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Assessment of iron deficiency in US preschool children and nonpregnant females of childbearing age: National Health and Nutrition Examination Survey 2003-2006.
Am J Clin Nutr. 2009 May; 89(5):1334-42.AJ

Abstract

BACKGROUND

A new index to determine body iron promises a simpler approach to monitoring iron deficiency (ID) prevalence.

OBJECTIVE

Our objective was to compare ID defined as body iron <0 mg/kg and calculated from the log ratio of transferrin receptor to ferritin (the body iron model) to ID defined as >/=2 of 3 abnormal concentrations in ferritin, transferrin saturation, or erythrocyte protoporphyrin (the ferritin model).

DESIGN

We used measures of iron status and inflammation from 486 children aged 1-2 y, 848 children aged 3-5 y, and 3742 nonpregnant females aged 12-49 y from the National Health and Nutrition Examination Survey 2003-2006.

RESULTS

ID prevalences (+/-SE) based on the body iron model in children (1-2 and 3-5 y) and in females (12-19 and 20-49 y) were 14.4 +/- 1.9%, 3.7 +/- 0.8%, 9.3 +/- 1.0%, and 9.2 +/- 1.6%, respectively. ID prevalences based on the ferritin model in children (3-5 y) and females (12-19 and 20-49 y) were 4.5 +/- 0.9%, 15.6 +/- 1.2%, and 15.7 +/- 0.8%, respectively. The kappa statistics for agreement between the 2 models were 0.5-0.7. Among females (12-49 y) the positive predictive values of ID based on the body iron model and the ferritin model for identifying anemia were 43 +/- 3% and 30 +/- 2%, respectively, whereas negative predictive values did not differ. C-reactive protein was elevated in 28.8 +/- 3.1% of females with ID by the ferritin model but not by the body iron model and in 0% of persons with ID by the body iron model but not by the ferritin model.

CONCLUSIONS

The agreement between the 2 indexes was fair to good. Among females, the body iron model produced lower estimates of ID prevalence, better predicted anemia, and appeared to be less affected by inflammation than the ferritin model.

Authors+Show Affiliations

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA. mcogswell@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19357218

Citation

Cogswell, Mary E., et al. "Assessment of Iron Deficiency in US Preschool Children and Nonpregnant Females of Childbearing Age: National Health and Nutrition Examination Survey 2003-2006." The American Journal of Clinical Nutrition, vol. 89, no. 5, 2009, pp. 1334-42.
Cogswell ME, Looker AC, Pfeiffer CM, et al. Assessment of iron deficiency in US preschool children and nonpregnant females of childbearing age: National Health and Nutrition Examination Survey 2003-2006. Am J Clin Nutr. 2009;89(5):1334-42.
Cogswell, M. E., Looker, A. C., Pfeiffer, C. M., Cook, J. D., Lacher, D. A., Beard, J. L., Lynch, S. R., & Grummer-Strawn, L. M. (2009). Assessment of iron deficiency in US preschool children and nonpregnant females of childbearing age: National Health and Nutrition Examination Survey 2003-2006. The American Journal of Clinical Nutrition, 89(5), 1334-42. https://doi.org/10.3945/ajcn.2008.27151
Cogswell ME, et al. Assessment of Iron Deficiency in US Preschool Children and Nonpregnant Females of Childbearing Age: National Health and Nutrition Examination Survey 2003-2006. Am J Clin Nutr. 2009;89(5):1334-42. PubMed PMID: 19357218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of iron deficiency in US preschool children and nonpregnant females of childbearing age: National Health and Nutrition Examination Survey 2003-2006. AU - Cogswell,Mary E, AU - Looker,Anne C, AU - Pfeiffer,Christine M, AU - Cook,James D, AU - Lacher,David A, AU - Beard,John L, AU - Lynch,Sean R, AU - Grummer-Strawn,Laurence M, Y1 - 2009/04/08/ PY - 2009/4/10/entrez PY - 2009/4/10/pubmed PY - 2009/5/15/medline SP - 1334 EP - 42 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 89 IS - 5 N2 - BACKGROUND: A new index to determine body iron promises a simpler approach to monitoring iron deficiency (ID) prevalence. OBJECTIVE: Our objective was to compare ID defined as body iron <0 mg/kg and calculated from the log ratio of transferrin receptor to ferritin (the body iron model) to ID defined as >/=2 of 3 abnormal concentrations in ferritin, transferrin saturation, or erythrocyte protoporphyrin (the ferritin model). DESIGN: We used measures of iron status and inflammation from 486 children aged 1-2 y, 848 children aged 3-5 y, and 3742 nonpregnant females aged 12-49 y from the National Health and Nutrition Examination Survey 2003-2006. RESULTS: ID prevalences (+/-SE) based on the body iron model in children (1-2 and 3-5 y) and in females (12-19 and 20-49 y) were 14.4 +/- 1.9%, 3.7 +/- 0.8%, 9.3 +/- 1.0%, and 9.2 +/- 1.6%, respectively. ID prevalences based on the ferritin model in children (3-5 y) and females (12-19 and 20-49 y) were 4.5 +/- 0.9%, 15.6 +/- 1.2%, and 15.7 +/- 0.8%, respectively. The kappa statistics for agreement between the 2 models were 0.5-0.7. Among females (12-49 y) the positive predictive values of ID based on the body iron model and the ferritin model for identifying anemia were 43 +/- 3% and 30 +/- 2%, respectively, whereas negative predictive values did not differ. C-reactive protein was elevated in 28.8 +/- 3.1% of females with ID by the ferritin model but not by the body iron model and in 0% of persons with ID by the body iron model but not by the ferritin model. CONCLUSIONS: The agreement between the 2 indexes was fair to good. Among females, the body iron model produced lower estimates of ID prevalence, better predicted anemia, and appeared to be less affected by inflammation than the ferritin model. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19357218/Assessment_of_iron_deficiency_in_US_preschool_children_and_nonpregnant_females_of_childbearing_age:_National_Health_and_Nutrition_Examination_Survey_2003_2006_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.27151 DB - PRIME DP - Unbound Medicine ER -