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International Medical Scientific Journal     Issue-2 

10.5281/zenodo.5080556 

34 

  



Art of Medicine         Volume-1 

International Medical Scientific Journal     Issue-2 

10.5281/zenodo.5080556 

35 

Art of Medicine 

International Medical Scientific journal 

 

Founder and Publisher Pascual Izquierdo-Egea 

Published science may 2021 year. Issued Quarterly. 

Internet address: http://artofmedicineimsj.us 

E-mail: info@artofmedicineimsj.us 

11931 Barlow Pl Philadelphia, PA 19116, USA +1 (929) 266-0862 

 

 

 

 

 

  



Art of Medicine         Volume-1 

International Medical Scientific Journal     Issue-2 

10.5281/zenodo.5080556 

36 

FEATURES OF CHANGE OF MICROELEMENTAL 

COMPOSITION IN ANEMIA OF CHRONIC DISEASES IN 

ELDERLY AND OLD AGE 

Boltaev Kamol Zhumaevich 

Bukhara State Medical Institute, Bukhara, Uzbekistan 

ABSTRACT. The purpose of this study is to carry out a comparative 

analysis of hematopoietic trace elements - iron, copper and zinc - in 

apparently healthy elderly men and women, depending on the age range. 

For these purposes, all surveyed men and women living both in urban and 

rural conditions were divided into two age ranges - surveyed - up to and 

over 70 years. The results of the analysis showed that there is no 

statistically significant difference between the indicators of blood 

hemoglobin and hematopoietic microelements - iron, copper and zinc in the 

whole group of examined elderly men and the group of examined elderly 

men and examined elderly women in old age. 

KEYWORDS: hematopoiesis, trace elements, blood serum, 

hemoglobin, age range. 

INTRODUCTION. It is known that anemia of chronic diseases (ACD) is 

the most common anemia worldwide, which ranks second after iron 

deficiency anemia (IDA). ACD accompanies infectious, rheumatic 

diseases, neoplasms, as well as chronic heart failure, chronic kidney 

disease, diabetes mellitus, liver cirrhosis and other nosological units [1, 2, 

3, 4]. 

It was found that the presence of anemia leads to a decrease in the 

oxygenation of organs and tissues, a decrease in physical activity, the 

appearance of weakness in the body and a deterioration in the quality of 

life. In contrast to IDA, in which the diagnosis is not difficult, ACD is often 



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not diagnosed, since at the wound stages it proceeds as normocytic and 

normochromic [5, 6, 10, 11]. 

Chronic diseases and anemia are independent factors of an 

unfavorable prognosis of the course of the disease in elderly and senile 

patients in relation to patients of a younger age [7, 8, 9]. 

Numerous studies of domestic and foreign scientists have studied 

AChD from the point of view of the etiopathogenesis of the disease. It has 

been established that with this pathology, the exchange of trace elements, 

primarily iron, is disturbed. In this regard, in the diagnosis of ACD, it is 

important to determine the transferrin and ferritin in the blood serum for 

the completeness of early diagnosis. But so far, the features of changes in 

essential trace elements in this category of persons with early diagnosis of 

ACD have not been fully studied. 

In this regard, the purpose of this part of the dissertation work was to 

determine and assess the indicators of ferrokinetics, as well as essential 

trace elements in elderly and senile people with IDA, ACD in a 

comparative aspect. 

MATERIALS  AND METHODS 

For this, the results of studies of elderly (n = 325) and senile (n = 65) 

persons with IDA, ACD and their combinations were analyzed. 

Analysis of the research results shows that the combined form of IDA and 

ACD occurs most often in both study groups. 

        RESULTS AND DISCUSSION. 

  Studies have found that in elderly people the number of patients with 

IDA and ACD did not significantly differ among themselves, amounting to 

23.08 + 2.13% (n = 90) and 27.18 + 2.25% (n = 106), respectively - P > 

0.05. As for IDA + ACD, the percentage of patients with a combination of 

these two ailments was significantly higher in relation to IDA and ACD 



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38 

taken separately - 1.43 times, respectively, in relation to IDA (respectively 

33.08 + 2.38% (n = 129) versus 23.08 + 2.13% (n = 90) - P <0.05), as well 

as 1.22 times in relation to ACD (respectively 33.08 + 2.38% (n = 129) 

versus 27 , 18 + 2.25% (n = 106) - P <0.05). 

        Almost the same picture was observed in the parameters of elderly 

people, with the only difference that the parameters of IDA and ACD also 

differed in reliability, respectively 2.56 + 0.80% (n = 10) versus 5.64 + 

1.17% (n = 22) - P <0.05. The combined incidence of these pathologies 

was most noticeably increased, as IDA + ACD were 3.30 times increased 

in relation to persons of old age with IDA (8.46 + 1.41%, n = 33 versus 

2.56 + 0.80% , n = 10) - P <0.001. The same trend was observed when 

comparing the data of ACD and IDA + ACD, where the difference was 

1.50 times (8.46 + 1.41%, n = 33 versus 5.64 + 1.17%, n = 22) - P <0.001. 

It should be emphasized that the number of elderly patients with a 

combined occurrence of IDA + ACD was higher than IDA and ACD, 

instead of 8.46% (n = 33) versus 8.2% (n = 32). 

Thus, the analysis of the parameters of the occurrence of various 

forms of anemia in elderly and senile people shows that in elderly people 

there is a significant difference between the indicators of the combined 

occurrence of IDA + ACD in relation to IDA (1.43 times, P <0.05) and to 

ACD (1.22 times, P <0.05). However, no significant differences were 

observed between the parameters of ACD and IDA. This indicates that 

ACD occurs quite often in elderly people, not yielding to the detection of 

IDA in this age group of patients, a significantly increased state of the 

combined occurrence of IDA and ACD (IDA + ACD) in these individuals 

indicates a peculiarity of the course of these diseases and allows more 

closely attention when diagnosing the above conditions. 



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39 

This tendency persisted in elderly people, with the following 

differences: firstly, the indicators of IDA and ACD significantly differed 

among themselves, the increase was in favor of ACD; secondly, the 

combined occurrence of IDA and ACD was sharply increased in relation to 

individual IDA and ACD (3.30 and 1.50 times, respectively, P <0.001); 

thirdly, the number of patients with the combined occurrence of IDA and 

ACD was greater than that of IDA and ACD instead of those taken. These 

facts should also be taken into account when planning diagnostic and 

treatment-and-prophylactic measures in relation to elderly people. 

In addition, there was an interesting comparative characteristic of the 

occurrence of these pathologies within a separate group of elderly and 

senile people. The results obtained show that IDA is less than 1/3 of 

patients in this age category - 27.69%. ACD makes up 32.60% of the total 

number of sick elderly people, most of it was the combined occurrence of 

IDA and ACD, which reached 39.69%. The data for the elderly were 

somewhat different - respectively, IDA - 15.38%, ACD - 33.85 and IDA + 

ACD - 50.77%. 

The true incidence of anemia in elderly and senile people differs 

from each other, which requires close attention when planning therapeutic 

and prophylactic measures for treatment and prevention of complications of 

this pathology. 

It should be emphasized that the following pathologies appeared with 

ACD: coronary heart disease (CHD), chronic heart failure (CHF), arthritis 

of various etiologies, hepatitis of various etiologies, chronic kidney disease 

(CKD), chronic inflammatory diseases of the gastrointestinal tract (GIT). 

The most common among patients with coronary artery disease, CHF 

and arthritis of various etiology (more than 60.0%). 



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The next stage of the research was to study the parameters of the 

hemogram in elderly and senile people with IDA, ACD and IDA + ACD. 

The results obtained show that the parameters of the hemogram in 

elderly and senile people practically did not differ among themselves, the 

difference between the obtained average figures was insignificant and not 

reliable, and therefore we did not consider it appropriate to provide a 

comparative analysis of the hemogram in this dissertation work. 

The obtained results show that in patients with IDA, the blood 

hemoglobin content was significantly reduced in relation to the reference 

values - to 76.8 + 7.3x1012 / l (P <0.001). In addition, the same parameters 

were significantly reduced in relation to the selected standard in patients 

with ACD (on average, up to 94.6 + 8.4x1012 / l, P <0.001) and with ACD 

+ IDA (on average, up to 82.1 + 6.8x1012 / l, P <0.001). 

Comparative analysis between the study groups shows that there is a 

significant difference between the hemoglobin data in patients with IDA 

and ACD, which is 1.23 times more in favor of ACD. 

A slight increase was also noted in patients with IDA + ACD, but the 

results between them were not reliable (P> 0.05). 

The number of erythrocytes was slightly increased in patients with 

IDA in relation to the compared groups, but if in patients with ACD the 

decrease in the number of erythrocytes was not significant (P <0.05), then 

with the combined occurrence of IDA and ACD, the decrease in relation to 

data with IDA was significant (P <0.05). The mean erythrocyte volume 

(MCV) also differed in the compared groups, the indicators of patients with 

ACD were significantly (P <0.05), and IDA + ACD were not significantly 

(P> 0.05) increased in relation to the data of patients with IDA. 

     The average amount of hemoglobin in the erythrocyte (MCH) and 

the average concentration of hemoglobin in the erythrocyte (MCHS) in 



Art of Medicine         Volume-1 

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patients with ACD and IDA + ACD were significantly higher than the 

parameters of patients with IDA, which has a certain diagnostic value. 

        The level of erythrocyte anisocytosis (RDW) was significantly 

increased in patients with IDA in relation to the data of patients with ACD 

and IDA + ACD ((P <0.05). 

It should be emphasized that in elderly and senile people with IDA, 

of the 6 studied parameters, all (100%) were lower than the reference 

values, while in ACD only 2m out of 6 parameters (33.3%) significantly 

differed from the reference values. The counts showed. That in patients 

with IDA + ACD, the differences from the reference values concerned 5 

parameters out of 6 (83.3%). This fact indicates that not only IDA, but also 

its combination with ACD will lead to an imbalance of hematological 

parameters concerning hemoglobin, its content, concentration, volume in 

erythrocytes. 

Thus, the study of comparative hemogram parameters in elderly and 

senile patients of patients with different forms of anemia, indicators that all 

parameters in relation to the reference values (100%) were reduced in 

patients with IDA in patients with ACD, this indicator was 33.3%, and in 

those surveyed with IDA + ACD was 83.3%. Significant differences 

between the comparison groups indicate the effect of ACD on 

hematological parameters in the surveyed. Significant differences between 

the compared parameters in patients with different forms of anemia 

indicate a different approach in planning treatment and prophylactic 

measures for elderly and senile patients. 

The next stage of the research was a comparative study of 

ferrokinetic indices and some parameters of the inflammatory process in 

elderly and senile people with different forms of anemia (IDA, ACD, IDA 

+ ACD). 



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Studies have established that serum iron is one of the main indicators 

of ferrokinetics, and therefore its determination is mandatory in research 

work. 

We found that the content of serum iron in elderly and senile persons 

differed from each other depending on the pathological process associated 

with anemia. So, if in those examined with IDA, the serum iron content 

averaged 7.7 + 0.74, then in individuals with ACD this parameter increased 

2.2 times (on average, up to 16.5 + 1.06. P <0, 05). Not such a significant, 

insignificant increase in relation to the data of patients with IDA was also 

distinguished in patients with IDA + AChD (on average, up to 10.4 + 0.86, 

P <0.05). 

Sharp differences between the indicators were distinguished in the 

determination of ferritin in the blood serum of patients. It was found that in 

elderly and senile patients with IDA, ferritin was determined on average in 

the amount of 12.6 + 1.2 μg / l, which is 19.62 times and 9.02 times, 

respectively, less than the data of patients with ACD and IDA + ACD ( 

respectively 213.2 + 2.5 μg / l and 113.7 + 2.4 μg / l. These data turned out 

to be increased reference values of this indicator. Huge differences between 

the studied parameters indicate a somewhat deep pathological process that 

involves ferritin and leads to a large imbalance between indicators. 

The opposite picture was observed when studying the results of a 

study to determine transferrin in the blood serum of the examined. The 

parameters of patients with IDA and IDA + AHZ were significantly 

reduced by 4.0 and 1.79 times in relation to the data of patients with IDA - 

1.3 + 0.11 g / l, respectively; 2.9 + 0.24 g / l versus 5.2 + 0.49 g / l (P 

<0.001). 

Noteworthy is the fact that in all cases CST (the ratio of serum iron 

to transferrin), which in all studied groups was below the reference values 



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(P <0.05). The lowest indices for CST were in patients with IDA (1.48 + 

0.4%) and IDA + ACD (3.6 + 0.9%). 

There is an increase in one of the main diagnostic markers of the 

inflammatory process, C-reactive protein (CRP) in patients with ACD and 

IDA + ACP in relation to the indicators of IDA. Such a 4.91 - short and 

4.24 - short increase in CRP in relation to the compared group (IDA) 

indicates the development of the inflammatory process in patients. 

Thus, the study and analysis of comparative indicators of 

ferrokinetics and some parameters of inflammation in elderly and senile 

people with IDA and AChD indicators are the following features; firstly, 

the parameters of serum iron in patients with ACD and IDA + ACD were 

significantly increased in relation to patients with IDA; secondly, the 

content of ferritin and transferrin in blood serum changed in different 

directions in patients also in relation to patients with IDA; thirdly, CST was 

significantly reduced in all study groups, especially this one concerned 

elderly and senile patients with IDA and IDA + ACD; fourthly, the marker 

of inflammation - CRP was significantly increased in patients with chronic 

diseases (ACD and IDA + ACD) in relation to patients with IDA without 

signs of inflammation; fifth, the CRP content directly, closely positively 

correlates with the concentration of serum iron, serum ferritin, and also has 

a negative strong, close relationship with the content of transferrin and 

TIBC. 

Studies have shown that in the pathogenesis of chronic inflammatory 

diseases, an important place is occupied by the deficiency of trace 

elements, especially essential trace elements - iron, zinc and copper. 

CONCLUSIONS  



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Based on the above, at the next stage of the research, the content of 

essential trace elements in the blood serum of elderly and senile patients 

was determined. 

The obtained results show that no significant differences were 

observed in the iron content in elderly and senile people - respectively 12.9 

+ 0.7 in elderly people and 13.4 + 0.7 in elderly people (P> 0.05) ... Almost 

the same picture is observed in the content of zinc in the blood serum 

(respectively 6.7 + 0.5 in the elderly and 5.5 + 0.7 in the elderly, P> 0.05), 

although a slight increase differs in individuals old age in relation to the 

data of elderly people. In terms of the content of copper in the blood serum, 

the opposite picture is observed, that is, a significant increase differs in 

elderly people - respectively, on average, 13.2 + 0.6 in elderly people 

versus 11.7 + 0.7 in elderly people, P> 0 , 05). 

Thus, the study of the content of essential trace elements (iron, zinc 

and copper) in the blood serum of elderly and senile patients with ACD 

showed that the tendency of a comparative increase was distinguished in 

the elderly in iron and copper, the opposite tendency was observed in the 

content of zinc. This pattern of change is typical for elderly and senile 

patients with ACD.                                                              

REFERENCES 

1. Boltaev K.Zh., Akhmedova N.Sh. Characteristics of the phenomenon 

of the development of polydeficiency states during aging // Problems 

of Biology and Medicine. - 2020. No. 1. Issue 116. P. 24-26.  

2. Buglanov A.A., Mamatkhonov O.A. Exchange of hematopoietic 

nutrients in healthy women of fertile age in Uzbekistan // Problems 

of hematology and blood transfusion, 2005.-N 3.-P.25-27 



Art of Medicine         Volume-1 

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45 

3. Fofanova I.Yu., Prilepskaya V.N. The content of folic acid, zinc and 

copper in blood serum in pregnant women with urogenital 

mycoplasma infection. Medical advice. 2015; (XX): 39-45.  

4. Skalnaya, M. Involvement of macro- and trace elements in 

dysregulatory mechanisms of obesity and type II diabetes 

pathogenesis in pre- and postmenopausal women // Cell Biology and 

Toxicology. — 2008. — Vol. 24 (Suppl. 1). — P. 39. — ISSN 0742-

2091. 

5. Abdullaeva U.K., Shadjanova N.S. Using the OLGA system in 

chronic atrophic gastritis // New day in medicine, № 2 (30) 2020, 

Bukhara, Uzbekistan, Р. 9-12. 

6. Abdullaeva U.K., Sobirova G.N., Karimov M.M., Aslonova I.J. The 

prevalence and possibilities of prevention of noncardial gastric 

cancer in the Bukhara region // American journal of medicine and 

medical sciences, 2020, 10(9), Р. 679-681. 

7. Sobirova G.N., Abdullaeva U.K., Nosirova M.S., Aslonova I.J. 

Evaluation of the gastrointestinal mucosa by the OLGA system in 

chronic atrophic gastritis // Journal of critical reviews, Kuala 

Lumpur, Malaysia, Vol. 7, Iss. 2, 2020, P. 409-413. 

8. Karimov M.M., Sobirova G.N., Abdullaeva U.K., Aslonova I.Zh., 

Tulyaganova F.M. Possibilities of serological diagnosis of atrophic 

processes of the gastric mucosa // European Journal of Molecular & 

Clinical Medicine  Vol. 7, Iss. 11, 2020, P. 2955-2960. 

9. Sobirova G.N., Abdullaeva U.K., Mirzaeva D.B., Ismitdinova N.S. 

Immunopatogenesis of chronic gastritis and its role in carcino 

genesis // ACADEMICIA An international multidisciplinary 

research journal, affliated to Kurukshetra university, Kurukshetra, 

India. Vol.8, Iss.12, 2018, P. 32-40. 



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10. Abdullaeva U.K. Predicting the risk of atrophic transformation in 

chronic gastritis using serum pepsinogen // World journal of 

pharmaceutical research,  Faculty of Pharmacy Medical University,  

Bulgaria, Vol. 8, Iss. 13, 2019, P. 219-228. 

11. Sobirova G.N., Abdullaeva U.K. Chronic gastritis and 

carcinogenesis issues // electronic journal of actual problems of 

modern science, education and training, Urganch, Uzbekistan, 2019-

I, P. 159-172. 

 


