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PubMed2005

Anemia, iron deficiency, and iron deficiency anemia in 12-36-mo-old children from low-income families.

BACKGROUND: Iron deficiency (ID) is the most common nutritional deficiency in the world and remains relatively common in at-risk groups in the United States. The actual prevalence of anemia, ID, and iron deficiency anemia (IDA) in California remains unclear. OBJECTIVE: The objective was to determine the prevalence of anemia, low iron stores, ID, and IDA in children participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) population, and to assess the value of using hemoglobin to predict ID. DESIGN: This was a cross-sectional study of a convenience sample of 12-36-mo-old children from WIC clinics in 2 California counties. RESULTS: The prevalence of anemia was 11.1% (hemoglobin <110 g/L at 12-24 mo or <111 g/L at 24-36 mo). Study- and literature-determined abnormal values for iron measures were as follows: serum ferritin or=8.4 or >10.0 microg/mL, and transferrin saturation or=2 abnormal iron measures) were 16.2% and 8.8%, and of IDA (ID with low hemoglobin) were 3.4% and 3.2% on the basis of study- and literature-determined cutoffs, respectively. Hemoglobin concentration was used to predict study- and literature-determined ID on the basis of receiver operating characteristic curves. The sensitivity of low hemoglobin in predicting study- and literature-determined ID was low (23.2% and 40.0%, respectively). CONCLUSIONS: Anemia and ID were prevalent in this WIC sample, but IDA was uncommon. Low hemoglobin is a poor predictor of ID.

Anemia↗
PubMed1992

[Prevalence of iron deficiency and iron deficiency anemia in infancy and related factors in a community of the Murcia region].

In this study of 98 children, we determined hematological values and serum iron concentrations. A nutritional investigation was also done. We found that 25.5% of the children were iron deficient and 12.2% were anemic. In the group of children with iron deficiency, the introduction of meat and cereals was significantly late (p less than 0.01 and p less than 0.05, respectively). In this same group of children the introduction of whole cow milk was earlier, although not significant (NS). The age of maximal prevalence was between 13 and 24 months. These results indicate a need to screen for iron deficiency during the second year of life, to delay the introduction of whole cow milk and not to delay the introduction of meat and cereals.

Anemia, Hypochromic↗
PubMed1998

Phenotypic expression of hemoglobin A2 in beta-thalassemia trait with iron deficiency.

Iron status was estimated in 463 heterozygous beta-thalassemics to delineate the effect of iron deficiency on the expression of hemoglobin A2 (HbA2) in these patients. One hundred and twenty-six (27.2%) patients with the trait were iron deficient. These iron-deficient patients had a significantly (p < 0.0002) higher prevalence of anemia (90.5%) compared with iron-replete patients with the trait (71.5%). The mean hemoglobin (Hb) concentration, MCV, and MCH were significantly (p < 0.0001) lower in patients with beta-thalassemia traits (BTT) who had iron deficiency than in those without iron deficiency. Mean RBC count and MCHC did not differ in the two groups. Mean HbA2 was not significantly different in the two groups of patients with the trait and was elevated (>3.5%) in all but one heterozygote investigated. Mean HbA2/cell was significantly (p < 0.05) lower in BTT patients with iron deficiency than in patients without iron deficiency. The presence of iron deficiency did not preclude the detection of BTT in this population. The effect of iron deficiency in BTT was apparent as a significant lowering of the Hb concentration and an increased prevalence of anemia. Iron therapy is warranted for BTT patients with iron-deficiency traits and would help to significantly raise their Hb concentration. The elevation of HbA2 was striking and could be used with reliability in making the diagnosis of BTT even in the presence of iron deficiency.

Anemia, Iron-Deficiency↗
PubMed1984

[Clinical aspects and therapy of iron deficiency].

Iron deficiency and iron deficiency anemias are very common disturbances of the hematopoiesis. Although symptomatology and therapeutic possibilities are well known, one should keep in mind that iron deficiency is a symptom and not a diagnosis. The causes of iron deficiency are iron loss, malabsorption and insufficient supply. The best therapy is peroral treatment with well absorbable preparations, whereby the bioavailability has to be taken into consideration. Only in few cases a parenteral therapy which has more side effects is necessary. A overview about the possible therapy is given.

Adult↗
PubMed2005

[Human iron deficiency].

Iron deficiency is the most widespread nutritional disorder in the world, affecting an estimated 1.2 billion people. Its prevalence is particularly high in developing countries (Africa, Asia, South America), but iron deficiency remains a public health problem in industrialised countries. Three successive stages of iron deficiency can be distinguished: iron store depletion, iron-deficient erythropoesis and iron-deficiency anemia. Investigations of iron deficiency should take into account the clinical background. In groups at risk (infants and children, women of childbearing age, pregnant women), management is limited to nutritional inquiries, gynecological examination, and oral iron supplementation. In men and post-menopausal women, iron deficiency is assumed to result from occult gastrointestinal bleeding, and this may necessitate upper and lower gastrointestinal endoscopy. Benign lesions are more frequently found in the upper digestive tract than in the lower digestive tract. When these investigations are negative and iron supplementation is unsuccessful, video-capsule endoscopy is recommended. Oral iron treatment is based on ferrous salts (200 mg/d). The duration of treatment depends on the severity of iron deficiency, ranging from three months for iron store depletion and iron-deficient erythropeisis to six months for iron-deficiency anemia.

Anemia, Iron-Deficiency↗
PubMed1997

The female Spanish population: a group at risk of nutritional iron deficiency.

Iron deficiency is one of the most common nutritional problems in the world. It is frequent in both developed and developing countries and mainly affects women of childbearing age. The aim of the present study was to investigate the prevalence of iron deficiency in a group of young women from Madrid, Spain. The study subjects were a group of 130 women aged between 19 and 35 (24.53 +/- 0.24 years). Measurements were made of iron intake and also of the haematological and biochemical indicators of iron status. 10.7% of subjects showed iron deficiency (defined as the recording of at least two indicator parameters with values below normal). The high incidence of iron deficiency at blood level (10.7%) coincided with the low iron intake of these subjects (11.08 +/- 2.98 mg/day). 98.3% of subjects showed intakes below recommended. Observed intake covered only 61.6% of recommended intake. 3.9% of subjects presented ferropenic anaemia, i.e. they showed both iron deficiency and low haemoglobin levels.

Adult↗
PubMed2003

Duodenal mucosal reductase in wild-type and Hfe knockout mice on iron adequate, iron deficient, and iron rich feeding.

BACKGROUND: Genetic haemochromatosis is a common hereditary iron loading disorder in humans. The disease is associated with loss of function mutations in the HFE gene. This is thought to change iron stores via increased iron absorption. AIMS: In this study we investigated how adaptation of mucosal reductase activity is engaged in this process and how the changes compare with adaptation seen when an iron deficient diet is fed. METHODS: Duodenal mucosal surface reductase was measured with nitroblue tetrazolium in age matched groups of male Hfe knockout mice (Hfe) and wild- type mice fed a purified diet containing normal (iron adequate), high (iron rich), or low (iron deficient) iron concentrations. RESULTS: Reductase activity increased when mice were fed an iron deficient diet and decreased when they were fed an iron rich diet. Total villus activity, as measured by the average area under the activity curve along the crypt-villus axis, was increased 2.8-2.9-fold by iron deficiency in both genotypes. Approximately half of this difference was attributable to the significantly increased length of the villi in mice on an iron deficient diet (p<0.05). Hfe knockout did not affect villus length but increased mucosal reductase activity near the villus tips. Similar increases (1.3-1.6-fold) were seen on all diets but the increase was significant for iron deficient and iron loaded diets only (p<0.05). CONCLUSION: Hfe gene product and dietary iron downregulate villus reductase activity in mice.

Animals↗
PubMed1997

[Basic principles and clinical significance of iron deficiency].

Iron deficiency is the most common cause of anemia, and the most common cause of iron deficiency is bleeding from the gastrointestinal tract, or gynecological bleeding in the case of women. More rarely it may be due to an increased need for, or a reduction in the uptake of, iron. In addition to the usual clinical symptoms of anemia, there may also be symptoms affecting the skin, mucosae, and appendages of the skin. For the establishment of the diagnosis, the various causes of hypochromic, microcytic anemia must be differentiated, and the underlying cause of the iron deficiency clarified. With respect to treatment, the underlying disease is of primary importance. In the absence of absorption disorders or intolerability, oral replacement of iron in a suitable form is the substitution treatment of choice.

Adolescent↗
PubMed2004

[Iron deficiency and iron overload in an adult population in Catalonia, Spain].

BACKGROUND AND OBJECTIVE: To ascertain the frequency of iron deficiency and iron overload in an adult Catalan population. SUBJECTS AND METHOD: Multiple iron measurements, including transferrin saturation (TS) and serum ferritin (SF), were performed in a representative sample of 1,296 adults. RESULTS: The prevalence of iron deficiency was 5.6% (95% CI, 4.4 to 6.9)(SF below 12 microg/l), and 9.3% (95% CI, 7.7 to 10.9) had an iron overload(SF above 300 microg/l in men and SF above 200 microg/l in women). Iron deficiency was especially frequent in women 50 years old or younger (14.8%; 95% CI, 11.4 to 18.1),while in men of the same age it was 1.1% (95% CI, 0.1 to 2.1), yet 11.7% (95% CI, 8.7 to 14.7) had iron overload. In the population over 50 years there was an iron deficiency in 0.9% (95% CI, 0.0 to 1.8), and an iron overload in 15.1% (95% CI, 11.7 to 18.4). 1.6% (95% CI, 0.9-2.3) of all population and 3.9% (1.4-6.4) of men older than 50 years had an SF above 500 microg/l. CONCLUSIONS: Iron overload is more prevalent than iron deficiency in Catalonia, particularly in men and people over 50 years. The causes and effects of the disorder should be investigated in order to carry out corrective measures in the future.

Adult↗
PubMed1998

Haematological parameters and HbA2 levels in beta-thalassaemia trait with coincident iron deficiency.

Iron status was estimated in 463 heterozygous beta-thalassaemics to delineate the effect of iron deficiency (ID) on the haematological parameters and expression of HbA2 in these patients. One hundred and twenty six (27.2%) traits had coincident ID. These iron deficient traits had a significantly (p < 0.0002), higher prevalence of anaemia (90.5%) as compared to iron replete traits (71.5%). Mean haemoglobin concentration was significantly lower (p < 0.0001) in beta-thalassaemics with ID (10.7 +/- 1.5) g/al as compared to those without ID (11.6 +/- 1.6 g/dl). Mean MCV and MCH were significantly lowered (p < 0.0001) in patients of beta-thalassaemia trait (BTT) with ID than in these without ID. Mean HbA2 was not significantly different in the two groups of traits and was elevated (> or = 3.5%) in all except one patient. However, mean HbA2/cell was significantly (p < 0.05) lower in traits with ID. The effect of ID in BTT was apparent with significant lowering of haemoglobin concentration and increased prevalence of anaemia. Iron therapy is warranted in iron deficient traits and would help in significantly raising their haemoglobin concentration. Elevation in HbA2 values was striking and could be used with reliability for diagnosis of BTT even in the presence of ID.

Anemia, Iron-Deficiency↗
PubMed1993

[Individual differences in the efficacy of Recormon in patients with terminal kidney failure. The role of iron deficiency].

Iron deficiency involvement in the results of long-term replacement therapy of renal anemia with recormon, a preparation of recombinant human erythropoietin, has been studied in chronic renal failure patients on programmed hemodialysis. The effect of recormon subcutaneous administration to 51 patients was found reduced in 9 patients; in 5 of them the decreased sensitivity to recormon was attributed to iron deficiency. During a year of treatment the percentage of iron-deficient patients rose from 9.1% to 45% as a result of intensive uptake of iron in the course of erythropoiesis. Iron preparation as a corrective treatment contributed to hematocrit increment reducing effective doses of erythropoietin. In addition to routine control of ferritin and iron it is recommended to trace the degree of transferrin saturation in the course of recombinant erythropoietin therapy.

Anemia, Hypochromic↗