 12. Task Force for the Diagnosis and Management of Syncope; European Society of Cardiology (ESC); European Heart Rhythm Association (EHRA); Heart Failure Association (HFA); Heart Rhythm Society (HRS), Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009; 30: 2631-71.
- 13. Vaddadi G, Esler MD, Dawood T, Lambert E. Persistence of muscle sympathetic nerve activity during vasovagal syncope. Eur Heart J 2010; 31: 2027-33.
- 14. Peatfield R, Gawel M, Clifford-Rose F, Guthrie D, Pearson T. The effects of exercise on platelet numbers and size. Med Lab Sci 1985; 42: 40-3.
- 15. Kabul H, Celik M, Yuksel U, Yalcinkaya E, Gokoglan Y, Bugan B, et al. Increased sympathetic activation in patients with vasovagal syncope is associated with higher mean platelet volume levels. Eur Rev Med Pharmacol Sci 2014; 18: 235-41.
- 16. Gökoğlan Y, Yıldırım E. Relationship between the mean platelet volume values and tilt-table test results in patients with vasovagal syncope. Med-Science 2018; 7: 110-3.
- 17. Yalçin M, Aparci M, Işilak Z, Uz Ö, Atalay M, Erdal E, et al. Gender and age effects on the type of result of head-up tilt-table test: A retrospective study. Gulhane Med J 2015; 57: 21-5.
- 18. Jarjour IT, Jarjour LK. Low iron storage in children and adolescents with neurally mediated syncope. J Pediat 2008; 153: 40-4.
- 19. Guven B, Oner T, Tavli V, Yilmazer MM, Demirpence S, Mese T. Low iron storage in children with tilt positive neurally mediated syncope. World J Pediatr 2013; 9: 146-51.
- 20. Kikushima S, Kobayashi Y, Nakagawa H, Katagiri T. Triggering mechanism for neurally mediated syncope induced by head-up tilt test: role of catecholamines and response to propranolol. J A Coll Cardiol 1999; 33: 350-7.
- 21. Keramati MR, Manavifar L, Badiee Z, Sadeghian MH, Farhangi H, Mood MB. Correlation between blood lead concentration and iron deficiency in Iranian children. Niger Med J 2013; 54: 325-8.
- 22. Malczewska-Lenczowska J, Orysiak J, Szczepańska B, Turowski D, Burkhard-Jagodzińska K, Gajewski J. Reticulocyte and erythrocyte hypochromia markers in detection of iron deficiency in adolescent female athletes. Biol Sport 2017; 34: 111-8.
- 23. Kovalchuk T, Boyarchuk O. Serum pyridoxine, folate, cobalamin, and homocysteine levels in children presenting with vasovagal syncope. Cardiol Young 2021; 32: 1-7.
- 24. Öner T, Guven B, Tavli V, Mese T, Yılmazer MM, Demirpence S. Postural orthostatic tachycardia syndrome (POTS) and vitamin B12 deficiency in adolescents. Pediatrics 2014; 133: e138-e42.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Çocuk Nörolojisi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 23 Sayı: 3 |