Droke EA, Kennedy TS, Hubbs-Tait L. Potential for Misclassification of Micronutrient Status in Children Participating in a Head Start Program.
ACTA ACUST UNITED AC 2006;
106:376-82. [PMID:
16503227 DOI:
10.1016/j.jada.2005.12.011]
[Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVE
To evaluate relations among measures of iron and zinc status, C-reactive protein (CRP), and leukocytes in low-income children participating in the Head Start program.
DESIGN
Cross-sectional correlational study with samples collected at Head Start centers in May 2003.
SUBJECTS/SETTING
Forty-seven children (aged 3 to 5 years) attending Head Start centers in three rural communities.
MEASURES
Zinc, ferritin, CRP, and complete blood count were analyzed in nonfasting blood samples.
STATISTICAL ANALYSES
Correlations were computed among leukocyte levels, CRP levels, and measures of micronutrient status. Children having two abnormal measures (ie, leukocytes and CRP) were compared by univariate analysis of variance with children having zero or one abnormal measure.
RESULTS
Most (72%) of the children had elevated CRP levels. Four percent were anemic (hemoglobin<11.0 g/dL [<110 g/L]); 11% had low iron stores (serum ferritin<or=15 ng/mL [<or=33.7 pmol/L]); and 77% had low iron stores when a reference value that accounts for the presence of infection was used (serum ferritin<or=30 ng/mL [<or=67.4 pmol/L]). Twenty-one percent had low plasma zinc levels. Children with two measures that indicated infection had higher serum ferritin and lower plasma zinc levels than children with zero or one indicator of infection.
CONCLUSIONS
The link between measures of infection and serum ferritin levels suggests low-income preschool children with low iron stores are not identified by the <or=15 ng/mL (<or=33.7 pmol/L) criterion. The link between zinc and infection suggests possible overestimations of zinc deficiency in low-income children. Thus, in this population, the presence of infection (as indicated by CRP levels and leukocyte counts) should be determined to assess micronutrient status.
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