Functional iron status of chronic kidney disease patients at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Background: Functional iron deficiency has been found to be a common cause of poor response to erythropoiesis stimulating agents in anaemic patients with chronic kidney disease (CKD). Objectives: Assess the functional iron status of patients with chronic kidney disease. Methods: This was a hospital based cross sectional study. The study subjects were chronic kidney disease patients with age and sex matched healthy controls. Full blood count, serum ferritin, soluble transferring receptor, C-reactive protein, serum iron and total iron binding capacity were measured in the patients and healthy controls. Data was analyzed with statistical package for the social sciences software version 22.0. And the level of statistical significance was set at p. value < 0.05. Results: The mean ± SD of the age of patient with CKD was 55.0 + 15.4 years, while that of controls was 52.7 + 13.6 years. The mean serum ferritin, serum iron, TIBC and CRP were significantly higher in patients compared with controls (p<0.001, 0.023, <0.001 and 0.001) respectively. Functional iron deficiency was seen in 19.5% of patients with CKD. Conclusion: The predominant form of iron deficiency in our study was functional iron deficiency

Relación entre ingesta dietética y estado nutricional del hierro en mujeres chilenas en edad fértil de una comunidad universitaria

RESUMEN Propósito: Relacionar la ingesta dietaria de hierro con el estado nutricional de éste en una muestra de mujeres en edad fértil de Santiago de Chile. Método: A 51 mujeres entre 18 - 35 años se aplicó una Encuesta de Tendencia de Consumo para estimar el aporte de hierro dietario, junto con la medición de los biomarcadores bioquímicos a modo de determinar el estado de los depósitos de hierro. Mediante prueba estadística de Mann-Whitney se analizaron diferencias significativas entre los grupos según estado nutricional del hierro y sus parámetros sanguíneos. Resultados: Treinta y siete de las participantes (72,5%) no cumple con la ingesta recomendada de hierro diario. Dos de las mujeres presentaron anemia, 2 deficiencia de hierro sin anemia y 12 tenía los depósitos de hierro depletados. Tres de las mujeres que presentaron depósitos deficientes tuvieron una ingesta de hierro adecuada, mientras que el 71% de las mujeres con depósitos normales presentaron una ingesta de hierro insuficiente. Conclusiones: Hay un bajo cumplimiento de los requerimientos diarios de hierro y no se observan mejores valores hematológicos a mayor ingesta de hierro, a pesar de presentar un alto porcentaje con depósitos normales de hierro. Se requiere mayor análisis de la alimentación de este grupo de la población para identificar el tipo de hierro que se está aportando principalmente y si hay otros factores dietarios y no dietarios afectando los depósitos de hierro.

ABSTRACT Objectives: To relate dietary intake of iron with iron status in a sample of women of childbearing age from Santiago de Chile. Methods: A Food Frequency Survey was applied to 51 women between 18 - 35 years of age to estimate intake of dietary iron, together with the measurement of biochemical biomarkers to determine iron stores. Using the Mann-Whitney statistical test, significant differences were analyzed between the groups according to nutritional status of iron and its blood parameters. Results: Thirty seven of the participants (72.5%) do not meet the recommended daily iron intake. Two had anemia, 2 had iron deficiency without anemia, and twelve had depleted iron stores. Three women with deficient iron stores had an adequate iron intake, while 71% of women with normal iron stores showed an insufficient iron intake. Conclusions: We observed a low compliance with the daily iron requirements and no better hematological values were associated with higher iron intake, despite a high percentage of women with normal iron stores. To identify the type of iron mainly contributed by the diet and if there are other dietary and non-dietary factors affecting iron stores, further analysis of this population group is required.

Study the iron status in children with febrile seizures: a hospital based cross sectional study

Background: Febrile seizures are most common among childhood seizures, accounts to 2% to 5% in children below 5 years of age. Iron deficiency can cause many neurological deficits and may lower the seizure threshold. The present study was conducted to determine the iron status in children with febrile seizures.Methods: The present cross-sectional study was conducted in the Department of Pediatrics, HIMS, Dehradun, over a period of 12 month from January 2018 to December 2018. A total of 105 children of age group 6 month to 5 years, coming to pediatrics department were included in the study. Total study subjects were divided into two groups, Group I (febrile seizure) and Group II (other than febrile seizure).  A consecutive sampling method was done for selection of study subjects.Results: In Group I (febrile seizure), the number of males were 71.7% while females were 28.3% with male: female ratio of 2.5:1. In Group I (febrile seizure), 61.7% of subjects had deficient iron level while 38.3% of subjects had normal serum iron level. Our study shows significantly low mean serum ferritin and mean serum iron level in subjects with febrile seizures.Conclusions: We concluded that iron deficiency is more common in febrile seizures and there is a positive association between serum iron level and febrile seizures.

Variations in Iron Status Indicators in Different Phases of Menstrual Cycle – A Study of Two Age-Matched Socio- Economic Groups of 18 – 25 Years of Age.

Background: Iron requirements are increased in adolescent girls with growth and the onset of menarche and remain high in women until menopause. Methods: We conducted a study on two study groups of girls in age group 18-25 years belonging to different socioeconomic classes as per the Modified Kuppuswamy’s Scale to study the effect of the phases of menstrual cycle & socioeconomic class on the iron status indicators (Hb, Serum Iron, TIBC, MCV & TS%).Menstrual phases were defined and blood samples were drawn from all the girls in all the 3 phases (menstrual, follicular & luteal) and Hb, Serum iron & Total iron binding capacity were assessed on a semi-auto-analyzer & MCV was estimated using a fully automated CBC machine. Transferrin Saturation was derived as Serum Iron / TIBC × 100. Results: We found significant (p< 0.01) difference in iron status indicators in both our groups, the values of iron status indicators varied significantly according to the menstrual cycle, with values highest during the luteal phase and lowest during the menstrual phase. From our observations we can conclude that the nutritional status (assessed by the height, weight & BMI) and the iron status indicators both differ significantly in the two age-matched comparable socio-economic groups. Conclusion: socioeconomic class has a major determining role on an individual’s health. The effect of hormonal fluctuations during the menstrual cycle also has a part to play in the variation of iron status measures, which has to be considered while measuring them in a female during her reproductive years

Study of Iron Status Indicators in Different Phases of Menstrual Cycle in Females of Lower Socio-Economic Group.

Background: Iron requirements are increased in adolescent girls with growth and the onset of menarche and remain high in women until menopause. Methods: We conducted a study on 18-25 years females of lower socioeconomic status as per the Modified Kuppuswamy’s Scale to study the effect of the phases of menstrual cycle & socioeconomic class on the iron status indicators (Hb, Serum Iron, TIBC, MCV & TS%).Menstrual phases were defined and blood samples were drawn from all the girls in all the 3 phases (menstrual, follicular & luteal) and Hb, Serum iron & Total iron binding capacity were assessed on a semi-auto-analyzer & MCV was estimated using a fully automated CBC machine. Transferrin Saturation was derived as Serum Iron / TIBC × 100. Results: We found that the values of iron status indicators varied significantly according to the menstrual cycle, with values highest during the luteal phase and lowest during the menstrual phase. From our observations we can conclude that the nutritional status (assessed by the height, weight & BMI) and the iron status indicators both are significantly lower in the females of lower SES. Hence, socio-economic class has a major determining role on an individual’s health. Conclusion: The effect of hormonal fluctuations during the menstrual cycle also has a part to play in the variation of iron status measures, which has to be considered while measuring them in a female during her reproductive years.

Association of iron status and food intake with blood heavy metal concentrations in Korean adolescent girls and women: Based on the 2010~2011 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined and compared the associations of the iron status and food intake with the blood lead, mercury, and cadmium concentrations among Korean adolescent girls, premenopausal women, and postmenopausal women. METHODS: The data from the 2010~2011 Korea National Health and Nutrition Examination Survey (KNHANES) was used. The subjects were classified into three groups: adolescent girls (n = 268), premenopausal women (n = 1,157), and postmenopausal women (n = 446). The iron status was assessed by hemoglobin, hematocrit, serum ferritin, and iron concentrations, as well as the total iron binding capacity (TIBC). The food intake was estimated by a food frequency questionnaire. RESULTS: The blood heavy metal concentrations and poisoning rate in postmenopausal women were higher than in the other groups. The iron status in the adolescent girls and postmenopausal women was higher than that in the premenopausal women. In the adolescent girls, the iron status was inversely associated with the blood cadmium concentration. The dairy food intake was inversely related to the blood lead and cadmium concentrations. In premenopausal women, the iron status was inversely associated with the cadmium concentrations. The fish and shellfish food intakes were positively associated with the mercury concentrations. In postmenopausal women, the iron status was positively associated with the mercury and cadmium concentrations. Fast foods and fried foods were inversely associated with the lead concentration. CONCLUSION: The premenopausal women showed a lower iron status than the adolescent girls and postmenopausal women. The associations of the iron status with the blood heavy metal concentrations were different among the adolescent girls, premenopausal women, and postmenopausal women. In addition, the relationships of the food intakes with the blood heavy metal concentrations differed among adolescent girls, premenopausal women, and postmenopausal women. Further studies will be needed to confirm these findings.

Clinical Study on NGAL and Iron Status in Patients with Chronic Renal Anemia / 现代检验医学杂志

Objective To evaluated the association between the NAGL and the chronic kidney disease (CKD) patients with iron status,which was occurred iron scarcity for CKD patient in clinical.Methods 154 CKD patients were included in this study.Serum neutrophil gelatinase-related lipid transport protein(NGAL) were detected in anemia group and non-anemia group of chronic kidney disease.The NGAL,univariate correlation and multivariate regression analysis,as well as ROC curve analysis,were used to assess and compared the diagnostic potential of NGAL,ferritin,EPO and Tfr (transferrin receptor) in CKD patients after analyzing the patient's iron status.Results NGAL levels were markedly higher in CKD patients with anemia than CKD patients without anemia.In the analysis,NGAL was inverse correlated with hemoglobin,hematocrit,MCV,MCH,serum iron and TSAT(correlation relation was-0.36,-0.32,-0.26,-0.31,-0.38,-0.3,respectively).ROC analysis was employed to assess and compare the diagnostic potentials of the NGAL,ferritin,EPO,and Tfr (transferritin receptor) in identifying this condition among CKD patients.The NGAL showed that the area under the curve of iron deficiency in CKD patients (AUC) was 0.713,with good sensitivity and specificity (58.6％ vs 74.7 ％).Conclusion NGAL might be proposed as a new tool in the assessment of iron deficiency and in the management of iron therapy for CKD patients.

Compliance with Home-based Fortification Strategies for Delivery of Iron and Zinc: Its Effect on Haematological and Growth Markers among 6-24 months Old Children in North India.

Compliance is a key component in successful implementation of the delivery of micronutrients among children. The present study evaluates the compliance with two home-based food fortification strategies (fortified complementary food or sprinkle) for providing iron and zinc among children aged 6-24 months. A total of 292 children were randomly allocated to receive either rice-based fortified complementary food and nutrition education (Cf=101), sprinkle and nutrition education (Mp=97), or nutrition education alone as control (Ed=94). All the enrolled children were breastfed at the beginning of the study and were advised to continue breastfeeding. Biweekly information on compliance and anthropometry was collected. Complete haemogram estimation was conducted at baseline and end of the study. Compliance with the fortified complementary food was higher compared to sprinkle (Cf=81%, Mp=64% child-days). Consumption of the fortified complementary food for 6 months resulted in a significant increase in mean haemoglobin in the intervention group compared to control group (Cf 1.29±1.6 g/dL; Ed 0.23±1.3 g/dL; p<0.001). Our results showed that fortified complementary food had higher compliance than sprinkle and is a suitable delivery mechanism for iron and zinc in preschool children.

Iron Status in Female College Students in the Gyeongnam Area

This study was undertaken to investigate iron status and related factors in female college students residing in Gyeongnam. The subjects were divided into normal (40.8%) and iron deficiency (ID) groups (59.2%) by iron status. Mean height, weight, lean body mass, percent body fat, body mass index, and wrist to hip ratio were not significantly different between the groups, but basic metabolic rate was significantly higher in the normal group than that in the ID group. The levels of hemoglobin, hematocrit, serum ferritin, transferrin saturation, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were significantly higher in the normal group than those in the ID group. However, total iron binding capacity was significantly lower in the normal group than that in the ID group. Daily intake of protein, heme-Fe, niacin, and vitamin C were significantly higher in the normal group than those in the ID group. The mean intake of protein, Fe, niacin, vitamin B12, and vitamin C based on the Korean recommended intake (RI) were significantly higher in the normal group than those in the ID group. The mean intakes of Ca, vitamin B12, and folate in both groups were < 75% of the Korean RI. In conclusion, increasing dietary heme-Fe and vitamin C may be helpful for preventing ID anemia in female college students.

Effect of Gender and Nutritional Status on Academic Achievement and Cognitive Function among Primary School Children in a Rural District in Malaysia

Introduction: The aim of this study was to investigate the relationship between gender, birth weight, nutritional status, and iron status of children with their academic performance and cognitive function. Methods: Two hundred and fortynine children, seven to nine years of age, were recruited by systematic sampling from six primary schools in a rural area in Malaysia. Cognitive function was assessed by using Raven’s Coloured Progressive Matrices (R-CPM). Academic performance of the children was recorded from their school final examination results in four subjects including Malay language, English, Mathematics, and Science. Birth weight was recorded from the birth certificate, and nutritional status was determined by weight-for-age z score and height-for-age z score. Results: Girls had a significantly higher score in all the academic tests, but a lower cognitive score compared to boys. Nutritional status was found to be correlated significantly with academic performance. Academic and cognitive function scores were also found to be correlated significantly with birth weight, parents’ education, and family income. In a multivariate analysis, gender remained the significant predictor of academic function, and iron status and haemoglobin were the significant predictors of cognitive function, after controlling for other variables. Conclusion: The study showed that girls performed better academically than boys in rural Malaysia. Nutritional status, parents’ education and family income could be additional modifiable factors to improve academic performance of the children. More attention is needed to improve academic achievements of boys at their early school years.

HFE gene mutations and iron status of Brazilian blood donors

Mutations of the HFE and TFR2 genes have been associated with iron overload. HFE and TFR2 mutations were assessed in blood donors, and the relationship with iron status was evaluated. Subjects (N = 542) were recruited at the Hemocentro da Santa Casa de São Paulo, São Paulo, Brazil. Iron status was not influenced by HFE mutations in women and was independent of blood donation frequency. In contrast, men carrying the HFE 282CY genotype had lower total iron-binding capacity (TIBC) than HFE 282CC genotype carriers. Men who donated blood for the first time and were carriers of the HFE 282CY genotype had higher transferrin saturation values and lower TIBC concentrations than those with the homozygous wild genotype for the HFE C282Y mutation. Moreover, in this group of blood donors, carriers of HFE 63DD plus 63HD genotypes had higher serum ferritin values than those with the homozygous wild genotype for HFE H63D mutation. Multiple linear regression analysis showed that HFE 282CY leads to a 17.21 percent increase (P = 0.018) and a 83.65 percent decrease (P = 0.007) in transferrin saturation and TIBC, respectively. In addition, serum ferritin is influenced by age (3.91 percent, P = 0.001) and the HFE 63HD plus DD genotype (55.84 percent, P = 0.021). In conclusion, the HFE 282Y and 65C alleles were rare, while the HFE 63D allele was frequent in Brazilian blood donors. The HFE C282Y and H63D mutations were associated with alterations in iron status in blood donors in a gender-dependent manner.

Iron Status According to Serum Selenium Concentration and Physique in Young Female Adults

Se and Fe are trace minerals acting as antioxidant scavenging free radicals. Iron deficiency is the most frequently reported nutritional deficiency in females. Body iron status are known to be dependent not only upon dietary iron intake, but also upon micro-mineral nutrition and obesity. Antioxidants such as selenium are reported to play an important role on the regulation of erythropoiesis by protecting RBC membrane from antioxidative damage. In this study, iron status in young females and its relationships with selenium status and physique were examined. Serum selenium and iron concentrations were measured by HANARO research reactor using neutron activation analysis method (NAA-method). The proportion with iron deficiency and anemia were 27.1% and 8.6%, respectively in young females, but the proportion with iron deficient anemia was 1.4%. The mean serum selenium level was 12.0 microgram/dL and in normal range in the young women. The study participants were tertiled according to BMI and serum selenium levels. Serum ferritin and iron levels inclined with increasing BMI tertiles. Serum iron and RBC count were higher in middle selenium group than low selenium group. Individuals had significantly lower hematocrit level in the lowest tertile for their serum selenium levels compared with the highest tertile. The serum ferritin level was predicted 25% by BMI and RBC count 26.2% by the serum selenium level and body fat%. In conclusion, this study shows that body iron status in young adult females are influenced by obesity and body selenium status.

¿Es la deficiencia de hierro un factor de riesgo para crisis epilépticas febriles?: 2do premio LII Congreso Nacional de Pediatría 2006 / Is iron defficiency a risk factor for febriles seizures?: 2nd prize Pedriatric Nacional Congreso 2006

Las crisis epilépticas febriles son un motivo de consulta frecuente en Neurología Infantil; su presentación coincide con el período de mayor prevalencia de deficiencia de hierro en la edad pediátrica. Evaluar la relación entre crisis epilépticas febriles y el estado del hierro. Se realizó un estudio no experimental de casos y controles en pacientes de 6 meses a 5 años de edad, evaluados en los Servicios de Neurología, Triaje, Emergencia, Niños Sanos y Consulta Externa del Hospital de Niños "J.M de Los Ríos" en Caracas, Venezuela, en el lapso comprendido entre enero 2004 y septiembre 2005. Se incluyeron 52 pacientes en cada grupo, a quienes se les determinó el estado del hierro utilizando como indicadores: Hemoglobina, Hematocrito e Índices Hematimétricos y Ferritina. Las variables cualitativas se expresaron en porcentaje y las cuantitativas a través de las medidas de tendencia central y dispersión, se aplicó la prueba de t de Student y la prueba de Wilcoxon, para un nivel del 5 por ciento como significancia estadística. No hubo diferencia estadísticamente significativa entre los valores de Hemoglobina, Hematocrito e Índices Hematimétricos entre los casos y los controles. La ferritina fue más baja en los pacientes con crisis febriles, siendo esta diferencia estadísticamente significativa (p=0,0005). Los pacientes con deficiencia de hierro podrían tener mayor probabilidad de presentar crisis febriles.

Febrile seizures are a very common consultation cause in Pediatric Neurology; their appearance coincides with the period of greater prevalence of iron deficiency in the pediatric age. To evaluate the relationship between febrile seizures and iron status. A non experimental study of cases and controls in patients between 6 months and 5 years from the Services of Pediatric Neurology, Emergency, Healthy Children and External Consultation of the Hospital de Niños “J. M de Los Ríos” in Caracas, Venezuela was performed from January 2004 to September 2005. Fifty two patients were included in each group. The iron status was determined in all the patients by using as indicators: hemoglobin, hematocrit, hematologic indices and serum ferritin. Qualitative variables were expressed in percentages and the quantitative ones by using their summary measures; Student t-test and Wilcoxon Test were applied, significance of 5% level. There was not a statistically significant difference among the values of hemoglobin, hematocrit and hematologic indices between cases and controls. Ferritin was lower in patients with febrile seizures and this difference was statistically significant (p=0.0005). Patients with iron deficiency could have a greater probability for presenting febrile seizures.

Relationship of body iron stores with the development of nonalcoholic fatty liver disease / 대한내과학회지

BACKGROUND: Although numerous reports have shown the influence of the iron overload state on the development of nonalcoholic fatty liver disease (NAFLD), there have been few reports on the prevalence of NAFLD according to the body iron stores. The aim of the present study was to determine the relationship of body iron stores with the development of NAFLD in apparently healthy women. METHODS: The present cross-sectional study was performed with data obtained from 5,249 women (mean age: 40.6+/-8.9 years), that received an annual health check-up. All components of metabolic syndrome criteria, anthropometric parameters, fasting insulin levels, level of C-reactive protein and serum iron tests were measured in each subject. RESULTS: The prevalence of NAFLD was significantly different according to body iron status (normal iron store/iron store depletion/iron deficient erythropoiesis/iron deficiency anemia: 10.6%/4.1%/6.5%/11.2%, p<0.001). Multivariate analysis revealed that age (odds ratio [OR]=1.284; 95% confidence interval [CI]: 1.1161.507) per 10 years), being overweight (OR=1.952; 95% CI: 1.3952.732), diabetes mellitus (OR=1.694; 95% CI: 1.198-2.397), hypertriglyceridemia (OR=2.434; 95% CI: 1.737-3.409), abdominal obesity (OR=3.559; 95% CI: 2.538-4.992), insulin resistance (OR=2.665; 95% CI: 1.979-3.587), anemia (OR=2.015; 95% CI: 1.150-3.532) and stored iron depletion (OR=0.580; 95% CI: 0.405-0.830) were profoundly associated with the development of NAFLD. CONCLUSION: The present study reveals a possible correlation between the development of NAFLD and body iron stores, and stored iron depletion and anemia seem to be key factors for this correlation.

The iron status, clinical symptom and anthropometry between normal and anemic groups of middle school girls

This research analyzed the iron status, clinical symptoms and physical characteristics between normal and anemic group of middle school girls in the Ulsan metropolitan area. It was carried out with 237 subjects (normal 190, anemic subject 47). They were evaluated with a questionnaire and measurement of hematological indices. BMI (kg/m2) of the two groups were 19.54 +/- 2.44 (normal girls) and 19.22 +/- 2.27 (anemic girls). The hemoglobin concentration of the anemic girls were 10.84 +/- 1.17g/dl and the serum iron of the anemic girls represent 35.15 +/- 27.47 microgram/100 ml. The TIBC (Total Iron Binding Capacity) of the anemic girls showed significantly high to 449.30 +/- 64.87 microgram/100 ml. The serum ferritin of the anemic girls was 20.53 +/- 42.29 microgram/l, it represented significantly low. The symptom of 'pale face' of the anemic girls were higher than the normal girls. Hemoglobin and serum iron were negatively correlated with 'pale face'. The TIBC was negatively correlated with 'Get a cold easily'. The duration and amount of menstruation were correlated with iron status. This research is to be utilized as basic data for dietary support and nutritional education to improve their iron status.

Iron Nutritional Status by ALAD Genotype and Intervention Study for Rural Area Residents / 대한지역사회영양학회지

Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However, in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of intervention group significantly improved except for ferritin and TIBC regardless of ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.

A Study on Calcium and Iron Status of Lactating Women

This study was intended to investigate the nutritional status between lactating and non- lactating women, especially calcium and iron. The subjects were 84 lactating women and 20 non-lactating women visiting a public health center and hospital in Daegu. Each subject was interviewed to collect the information on dietary intake for 2 consecutive days. Biochemical assessment of iron status and bone mineral density (BMD) measurement were conducted. Dietary intake of carbohydrate, potassium, Vit B1, B2, Vit C were significantly higher in women during lactating period (p < 0.05). However, relative intake as expressed by percentage of Korean Recommended Dietary Allowances (RDA) was not significantly different between the two groups. The dietary intake of iron and calcium were 58.8%, 60.4% of Korean RDA respectively in women during lactating period. The current food habit score of these women was significantly higher than that of non-lactating women (p < 0.05). When we compared the quality of nutritional status, the Index of nutritional quality (INQ) was significantly higher for vitamin B2, P in lactating women than in non-lactating women (p < 0.1). Mean adequacy ratio (MAR) was not significantly different between two groups. Dietary variety score (DVS) was significantly higher in women during the lactating period (p < 0.05). There was no significant difference in biomarkers (Hb, Hct, Serum ferritin, Transferrin) related to iron status between the two groups. No significant difference in bone mineral density (BMD) T-score was not observed. However, it appeared that BMD of lactating women was lower than that of non- lactating women.

A Study on the Changes of Maternal Dietary Iron Intakes, Its Bioavailability, and Iron Status during Pregnancy / 대한지역사회영양학회지

To increase both iron and enhancers for iron absorption through diets should be a basic strategy to sufficiently provide increased iron for pregnancy. Previous studies reported that iron intakes of Korean pregnant women were short and their iron status deteriorated as pregnancy progressed. However, there is little data about the bioavailability of dietary iron during pregnancy. Therefore, this study was conducted to determine the changes of dietary iron intakes, its bioa-vailability and iron status during pregnancy longitudinally in Korean women. A total of 151 pregnant women in their first trimester of pregnancy voluntarily participated. Among them, 72 women finished the research protocol during the second trimester and 55 did it during the third trimester. Dietary intakes of total iron, both non-heme and heme iron, as well as enhancers, both MPF (meat, poulty, and fish) and vitamin C, increased significantly as pregnancy progressed. As the results, bioavailability of dietary iron and iron absorbed increased significantly as pregnancy progressed. However, the amount of iron absorbed at each trimester did not meet considerably the iron needed during pregnancy. All five indices examined in the study, Hb level, Hct, serum concentrations of ferritin and sTfR (soluble transferrin receptor), and sTfR:ferritin ratio, showed that iron status of the subjects deteriorated as pregnancy progressed. The rate of anemia of the subjects increased as pregnancy progressed although more than 80% of the subjects took iron supplements after the 20th week of pregnancy. These results imply that it is needed to provide more iron especially, heme iron and dietary enhancers to prevent the deterioration of iron status during pregnancy. Future research on bioavaila-blility of supplemental iron should be performed to determine the iron balance precisely.

Iron Status and Anemia of Middle School Girls in Ulsan Metropolitan City / 대한지역사회영양학회지

This study was designed to assess the nutritional iron status and anemia of middle school girls. Three-hundred-fiftythree female subjects in Ulsan metropolitan city were evaluated using a questionnaire, and hematological indices. The average height and weight of the respondents were 157.19 +/- 5.57 cm and 51.06 +/-9.42 kg, respectively. The average Body Mass Index (BMI, Kg/m2) was 20.63 +/-3.23, which was within the normal range. With regard to clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concentrate'. The total caloric intake of each subject was 1743.28 +/- 343.47 kcal (83.01% of the Korean RDA) and the calcium intake was 634.98 +/- 201.43 mg (79.37% of the Korean RDA). The mean daily intake of iron was 14.76 +/- 4.36 mg (92.25% of the Korean RDA) and the heme iron intake was 6.12 +/- 2.30 mg, which was 41.5% of the total iron intake. The average hemoglobin (Hb) concentration of the subjects was 13.24 +/- 1.01 g/dl, and the average hematocrit (Hct) level was 37.79 +/- 4.10%. The transferrin saturation {TS (%)} was 19.41 +/- 9.21%, and the ferritin level was 26.26 +/- 18.60 ng/ml. The iron deficiency anemia among the subjects was estimated at 6.1% by using Hb (< 12 g/dl), 20.5% by using Hct (< 36%), 30.8% by using TS (< 14%), and 23.1% by using ferritin (< 12 ng/ml). The total iron binding capacity (TIBC) showed a negative correlation with the Hb, iron, ferritin and TS. With regard to the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'pale face' (p < 0.05). In addition, the level of iron was significantly and negatively correlated with 'poor memory' (p < 0.01) and the ferritin concentration was negatively correlated with 'no appetite' (p < 0.05), 'pale face (p < 0.05). These results suggest that the prevalence of iron deficiency among middle school girls is very high; therefore, guidelines on dietary support and nutritional education to improve their dietary iron status should be provided.

The Iron Status and Diet Quality of Pregnant Women during the First Five Months of Pregnancy / 대한지역사회영양학회지

Literature suggests that iron deficiency anemia is prevalent among pregnant women all over the world. This study was designed to evaluate the iron status of pregnant women during the fist five months, with the intention of determining ways to reduce the prevalence of iron deficiency anemia among pregnant women in Korea. We collected dietary information and measured the biochemical status of iron in 171 pregnant women over 16 weeks of gestation (= 16.7 +/- 2.34 week). Dietary intakes for 3 days were collected using the 24 hour recall and food record methods. The daily Fe intake was measured using the food frequency method. The Body Mass Index (BMI), calculated by using the pre-pregnancy weight and height, indicated that 31.3% of subjects were under-weight. We divided the subjects into normal and anemic group by using the serum ferritin levels. It appeared that the mean dietary intake of iron was 52.3% of the recommended level for pregnant women. The dietary quality evaluation showed that pregnant women ate only 58% of the recommended amount in the food groups of meat, fish, eggs, beans and milk and dairy products. The hematological indices showed that the mean Hemoglobin (Hb) was 11.9 g/dl, Hematocrit (Hct) was 35.1%, ferritin was 23.9 ng/ml, and transferrin was 297.3 microgram/dl. The dietary intake of iron was significantly lower and the vitamin C intake was significantly higher in the anemic group. The pre-pregnancy BMI was significantly lower in the anemic group. Variables affecting iron intake were the Fe intake frequency index and the food group score. The Fe index showed significantly positive correlation with the pre-pregnancy food intake and the food group score. Hb showed a significantly positive correlation with the prepregnancy food intake. We concluded that strategies to improve iron status be implemented in the pre-pregnant stage so as to reduce the prevalence of iron deficiency and that we should stress on the importance of an adequate diet as well as the maintenance of a heathy weight.