Serum retinol levels are positively correlated with hemoglobin concentrations,independent of iron homeostasis: a population-based study

Micronutrient interactions give rise to complex issues that have an impact on preventive strategies when multiple micronutrient deficiencies coexist. The aim of this population-based study was to determine the prevalence of vitamins A and E and iron deficiencies among women 15 to 49 years of age in the northern Persian Gulf region. We hypothesized that serum retinol levels may show correlations with hemoglobin (Hb) concentrations, independent of iron status. A total of 1242 nonpregnant women of reproductive age were selected via a multistage stratified random cluster sampling technique. Serum ferritin and soluble transferrin receptor levels were measured using enzyme immunoassay techniques. Serum retinol (vitamin A) and α-tocopherol (vitamin E) were determined for 727 women by high-performance liquid chromatography. The prevalence of anemia (Hb <12 g/dL), iron deficiency (serum ferritin <15 μg/L), and iron deficiency anemia was 8.7%, 25.4%, and 4.6%, respectively. Vitamin A (<0.7 μmol/L) and vitamin E (<11.6 μmol/L) deficiencies were found in 1.2% and 5.9% of the studied population, respectively. Multiple regression analysis revealed that serum retinol levels exhibit a significant association with Hb concentrations after controlling for serum ferritin levels, anemia associated with chronic disease, and risk factors for anemia. Therefore, most nonpregnant women of reproductive age in the northern Persian Gulf were found to have adequate serum vitamin A and E levels. However, the status of anemia and iron deficiency anemia could be considered a mild public health problem in this region. On the basis of multivariate analyses, we conclude that low serum retinol levels may contribute to anemia, independent of iron homeostasis.     

Strong negative association between intake of tofu and anemia among Chinese adults in Jiangsu, China

BACKGROUND: Anemia is prevalent in China. Tofu made from soybean is a popular food. Soybean is shown to have an affect on iron status. No study has examined the relation between tofu and iron status. OBJECTIVE: To investigate the association between tofu intake and anemia among Chinese adults. DESIGN: A cross-sectional household survey of 2,849 men and women aged 20 years and older (mean age 47.0+/-14.5 years), from a nationally representative random sample in Jiangsu province undertaken in 2002 (response rate 89%). Tofu intake was assessed by food frequency questionnaire. Nutrient intake was measured by 3-day weighed food records. Serum ferritin and hemoglobin were measured. RESULTS: The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin values increased by quartiles of tofu intake (men: 14.1, 14.0, 14.5, and 14.8 mg/dL [141, 140, 145, and 148 g/L]; women: 12.4, 12.5, 12.6 and 13.3 g/dL [124, 125,126, and 133 g/L]), and the prevalence of anemia decreased concomitantly. Comparing first and fourth quartiles of tofu intake, the prevalence of anemia was 23.9% vs 10.7% in men, and 38.1% vs 16.8% in women. Tofu intake was inversely associated with serum ferritin levels in women. In multivariate analyses, the odds ratio of anemia for men in fourth compared to first quartile of tofu intake was 0.30 (95% confidence interval 0.17 to 0.50), and the corresponding odds ratio for women was 0.31 (95% confidence interval 0.20 to 0.47). The association between tofu intake and anemia was independent of iron intake. CONCLUSIONS: Tofu intake was associated with lower risk of anemia among Chinese adults in both sexes.     

Iron stores and cardiovascular disease risk factors in women of reproductive age in the United States

BACKGROUND: The increasing proportion of iron-replete individuals in industrialized countries and the possible increased risk of cardiovascular disease (CVD) among men with high iron stores raise concerns regarding improved iron status in women of reproductive age. OBJECTIVE: This study examined the association between iron stores and a set of established CVD risk factors among nonpregnant women aged 20-49 y. DESIGN: Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to examine the relation between race-ethnicity-specific quartiles of serum ferritin (SF) and a set of CVD risk factors [body mass index (BMI), total cholesterol, triacylglycerol, HDL cholesterol, plasma glucose, and blood pressure (BP)]. Women with a history of CVD or liver disease were excluded. We controlled for age, session of measurement, prevalent infection, recent blood donation, and treatment with iron for anemia. RESULTS: Mean SF values were 53.22 +/- 2.08 micro g/L (n = 1178), 58.93 +/- 2.39 micro g/L (n = 1093), and 43.33 +/- 1.39 micro g/L (n = 1075) among non-Hispanic white, non-Hispanic black, and Mexican American women, respectively. Iron stores were positively associated with CVD risk factors only among non-Hispanic black and Mexican American women after adjustment for confounding variables. The strongest associations were seen among Mexican American women: compared with the middle 2 quartiles, the lowest and highest quartiles of SF had lower and higher values, respectively, for BMI, total cholesterol, triacylglycerol, glucose, and diastolic BP. CONCLUSION: These findings suggest that CVD risk factors, especially those related to glucose and lipid metabolism, are positively associated with iron status in women.     

Lead, hemoglobin, zinc protoporphyrin and ferritin concentrations in children

OBJECTIVE: To assess the relationship of blood lead and hemoglobin, zinc protoporphyrin, and ferritin concentrations in children. METHODS: A cross-sectional study was carried out in 136 anemic and non-anemic children from two rural villages near a lead smelter in Adrianópolis, Southern Brazil, from July to September 2001. Hemoglobin electrophoresis was performed to exclude children with hemoglobin variants and thalassemia syndromes associated with anemia. Lead was determined by atomic absorption spectrophotometry; hemoglobin by automated cell counting; zinc protoporphyrin by hematofluorometry; ferritin by chemiluminescence. Student's t-test, Mann-Whitney test, and the c(2) test were used to assess the significance of the differences between the variables investigated in anemic and non-anemic children. Stepwise multivariate linear regression analysis was performed using two models for anemic and non-anemic children respectively. RESULTS: Lead was negatively associated to hemoglobin (p<0.017) in the first model, and in the second model lead was positively associated to zinc protoporphyrin (p<0.004) after controlling for ferritin, age, sex, and per capita income. There was an inverse association between hemoglobin and blood lead in anemic children. It was not possible to confirm if anemic children had iron deficiency anemia or subclinical infection, considering that the majority (90.4%) had normal ferritin. CONCLUSIONS: The study detected a relationship between anemia and elevated blood lead concentrations. Further epidemiological studies are necessary to investigate the impact of iron nutritional interventions as an attempt to decrease blood lead in children.     

Maternal blood lead concentration,diet during pregnancy,and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population

To determine the influences of maternal diet and nutrition during pregnancy on the blood lead level of neonates, we conducted a study of mother-infant pairs from lower socioeconomic circumstances living in Albany County, New York. Maternal blood lead (MBPb), anthropometry, and diet were assessed in each trimester. Neonates' blood lead (NBPb) levels were low (geometric mean = 1.58 micro g/dL), and none had elevated blood lead. More than 50% of the mothers had intakes below the recommended dietary allowances for zinc, calcium, iron, vitamin D, and kilocalories. As expected, MBPb was strongly and positively related to NBPb. Among the anthropometric measures of maternal nutritional status, variables measuring gain in weight and arm circumference were negatively related to NBPb. In multivariable models reflecting different analytic strageties and including MBPb, anthropometry, and sociodemographic characteristics, dietary intakes of iron and vitamin D were negatively related to NBPb. The effect of zinc varied substantially depending on model covariates. Effects of dietary constituents are difficult to distinguish, given the intercorrelated nature of nutrients in the diet. Nevertheless, the influences of maternal anthropometric variables, iron, and vitamin D on neonatal lead levels are clear in our analyses.     

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   

Iron status in association with cardiovascular disease risk in 3 controlled feeding studies

BACKGROUND: The role of body iron stores in free radical-induced peroxidation and cardiovascular disease risk has been debated, but controlled feeding studies using measurements of non-transferrin-bound iron (NTBI) and LDL oxidation have not been conducted. OBJECTIVE: We tested the hypothesis that NTBI and other measures of iron status do not affect oxidative susceptibility in healthy subjects with normal iron status. DESIGN: Plasma samples were analyzed from 77 healthy men and women aged 20-65 y who participated in 3 controlled feeding studies in which the type and amount of dietary fat were controlled. Iron status and in vitro LDL oxidation were assessed at baseline and at the end of each feeding period (4-8 wk). RESULTS: No significant relations were found between any measure of iron status (ferritin: 83 +/- 8.9 micro g/L; iron: 20.9 +/- 5.4 micro mol/L; TIBC: 74.4 +/- 11.0 micro mol/L; NTBI: 0.184 +/- 0.15 micro mol/L) and the in vitro measures of LDL oxidation (total dienes: 485 +/- 55 micro mol/mg LDL protein; lag time: 51.7 +/- 15.9 min; and rate of oxidation: 25.4 +/- 6.8 micro mol dienes.min(-1).g LDL protein(-1)). Equal-iron peanut butter-based diets were associated with higher plasma iron in men (22.4 +/- 3.8 micro mol/L) than was the olive oil diet (17.7 +/- 4.5 micro mol/L) (P = 0.02), but this slight elevation did not alter LDL oxidation. CONCLUSIONS: Diet composition may affect plasma iron in men, but LDL oxidative susceptibility is unaffected by the subtle variation in iron status. Thus, the results do not support a relation between iron status and LDL oxidative susceptibility, a possible risk factor for cardiovascular disease.     

Arsenic exposure and cognitive performance in Mexican schoolchildren

BACKGROUND: Previous studies have suggested an effect of high arsenic concentration on cognitive and neurobehavioral function in humans. OBJECTIVE: Our goal was to identify demographic and nutritional factors that are associated with As exposure and the influence of this exposure on cognitive function in school-age children. METHODS: We recruited 602 children 6-8 years of age living within 3.5 km of a metallurgic smelter complex in the city of Torreón, Mexico, to participate in a cross-sectional evaluation. Of these, 591 had complete anthropometry, iron, and zinc status by biochemical measurements in serum, blood lead concentration (PbB), and arsenic in urine (UAs), and 557 completed several cognitive performance tests. RESULTS: The mean for UAs was 58.1 +/- 33.2 microg/L; 52% of the children had UAs concentrations > 50 microg/L, and 50.7% of children had PbB > or = 10 microg/dL. UAs concentration was associated with low socioeconomic status. Nutritional status indicators were not related to UAs concentrations. Linear and logistic regressions adjusted for hemoglobin concentration, PbB, and sociodemographic confounders showed a significant inverse association between UAs and Visual-Spatial Abilities with Figure Design, the Peabody Picture Vocabulary Test, the WISC-RM Digit Span subscale, Visual Search, and Letter Sequencing Tests (p < 0.05). Boys excreted significantly more UAs (p < 0.05) and were affected on different cognitive areas than girls. CONCLUSIONS: Children living in an area contaminated with both As and lead showed that As contamination can affect children's cognitive development, independent of any effect of lead.     

Cognitive deficits associated with blood lead concentrations <10 microg/dL in US children and adolescents

OBJECTIVE: Lead is a confirmed neurotoxicant, but the lowest blood lead concentration associated with deficits in cognitive functioning and academic achievement is poorly defined. The purpose of the present study was to examine the relationship of relatively low blood lead concentrations-especially concentrations <10 micrograms per deciliter (microg/dL)--with performance on tests of cognitive functioning in a representative sample of US children and adolescents. METHODS: The authors used data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to assess the relationship between blood lead concentration and performance on tests of arithmetic skills, reading skills, nonverbal reasoning, and short-term memory among 4,853 children ages 6-16 years. RESULTS: The geometric mean blood lead concentration for children n the study sample was 1.9 microg/dL; 172 (2.1%) had blood lead concentrations > or =10 microg/dL. After adjustment for gender, race/ethnicity, poverty, region of the country, parent or caregiver's educational level, parent or caregiver's marital status parent, serum ferritin level, and serum cotinine level, the data showed an inverse relationship between blood lead concentration and scores on four measures of cognitive functioning. For every 1 microg/dL increase in blood lead concentration, there was a 0.7-point decrement in mean arithmetic scores, an approximately 1-point decrement in mean reading scores, a 0.1-point decrement in mean scores on a measure of nonverbal reasoning, and a 0.5-point decrement in mean scores on a measure of short-term memory. An inverse relationship between blood lead concentration and arithmetic and reading scores was observed for children with blood lead concentrations lower than 5.0 microg/dL. CONCLUSION: Deficits in cognitive and academic skills associated with lead exposure occur at blood lead concentrations lower than 5 microg/dL.     

Milk folate but not milk iron concentrations may be inadequate for some infants in a rural farming community in San Mateo, Capulhuac, Mexico

BACKGROUND: We were interested in identifying possible nutritional reasons for growth faltering among breastfed infants in the rural farming community of San Mateo, Capulhuac, Mexico (2800 m above sea level). OBJECTIVE: We examined the prevalence of inadequate iron and folate status among lactating Otomi women and determined to what extent their iron and folate nutriture influenced the milk concentrations of these nutrients. DESIGN: Lactating women (n = 71) provided blood and milk samples and dietary information at a mean (+/- SD) of 22 +/- 13 d postpartum. Blood indexes included hemoglobin, hematocrit, serum iron, total-iron-binding capacity, ferritin, transferrin receptor, mean cell volume, plasma folate, and erythrocyte folate. RESULTS: Approximately 62% and 58% of the women had nutritional anemia defined as a hemoglobin concentration 相似文献   

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.     

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.     

Liver and kidney function tests amongst paint factory workers in Nkpor, Nigeria

Lead, cadmium, nickel and other industrial metals used as part of paint varnishes have been reported to have adverse health implications. An evaluation study on some toxicological effects of occupational exposure to paint, among 25 occupationally exposed artisans and 25 students (control) of Ichi Technical College, Ichi Ekwusigo Local Government Area, Anambra State, Nigeria was carried out. Heavy metals were analysed by atomic absorption spectrophotometry and standard assay procedures were employed for biochemical parameters. The biochemical indices used include serum electrolytes urea, creatinine, alanine (ALT) and aspartate aminotransferases (AST), alkaline phosphatase (ALP), conjugated and total bilirubin. Others include blood lead, serum cadmium and nickel. Our results showed that occupational exposure of humans to paints increased the blood lead (39 +/- 4 microg/dL), serum cadmium (13 +/- 1 microg/dL) and nickel (63 +/- 1 microg/dL), when compared with non-paint factory workers (PFW) lead (17 +/- 4 microg/dL), serum cadmium (9 +/- microg/dL) and nickel (25 +/- 44 microg/dL), significantly at P < 0.05 lower values were observed for serum sodium (138.96 +/- 0.58 mmol/L), bicarbonate (26.88 +/- 0.39 mmol/L), urea (3.15 +/- 0.13 mmol/L) and creatinine (80.48 +/- 1.04 micromol/L) for paints factory workers when compared with non-paint factory workers, sodium (139.84 +/- 0.62 mmol/L), bicarbonate (26.20 +/- 0.22 mmol/L), urea (3.44 +/- 0.11 mmol/L) and creatinine (80.40 +/- 1.55 micromol/L); at P > 0.05. The activities of AST (10.36 +/- 0.58 micro/L), ALT(8.76 +/- 0.47 micro/L) and ALP (47.12 +/- 3.33 micro/L) in PFW were slightly elevated compared with non-PFW. Our result indicates that occupational exposure of humans to heavy metals in paints may have long term deleterious effects on liver and renal functions. In conclusion, it should be noted that occupational exposure to cadmium or lead among PFW, may compromise the liver and renal functions in man.     

Deficits in cognitive function and achievement in Mexican first-graders with low blood lead concentrations

Elevated blood lead levels in children are associated with lower scores on tests of cognitive functioning. Recent studies have reported inverse relations between lifetime exposure and intellectual functioning at blood lead concentrations below 10 microg/dL, the Centers for Disease Control and Prevention's (CDC) level of concern. We report associations between blood lead and cognitive performance for first-grade Mexican children living near a metal foundry. Using a cross-sectional design, we examined the relation between children's concurrent blood lead concentrations (mean (SD) 11.4 microg/dL (6.1)) and their performance on 14 tests of global or specific cognitive functions. The blood lead-cognition relations were modeled using both linear and nonlinear methods. After adjustment for covariates, a higher blood lead level was associated with poorer cognitive performance on several cognitive tests. Segmented linear regressions revealed significant effects of lead but only for the segments defined by a concurrent blood lead concentration below 10-14 microg/dL. One implication of these findings is that at the age of 7 years, even in the absence of information on lead exposure in infancy and early childhood, a test result with blood lead < 10 microg/dL should not be considered safe. Together with other recent findings, these results add to the empirical base of support available for evaluating the adequacy of current screening guidelines and for motivating efforts at primary prevention of childhood lead exposure.     

Iron Status and Its Determinants in a Nationally Representative Sample of Pregnant Women

Iron-deficiency anemia is associated with adverse neonatal health outcomes. Iron status and its determinants were assessed in a representative sample of Belgian pregnant women. Blood samples were collected and a questionnaire was completed face-to-face. Hemoglobin (Hb) and mean cell volume were measured using a Beckman Coulter Hematology Analyzer and serum ferritin (SF) and transferrin receptor (sTfr) concentrations by immunoassay. In total, 55 obstetric clinics and 1,311 pregnant women were included. Approximately 40% of third-trimester and 6% of first-trimester women had SF levels less than 15 μg/L. Approximately 21% of third-trimester and 4% of first-trimester women had anemia (Hb <110 g/L). Of the third-trimester women, 23% were iron-deficient nonanemic (SF <15 μg/L and Hb ≥110 g/L), 16% had iron-deficiency anemia (SF <15 μg/L and Hb <110 g/L), and approximately 7% had tissue iron deficiency (sTfr >8.5 mg/L). The median body iron stores were 8.1 mg/kg among first-trimester women, but only 3.6 mg/kg among third-trimester women. SF levels were significantly positively associated with age and education level, and were higher among nulliparous women and lower among North-African women. sTfr concentrations were significantly negatively associated with age and were lower among smokers, nulliparous women, and women who planned their pregnancy. Despite the fact that two thirds of Belgian pregnant women took iron-containing supplements, iron deficiency and iron-deficiency anemia were frequent in third-trimester women. The World Health Organization regards this as a moderate public health problem. National iron supplementation guidelines are needed in Belgium to optimize iron status during pregnancy.     

Lack of association between iron status at birth and growth of preterm infants

OBJECTIVE: To assess the association between iron status at birth and growth of preterm infants. METHODS: Ninety-five premature babies (26 to 36 weeks of gestational age) born from July 2000 to May 2001 in a public hospital in Rio de Janeiro, Southeastern Brazil, were followed up for six months, corrected by gestational age. Iron measurements at birth were available for 82 mothers and 78 children: hemoglobin, hematocrit, mean corpuscular volume and plasma iron. All children received free doses of iron supplement (2 mg/kg/day) during the follow-up period and up to two years of age. Multivariate linear regression analyses with repeated measurements were performed to assess factors associated to linear growth. RESULTS: Growth was more pronounced up to 40 weeks of gestational age, increasing about 1.0 cm/week and then slowing down to 0.75 cm/week. The multivariate analysis showed growth was positively associated with birth weight (0.4 cm/100 g; p<0.001) and negatively associated with gestational age at birth (-0.5 cm/week; p<0.001). There was no association between cord iron and mother iron measurements and growth (p>0.60 for all measures). Only two children had anemia at birth, whereas 43.9% of mothers were anemic (hemoglobin <11 g/dl). Also, there was no correlation between anemia indicators of mothers and children at birth (r<0.15; p>0.20). CONCLUSIONS: Maternal anemia was not associated with anemia in preterm infants and iron status of mothers and children at birth was not associated with short-term growth of preterm infants.     

Poor iron status is more prevalent in Hispanic than in non-Hispanic white older adults in Massachusetts

Iron status and dietary correlates of iron status have not been well described in Hispanic older adults of Caribbean origin. The aim of this study was to evaluate iron status and describe dietary components and correlates of iron status in Hispanic older adults and in a neighborhood-based comparison group of non-Hispanic white older adults. Six hundred four Hispanic and non-Hispanic white adults (59-91 y of age) from the Massachusetts Hispanic Elders Study were included in the analysis. We examined physiological markers of iron status as well as dietary factors in relation to iron status. Dietary intake was assessed by FFQ. Our results revealed that Hispanics had significantly lower geometric mean serum ferritin (74.1 microg/L vs. 100 microg/L; P<0.001), lower hemoglobin concentrations (137+/-13 vs. 140+/-12 g/L; P<0.01), higher prevalence of anemia (11.5 vs. 7.3%; P<0.05), and suboptimal hemoglobin concentrations (<125 g/L) for this age group (21.4 vs. 13.3%; P<0.05). Iron deficiency anemia was higher (7.2% vs. 2.3%; P<0.05) in Hispanic women. Hispanics had lower mean intakes of total iron, vitamin C, supplemental vitamin C, and total calcium than did non-Hispanic whites. After adjusting for age, sex, BMI, alcohol use, smoking, total energy intake, inflammation, diabetes, and liver disease, intake of heme iron from red meat was positively associated and dietary calcium was negatively associated with serum ferritin. This population of Hispanic older adults was significantly more likely than their non-Hispanic white neighbors to suffer from anemia and poor iron status, particularly among women. Cultural variation in dietary patterns may influence iron availability and body iron stores and contribute to an increased risk for iron deficiency anemia among some Hispanic older adults.     

A micronutrient-fortified beverage prevents iron deficiency,reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women

Maternal malnutrition continues to be a major contributor to adverse reproductive outcomes in developing countries, despite longstanding efforts to fortify foods or to distribute medicinal supplements to pregnant women. The objective of this study was to test the effect of a micronutrient-fortified beverage containing 11 micronutrients (iron, iodine, zinc, vitamin A, vitamin C, niacin, riboflavin, folate, vitamin B-12, vitamin B-6 and vitamin E) on the hemoglobin, iron and vitamin A status of pregnant women in Tanzania. A group of 259 pregnant women with gestational ages of 8 to 34 wk were enrolled in a randomized double-blind controlled trial in which study women received 8 wk of supplementation. Hemoglobin, ferritin and dried blood spot retinol were measured at baseline and at the end of the supplementation period. The supplement resulted in a 4.16 g/L increase in hemoglobin concentration and a 3 micro g/L increase in ferritin and reduced the risk of anemia and iron deficiency anemia by 51 and 56%, respectively. The risk of iron deficiency was reduced by 70% among those who had iron deficiency at baseline and by 92% among those who had adequate stores. The micronutrient-fortified beverage may be a useful and convenient preventative measure, one that could help improve the nutritional status of women both before and during pregnancy and thereby help avoid some of the potential maternal and fetal consequences of micronutrient deficiencies.     

血清铁、TIBC、Tf、SF在缺铁性贫血患儿中的变化及其意义

目的 分析血清铁(SI)、总铁结合力(TIBC)、转铁蛋白(Tf)和铁蛋白(SF)在缺铁性贫血(IDA)患儿中的变化及意义,为临床诊治提供参考依据。方法 选取2014年1月-2016年2月在海南省妇幼保健院治疗的贫血患儿101例,其中IDA患儿67例(IDA组),慢性疾病性贫血(ACD)34例(ACD组),同时选取健康儿童100例作为对照组,检测各组血清SI、TIBC、Tf和SF水平。结果 IDA组患儿SI和SF分别为(4.70±1.30) mol/L和(59.43±18.84) g/L,明显低于对照组和ACD组(P＜0.05);IDA组患儿TIBC为(74.60±6.52) mol/L,明显高于对照组和ACD组(P＜0.05);IDA组和ACD组Tf分别为(3.30±0.52)g/L和(3.35±0.60)g/L,均明显高于对照组(P＜0.05);SI、TIBC和SF 诊断IDA的受试者工作特征(ROC)曲线下面积分别为0.837、0.822和0.755(P＜0.05),Tf ROC曲线下面积为0.515(P＞0.05);SI、TIBC和SF截断值分别为6.99 mol/L、61.90 mol/L和71.92 g/L,诊断IDA的灵敏度分别为73.50%、97.00%和73.50%,特异度分别为94.00%、64.70%和70.10%。结论 SI、TIBC和SF在小儿缺铁性贫血诊断中有一定的价值,可作为缺铁性贫血和慢性疾病性贫血鉴别诊断指标。     

Combined iron and zinc supplementation in infants improved iron and zinc status, but interactions reduced efficacy in a multicountry trial in southeast Asia

Deficiencies of iron and zinc are prevalent worldwide. Interactions between these micronutrients therefore have important consequences, also for supplementation. To investigate effects on hemoglobin and zinc concentrations and interactions of iron and zinc supplementation in infants, data from 4 parallel, randomized, placebo-controlled, double-blind trials in Indonesia, Thailand, and Vietnam were pooled. Infants (n=2468), aged 4-6 mo, were supplemented daily with iron (10 mg) and/or zinc (10 mg) for 6 mo. At 3 sites, infants were given vitamin A capsules (VAC) at recruitment. Combined supplementation reduced prevalences of anemia by 21% (P<0.01) and zinc deficiency by 10% (P<0.05) but was less effective (P<0.05) than supplementation with either iron (28% reduction in anemia) or zinc alone (18% reduction in zinc deficiency). Iron reduced the effect of zinc supplementation (interaction P<0.01), but had no separate effect on zinc status, whereas zinc supplementation had a negative effect on hemoglobin concentrations (-2.5 g/L, P<0.001), independent of iron supplementation (Pinteraction=0.25). The effect of iron supplementation on hemoglobin concentrations was almost twice as large in boys than in girls (effect size 12.0 vs. 6.8 g/L, respectively). In infants not receiving iron, VAC administration tended to be associated with lower (3.2%, P=0.07) hemoglobin concentrations. Combined supplementation of iron and zinc was safe and effective in reducing the high prevalences of anemia and iron and zinc deficiencies. Zinc supplementation may negatively affect iron status but iron supplementation does not seem to affect zinc status. Furthermore, VAC administration in the absence of iron supplementation may increase the incidence of anemia.