Iron status of inner-city elementary school children: lack of correlation between anemia and iron deficiency

The iron status of 103 inner-city third and fourth graders was evaluated. These children had significantly lower hemoglobin concentrations and significantly higher serum ferritin concentrations than values previously reported. Mean erythrocyte protoporphyrin concentrations agree with previous results whereas mean corpuscular volume was significantly lower than in some previous studies. Though 11 children (10.7%) were anemic, only 1 anemic child had another abnormal measure of iron status. Three children (2.9%) had a low serum ferritin concentration along with another abnormal measure of iron status. Four children (3.9%) had at least two abnormal measurements of iron status without an elevated blood lead concentration. These results agree with recent observations of decreasing rates of anemia in preschool children. The poor utility of hemoglobin measures to identify iron-deficient children suggests the need for alternate screening methods, and the relatively high serum ferritin concentration suggests a trend of rising iron stores in school-age children.