铁缺乏对大鼠维生素A代谢的影响

目的研究铁缺乏对大鼠维生素A(VA)代谢的影响。方法44只雄性SD大鼠按体重随机分为4组,每组11只,正常对照组(Ⅰ组),Fe完全缺乏VA正常组(Ⅱ组),Fe轻度缺乏VA正常组(Ⅲ组),Fe和VA轻度缺乏组(IV组)。喂饲10周后处死,测定血清视黄醇、血清视黄醇结合蛋白(RBP)、血红蛋白(Hb)、血清铁、血清铁饱和度、肝脏VA含量,肝脏视黄基酯含量,并用逆转录-聚合酶链反应(RT-PCR)法检测各组大鼠肝脏RBP mRNA的表达。结果与对照组相比,铁缺乏可以使血清视黄醇、肝脏VA含量显著降低(P<0.05),使肝脏视黄基酯与肝脏VA的摩尔比值升高,使RBP含量有降低趋势,铁缺乏时肝脏RBP mRNA表达显著降低。结论铁缺乏可能通过影响维生素A吸收、储存、转运来影响体内维生素A的营养状况。     

铜缺乏对大鼠铁代谢影响的研究

目的研究铜缺乏对大鼠铁营养状况和肝脏转铁蛋白受体mRNA及铁调素mRNA的影响。方法 48只雄性SD大鼠按体重随机分为4组,每组12只,正常对照组(Ⅰ组),铁正常铜完全缺乏组(Ⅱ组),铁正常铜轻度缺乏组(Ⅲ组),铁/铜轻度缺乏组(IV组)。喂饲8周后处死,取大鼠肝脏、脾脏和血清,测定血红蛋白,血清铜、血清铁、血清转铁蛋白受体、血清铁蛋白、肝脏铁和铜含量、脾脏铁和铜含量,并用逆转录-聚合酶链反应(RT-PCR)法检测各组大鼠肝脏转铁蛋白受体(TfR)和铁调素mRNA的表达水平。结果与正常对照组相比,铜缺乏使血清铁、血清铁蛋白含量显著降低(P0.05),血清转铁蛋白受体水平、肝脾脏铁含量显著升高(P0.05),铜缺乏时肝脏TfRmRNA表达增强,而肝脏铁调素mRNA表达下降。结论铜缺乏可能通过影响铁吸收、储存、转运来影响体内铁的营养状况。铜缺乏对大鼠铁调素mRNA的表达与IRE-IRP途径调节的转铁蛋白受体mRNA的表达均产生影响。     

Iron deficiency in young rats alters the distribution of vitamin A between plasma and liver and between hepatic retinol and retinyl esters.

We assessed whether iron deficiency alters the concentration of vitamin A (VA) in plasma or liver and the chemical distribution between hepatic unesterified and esterified retinol. Weanling male Sprague-Dawley rats (n = 10/group) were allocated to one of four diet groups: low iron (ID3, 3 mg of elemental iron/kg diet), marginal iron (ID15, 15 mg/kg), control diet food-restricted to the ID3 group (FR, 35 mg/kg), and control diet ad libitum consumption (AD, 35 mg/kg). Both ID3 and FR rats grew less than AD and ID15 rats. At the end of 5.5 wk, plasma retinol concentrations of the ID3 and FR rats were reduced >40% compared to ID15 and AD rats [Kruskal-Wallis test (K-W), P < 0.0042)]. Paradoxically, the hepatic VA concentration was greater in FR rats, with accumulation of more retinyl esters and retinol compared to the other dietary groups. Concentrations of hepatic retinyl esters and retinol did not differ among the other groups, but the molar ratio of hepatic retinyl esters to retinol was greater in ID3 rats (20.1 +/- 1.4) compared to ID15 rats (13.8 +/- 1.6, P = 0.02), AD (11.3 +/- 2.1, P < 0.0042) and FR (9.5 +/- 1.1, P < 0.0042). Iron deficiency may cause changes in liver and plasma VA that are refractory to VA intake, and thus a benefit may be derived from combining iron and VA supplements during nutrition interventions.     

儿童维生素A与铁营养状况的相关性研究

目的了解中国儿童维生素A(VA)的营养状况、VA缺乏率、VA边缘缺乏率,研究血浆VA与铁营养状况的相关性。方法由2002年“中国居民营养与健康状况调查”的大样本中随机抽取380名3~12岁儿童,检测血浆VA含量,同时测定血红蛋白(Hb)、总铁结合力(TIBC)、铁蛋白(SF)及转铁蛋白受体(sTfR)。了解儿童VA营养状况,计算VA缺乏率、VA边缘缺乏率,研究VA与铁营养状况评价指标的相关性。结果受试儿童VA平均含量为(1·03±0·24)μmol/L,其中8·4%儿童VA缺乏,44·7%儿童VA边缘缺乏。血浆VA与Hb呈正相关(r=0·16986,P<0·01),与sTfR呈负相关(r=-0·12863,P<0·05),与TIBC、SF不相关。结论铁缺乏伴随VA边缘缺乏在中国儿童中普遍存在,VA与铁营养状况存在相关性。     

Low vitamin a intake affects milk iron level and iron transporters in rat mammary gland and liver

Marginal vitamin A deficiency is common and can result in a secondary iron (Fe) deficiency. A positive correlation between maternal Fe status and milk Fe was observed in lactating women supplemented with both vitamin A and Fe but not with Fe alone, suggesting effects of vitamin A on mammary gland Fe transport. We hypothesized that low vitamin A intake during lactation elicits differential effects on mammary gland and liver Fe transport and storage proteins, thus affecting milk Fe concentration but not maternal Fe status. We fed rats a control (CON, 4 RE/g) or a marginal vitamin A diet (AD, 0.4 RE/g) through midlactation. Effects on plasma, milk, liver and mammary gland Fe and vitamin A concentrations, and divalent metal transporter-1 (DMT1), ferroportin (FPN), ferritin (Ft), and transferrin receptor (TfR) expression were determined. Dams fed AD were not vitamin A or Fe deficient. Milk and liver vitamin A and Fe and mammary gland Fe concentrations were lower in rats fed AD compared with rats fed CON. Liver TfR expression was higher, whereas mammary gland TfR expression was lower in rats fed AD compared with rats fed CON. Liver Ft was unaffected, whereas mammary gland Ft was lower in rats fed AD compared with rats fed CON. Liver and mammary gland DMT1 and FPN protein levels were lower in rats fed AD compared with rats fed CON. Our results indicate that the mammary gland and liver respond differently to marginal vitamin A intake during lactation and that milk Fe is significantly decreased due to effects on mammary gland Fe transporters, putting the nursing offspring at risk for Fe deficiency.     

Dietary iron supplements and Moringa oleifera leaves influence the liver hepcidin messenger RNA expression and biochemical indices of iron status in rats

In this study, the effects of iron depletion and repletion on biochemical and molecular indices of iron status were investigated in growing male Wistar rats. We hypothesized that iron from Moringa leaves could overcome the effects of iron deficiency and modulate the expression of iron-responsive genes better than conventional iron supplements. Iron deficiency was induced by feeding rats an iron-deficient diet for 10 weeks, whereas control rats were maintained on an iron-sufficient diet (35.0-mg Fe/kg diet). After the depletion period, animals were repleted with different source of iron, in combination with ascorbic acid. Iron deficiency caused a significant (P < .05) decrease in serum iron and ferritin levels by 57% and 40%, respectively, as compared with nondepleted control animals. Significant changes in the expression (0.5- to100-fold) of liver hepcidin (HAMP), transferrin, transferrin receptor-2, hemochromatosis type 2, ferroportin 1, ceruloplasmin, and ferritin-H were recorded in iron-depleted and iron-repleted rats, as compared with nondepleted rats (P < .05). Dietary iron from Moringa leaf was found to be superior compared with ferric citrate in overcoming the effects of iron deficiency in rats. These results suggest that changes in the relative expression of liver hepcidin messenger RNA can be used as a sensitive molecular marker for iron deficiency.     

不同锌营养状况对大鼠铁代谢的影响

目的研究不同锌营养状况对大鼠铁代谢和肝脏铁调节蛋白(IRP)mRNA、铁蛋白(Fn)mRNA及转铁蛋白受体(TfR)mRNA的影响。方法 40只雄性SD大鼠按体重随机分为4组,每组10只,铁和锌正常对照组(ZA组),铁正常锌缺乏组(ZD组),铁和锌正常配饲组(PF组),铁正常锌过量组(ZE组)。喂饲8周后麻醉处死,取大鼠肝脏、脾脏和血清,测定血红蛋白,血清锌、血清铁、血清转铁蛋白受体、血清铁蛋白、肝脏铁和锌含量、脾脏铁和锌含量,并用逆转录-聚合酶链反应(RT-PCR)法检测各组大鼠IRP2 mRNA和肝脏TfR mRNA以及Fn mRNA的表达水平。结果与对照组相比,锌过量使肝脏和脾脏铁含量、血清铁水平显著降低(P<0.05);锌缺乏使肝脏铁含量、血清转铁蛋白受体水平显著增高(P<0.05),同时,血清铁水平显著降低(P<0.05);锌缺乏时肝脏IRP mRNA及TfR mRNA表达显著增强。结论锌缺乏可能通过影响铁吸收、储存、转运来影响体内铁的营养状况。锌缺乏通过改变IRP2表达、IRP-RNA结合活性,在转录后水平改变TfR mRNA和FnmRNA表达,影响铁稳态。     

Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A-fortified rice in iron-deficient, pregnant, nightblind Nepali women

BACKGROUND: Nightblindness affects 16-52% of pregnant women in areas of Nepal and in some cases persists after vitamin A treatment. Iron and riboflavin affect vitamin A utilization and photoreceptor function, respectively, and pilot data in the study population showed a high prevalence of iron and riboflavin deficiencies. OBJECTIVE: The objective was to assess the effect of supplemental iron and riboflavin on pupillary threshold (PT) and plasma retinol in nightblind, pregnant Nepali women given vitamin A-fortified rice. DESIGN: Nightblind pregnant women were randomly assigned to receive, 6 d/wk under supervision for 6 wk, a vitamin A-fortified rice curry dish providing 850 microg retinal activity equivalents/d with either a 30-mg Fe and 6-mg riboflavin (FeR + VA) capsule or a placebo control (VA only) capsule. Hemoglobin, erythrocyte riboflavin, and plasma ferritin and retinol were measured before and after the intervention. Dark adaptation was assessed by PT score. RESULTS: Women who were iron deficient at baseline (n=38) had significantly greater improvement in PT score with iron and riboflavin supplementation than without (P=0.05). Iron and riboflavin supplements significantly reduced the prevalences of riboflavin deficiency (from 60% to 6%; P<0.0001), iron deficiency anemia (from 35% to 15%; P<0.007), and abnormal PT (from 87% to 30%; P<0.05) from baseline. Mean increases in erythrocyte riboflavin (P<0.0001) and plasma ferritin (P=0.01) were greater in the FeR + VA group than in the VA only group. CONCLUSIONS: Iron deficiency may limit the efficacy of vitamin A to normalize dark adaptation in pregnant Nepali women. Further studies are needed to assess the effect of simultaneous delivery of iron and vitamin A for the treatment of nightblindness.     

铜缺乏对大鼠铁代谢的影响

目的研究铜缺乏对大鼠肝脏铁调节蛋白2(IRP2)、转铁蛋白受体(TfR)及铁蛋白(Fn)mRNA的影响。方法 40只雄性SD大鼠按体重随机分为4组,每组10只,对照组(Ⅰ组),铜完全缺乏组(Ⅱ组),铜边缘缺乏组(Ⅲ组),铁及铜边缘缺乏组(IV组)。喂养8周后处死,取大鼠组织和血清,进行相关指标和基因表达检测。结果与对照组比较,铜缺乏使大鼠血清铁和血清铁蛋白含量显著降低(P<0.05),血清转铁蛋白受体水平明显升高,铜缺乏时大鼠肝脏IRP2、TFR mRNA表达水平明显升高,Fn mRNA明显降低(P<0.05)。结论铜缺乏通过影响铁吸收、储存、转运而影响大鼠体内铁的营养状况。铜缺乏影响大鼠IRP2 mRNA表达与IRE-IRP结合活性,在转录后水平改变TfR和Fn mRNA的表达,影响机体的铁稳态。     

Prevalence of iron deficiency with and without anemia in recreationally active men and women

The objective of this study was to determine the prevalence of iron deficiency with and without anemia in a convenience sample of trained male and female adults. One hundred twenty-one adults (72 female, 49 male) involved in aerobic training (11.2+/-6.3 hr/wk for >/=6 consecutive months), ages 18 to 41 years old, participated in an iron status screening. The concentrations of hemoglobin (Hb), ferritin, and transferrin receptor were measured in serum to determine the prevalence of iron deficiency with and without anemia. Eight individuals (seven female, one male) had iron deficiency with anemia (serum ferritin <16 microg/L; Hb<120 g/L female, <136 g/L male). Iron deficiency without anemia (serum ferritin /=4.5) found 36% of female and 6% of male subjects to be iron deficient without anemia. Recreational athletes should be screened for iron deficiency without anemia using serum ferritin, serum transferrin receptor, and Hb.     

Redistribution of vitamin A after iron supplementation in Indonesian infants

BACKGROUND: Deficiencies of iron and vitamin A are prevalent worldwide. Single-micronutrient supplementation is widely used to combat these deficiencies. However, micronutrient deficiencies often occur concurrently, and there are many interactions between micronutrients. OBJECTIVE: This study investigated interactions among 3 important micronutrients--iron, vitamin A, and zinc--when they are given as supplements. DESIGN: In a randomized, double-blind, placebo-controlled supplementation trial, 387 Indonesian infants aged 4 mo were supplemented 5 d/wk for 6 mo with 10 mg Fe, 10 mg Zn, 2.4 mg beta-carotene, 10 mg each of Fe and Zn, 10 mg Zn + 2.4 mg beta-carotene, or placebo. Complete data on micronutrient status, including hemoglobin, ferritin, retinol, zinc, and the modified relative dose response (a measure of liver retinol stores), were available from 256 infants at the end of the study. RESULTS: Iron-supplemented infants had significantly lower plasma retinol concentrations and a significantly higher prevalence of vitamin A deficiency, as defined by a plasma retinol concentration <0.70 micromol/L, than did the non-supplemented infants. In contrast, the modified relative dose response of the iron-supplemented infants indicated greater liver stores of vitamin A. Iron supplementation improved iron status, and zinc supplementation improved zinc status, but beta-carotene supplementation did not significantly improve vitamin A status. CONCLUSIONS: In this study, iron supplementation in infants with marginal vitamin A status led to lower plasma vitamin A concentrations and simultaneously to greater vitamin A liver stores. This implies a redistribution of retinol after iron supplementation, which might induce vitamin A deficiency. Therefore, iron supplementation in infants should be accompanied by measures to improve vitamin A status.     

Diet-induced obese rats have higher iron requirements and are more vulnerable to iron deficiency

Purpose

Since obesity is associated with poorer iron status, the effects of diet-induced obesity on iron status and iron-regulatory pathways were examined.

Methods

Weanling male diet-induced obese sensitive (n = 12/diet group) and resistant (n = 12/diet group) rats were fed one of four high-fat, high-energy diets supplemented with 5 (5Fe, low), 15 (15Fe, marginal), 35 (35Fe, normal) or 70 (70Fe, high) mg iron/kg diet for 12 weeks. At the end of the study, rats in each diet group were categorised as obese (>19 %) or lean (<17 %) based on percentage body fat.

Results

Obese rats gained more weight, had larger total lean mass, consumed more food and showed greater feed efficiency compared with lean rats. Obese rats fed the 5Fe and 15Fe diets had poorer iron status than lean rats fed the same diet. Obese 5Fe rats had lower serum iron and more severe iron-deficiency anaemia. Obese 15Fe rats had lower mean corpuscular haemoglobin and liver iron concentrations. Hepcidin mRNA expression in liver and adipose tissue was similar for obese and lean rats. Iron concentration and content of the iron transporters divalent metal transporter 1 and ferroportin 1 in duodenal mucosa were also similar.

Conclusions

Obese rats that were larger, regardless of adiposity, had higher iron requirements compared with lean rats that appeared independent of hepcidin, inflammation and intestinal iron absorption. Higher iron requirements may have resulted from larger accretion of body mass and blood volume. Greater food consumption did not compensate for the higher iron needs, indicating increased susceptibility to iron deficiency.     

Non-anemic iron depletion,oral iron supplementation and indices of copper status in college-aged females

OBJECTIVES: Indices of copper status, specifically serum copper and ceruloplasmin concentrations and erythrocyte superoxide dismutase activity, and iron status, including serum ferritin, transferrin receptors, hemoglobin and hematocrit, were studied in 27 college-aged females with adequate iron versus low iron stores. METHODS: Serum copper and ceruloplasmin concentrations, erythrocyte superoxide dismutase activity, serum ferritin, transferrin receptors, hemoglobin and hematocrit were studied in 15 females with non-anemic iron depletion before and after five weeks of iron supplementation and in 12 healthy iron-adequate females aged 19 to 28 years. RESULTS: Mean hemoglobin, hematocrit and ferritin concentrations of the control group (144 +/- 11 g/L, 43 +/- 3% and 38 +/- 15 micro g/L, respectively) were significantly higher than those of the iron depleted group prior to supplementation (134 +/- 9 g/L, 39 +/- 2% and 11 +/- 6 micro g/L, respectively). The serum transferrin receptor to serum ferritin ratio was significantly greater for the iron depleted group prior to supplementation (890 +/- 753) versus the control group (151 +/- 61). Mean serum copper and ceruloplasmin concentrations and erythrocyte superoxide dismutase activity of the iron-adequate control group (20.0 +/- 5.7 micro mol/L, 463 +/- 142 mg/L and 527 +/- 124 U/mL, respectively) were significantly higher than those of the iron depleted group (12.4 +/- 3.8 micro mol/L, 350 +/- 108 mg/L and 353 +/- 186 U/mL, respectively) prior to supplementation. Following iron supplementation, hematocrit and ferritin concentrations of the iron depleted group significantly increased to 42 +/- 3% and 26 +/- 8 micro g/L, respectively. Mean serum transferrin receptor concentrations and the serum transferrin receptor to ferritin ratios significantly decreased in the iron depleted group following supplementation (6.1 +/- 1.6 mg/L to 4.6 +/- 1.5 mg/L and 890 +/- 753 to 198 +/- 114, respectively). Iron supplementation also significantly increased the mean serum copper concentration to 14.2 +/- 5.4 micro mol/L and, in subjects with serum ferritin concentrations 相似文献   

维生素A缺乏对大鼠十二指肠DMT1,FPN1 mRNA表达的影响

目的研究维生素A(VA)缺乏对大鼠十二指肠二价金属离子转运蛋白(DMT1),膜铁转运蛋白(FPN1)mRNA表达的影响,为进一步研究维生素A缺乏影响铁代谢的相关机制提供基础。方法雄性SD大鼠52只,按体重随机分为4组,每组13只,Ⅰ组VA正常对照组,Ⅱ组VA完全缺乏组,Ⅲ组VA轻度缺乏组,IV组VA和铁轻度缺乏组。实验动物喂饲8w后处死,测定血清VA、血红蛋白、血清铁、血清铁蛋白,并用逆转录—聚合酶链反应(RT—PCR)法检测各组大鼠十二指肠二价金属离子转运蛋白(DMT1),膜铁转运蛋白(FPN1)mRNA表达的情况。结果 VA缺乏可使血清铁、血清铁蛋白含量显著降低。VA缺乏时十二指肠二价金属离子转运蛋白(DMT1)、膜铁转运蛋白(FPN1)mRNA的表达显著增强。结论 VA缺乏可能通过多种途径使大鼠十二指肠DMT1、FPN1 mRNA的表达增强,需要进一步研究证实。     

Prevalence of iron deficiency and iron deficiency anemia among three populations of female military personnel in the US Army

BACKGROUND: Iron deficiency is the most prevalent micronutrient deficiency disease in the world and occurs in young women in the United States. Female military personnel represent a unique population faced with intense physical and cognitive demands. OBJECTIVE: The objective of this study was to determine the prevalence of iron deficiency and iron deficiency anemia among three populations of female military personnel in the US Army. METHODS: Iron status was assessed in 1216 volunteers. Volunteers were recruited from three groups: immediately following initial entry to the Army (IET), immediately following basic combat training (AIT), or following at least six months of permanent assignment (PP). Iron deficiency was determined using a three variable model, including cut-off values for serum ferritin, transferrin saturation, and red cell distribution width (RDW). Iron deficiency anemia was categorized by iron deficiency and a hemoglobin (Hgb) value of <12 g/dL. RESULTS: The prevalence of iron deficiency was greater in women in the AIT group (32.8%) than in the IET and PP groups (13.4 and 9.6%, respectively). The prevalence of iron deficiency anemia was greater in the AIT group (20.9%) than in the IET and PP groups (5.8 and 4.8%, respectively). Furthermore, the prevalence of iron deficiency anemia was greater in Hispanic (21.9%) and African-American military personnel (22.9%) than in Caucasian military personnel (10.5%). CONCLUSIONS: These data indicate that female military personnel experience diminished iron status following training, and that iron nutriture is an important issue facing females in the military.     

The diagnostic criteria for iron deficiency in infants should be reevaluated

Diagnostic criteria for iron deficiency (ID) and iron deficiency anemia (IDA) in infants are poorly defined. Our aim was to establish appropriate cut-off values for hemoglobin (Hb), plasma ferritin, erythrocyte mean cell volume (MCV), zinc protoporphyrin (ZPP) and soluble transferrin receptors (TfR) in infancy. Exclusively breast-fed infants (n = 263) in Honduras and Sweden were randomly assigned to receive iron supplementation or placebo, and blood samples were obtained at 4, 6 and 9 mo of age. Reference ranges were determined using three different approaches for defining iron-replete infants. The usefulness of several variables for predicting the Hb response to iron was evaluated. We found the following 2 SD cut-off values in iron-replete infants: Hb <105 g/L at 4-6 mo and <100 g/L at 9 mo; ZPP >75 micro mol/mol heme at 4-6 mo and >90 micro mol/mol heme at 9 mo; ferritin <20 micro g/L at 4 mo, <9 micro g/L at 6 mo and <5 micro g/L at 9 mo; and TfR >11 mg/L at 4-9 mo. The Hb response to iron was not a useful definition of IDA at 4 mo of age. Hb, MCV and ZPP at 6 mo as well as growth variables predicted the Hb response at 6-9 mo, but ferritin and TfR at 6 mo did not. We conclude that there is need for a reevaluation of the definitions of ID and IDA in infants.     

A traditional beverage prevents iron deficiency in African women of child bearing age.

OBJECTIVE: To determine if a traditional item in the diet might be useful in preventing iron deficiency in African women of child-bearing age. DESIGN: In a prospective study, the iron status of women who did and did not drink traditional beer high in iron and folic acid, was compared. Iron status was determined by a combination of haemoglobin, serum ferritin and transferrin saturation. SETTING: The study was conducted amongst rural villagers in the Murehwa and Zaka districts of Zimbabwe and in Mpumalanga Province, South Africa. SUBJECTS: 112 women aged between 12 and 50 y from a population of 425 rural people participating in on-going family genetic studies. RESULTS: Women who consumed traditional beer had significantly higher serum ferritin concentrations and transferrin saturations compared to non-drinkers (P = 0.0001 and 0.03 respectively). Iron deficiency anaemia was not present in drinkers but the prevalence in non-drinkers was 13%. Forty seven percent of the non-drinkers and only 14% of the drinkers had evidence of iron deficiency (P = 0.002). Six (21%) of the drinkers and none of the non-drinkers had evidence of iron overload (transferrin saturation > 55% and serum ferritin > 400 ug/l). CONCLUSION: We conclude that the consumption of traditional beer, rich in iron, protects women against iron deficiency. While the use of an alcoholic beverage is not ideal, our findings suggest that indigenous cultural practices might be successfully employed or adapted for promoting iron nutrition.     

Hookworms, malaria and vitamin A deficiency contribute to anemia and iron deficiency among pregnant women in the plains of Nepal

Anemia and iron deficiency during pregnancy are prevalent in developing countries, but their causes are not always known. We assessed the prevalence and severity of anemia and iron deficiency and their association with helminths, malaria and vitamin A deficiency in a community-based sample of 336 pregnant women in the plains of Nepal. Hemoglobin, erythrocyte protoporphyrin (EP) and serum ferritin were assessed in venous blood samples. Overall, 72.6% of women were anemic (hemoglobin < 110 g/L), 19.9% had moderate to severe anemia (hemoglobin < 90 g/L) and 80.6% had iron deficiency (EP > 70 micromol/mol heme or serum ferritin < 10 microg/L). Eighty-eight percent of cases of anemia were associated with iron deficiency. More than half of the women (54.2%) had a low serum retinol concentration (<1.05 micromol/L), 74.2% were infected with hookworms and 19.8% had Plasmodium vivax malaria parasitemia. Hemoglobin, EP and serum ferritin concentrations were significantly worse and the prevalence of anemia, elevated EP and low serum ferritin was increased with increasing intensity of hookworm infection. Hookworm infection intensity was the strongest predictor of iron status, especially of depleted iron stores. Low serum retinol was most strongly associated with mild anemia, whereas P. vivax malaria and hookworm infection intensity were stronger predictors of moderate to severe anemia. These findings reinforce the need for programs to consider reducing the prevalence of hookworm, malaria infection and vitamin A deficiency where indicated, in addition to providing iron supplements to effectively control anemia.     

Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh

OBJECTIVE: To investigate the prevalence of anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh, and to identify various factors associated with anaemia in this population. DESIGN: A cross-sectional design. SETTING: Girls' high schools in five sub-districts of Dhaka. SUBJECTS: Adolescent girls (n=548) aged 11-16 y from nine schools in Dhaka district participated in the study. Socio-economic, anthropometric and dietary information were collected. Blood haemoglobin (Hb), serum iron, total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF) and serum retinol (vitamin A) were determined. RESULTS: The prevalence of anaemia (Hb<120 g/l) among the participants was 27%. Seventeen percent had depleted iron stores (SF<12 microg/l). Of all anaemic girls, 32% had iron deficiency anaemia (Hb<120 g/l and SF<12 microg/l). When the girls were classified by serum vitamin A, the third with the lowest serum retinol levels had significantly lower Hb and SF levels. Significant positive correlations were observed between Hb and serum iron, TS, SF and retinol, while there was a negative correlation with serum TIBC. Occupancy, frequency of consumption of large fish, serum iron, TIBC, TS, SF and serum vitamin A were strongly related to Hb by multiple regression analysis. For 1 microg/l change in SF concentration, there was a 0.046 g/l change in Hb, when adjusted for all other factors. CONCLUSION: Anaemia among these adolescent schoolgirls in peri-urban Bangladesh cannot be explained by iron deficiency alone, and other causes may also exist in this population.