Evidence mapPaperPMID 42015238Full record

ArticleBMC nursing2026

Effect of nurse-led phlebotomy on iron stores, insulin resistance, and blood lipids: a systematic review and meta-analysis.

Diego Mora-Gonzalez, Alfonso Moreno-Cabañas, Lucía Gonzalez García, Ana Isabel Cobo-Cuenca, Maria Del Carmen Muñoz-Turrillas, Ricardo Mora-Rodriguez, Felix Morales-Palomo

Abstract read
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Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Diego Mora-GonzalezGrupo IMCU, Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, 45071, Spain.
Alfonso Moreno-CabañasExercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.
Lucía Gonzalez GarcíaExercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.
Ana Isabel Cobo-CuencaGrupo IMCU, Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, 45071, Spain. anaisabel.cobo@uclm.es.
Maria Del Carmen Muñoz-TurrillasDonation and Transfusion Center, Castilla-La Mancha Public Health System (SESCAM), Toledo, Spain.
Ricardo Mora-RodriguezExercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.
Felix Morales-PalomoExercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLowering bodily iron stores through phlebotomy is a nursing-led procedure widely used to treat and manage hemochromatosis and polycythemia. Alternatively, it could contribute to the management of metabolic diseases associated with iron overload. This study aims to determine whether phlebotomy can improve insulin resistance and lipid profile in individuals with hyperferritinemia-related metabolic disorders.

methodsPublications in Cochrane Library, MEDLINE (PubMed), CINAHL (EBSCO), Academic Search Ultimate, and Web of Science were searched up to the 15th of December 2025. Search was limited to English- and Spanish-language publications. Funnel plots were calculated for each main outcome to assess potential publication bias, and the risk of bias in individual studies was evaluated using the RoB 2 and ROBINS-I tools. Standard mean differences (SMDs) and 95% CIs between individuals phlebotomized and controls were used to calculate the effect size using a random-effects model. Meta-regression assessed whether baseline ferritin levels and phlebotomy-induced reductions in ferritin correlated with improvements in insulin resistance and lipid profile.

resultsTwelve studies were eligible for analysis, comprising 549 phlebotomized and 571 control subjects. Phlebotomy was associated with a small but significant improvement in insulin resistance (SMD −0.33; CI −0.56 to −0.10; p = 0.006; I2 = 70%) and a borderline improvement in blood triglycerides (SMD −0.12; CI −0.25 to −0.001; p = 0.05; I2 = 3%), but did not improve total cholesterol (SMD −0.10; CI −0.33 to 0.12; p = 0.36; I2 = 50%). No significant associations were found between baseline ferritin levels or post-phlebotomy ferritin reduction and insulin resistance. However, ferritin reductions correlated with reductions in triglyceride levels after phlebotomy.

conclusionThe findings highlight the potential of phlebotomy as an adjuvant therapy to improve insulin resistance, independent of baseline ferritin levels. Given that phlebotomy is a safe, well-tolerated, and low-cost procedure, it could lead to increased blood donation rates, which in turn could impact nursing practice, as nurses are the primary healthcare professionals involved in this clinical procedure. META-ANALYSIS REGISTRATION: This meta-analysis was registered in the Prospective International Register of Systematic Reviews (PROSPERO) ID: CRD42024522931.

Indexed as

FerritinHealthcare providerInsulin resistanceLipidsMeta-analysisMetabolic diseasesNursing practice

Identifiers

PMID42015238
PMCPMC13227817

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.