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Depleted iron stores and iron deficiency anemia associated with reduced ferritin and hepcidin and elevated soluble transferrin receptors in a multiethnic group of preschool-age children.
Appl Physiol Nutr Metab. 2015 Sep; 40(9):887-94.AP

Abstract

Iron deficiency anemia is prevalent in subgroups of the Canadian population. The objective of this study was to examine iron status and anemia in preschool-age children. Healthy children (n = 430, 2-5 years old, Montreal, Quebec, Canada) were sampled from randomly selected daycares. Anthropometry, demographics, and diet were assessed. Biochemistry included hemoglobin, ferritin, soluble transferrin receptors (sTfR), ferritin index, markers of inflammation (C-reactive protein, interleukin 6 (IL-6), and tumour necrosis factor alpha (TNFα)), and hepcidin. Iron deficiency and anemia cutoffs conformed to the World Health Organization criteria. Differences among categories were tested using mixed-model ANOVA or χ(2) tests. Children were 3.8 ± 1.0 years of age, with a body mass index z score of 0.48 ± 0.97, and 51% were white. Adjusted intakes of iron indicated <1% were at risk for deficiency. Hemoglobin was higher in white children, whereas ferritin was higher with greater age and female sex. Inflammatory markers and hepcidin did not vary with any demographic variable. The prevalence of iron deficiency was 16.5% (95% confidence interval (CI), 13.0-20.0). Three percent (95% CI, 1.4-4.6) of children had iron deficiency anemia and 12.8% (95% CI, 9.6-16.0) had unexplained anemia. Children with iron deficiency, with and without anemia, had lower plasma ferritin and hepcidin but higher sTfR, ferritin index, and IL-6, whereas those with unexplained anemia had elevated TNFα. We conclude that iron deficiency anemia is not very common in young children in Montreal. While iron deficiency without anemia is more common than iron deficiency with anemia, the correspondingly reduced circulating hepcidin would have enabled heightened absorption of dietary iron in support of erythropoiesis.

Authors+Show Affiliations

School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada. School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada.School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada. School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada.School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada. School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada.School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada. School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada.School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada. School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26288393

Citation

Weiler, Hope A., et al. "Depleted Iron Stores and Iron Deficiency Anemia Associated With Reduced Ferritin and Hepcidin and Elevated Soluble Transferrin Receptors in a Multiethnic Group of Preschool-age Children." Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme, vol. 40, no. 9, 2015, pp. 887-94.
Weiler HA, Jean-Philippe S, Cohen TR, et al. Depleted iron stores and iron deficiency anemia associated with reduced ferritin and hepcidin and elevated soluble transferrin receptors in a multiethnic group of preschool-age children. Appl Physiol Nutr Metab. 2015;40(9):887-94.
Weiler, H. A., Jean-Philippe, S., Cohen, T. R., Vanstone, C. A., & Agellon, S. (2015). Depleted iron stores and iron deficiency anemia associated with reduced ferritin and hepcidin and elevated soluble transferrin receptors in a multiethnic group of preschool-age children. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme, 40(9), 887-94. https://doi.org/10.1139/apnm-2014-0328
Weiler HA, et al. Depleted Iron Stores and Iron Deficiency Anemia Associated With Reduced Ferritin and Hepcidin and Elevated Soluble Transferrin Receptors in a Multiethnic Group of Preschool-age Children. Appl Physiol Nutr Metab. 2015;40(9):887-94. PubMed PMID: 26288393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depleted iron stores and iron deficiency anemia associated with reduced ferritin and hepcidin and elevated soluble transferrin receptors in a multiethnic group of preschool-age children. AU - Weiler,Hope A, AU - Jean-Philippe,Sonia, AU - Cohen,Tamara R, AU - Vanstone,Catherine A, AU - Agellon,Sherry, Y1 - 2015/05/04/ PY - 2015/8/20/entrez PY - 2015/8/20/pubmed PY - 2016/6/9/medline KW - Canadian KW - Canadiens KW - apports alimentaires KW - children KW - dietary intakes KW - enfants KW - fer KW - ferritin KW - ferritine KW - hepcidin KW - hepcidine KW - inflammatory markers KW - iron KW - marqueurs inflammatoires KW - multiethnic KW - multiethnique KW - supplements KW - suppléments SP - 887 EP - 94 JF - Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme JO - Appl Physiol Nutr Metab VL - 40 IS - 9 N2 - Iron deficiency anemia is prevalent in subgroups of the Canadian population. The objective of this study was to examine iron status and anemia in preschool-age children. Healthy children (n = 430, 2-5 years old, Montreal, Quebec, Canada) were sampled from randomly selected daycares. Anthropometry, demographics, and diet were assessed. Biochemistry included hemoglobin, ferritin, soluble transferrin receptors (sTfR), ferritin index, markers of inflammation (C-reactive protein, interleukin 6 (IL-6), and tumour necrosis factor alpha (TNFα)), and hepcidin. Iron deficiency and anemia cutoffs conformed to the World Health Organization criteria. Differences among categories were tested using mixed-model ANOVA or χ(2) tests. Children were 3.8 ± 1.0 years of age, with a body mass index z score of 0.48 ± 0.97, and 51% were white. Adjusted intakes of iron indicated <1% were at risk for deficiency. Hemoglobin was higher in white children, whereas ferritin was higher with greater age and female sex. Inflammatory markers and hepcidin did not vary with any demographic variable. The prevalence of iron deficiency was 16.5% (95% confidence interval (CI), 13.0-20.0). Three percent (95% CI, 1.4-4.6) of children had iron deficiency anemia and 12.8% (95% CI, 9.6-16.0) had unexplained anemia. Children with iron deficiency, with and without anemia, had lower plasma ferritin and hepcidin but higher sTfR, ferritin index, and IL-6, whereas those with unexplained anemia had elevated TNFα. We conclude that iron deficiency anemia is not very common in young children in Montreal. While iron deficiency without anemia is more common than iron deficiency with anemia, the correspondingly reduced circulating hepcidin would have enabled heightened absorption of dietary iron in support of erythropoiesis. SN - 1715-5320 UR - https://www.unboundmedicine.com/medline/citation/26288393/Depleted_iron_stores_and_iron_deficiency_anemia_associated_with_reduced_ferritin_and_hepcidin_and_elevated_soluble_transferrin_receptors_in_a_multiethnic_group_of_preschool_age_children_ L2 - https://cdnsciencepub.com/doi/10.1139/apnm-2014-0328?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -