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Floegel A, Intemann T, Siani A, Moreno LA, Molnár D, Veidebaum T, Hadjigeorgiou C, De Henauw S, Hunsberger M, Eiben G, Ahrens W, Wolters M. Cohort-Based Reference Values for Serum Ferritin and Transferrin and Longitudinal Determinants of Iron Status in European Children Aged 3-15 Years. J Nutr 2024; 154:658-669. [PMID: 38048991 PMCID: PMC10900138 DOI: 10.1016/j.tjnut.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Reference values of ferritin and transferrin for European children do not exist. OBJECTIVE We aimed to provide sex-, age-, and body mass index (BMI)-specific serum ferritin and transferrin reference percentiles of 3-15-y-old children based on cohort data and to investigate determinants of iron status. METHODS A total of 3390 ferritin and 3416 transferrin measurements from children residing in 8 European countries participating in the IDEFICS/I.Family cohort (https://www.isrctn.com/ISRCTN62310987) at baseline (W0) and 6 y later (W3) were used to estimate percentiles using the generalized additive model for location, scale and shape. Associations of serum ferritin and transferrin concentrations with total iron intake, total iron intake additionally adjusted for vitamin C intake, and iron from heme sources were investigated separately with adjustment for sex, age, country of residence, parental education, usual energy intake and BMI z-score in regression models using cross-sectional and longitudinal data. RESULTS The age-specific ferritin and transferrin 5th and 95th reference percentiles ranged from 10.9 to 81.1 μg/L and 2.23 to 3.56 g/L, respectively. A deficient iron status was observed in 3% of children at W0 and 7% of children and adolescents at W3, respectively. At both waves, a higher iron intake from heme sources was positively associated with serum ferritin {W0: β = 3.21 [95% confidence interval (CI): 0.71, 5.71]; W3: β = 4.48 [95% CI: 2.09, 6.87]}, that is, children consuming one mg more heme iron had a 3.21 and 4.48 μg/L higher ferritin concentration. Adherence to a mainly vegetarian diet was associated with a lower chance for sufficient serum ferritin cross-sectionally at W3 [odds ratio (OR) 0.40 (95% CI: 0.21, 0.81)] and longitudinally [OR 0.35 (95% CI: 0.15, 0.93)]. CONCLUSIONS Age-, sex-, and BMI-specific reference percentiles of serum ferritin and transferrin concentrations based on cohort data are provided for European children aged 3-15 y and may be used in clinical practice.
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Affiliation(s)
- Anna Floegel
- Section of Dietetics, Faculty of Agriculture and Food Sciences, Hochschule Neubrandenburg - University of Applied Sciences, Neubrandenburg, Germany; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Toomas Veidebaum
- National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Monica Hunsberger
- Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Zhang Y, Ding R, Zhang Y, Qi J, Cao W, Deng L, Zhou L, Ye Y, Xue Y, Liu E. Dysfunction of DMT1 and miR-135b in the gut-testis axis in high-fat diet male mice. GENES & NUTRITION 2024; 19:1. [PMID: 38243197 PMCID: PMC10797958 DOI: 10.1186/s12263-024-00737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Obese patients have been found to be susceptible to iron deficiency, and malabsorption of dietary iron is the cause of obesity-related iron deficiency (ORID). Divalent metal transporter 1 (DMT1) and ferroportin (FPN), are two transmembrane transporter proteins expressed in the duodenum that are closely associated with iron absorption. However, there have been few studies on the association between these two proteins and the increased susceptibility to iron deficiency in obese patients. Chronic inflammation is also thought to be a cause of obesity-related iron deficiency, and both conditions can have an impact on spermatogenesis and impair male reproductive function. Based on previous studies, transgenerational epigenetic inheritance through gametes was observed in obesity. RESULTS Our results showed that obese mice had decreased blood iron levels (p < 0.01), lower protein and mRNA expression for duodenal DMT1 (p < 0.05), but no statistically significant variation in mRNA expression for duodenal FPN (p > 0.05); there was an increase in sperm miR-135b expression (p < 0.05). Bioinformatics revealed ninety overlapping genes and further analysis showed that they were primarily responsible for epithelial cilium movement, fatty acid beta-oxidation, protein dephosphorylation, fertilization, and glutamine transport, which are closely related to spermatogenesis, sperm development, and sperm viability in mice. CONCLUSIONS In obese mice, we observed downregulation of DMT1 in the duodenum and upregulation of miR-135b in the spermatozoa.
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Affiliation(s)
- Yanru Zhang
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Ruike Ding
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Yulin Zhang
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Jia Qi
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Wenbin Cao
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Lijun Deng
- Spring Biological Technology Development Co., Ltd, Fangchenggang, Guangxi, 538000, China
| | - Lin Zhou
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Yun Ye
- Central Laboratory, The First Affiliated Hospital of Xi'an Medical University, Xi'an, 710000, China
| | - Ying Xue
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China.
| | - Enqi Liu
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China.
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education of China, Xi'an, 710049, China.
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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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Sun Z, Pan X, Tian A, Surakka I, Wang T, Jiao X, He S, Song J, Tian X, Tong D, Wen J, Zhang Y, Liu W, Chen P. Genetic variants in HFE are associated with non-alcoholic fatty liver disease in lean individuals. JHEP Rep 2023; 5:100744. [PMID: 37235137 PMCID: PMC10206181 DOI: 10.1016/j.jhepr.2023.100744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 05/28/2023] Open
Abstract
Background & Aims Around 20% of patients with non-alcoholic fatty liver disease (NAFLD) are lean. Increasing evidence suggests that lean NAFLD is a unique subtype of the disease. We aimed to explore the metabolic profile, genetic basis, causal risk factors, and clinical sequelae underlying lean NAFLD. Methods NAFLD was diagnosed by whole liver proton density fat fraction ≥5%. Whole liver proton density fat fraction and hepatic iron were quantified using magnetic resonance imaging in the UK Biobank. Individuals in this study were stratified according to the World Health Organization criteria of obesity, into lean, overweight, and obese. Mediation analysis, Mendelian randomisation analysis, and Bayesian networks were used to identify a risk factor or a clinical sequela of lean/obese NAFLD. Results Lean NAFLD manifested a distinct metabolic profile, featured by elevated hepatic iron and fasting glucose. Four loci, namely, HFE rs1800562, SLC17A3-SLC17A2-TRIM38 rs9348697, PNPLA3 rs738409, and TM6SF2 rs58542926, were associated with lean NAFLD (p <5 × 10-8). HFE rs1800562 was specifically associated with lean NAFLD and demonstrated a significant mediation effect through elevating hepatic iron. Type 2 diabetes was the most pronounced clinical sequela of lean NAFLD, followed by liver cirrhosis. Conclusions Our study suggested that HFE plays a potential steatogenic role rather than regulating iron homoeostasis in patients with lean NAFLD. The increased liver iron deposition is associated with lean NAFLD, whereas obese NAFLD is not related to hepatic iron. The clinical management of patients with lean NAFLD shall be concerned with the prevention and treatment of type 2 diabetes and liver cirrhosis. Impact and implications Lean NAFLD has a distinct natural history from obese NAFLD. This study underscored liver iron content and the genetic variant of the iron homoeostasis gene HFE as major risks of lean NAFLD, in addition to the unique metabolic profile. The development of type 2 diabetes or liver cirrhosis shall be closely monitored and prevented in patients with lean NAFLD.
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Affiliation(s)
- Zewen Sun
- Department of Genetics, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China
| | - Xingchen Pan
- Department of Molecular Biology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Aowen Tian
- Department of Pathology, College of Basic Medical Sciences, Jilin University, Changchun, China
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
| | - Ida Surakka
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Tao Wang
- Software College of Jilin University, Changchun, China
| | - Xu Jiao
- Software College of Jilin University, Changchun, China
| | - Shanshan He
- Software College of Jilin University, Changchun, China
| | - Jinfang Song
- Department of Pediatrics, The Second Hospital of Jilin University, Changchun, China
| | - Xin Tian
- Department of Pediatrics, The Second Hospital of Jilin University, Changchun, China
| | - Dan Tong
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Jianping Wen
- Department of Genetics, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China
| | - Yonggang Zhang
- The Key Laboratory of Symbol Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
- College of Computer Science and Technology, Jilin University, Changchun, China
| | - Wanqing Liu
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Peng Chen
- Department of Genetics, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China
- Department of Pathology, College of Basic Medical Sciences, Jilin University, Changchun, China
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
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Wang T, Gao Q, Yao Y, Luo G, Lv T, Xu G, Liu M, Xu J, Li X, Sun D, Cheng Z, Wang Y, Wu C, Wang R, Zou J, Yan M. Causal relationship between obesity and iron deficiency anemia: a two-sample Mendelian randomization study. Front Public Health 2023; 11:1188246. [PMID: 37397759 PMCID: PMC10313085 DOI: 10.3389/fpubh.2023.1188246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Background Observational studies have suggested an association between obesity and iron deficiency anemia, but such studies are susceptible to reverse causation and residual confounding. Here we used Mendelian randomization to assess whether the association might be causal. Methods Data on single-nucleotide polymorphisms that might be associated with various anthropometric indicators of obesity were extracted as instrumental variables from genome-wide association studies in the UK Biobank. Data on genetic variants in iron deficiency anemia were extracted from a genome-wide association study dataset within the Biobank. Heterogeneity in the data was assessed using inverse variance-weighted regression, Mendelian randomization Egger regression, and Cochran's Q statistic. Potential causality was assessed using inverse variance-weighted, Mendelian randomization Egger, weighted median, maximum likelihood and penalized weighted median methods. Outlier SNPs were identified using Mendelian randomization PRESSO analysis and "leave-one-out" analysis. Results Inverse variance-weighted regression associated iron deficiency anemia with body mass index, waist circumference, trunk fat mass, body fat mass, trunk fat percentage, and body fat percentage (all odds ratios 1.003-1.004, P ≤ 0.001). Heterogeneity was minimal and no evidence of horizontal pleiotropy was found. Conclusion Our Mendelian randomization analysis suggests that obesity can cause iron deficiency anemia.
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Affiliation(s)
- Tingting Wang
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Gao
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuanyuan Yao
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ge Luo
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Lv
- Department of Anesthesiology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Guangxin Xu
- Department of Anesthesiology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Mingxia Liu
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingpin Xu
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuejie Li
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dawei Sun
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenzhen Cheng
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Wang
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chaomin Wu
- Department of Anesthesiology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Ruiyu Wang
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingcheng Zou
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Yan
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Sappani M, Mani T, Asirvatham ES, Joy M, Babu M, Jeyaseelan L. Trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age during the last 15 years in India. PLoS One 2023; 18:e0286464. [PMID: 37262022 DOI: 10.1371/journal.pone.0286464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Anaemia is a serious global public health problem that disproportionally affects children, adolescent girls, and women of reproductive age, especially pregnant women. Women of reproductive age are more vulnerable to anaemia, particularly severe and moderate anaemia leads to adverse outcomes among pregnant women. Despite continuous Government efforts, anaemia burden still poses a serious challenge in India. The objective of this study is to assess the trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age between 15 and 49 years. METHOD We used three rounds of the large-scale National Family Health Survey (NFHS) India, conducted on a representative sample of households using a cross-sectional design across the country in 2005-06, 2015-16 and 2019-2021. We included all the women aged 15 to 49 years in our analysis. We used the same haemoglobin (Hb) cut-off values for all the three rounds of surveys to ensure comparability. Generalized linear regression analyses with log link were done. Survey weights were incorporated in the analysis. RESULTS The prevalence of severe or moderate Anaemia (SMA) in non-pregnant women was 14.20%, 12.43% and 13.98%; it was 31.11%, 25.98% and 26.66% for pregnant women in 2006, 2016 and 2021 respectively. The decline in SMA prevalence was 1.54% in non-pregnant women, whereas it was 14.30% in pregnant women in 15 years. Women who were poor, and without any formal education had a higher risk for severe and moderate Anaemia. CONCLUSION Despite the intensive anaemia control program in India, SMA has not declined appreciably in non-pregnant women during the last two decades. Despite the decline, the prevalence of SMA was about 26% in pregnant women which calls for a comprehensive review of the existing anaemia control programmes and there must be targeted programmes for the most vulnerable and high-risk women such as rural, poor and illiterate women of reproductive age to reduce the burden of anaemia among them.
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Affiliation(s)
- Marimuthu Sappani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thenmozhi Mani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Melvin Joy
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Malavika Babu
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Lakshmanan Jeyaseelan
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, UAE
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Cavaliere G, Cimmino F, Trinchese G, Catapano A, Petrella L, D'Angelo M, Lucchin L, Mollica MP. From Obesity-Induced Low-Grade Inflammation to Lipotoxicity and Mitochondrial Dysfunction: Altered Multi-Crosstalk between Adipose Tissue and Metabolically Active Organs. Antioxidants (Basel) 2023; 12:1172. [PMID: 37371902 DOI: 10.3390/antiox12061172] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
Obesity is a major risk factor for several metabolic diseases, including type 2 diabetes, hyperlipidemia, cardiovascular diseases, and brain disorders. Growing evidence suggests the importance of inter-organ metabolic communication for the progression of obesity and the subsequent onset of related disorders. This review provides a broad overview of the pathophysiological processes that from adipose tissue dysfunction leading to altered multi-tissue crosstalk relevant to regulating energy homeostasis and the etiology of obesity. First, a comprehensive description of the role of adipose tissue was reported. Then, attention was turned toward the unhealthy expansion of adipose tissue, low-grade inflammatory state, metabolic inflexibility, and mitochondrial dysfunction as root causes of systemic metabolic alterations. In addition, a short spot was devoted to iron deficiency in obese conditions and the role of the hepcidin-ferroportin relationship in the management of this issue. Finally, different classes of bioactive food components were described with a perspective to enhance their potential preventive and therapeutic use against obesity-related diseases.
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Affiliation(s)
- Gina Cavaliere
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
| | - Fabiano Cimmino
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Giovanna Trinchese
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Angela Catapano
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Lidia Petrella
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Margherita D'Angelo
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Lucio Lucchin
- Dietetics and Clinical Nutrition, Bolzano Health District, 39100 Bolzano, Italy
| | - Maria Pina Mollica
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80138 Naples, Italy
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Abstract
Metabolic syndrome (MS), a conglomeration of several conditions including obesity, type 2 diabetes mellitus (T2DM), insulin resistance, elevated blood pressure, and dyslipidemia is reaching epidemic proportions. Anemia is caused by iron deficiency or dysregulation of iron homeostasis, leading to tissue hypoxia. Coexistence of anemia and MS or its components has been reported in the literature. The term "rubrometabolic syndrome" acts as a unifying entity linking the importance of blood in health and anemia in MS; it justifies two principles - redness of blood and low-grade inflammation. Chronic low-grade inflammation in MS affects iron metabolism leading to anemia. Tissue hypoxia that results from the anemic condition seems to be a major causative factor for the exacerbation of several microvascular and macrovascular components of T2DM, which include diabetic neuropathy, nephropathy, retinopathy, and cardiovascular complications. In obesity, anemia leads to malabsorption of micronutrients and can complicate the management of the condition by bariatric surgery. Anemia interferes with the diagnosis and management of T2DM, obesity, dyslipidemia, or hypertension due to its effect on pathological tests as well as medications. Since anemia in MS is multifaceted, the management of anemia is challenging as overcorrection of anemia with erythropoietin-stimulating agents can cause detrimental effects. These limitations necessitate availability of an effective and safe therapy that can maintain and elevate the hemoglobin levels along with maintaining the physiological balance of other systems. This review discusses the physiological links between anemia and MS along with diagnosis and management strategies in patients with coexistence of anemia and MS.
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Affiliation(s)
| | - Ankia Coetzee
- Division of Endocrinology, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa
| | - Philip A Kalra
- Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK
| | - Joel R Saldaña
- Resultados Medicos, Desarrollo e Investigación, SC, Boulevard Valle de San Javier, Pachuca Hidalgo, Mexico City, Mexico
| | - Gary Kilov
- University of Melbourne, Launceston, Australia
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Laboratory Findings in Children with Excess Body Weight in Romania. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020319. [PMID: 36837520 PMCID: PMC9964917 DOI: 10.3390/medicina59020319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Background and Objectives: Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. Materials and Methods: We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. Results: A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Conclusions: Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings.
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Obesity and visceral fat: Indicators for anemia among household women visiting a health camp on world obesity day. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2023.101255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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11
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Cheung YT, Chan DFY, Lee CK, Tsoi WC, Lau CW, Leung JNS, So JCC, Wong CLP, Tsang STY, Chu YYL, Li CK. Iron Deficiency among School-Aged Adolescents in Hong Kong: Prevalence, Predictors, and Effects on Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2578. [PMID: 36767942 PMCID: PMC9916133 DOI: 10.3390/ijerph20032578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/28/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Iron deficiency (ID) is a prevalent nutritional deficiency affecting children/adolescents worldwide. We reported (1) the prevalence of ID and ID with anemia (IDA) among Chinese school-aged adolescents, (2) clinical and dietary predictors of iron status, and (3) its impact on health-related qualities of life (HRQoL). This cross-sectional study recruited 183 boys and 340 girls (mean age = 17.55) from 16 schools in Hong Kong. ID is defined as serum ferritin <15 μg/L. The participants reported their dietary habits, menstrual patterns (girls), and HRQoL using structured questionnaires. The overall prevalence of ID was 11.1%. None of the boys had ID or IDA. Among girls, the rate of ID was 17.1% and IDA was 10.9%. One-third (36.3%) reported a regular habit of skipping ≥1 meal/day. Lower ferritin was found in adolescents who skipped meals (Est = -35.1, p = 0.017). Lower ferritin is correlated with poorer school functioning (Est = 0.81, p = 0.045) and fatigue (Est = 0.92, p = 0.016). Skipping meals is associated with poorer physical (p = 0.0017) and school functioning (p = 0.027). To conclude, 1 in 10 school-aged adolescents in Hong Kong are iron-deficient. The ID rate in girls (17.1%) is similar to that in other industrialized countries (5.2-16.6%). Future work should promote awareness on the potential health consequences of poor dietary habits on ID and the well-being of adolescents.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | - Wai Chiu Tsoi
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | - Ching Wa Lau
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | | | - Jason Chi Chiu So
- Department of Pathology, Hong Kong Children’s Hospital, Hong Kong SAR, China
| | - Chris Lei Po Wong
- Hong Kong Molecular Pathology Diagnostic Centre, Hong Kong SAR, China
| | | | - Yvonne Yuen Ling Chu
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Kong Li
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Kundu S, Alam SS, Mia MAT, Hossan T, Hider P, Khalil MI, Musa KI, Islam MA. Prevalence of Anemia among Children and Adolescents of Bangladesh: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1786. [PMID: 36767153 PMCID: PMC9914578 DOI: 10.3390/ijerph20031786] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 06/18/2023]
Abstract
The prevalence of anemia is high among children and adolescents in low- and middle-income countries because of undernutrition resulting from their poor socioeconomic status and lack of knowledge on proper nutrition. We conducted a systematic review and meta-analysis to determine the prevalence of anemia among children and adolescents aged between 6 months and 19 years in Bangladesh. Databases such as PubMed, Scopus, and Google Scholar were searched to identify the studies that reported the prevalence of anemia among children and adolescents. A total of 24 studies, including the data of 14,062 cases, were included in the systematic review and meta-analysis of the time period between 1997 and 2019. The random-effects model was used to calculate the summary estimates. The protocol was registered with PROSPERO (CRD42021246960). The pooled prevalence of anemia, iron deficiency anemia (IDA), and non-severe and severe anemia were 46.8% [95% CI: 36.0-57.6], 13.6% [95% CI: 8.0-19.2], 56.4% [95% CI: 39.6-73.1] and 0.7% [95% CI: 0.1-1.4], respectively. Prevalence of anemia exhibited the highest among the children aged ≤2 years. Briefly, 91.67% of the studies were of high quality. No significant publication bias was found; however, two outlier studies were detected. The prevalence of anemia among children and adolescents was estimated as high in Bangladesh.
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Affiliation(s)
- Shoumik Kundu
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Sayeda Sadia Alam
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Md Al-Tareq Mia
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Tareq Hossan
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
- Department of Bone Marrow Transplant, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Phil Hider
- Department of Population Health, University of Otago, Christchurch 8140, New Zealand
| | - Md. Ibrahim Khalil
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
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13
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Kassem E, Na’amnih W, Shapira M, Ornoy A, Muhsen K. Comparison between School-Age Children with and without Obesity in Nutritional and Inflammation Biomarkers. J Clin Med 2022; 11:jcm11236973. [PMID: 36498548 PMCID: PMC9739253 DOI: 10.3390/jcm11236973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Childhood obesity is a major health problem. We examined differences between children with obesity and normal weight in nutritional and inflammation biomarkers. A cross-sectional study was conducted among healthy children aged 10-12 years from Arab villages in Israel. Parents were interviewed regarding sociodemographic and children's health status. Body weight and height measurements were performed and weight categories were defined using the 2007 WHO growth curves. Blood samples were tested for complete blood count, levels of iron, ferritin, lipids, uric acid, and C-reactive protein (CRP). Overall, 146 children (59.0% males, mean age = 11.3 [SD = 0.5]) were enrolled. In total 43.8%, 14.1% and 42.3% of the participants had normal weight, overweight and obesity, respectively. A multivariable logistic regression model showed that children with overweight and obesity had lower iron, and HDL-C levels than children with normal weight. Levels of CRP, uric acid, LDL-C and lymphocytes were higher among children with overweight and obesity. In conclusion, our findings highlight the worse metabolic and nutritional status in overweight and obese children. Such markers play a role in metabolic syndrome, thus suggesting that metabolic syndrome might start in childhood.
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Affiliation(s)
- Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera 3810101, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel
| | - Wasef Na’amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Maanit Shapira
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel
- Laboratory Division, Hillel Yaffe Medical Center, Hadera 3810101, Israel
| | - Asher Ornoy
- Adelson School of Medicine, Ariel University, Ariel 4077625, Israel
- Laboratory of Teratology, Department of Medical Neurobiology, The Hebrew University Hadassah Medical School, Jerusalem 9112002, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-3-6405945
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The Association between Index of Nutritional Quality (INQ) and Obesity: Baseline Data of Kharameh Cohort. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8321596. [PMID: 36817069 PMCID: PMC9929214 DOI: 10.1155/2022/8321596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/16/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
Obesity is an increasing problem that can lead to noncommunicable diseases. The role of dietary factors on one's obesity is confirmed in many studies. One nutritional approach that can be used for assessment of the foods and diets is the Index of Nutritional Quality (INQ). Our study is aimed at exploring the association between INQ and obesity. Our hypothesis is that enriched and high-quality diets reduce the risk of overweight or obesity. This study was carried out on 6248 overweight and obese participants, from whom 4356 (69.7%) and 1892 (30.3%) were overweight and obese, respectively. To assess the dietary intake for the participants, a valid food frequency questionnaire (FFQ) with 130 food items was utilized. The analysis revealed an inverse association between the overweight and the INQ of iron, thiamin, riboflavin, B6, folate, zinc, magnesium, calcium, and vitamin C and E. For the obese group, this inverse association was found for iron, B6, folate, zinc, magnesium, calcium, and vitamin C and E. These results approved our hypothesis that a rich nutrition diet may lead to a lower risk of obesity.
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“Ferrocrinology”—Iron Is an Important Factor Involved in Gluco- and Lipocrinology. Nutrients 2022; 14:nu14214693. [DOI: 10.3390/nu14214693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
“Ferrocrinology” is the term used to describe the study of iron effects on the functioning of adipose tissue, which together with muscle tissue makes the largest endocrine organ in the human body. By impairing exercise capacity, reducing AMP-activated kinase activity, and enhancing insulin resistance, iron deficiency can lead to the development of obesity and type 2 diabetes mellitus. Due to impaired browning of white adipose tissue and reduced mitochondrial iron content in adipocytes, iron deficiency (ID) can cause dysfunction of brown adipose tissue. By reducing ketogenesis, aconitase activity, and total mitochondrial capacity, ID impairs muscle performance. Another important aspect is the effect of ID on the impairment of thermogenesis due to reduced binding of thyroid hormones to their nuclear receptors, with subsequently impaired utilization of norepinephrine in tissues, and impaired synthesis and distribution of cortisol, which all make the body’s reactivity to stress in ID more pronounced. Iron deficiency can lead to the development of the most common endocrinopathy, autoimmune thyroid disease. In this paper, we have discussed the role of iron in the cross-talk between glucocrinology, lipocrinology and myocrinology, with thyroid hormones acting as an active bystander.
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Changes in obesity and iron deficiency between 4 and 9 years of age. Longitudinal study of childhood obesity (ELOIN). Int J Obes (Lond) 2022; 46:1992-1999. [PMID: 35931811 DOI: 10.1038/s41366-022-01196-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent studies revealed that children who are overweight have a higher risk of iron deficiency, although the etiology of this relationship remains unclear. The aim of the study was to evaluate the association between changes in obesity status between 4 and 9 years of age and iron deficiency. SUBJECTS This population-based cohort study included 1347 children from the ELOIN study, conducted in Madrid, Spain. Follow-up with physical examinations and a computer-assisted telephone interview were carried out at 4, 6 and 9 years of age, and a blood test was performed at 9 years. METHODS Changes in obesity were estimated based on body mass index and waist circumference, according to the persistence or variation in obesity rates at 4, 6 and 9 years and were classified as follows: (1) Stable without obesity; (2) Remitting obesity at 9 years; (3) Incident obesity or relapse at 9 years; and (4) Stable with obesity. Iron deficiency was defined as transferrin saturation value below 16%. Odds ratios (ORs) for iron deficiency were estimated according to obesity status using logistic regression and adjusted for confounding variables, including C-reactive protein (CRP). RESULTS The prevalence of iron deficiency in the stable general obesity (GO) and abdominal obesity (AO) groups was 38.2% and 41.2%, versus 23.6% and 23.4% in the stable without obesity groups, respectively. The ORs for iron deficiency were 1.85 (95% CI: 1.03-3.32) in the stable GO group and 2.34 (95% CI: 1.29-4.24) in the stable AO group. This association disappeared when CRP was included in the analysis. CONCLUSIONS An extended state of obesity during the first stages of life is associated with iron deficiency, and this association may be mediated by CRP. Prevention and early detection of obesity in children should be a priority to avoid a double burden of malnutrition.
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Szklarz M, Gontarz-Nowak K, Matuszewski W, Bandurska-Stankiewicz E. Can Iron Play a Crucial Role in Maintaining Cardiovascular Health in the 21st Century? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11990. [PMID: 36231287 PMCID: PMC9565681 DOI: 10.3390/ijerph191911990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/01/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
In the 21st century the heart is facing more and more challenges so it should be brave and iron to meet these challenges. We are living in the era of the COVID-19 pandemic, population aging, prevalent obesity, diabetes and autoimmune diseases, environmental pollution, mass migrations and new potential pandemic threats. In our article we showed sophisticated and complex regulations of iron metabolism. We discussed the impact of iron metabolism on heart diseases, treatment of heart failure, diabetes and obesity. We faced the problems of constant stress, climate change, environmental pollution, migrations and epidemics and showed that iron is really essential for heart metabolism in the 21st century.
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18
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Kumar SB, Arnipalli SR, Mehta P, Carrau S, Ziouzenkova O. Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies. Nutrients 2022; 14:nu14142976. [PMID: 35889932 PMCID: PMC9315959 DOI: 10.3390/nu14142976] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/16/2022] Open
Abstract
Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0–5-year-old children and young women of childbearing age, especially during pregnancy. Iron deficiency can lead to life-threatening loss of red blood cells, muscle function, and energy production. Therefore, the pathogenic features associated with IDA are weakness and impaired growth, motor, and cognitive performance. IDA affects the well-being of the young generation and the economic advancement of developing countries, such as India. The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA. However, numerous strategic programs aimed to increase iron intake have shown that improvement of iron intake alone has not been sufficient to mitigate IDA. Emerging critical risk factors for IDA include a composition of cultural diets, infections, genetics, inflammatory conditions, metabolic diseases, dysbiosis, and socioeconomic parameters. In this review, we discuss numerous IDA mitigation programs in India and their limitations. The new multifactorial mechanism of IDA pathogenesis opens perspectives for the improvement of mitigation programs and relief of IDA in India and worldwide.
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Li S, Zhao L, Yu D, Ren H. Attention Should Be Paid to Adolescent Girl Anemia in China: Based on China Nutrition and Health Surveillance (2015-2017). Nutrients 2022; 14:nu14122449. [PMID: 35745178 PMCID: PMC9228540 DOI: 10.3390/nu14122449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Adolescent girls are in the key stages of rapid physical and psychological development and have a great demand for iron. Anemia affects adolescent girls’ health, future development, and even the health of their offspring. There has been limited study of adolescent girl anemia at the national and provincial levels in China. We investigated the anemia status of adolescent girls in China based on data from the China Nutrition and Health Surveillance (CNHS, 2015−2017). The anemia prevalence in Chinese adolescent girls aged 10−17 years is 8.5%, with mild anemia and moderate anemia accounting for 65.9 and 31.8%, respectively, and severe anemia accounting for only 2.3%. Significant urban−rural disparities and regional disparities were found in adolescent girl anemia. The anemia prevalence in adolescent girls varied from 3 to 13.4% in different provinces, and 90% of the provinces had anemia prevalence higher than 5%. Having started menstruating (OR = 2.58, p < 0.01) and living in rural areas (OR = 1.18, p < 0.05) were risk factors for anemia; having a mother with higher education was a protective factor (OR = 0.87, p < 0.05). As for food intake, consuming meat ≥35 g per day was a protective factor (OR = 0.90, p < 0.05). Consuming vegetables ≥3 times per day was also a protective factor (OR = 0.72, p < 0.01), while consuming vegetables ≥400 g per day was a risk factor (OR = 1.24, p < 0.01). Special attention should be paid to adolescent girls, especially to those already having started menstruating, living in rural areas, to those whose mother has a low education level, and to those with a relatively unbalanced diet. Comprehensive measures, including paying special attention to vulnerable areas and vulnerable subgroups of adolescent girls, would reduce the risk of anemia.
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Affiliation(s)
- Shujuan Li
- NHK Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (S.L.); (L.Z.)
| | - Liyun Zhao
- NHK Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (S.L.); (L.Z.)
| | - Dongmei Yu
- NHK Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (S.L.); (L.Z.)
- Correspondence: (D.Y.); (H.R.)
| | - Hongyan Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- Correspondence: (D.Y.); (H.R.)
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20
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Overweight and obese adolescents: A risk group for vitamin B12 deficiency and anemia? JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.898510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Positive Associations between Body Mass Index and Hematological Parameters, Including RBCs, WBCs, and Platelet Counts, in Korean Children and Adolescents. CHILDREN 2022; 9:children9010109. [PMID: 35053734 PMCID: PMC8774222 DOI: 10.3390/children9010109] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/21/2022]
Abstract
We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and 3738 girls) aged 10–18 years were recorded. The parameters were compared among participants with normal weight, overweight, and obesity. Significantly higher mean levels of WBCs (7.16 vs. 6.16 × 103/mm3, p < 0.001), RBCs (4.90 vs. 4.82 × 106/mm3, p < 0.001), Hb (14.07 vs. 13.99 g/dL, p < 0.05), Hct (42.31 vs. 41.91%, p < 0.001), and platelets (311.87 vs. 282.66 × 103/mm3, p < 0.001) were found in the obese than normal weight group, respectively, after adjusting for body mass index (BMI) and sex. BMI SDS had significant positive associations with the levels of WBCs (β = 0.275, p < 0.001), RBCs (β = 0.028, p < 0.001), Hb (β = 0.034, p < 0.001), Hct (β = 0.152, p < 0.001), and platelets (β = 8.372, p < 0.001) after adjusting for age, sex, and socioeconomic factors in a multiple linear regression analysis. A higher BMI was associated with elevated WBC, RBC, Hb, Hct, and platelet counts in children and adolescents. Because higher levels of hematological parameters are potential risk factors for obesity-related diseases, hematological parameters should be evaluated in obese children and adolescents.
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22
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Eiduson R, Heeney MM, Kao PC, London WB, Fleming MD, Shrier LA. Prevalence and Predictors of Iron Deficiency in Adolescent and Young Adult Outpatients: Implications for Screening. Clin Pediatr (Phila) 2022; 61:66-75. [PMID: 34796723 DOI: 10.1177/00099228211059647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Current screening guidelines may not be adequate to identify iron deficiency (ID) and iron deficiency anemia (IDA) in adolescent and young adults. Adolescent and young adult outpatients from 4 hospital-based clinics (N = 493) reported on diet, health, and bleeding, and had phlebotomy for iron and hematologic tests. We examined sex-specific factors associated with ID and IDA and ability of universal and risk factor-based screening using hemoglobin and hemoglobin plus ferritin to detect ID and IDA. Among females (n = 350), 34.6% had ID and 6.3% had IDA. Nearly 1 in 3 females with ID had no risk factors. Among males, 12.6% had ID; none had IDA. More than 1 in 3 males with ID did not have risk factors. Current screening approaches would have missed ID in 47% to 82% of females and 95% to 100% of males. ID was prevalent in both male and female adolescents and young adult outpatients. New approaches to screening for ID are needed to accurately evaluate iron status in this population.
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Affiliation(s)
| | - Matthew M Heeney
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Pei-Chi Kao
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Wendy B London
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
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Hernández-Aguilera A, Casacuberta N, Castañé H, Fibla M, Fernández-Arroyo S, Fort-Gallifa I, París M, Sabench F, Del Castillo D, Baiges-Gaya G, Rodríguez-Tomàs E, Sans T, Camps J, Joven J. Nonalcoholic Steatohepatitis Modifies Serum Iron-Related Variables in Patients with Morbid Obesity. Biol Trace Elem Res 2021; 199:4555-4563. [PMID: 33559024 DOI: 10.1007/s12011-021-02610-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/24/2021] [Indexed: 12/17/2022]
Abstract
Nonalcoholic steatohepatitis (NASH) is frequently associated with severe obesity. The liver is the principal storage repository for iron, and the excessive accumulation of this metal may promote hepatic inflammation. Laparoscopic sleeve gastrectomy (LSG) results in weight loss and improvement in comorbidities such as NASH. The aim of this study was to assess the specific NASH-related changes in iron metabolism and to investigate whether these changes are reversed by LSG. We included 150 patients with morbid obesity who provided 12-h fasting blood samples immediately before LSG together with an intraoperative wedge-liver biopsy. Thirty-eight patients with NASH underwent a second blood extraction 12 months postsurgery. Serum samples were collected from a control group comprising 50 healthy volunteers. We found significantly higher serum iron and transferrin concentrations in patients with NASH along with the highest degrees of steatosis, fibrosis, hepatocellular ballooning, and lobular inflammation. However, we did not find any significant accumulation of iron in the hepatic biopsies. Presurgery serum iron concentrations were lower in the patient group than in the control group and increased 1 year postsurgery. Serum ferritin levels showed changes in the opposite direction. We did not observe any significant change in serum transferrin concentrations. These changes were reversed by LSG. We conclude that alterations in serum iron-related variables are related to the severity of NASH in patients with morbid obesity, and these alterations are reversed by LSG. We also found that severe forms of NASH can be found in the absence of increased iron stores.
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Affiliation(s)
- Anna Hernández-Aguilera
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
| | - Núria Casacuberta
- Laboratoris ICS Camp de Tarragona-Terres de l'Ebre, Universitat Rovira i Virgili, C. Esplanetes 14, 43500, Tortosa, Spain
| | - Helena Castañé
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
| | - Montserrat Fibla
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
| | - Salvador Fernández-Arroyo
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
| | - Isabel Fort-Gallifa
- Laboratoris ICS Camp de Tarragona-Terres de l'Ebre, Universitat Rovira i Virgili, C. Esplanetes 14, 43500, Tortosa, Spain
| | - Marta París
- Universitat Rovira i Virgili, Department of Surgery, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Av. Doctor Josep Laporte 2, 43204, Reus, Spain
| | - Fàtima Sabench
- Universitat Rovira i Virgili, Department of Surgery, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Av. Doctor Josep Laporte 2, 43204, Reus, Spain
| | - Daniel Del Castillo
- Universitat Rovira i Virgili, Department of Surgery, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Av. Doctor Josep Laporte 2, 43204, Reus, Spain
| | - Gerard Baiges-Gaya
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
| | - Elisabet Rodríguez-Tomàs
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
| | - Teresa Sans
- Laboratoris ICS Camp de Tarragona-Terres de l'Ebre, Universitat Rovira i Virgili, C. Esplanetes 14, 43500, Tortosa, Spain
| | - Jordi Camps
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain.
| | - Jorge Joven
- Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, C. Sant Joan s/n, 43201, Reus, Spain
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Kamruzzaman M. Is BMI associated with anemia and hemoglobin level of women and children in Bangladesh: A study with multiple statistical approaches. PLoS One 2021; 16:e0259116. [PMID: 34710186 PMCID: PMC8553127 DOI: 10.1371/journal.pone.0259116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/12/2021] [Indexed: 01/09/2023] Open
Abstract
Background The coexistence of undernutrition and obesity is an emerging problem for developing countries like Bangladesh. Anemia is another critical public health threat, prevalent predominantly among women and children. Undernutrition is linked with a higher risk of anemia, and lower dietary iron intake might be the possible reason. However, the risk of anemia among obese/overweight individuals is controversial. The study explores the relation of BMI with anemia and blood hemoglobin level among women and children in Bangladesh. Methods Multiple statistical approaches were employed to nationally representative secondary data (BDHS 2011) on women (n = 5680) age 15–49 years and children (n = 2373) age 6–59 months to illuminate the relation between BMI and anemia. BMI was categorized according to the WHO recommended BMI category for Asian people. Descriptive statistics were used to measure mean hemoglobin level. Chi-square test, Pearson correlation, Two-way ANOVA, binary, ordinal, and restricted cubic splines (RCS) regression were used to study the association of BMI with anemia and hemoglobin level. Results Chi-square test reveals significant association, though not intense, among BMI and anemia categories of women (15–49 years) (χ2 ≥99, p<2.2e-16 and Cramér’s V = 0.0799–0.1357). From ANOVA analysis, a significant difference in blood hemoglobin level was found among women (total sample and nonpregnant) with different BMI categories (p≤0.05). Binary (Severely Underweight: OR 1.2680, 95% CI 0.755–2.161; Obese: OR 0.4038, 95% CI 0.120–1.177), Ordinal logistic regression (Severely Underweight: OR 1.337, 95% CI 0.842–2.115; Obese: OR 0.504, 95% CI 0.153–1.411) and restricted cubic spline regression (Severely Underweight: OR >1.5; Obese: OR ~0.5) reveal that the risk of anemia was higher among underweight and lower among obese/overweight women compared to normal women. Lower anemia risk among richest women indicates probable higher dietary iron intake among obese/overweight women. Conclusion In the current study, women with overweight/obesity from Bangladesh were shown to have lower likelihood of being anemic, while underweight women more likely to be anemic. However, no relation between BMI and anemia was found among children.
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Affiliation(s)
- Md Kamruzzaman
- Dept. of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
- * E-mail: ,
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Alshwaiyat NM, Ahmad A, Wan Hassan WMR, Al-Jamal HAN. Association between obesity and iron deficiency (Review). Exp Ther Med 2021; 22:1268. [PMID: 34594405 PMCID: PMC8456489 DOI: 10.3892/etm.2021.10703] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
Obesity is a risk factor for several comorbidities and complications, including iron deficiency anemia. Iron deficiency anemia is a serious global public health problem, with a worldwide prevalence. The high prevalence of obesity in combination with iron deficiency incidence observed in different age and sex categories suggests an association between obesity and iron status. Obesity may disrupt iron homeostasis, resulting in iron deficiency anemia. The association between obesity and iron deficiency may be due to increased hepcidin levels mediated by chronic inflammation. Hepcidin is a small peptide hormone that functions as a negative regulator of intestinal iron absorption. Significant body weight loss in overweight and obese individuals decreases chronic inflammation and serum hepcidin levels, resulting in improved iron status due to increased iron absorption. However, further randomized controlled trials are required to confirm this effect.
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Affiliation(s)
- Naseem Mohammad Alshwaiyat
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Terengganu, Terengganu 21300, Malaysia
| | - Aryati Ahmad
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Terengganu, Terengganu 21300, Malaysia.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
| | - Wan Mohd Razin Wan Hassan
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, Kuala Terengganu, Terengganu 20400, Malaysia
| | - Hamid Ali Nagi Al-Jamal
- School of Biomedicine, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Terengganu, Terengganu 21300, Malaysia
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26
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Zhang Z, Funcke JB, Zi Z, Zhao S, Straub LG, Zhu Y, Zhu Q, Crewe C, An YA, Chen S, Li N, Wang MY, Ghaben AL, Lee C, Gautron L, Engelking LJ, Raj P, Deng Y, Gordillo R, Kusminski CM, Scherer PE. Adipocyte iron levels impinge on a fat-gut crosstalk to regulate intestinal lipid absorption and mediate protection from obesity. Cell Metab 2021; 33:1624-1639.e9. [PMID: 34174197 PMCID: PMC8338877 DOI: 10.1016/j.cmet.2021.06.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/06/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
Iron overload is positively associated with diabetes risk. However, the role of iron in adipose tissue remains incompletely understood. Here, we report that transferrin-receptor-1-mediated iron uptake is differentially required for distinct subtypes of adipocytes. Notably, adipocyte-specific transferrin receptor 1 deficiency substantially protects mice from high-fat-diet-induced metabolic disorders. Mechanistically, low cellular iron levels have a positive impact on the health of the white adipose tissue and can restrict lipid absorption from the intestine through modulation of vesicular transport in enterocytes following high-fat diet feeding. Specific reduction of adipocyte iron by AAV-mediated overexpression of the iron exporter Ferroportin1 in adult mice effectively mimics these protective effects. In summary, our studies highlight an important role of adipocyte iron in the maintenance of systemic metabolism through an adipocyte-enterocyte axis, offering an additional level of control over caloric influx into the system after feeding by regulating intestinal lipid absorption.
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Affiliation(s)
- Zhuzhen Zhang
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jan-Bernd Funcke
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zhenzhen Zi
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shangang Zhao
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Leon G Straub
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yi Zhu
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Qingzhang Zhu
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Clair Crewe
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yu A An
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shiuhwei Chen
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Na Li
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - May-Yun Wang
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra L Ghaben
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Charlotte Lee
- Center for Hypothalamic Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Laurent Gautron
- Center for Hypothalamic Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Luke J Engelking
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Prithvi Raj
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yingfeng Deng
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ruth Gordillo
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christine M Kusminski
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Philipp E Scherer
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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The Association between Hepcidin and Iron Status in Children and Adolescents with Obesity. J Nutr Metab 2021; 2021:9944035. [PMID: 34258058 PMCID: PMC8257374 DOI: 10.1155/2021/9944035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/27/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Iron deficiency (ID) is the most common nutritional deficiency found in pediatric practice. A higher prevalence of ID may be found in children with obesity. Obesity is a chronic low-grade inflammatory condition. It is postulated that inflammation increases hepcidin, a regulator of iron homeostasis. The aim of this study was to investigate the associations between iron status, hepcidin, and BMI-standard deviation score (BMI-SDS) in children with and without obesity. Methods A cross-sectional study of Thai children with obesity (5 to 15 years old) versus age- and sex-matched, nonobese controls was conducted. A total of 63 children with obesity and 27 controls were enrolled. Complete blood count, serum iron, ferritin, transferrin saturation, and total iron binding capacity were analyzed. Serum hepcidin-25 was assayed using a hepcidin ELISA Kit (Human Hepc25). Results There were 63 children with obesity, the median age (IQR) being 10 (9–13) years, and 27 controls. The median (IQR) BMI-SDS of the obese group was 2.3 (2.0–2.6) vs. −0.5 ((−1.3)−0.4) of the control group. ID was diagnosed in 27 children in the obese group (42.9%); 4 of the children with obesity and ID had anemia. Serum hepcidin-25 levels of the children with ID vs. without ID in the obese group were not significantly different (median (IQR) 25 (12.9–49.2) and 26.4 (12.6–43.6), respectively) but both of them were significantly higher than controls (19.7 (8.3–25.5) ng/ml, p = 0.04). BMI-SDS was positively correlated with hepcidin-25 (r = 0.28, p = 0.001). Conclusion Prevalence of iron deficiency in Thai children with obesity and serum hepcidin-25 was higher than controls. Further study in a larger population, preferably with interventions such as weight loss program, is warranted to clarify this association.
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Wawer AA, Hodyl NA, Fairweather-Tait S, Froessler B. Are Pregnant Women Who Are Living with Overweight or Obesity at Greater Risk of Developing Iron Deficiency/Anaemia? Nutrients 2021; 13:1572. [PMID: 34067098 PMCID: PMC8151407 DOI: 10.3390/nu13051572] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
Low-grade inflammation is often present in people living with obesity. Inflammation can impact iron uptake and metabolism through elevation of hepcidin levels. Obesity is a major public health issue globally, with pregnant women often affected by the condition. Maternal obesity is associated with increased pregnancy risks including iron deficiency (ID) and iron-deficiency anaemia (IDA)-conditions already highly prevalent in pregnant women and their newborns. This comprehensive review assesses whether the inflammatory state induced by obesity could contribute to an increased incidence of ID/IDA in pregnant women and their children. We discuss the challenges in accurate measurement of iron status in the presence of inflammation, and available iron repletion strategies and their effectiveness in pregnant women living with obesity. We suggest that pre-pregnancy obesity and overweight/obese pregnancies carry a greater risk of ID/IDA for the mother during pregnancy and postpartum period, as well as for the baby. We propose iron status and weight gain during pregnancy should be monitored more closely in women who are living with overweight or obesity.
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Affiliation(s)
- Anna A. Wawer
- Department of Anaesthesia, Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia;
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia;
| | - Nicolette A. Hodyl
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia;
| | - Susan Fairweather-Tait
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK;
| | - Bernd Froessler
- Department of Anaesthesia, Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia;
- Discipline of Acute Care Medicine, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
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Yous F, Zaabar S, Aoun O, Adjeroud-Abdellatif N, Madani K. Comparative mapping approach of energy intake and expenditure of obesity prevalence among school adolescents. Clin Nutr ESPEN 2021; 43:397-407. [PMID: 34024547 DOI: 10.1016/j.clnesp.2021.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims to describe the prevalence of overweight and obesity in an obesogenic environment among adolescents in the wilaya of Bejaia (eastern Algeria), and to assess their Physical Activity Level (PAL), Daily Energy Expenditure (DEE) and Total Energy Intake (TEI). METHODS A cross-sectional study was carried out on a sample of 3038 adolescents consisting of 1635 girls and 1403 boys in middle and high schools in 19 regions of Bejaia. The average age was 14.78 ± 2.53. Two questionnaires were assigned to collect data on their nutritional habits (24-h dietary call) and physical activity levels. BMI measurement was adopted in this study to determine the weight status of this sample and to assess the distribution of BMI, PAL, DEE, TEI over geographical areas of an administrative territory using the Student test descriptive statistical method (p < 0.05). RESULTS The prevalence of obesity and overweight was equal to 3.3%, the physical activity level in adolescents was 1.72 ± 0.21, with boys more likely to participate in sports than girls (16.5% for boys and 6% for girls). However, energy intake (3775.44 ± 719.07 kcal/day), energy expenditure (3144.13 ± 850.54 kcal) and body mass index (30.51 ± 2.99 kg/m2) were high. Body mass index (BMI) is negatively correlated with PAL (r = -0.05) and positively correlated with TEI (r = 0.31) and DEE (r = 0.30), these results show that DEE and TEI factors play an important role in the prevalence of BMI with excessive consumption of high carbohydrate (614.55 g) and fat (98.9 g) foods, which is due to poor diet and are related to insufficient level of physical activity. The mapping shows that there is a disparity between the studied parameters: high BMI, low PAL and consumption of unhealthy foods (DEE, TEI). CONCLUSION The lack of physical activity and the imbalance between energy intake and expenditure are the main factors that could lead to an increased risk of obesity in adolescents.
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Affiliation(s)
- Fouzia Yous
- Laboratoire de Biomathématiques, Biophysique, Biochimie et Scientométrie (L3BS), Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, 06000, Bejaia, Algérie.
| | - Salim Zaabar
- Laboratoire de Biomathématiques, Biophysique, Biochimie et Scientométrie (L3BS), Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, 06000, Bejaia, Algérie
| | - Omar Aoun
- Laboratoire de Biomathématiques, Biophysique, Biochimie et Scientométrie (L3BS), Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, 06000, Bejaia, Algérie; Département de Microbiologie et de Biochimie, Faculté des Sciences, University of M'sila, 28000, M'sila, Algérie
| | - Nawel Adjeroud-Abdellatif
- Laboratoire de Biomathématiques, Biophysique, Biochimie et Scientométrie (L3BS), Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, 06000, Bejaia, Algérie
| | - Khodir Madani
- Centre de Recherche en Technologies Agro-alimentaires. Route de Targua Ouzemmour, 06000, Bejaia, Algérie
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Zhang YX, Chen J, Liu XH. Profiles of anemia among school-aged children categorized by body mass index and waist circumference in Shandong, China. Pediatr Neonatol 2021; 62:165-171. [PMID: 33485821 DOI: 10.1016/j.pedneo.2020.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/29/2020] [Accepted: 11/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The prevalence of childhood obesity has been increasing worldwide. The connection between iron deficiency and obesity has received much research interest. The present study examined the profiles of anemia among school-aged children categorized by obesity-related index in Shandong, China. METHODS A total of 20,172 children aged 7, 9, 12, and 14 years participated in the study, whose hemoglobin (Hb) concentration was measured by laboratory technicians. The prevalence rates of anemia among children within each subgroup categorized by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) were determined. RESULTS On the whole, 3.99% of boys and 6.68% of girls suffer from anemia. Disparities in the prevalence of anemia were observed between different subgroups categorized by BMI, WC and WHtR. For both boys and girls, the prevalence of anemia increased with the severity of thinness and obesity, suggesting that both severe thinness and severe obesity are associated with an elevated prevalence of anemia. CONCLUSION In the era of the obesity pandemic, obesity could potentially add to the burden of anemia, suggesting that obese children should not be ignored when establishing strategies targeted at preventing anemia.
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Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China.
| | - Jian Chen
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Shandong, China.
| | - Xiao-Hui Liu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Shandong, China
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Hoang NTD, Orellana L, Gibson RS, Le TD, Worsley A, Sinclair AJ, Hoang NTT, Szymlek-Gay EA. Multiple micronutrient supplementation improves micronutrient status in primary school children in Hai Phong City, Vietnam: a randomised controlled trial. Sci Rep 2021; 11:3728. [PMID: 33580103 PMCID: PMC7881239 DOI: 10.1038/s41598-021-83129-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/28/2021] [Indexed: 01/21/2023] Open
Abstract
We aimed to determine the efficacy of multiple micronutrient supplementation on the biomarkers of iron, zinc, and vitamin A status across anthropometric status categories in Vietnamese school children. In this 22-week randomised controlled trial, 347 undernourished, normal weight, or overweight/obese children aged 6–9 years were allocated to receive every school day a multiple micronutrient supplement (10 mg iron, 10 mg zinc, 400 µg vitamin A) or a placebo. Haematological indices; circulating ferritin, zinc, and retinol (corrected for inflammation); and C-reactive protein were measured at baseline and 22 weeks. At week 22, linear mixed models showed that mean corpuscular volume increased by 0.3 fL, serum ferritin by 9.1 µg/L, plasma zinc by 0.9 µmol/L, and plasma retinol by 15%, and the prevalence of zinc deficiency decreased by 17.3% points in the intervention group compared to placebo. No intervention effects were found for other haematological indices, or the prevalence of anaemia. Multiple micronutrient supplementation for 22 weeks improved the biomarkers of zinc and vitamin A status and some biomarkers of iron status, and reduced the prevalence of zinc deficiency in Vietnamese school children. Trial registration: This trial was registered on 06/09/2016 at www.anzctr.org.au as ACTRN12616001245482.
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Affiliation(s)
- Ngan T D Hoang
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Tuyen D Le
- National Institute of Nutrition, Hanoi, Vietnam
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | | | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Alkazemi D, Rahman A, Habra B. Alterations in glutathione redox homeostasis among adolescents with obesity and anemia. Sci Rep 2021; 11:3034. [PMID: 33542364 PMCID: PMC7862436 DOI: 10.1038/s41598-021-82579-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022] Open
Abstract
The reduced (GSH)-to-oxidized (GSSG) glutathione ratio represents a dynamic balance between oxidants and antioxidants. However, redox status in adolescents with obesity and anemia has not been investigated. This study investigated the association of erythrocyte GSH redox status (GSH, GSH:GSSG ratio, and glutathione peroxidase [GPx] activity) with anemia and adiposity in adolescents. This case–control study nested in a cross-sectional study enrolled 524 adolescents (268 boys; 256 girls). The prevalence of anemia in overweight and obesity (OWOB) was 5.2% in boys and 11.7% in girls. The GSH:GSSG ratio and GPx activity were significantly higher in girls than in boys (p < 0.001), in anemic than in non-anemic subjects (p < 0.001), and in OWOB than in normal-weight subjects (p < 0.001). Similarly, significantly higher GSH: GSSG level (p < 0.001) and GPx activity (p < 0.001) were found in subjects with 90th percentile waist circumference than in those with < 90th percentile. GPx and GSH:GSSG were positively associated with anemia after adjusting for age, sex, and body mass index (adjusted odds ratio, adjOR [95% confidence interval, CI] 2.18 [1.44–3.29]) or tertiles (adjOR [95% CI], T3 = 2.49 [1.03–6.01]). A similar association was noted for GSH and GPx. A compensatory increased redox defense mechanism exists in anemia and obesity among adolescents without metabolic disturbances.
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Affiliation(s)
- Dalal Alkazemi
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, AlShadadiyah, Kuwait.
| | - Abdur Rahman
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, AlShadadiyah, Kuwait
| | - Banan Habra
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, AlShadadiyah, Kuwait
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Kim TG, Lee SH, Shin S, Cho JH, Kim KW, Ha IH. Sex-related associations among anemia, body mass index, and kidney function in Koreans: A cross-sectional study with propensity analysis. Medicine (Baltimore) 2021; 100:e23990. [PMID: 33530196 PMCID: PMC7850755 DOI: 10.1097/md.0000000000023990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/29/2020] [Indexed: 01/05/2023] Open
Abstract
The association between anemia and body mass index (BMI) in Koreans, considering kidney function, has not been clarified. Thus, we aimed to examine the association between anemia and BMI among Korean adults aged ≥19 years.This retrospective cross-sectional study evaluated male and female Korean adults aged ≥19 years who participated in the 5th, 6th, and 7th Korean National Health and Nutrition Examination Surveys (KNHANES) conducted between 2010 and 2017 were used. The participants were classified as underweight, normal weight, and overweight according to their BMI. Anemia was defined as hemoglobin levels of <13 g/dL for men and <12 g/dL for women according to the World Health Organization standards. Kidney function was evaluated according to the estimated glomerular filtration rate (eGFR), with abnormal kidney function in men defined as eGFR <60 mL/min/1.73 m2. Clinicodemographic variables were analyzed using logistic regression adjusted for weight. After propensity score matching (PSM), 6596 study participants were divided into 2 groups of 3298 participants each. Additionally, subgroup analysis by sex and kidney function was performed.On PSM, similar distribution patterns were obtained between the anemia and non-anemia groups; significant differences in BMI; kidney function; level of hemoglobin, hematocrit, and serum creatinine; iron intake; and eGFR were also observed between these groups. Anemia and BMI showed a significant association in both crude and adjusted logistic regression models. In model 2, which was adjusted for age, sex, education level, household income, alcohol consumption, smoking status, and exercise period, underweight men with abnormal kidney function showed a significantly higher risk of anemia than did normal weight men (odds ratio [OR]: 3.27; 95% confidence interval [CI]: 1.25-8.57; P = .016). Meanwhile, overweight men showed a significantly lower risk of anemia than did normal weight men (OR: 0.48; 95% CI: 0.33-0.70, P < .001).Anemia is associated with BMI according to sex. Compared with normal weight men, underweight men with abnormal kidney function had a significantly higher prevalence of anemia after adjusting for kidney function and sex, thus highlighting their need for careful management for anemia.
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Affiliation(s)
| | - Sook-Hyun Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Anseong
| | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation
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Affiliation(s)
- Schuyler Tong
- Department of Pediatrics and Pediatric Hematology Oncology, University of California at San Francisco Benioff Children's Hospital Oakland, Oakland, CA
| | - Elliott Vichinsky
- Department of Pediatrics and Pediatric Hematology Oncology, University of California at San Francisco Benioff Children's Hospital Oakland, Oakland, CA.,Pediatric Hematology Oncology, University of California, San Francisco, CA
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Hassen HY, Ali JH, Gebreyesus SH, Endris BS, Temesgen AM. National incidence, prevalence and disability-adjusted life years (DALYs) of common micronutrient deficiencies in Ethiopia from 1990 to 2017: estimates from the global burden of diseases study. Glob Health Action 2020; 13:1776507. [PMID: 32615870 PMCID: PMC7480576 DOI: 10.1080/16549716.2020.1776507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/26/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Understanding the national burden and trend of micronutrient deficiencies helps to guide effective intervention strategies under various circumstances. There is, however, a lack of evidence on trends, age- and sex-specific variations in Ethiopia. OBJECTIVE This study aimed to provide evidence on the trends of common micronutrient deficiencies including, dietary iron, iodine, vitamin A and other nutritional deficiencies in Ethiopia, from 1990 to 2017, using findings from the Global Burden of Disease study. METHOD We used estimates from the GBD 2017 study to report the incidence, prevalence and disability-adjusted life years of micronutrient deficiencies in Ethiopia from 1990 to 2017. All estimates, both crude counts, as well as all-age and age-standardized rates per 100,000 population, are accompanied by 95% uncertainty intervals (UIs). We summarized the age- and sex-specific patterns and we compared the burden with the sub-Saharan Africa and global estimate. RESULTS From 1990 to 2017, the age-standardized prevalence rate of dietary iron, vitamin A and iodine deficiency decreased by 20.1%, 16.7%, and 91.6%, respectively. However, MNDs still account for a large number of DALYs in the country. In 2017, the all-age total DALYs due to dietary iron deficiency were estimated to be 448.4 thousand [95% UI: 298.9-640.7], accounting for 1.18% of the total DALYs. Similarly, the all-age total DALYs due to vitamin A deficiency were 397.8 thousand [256.1-589.2]. The total DALYs due to iodine deficiency were estimated to be 89.6 thousand [48.3-155.4]. CONCLUSIONS Micronutrient deficiencies and associated morbidity and mortality are still high in Ethiopia compared with the sub-Saharan and global estimate. Adolescent and early adult females and children aged under-five are disproportionately affected segments of the population. Therefore, in collaboration with other sectors, the National Nutrition Program needs to place greater emphasis upon improving accessibility and utilization of nutrient-rich foods and supplementation, particularly for vulnerable groups of the population.
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Affiliation(s)
- Hamid Yimam Hassen
- Department of Public Health, Mizan Tepi University, Mizan Teferi, Ethiopia
| | - Jemal Haider Ali
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Awoke Misganaw Temesgen
- National Data Management Center, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Institute for Health Metrics and Evaluation, University of Washington, Washington, DC, USA
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Prevalence of iron deficiency among university kendo practitioners in Japan: an observational cohort study. J Int Soc Sports Nutr 2020; 17:62. [PMID: 33287850 PMCID: PMC7720520 DOI: 10.1186/s12970-020-00393-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/18/2020] [Indexed: 01/01/2023] Open
Abstract
Background Iron deficiency is widely recognized as being the cause of anemia in athletes, although iron status in athletes of Kendo, a traditional Japanese martial art based on swordsmanship and practiced as an educational sport, has not been widely investigated. Methods We performed a health assessment on anemia and serum ferritin levels, along with nutrient intake evaluation, for Kendo practitioners in a university in Japan. Results A total of 56 Kendo practitioners (39 male and 17 female) aged between 18 and 23 years participated in the study. No individuals exhibited WHO-defined anemia (less than 13 or 12 g/dL of hemoglobin levels in male or female), while hypoferritinemia (less than 30 ng/mL) was found in seven (41%) females but not in males. Significantly higher body mass index was found in the female athletes with hypoferritinemia compared to females with normo-ferritinemia in sub-analysis (median [interquartile range]; 25.6 [24.2, 26.9] versus 22.6 [21.7, 24.1], respectively. p < 0.05). No significant differences in the intake of iron were registered between males and females (with and without hypoferritinemia) using data from a food-frequency questionnaire survey. Conclusion No apparent anemia was found in adolescent Kendo practitioners, although this study confirmed the presence of hypoferritinemia in several female athletes. Careful follow-up, involving both clinical and nutritional assessment, will be necessary for them to prevent progression into anemia. A future study with larger cohorts in multiple sites is warranted to assess the prevalence of iron deficiency for validation and, if necessary, to devise a strategy for improving the iron status in Kendo athletes.
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Holt RR, Zuelch ML, Charoenwoodhipong P, Al-Dashti YA, Hackman RM, Keen CL. Effects of short-term consumption of strawberry powder on select parameters of vascular health in adolescent males. Food Funct 2020; 11:32-44. [PMID: 31942892 DOI: 10.1039/c9fo01844a] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cardiovascular disease is a leading cause of death in the United States and much of the developed world, costing billions of dollars in lost work time, lower productivity and high health care expenditures. Research on foods and bioactive food components that have cardioprotective benefits may provide new insights as to how modest changes in one's diet may result in a reduced risk of vascular disease. In intervention trials, the consumption of strawberries, either fresh or freeze-dried, has been reported to improve select markers of cardiovascular health, including improved lipid profiles, microvascular function, and platelet reactivity. Consistent with the above, epidemiological studies suggest beneficial effects of strawberries on vascular function. Preliminary studies on the effects of freeze-dried strawberry powder on vascular health are reviewed in the current paper.
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Affiliation(s)
- Roberta R Holt
- Department of Nutrition, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
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Ortíz Pérez M, Vázquez López MA, Ibáñez Alcalde M, Galera Martínez R, Martín González M, Lendínez Molinos F, Bonillo Perales A. Relationship between Obesity and Iron Deficiency in Healthy Adolescents. Child Obes 2020; 16:440-447. [PMID: 32877290 DOI: 10.1089/chi.2019.0276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The relationship between overweight/obesity (excess of weight [EW]) and iron deficiency (ID) is not well defined. Objective: To analyze the relationship between EW and ID in healthy adolescents, assessing the contribution of new diagnostic measures of iron status and erythropoietic activity. Method: A cross-sectional study was made of 405 healthy adolescents, 12-16 years of age. A total of 289 were normal weight (NW) and 116 were otherwise healthy EW. Epidemiological, socioeconomic, diet, BMI Z-score, CRP (C-reactive protein), hematological, iron status, and erythropoietic activity parameters were measured. Statistical tests were Student's, analysis of variance (ANOVA), Chi-square, Pearson's correlation, and odds ratio. Results: ID prevalence in the EW group was 22.6% vs. 29.5% in the NW group (p: 0.3). Greater body weight was associated with lower reticulocyte hemoglobin content (CHr) (NW: 31.3 ± 1.7 pg vs. OW: 30.2 ± 1.7 pg, p: 0.007) and greater CRP (NW: 0.1 ± 0.2 mg/dL vs. OW: 0.2 ± 0.18 mg/dL, p < 0.001), leukocytes (NW: 6.69 ± 1.57 × 103/L vs. OW: 7.43 ± 1.63 × 103/L, p < 0.02), platelets (NW: 265.6 ± 58.9 × 103/L vs. OW: 291.8 ± 54.4 × 103/L, p < 0.002), ferritin (NW: 32.1 ± 17.9 ng/mL vs. OW: 42.8 ± 20.3 ng/mL, p: 0.01), serum transferrin receptor (sTfR) (NW: 1.39 ± 0.4 mg/L vs. OW: 1.73 ± 0.45 mg/L, p: 0.008), sTfR-F index (sTfR/log Ferritin) (NW: 1.06 ± 0.7 vs. OW: 1.33 ± 0.85, p: 0.036) and reticulocyte count (NW: 54.2 ± 18 × 103/L vs. OW: 65.4 ± 24.2 × 103/L, p: 0.003). A positive correlation was observed between the BMI Z-score and CRP, ferritin, sTfR, leukocytes, platelets, and reticulocyte count, and a negative one between the BMI Z-score and CHr and medium corpuscular volume. Conclusions: The prevalence of ID in otherwise healthy EW adolescents was no higher than in NW. The effect of obesity on iron status was low. The findings reveal the concomitant low-grade inflammation, and probably the effect of adiposity on erythropoietic activity. Specific cutoff values for ID in adolescents with OW need to be defined.
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Al Sabbah H. Prevalence of overweight/obesity, anaemia and their associations among female university students in Dubai, United Arab Emirates: a cross-sectional study. J Nutr Sci 2020; 9:e26. [PMID: 32742643 PMCID: PMC7372161 DOI: 10.1017/jns.2020.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 12/21/2022] Open
Abstract
The present study assessed the associations of overweight, obesity and anaemia with selected lifestyle factors, total body fat and abdominal obesity among female university students in Dubai. A total of 251 female students from a national university in Dubai participated in the present study. Weight, height, waist circumference, Hb level and total body fat percentage were measured. Participants also completed a self-reported questionnaire that included items related to the factors of obesity, anaemia and lifestyle. The study was approved by the University Ethical Committee. Almost one-third of the participants were overweight/obese; 8⋅5 % had abdominal obesity while 18⋅1 % had anaemia. Out of the total, 71⋅7 % reported that they have irregular meals and the highest percentages were found among obese (89⋅3 %) and overweight (78⋅0 %) compared with normal-weight (65⋅4 %) students (P < 0⋅05). Overweight/obese students reported that they exercise more than those of normal weight (P = 0⋅05). Students with anaemia reported less exercise than students without anaemia (P = 0⋅05). Also, the percentage of total body fat was found to be the highest (38⋅9 %) among students with anaemia (P < 0⋅05). Overweight, obesity and anaemia are prevalent among female university students. Anaemia seems to be associated with the percentage of total body fat, lack of physical activity and junk food. Further studies are required to investigate the detailed dietary habits of overweight and obese young adult females with anaemia.
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Affiliation(s)
- Haleama Al Sabbah
- Public Health Nutrition Department, Zayed University, Dubai, United Arab Emirates
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Correlations Between Red Blood Cells' Variables, Cardio-Pysiological and Anthropological Variables in Young Athletes. ACTA ACUST UNITED AC 2020; 41:47-55. [PMID: 32573473 DOI: 10.2478/prilozi-2020-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to determine and analyse the relations between anthropometric parameters, red blood cells' (RBC) variables and cardio-physiological parameters in healthy and physically active children and adolescents. MATERIAL AND METHODS In this study 625 subjects, (410 males and 215 females; age span 8 to 18 years) underwent body composition analysis (Matiegka method), blood analysis and ergometry testing (Bruce protocol). RESULTS In both groups, body height and weight were positively correlated with RBC variables. In female group almost all correlations between RBC variables and body components were insignificant. In boys all absolute body mass components showed positive correlations with RBC variables with notice that body fat mass had lowest correlation coefficient. Body fat percent (BF %) did not show any correlation with RBC variables in both gender groups. In boys BF % had moderate negative correlation with aerobic performance: exercise time (ET) and VO2max (rs = -0.41 and rs = -0.39). Lean body components showed weak positive correlations with ET and VO2max. RBC count did not show significant correlation with any cardio-physiological parameter in both groups. Haematocrit and haemoglobin showed weak positive correlations with VO2 max and general endurance (exercise time). In girls all correlations between cardio-physiological and RBC variables were insignificant. The relationship between all body components and all cardio-physiological variables in girls were statistically insignificant. CONCLUSIONS Our findings revealed that there are some expected positive correlations between lean body mass components, aerobic performance and RBC variables in boys, while in girls such relations were not noticed.
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Hirschler V, Lapertosa S, Raquel Scaiola E, Garcia C, Maldonado N, Guntsche Z, Miorin C, Obeziuk A, Molinari C, Gonzalez CD. Adiposity, lifestyle behaviors, and cardiometabolic markers in Argentinean schoolchildren. Clin Chim Acta 2020; 507:280-285. [PMID: 32387636 DOI: 10.1016/j.cca.2020.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND We determined the association between schoolchildren's OW/OB with age, sex, lifestyle behaviors, and cardiometabolic markers. METHODS Age, sex, anthropometric measures, and BP (blood pressure) were recorded in 1249 (554 M) schoolchildren. OW/OB was defined as BMI > 85%ile and BMI > 95%ile respectively. A validated questionnaire for lifestyle behaviors was performed. We offered free laboratory testing to a subgroup of 168 children. RESULTS Schoolchildren aged 8.8 ± 2.1 y from 9 elementary schools in 4 areas of Argentina were examined between April and September 2019. 265 (21.2%) of the children were OW, 265 (21.2%) were OB, and 425 (35%) had central OB. OW/OB was associated with low milk intake (OR = 1.92; 95% CI, 1.1-3.3), skipping breakfast (OR = 2.00; 95% CI, 1.2-3.4), a family history of hypertension (OR = 1.74; 95% CI, 1.1-2.9), and systolic BP (OR = 1.03; 95% CI, 1.01-1.05); adjusted for confounding variables. The subgroup analysis showed that OW/OB children had lower iron (83 vs. 94 ug/dl, respectively) and HDL-C (43 vs. 47 mg/dl) levels, but higher non-HDL-C (107 vs. 99 mg/dl) levels than normal-weight children. Multiple logistic regression analysis showed that OW/OB was inversely associated with iron (OR = 0.99; 95% CI, 0.98-0.998) and HDL-C (OR = 0.94; 95% CI, 0.91-0.97) levels; adjusted for confounding variables. CONCLUSION Adiposity in schoolchildren was associated with unhealthy lifestyle behaviors, higher atherogenic risk, and lower iron concentrations, suggesting that OW/OB children are at increased risk for anemia and cardiometabolic disease.
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Affiliation(s)
| | | | | | | | | | | | - Cecilia Miorin
- Universidad of Cuyo, Argentina; University of La Plata, Argentina
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Prevalence of Iron deficiency in Lebanese schoolchildren. Eur J Clin Nutr 2020; 74:1157-1163. [PMID: 32127687 DOI: 10.1038/s41430-020-0590-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 02/06/2020] [Accepted: 02/17/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The prevalence of iron deficiency in the Lebanese pediatric population is unknown. The aim of this study is to estimate this prevalence in Lebanese schoolchildren and to assess the relation between iron status and related factors. SUBJECTS/METHODS A total of 903 children aged 8-18 years (466 boys and 437 girls) were included in the study. Recruitment was done from ten schools with different SES levels and located in the Great Beirut and Mount Lebanon areas. Serum ferritin was measured in all participants and testosterone was measured only in boys using Immulite chemiluminescent assays. RESULTS For the entire sample, the median serum ferritin concentration was 30.0 [19.8-44.8] ng/mL and the prevalence of iron deficiency (ferritin < 15 ng/mL) was 14.2%. Iron deficiency was higher in girls compared with boys (respectively, 20.8% and 7.9%). This prevalence varied with the SES (respectively, 11.6%, 11.9%, and 16.8% in high, middle, and low SES, p = 0.09). Iron deficiency increased with age (9.5%, 15.7%, and 17.5%, respectively, for the age groups 8-11, 12-14, and 15-18, p = 0.014) and did not differ between normal, overweight, and obese groups (p = 0.07). In boys, a significant positive correlation was observed between ferritin and total testosterone (rho = 0.150, p = 0.001). CONCLUSION The prevalence of iron deficiency is relatively low in Lebanon. Younger boys, menstruating girls, and children from low SES are more prone to iron deficiency, while BMI has no impact.
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Lee YA, Kim SH, Kim HN, Song SW. Are There Differences in Hair Mineral Concentrations Between Metabolically Healthy and Unhealthy Obese Adults? Biol Trace Elem Res 2020; 193:311-318. [PMID: 30972534 DOI: 10.1007/s12011-019-01714-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/01/2019] [Indexed: 12/28/2022]
Abstract
Obesity is a risk factor for metabolic syndrome, dyslipidemia, hypertension, insulin resistance, type 2 diabetes mellitus, and cardiovascular disease. However, obesity is not a homogenous state and not all subjects in an obese population are at an increased risk for metabolic abnormalities. Thus, obesity types can be subdivided into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) according to metabolic status. Body minerals are important and are involved in various metabolic processes that may be related to obesity. Thus, this study determined whether hair mineral concentrations differ between MHO and MUO adults. The associations between metabolic risk factors and hair mineral concentrations were analyzed in 141 obese Korean adults (62 MHO subjects and 79 MUO subjects). The MUO subjects showed significantly higher triglyceride levels, systolic blood pressure, waist circumference and body mass index, lower high-density lipoprotein cholesterol levels, and greater insulin resistance as reflected by the homeostasis model assessment-insulin resistance (HOMA-IR) index compared with MHO subjects. No significant differences in hair mineral concentrations were detected between MHO and MUO adults. Hair iron and cobalt concentrations were significantly negatively correlated with blood pressure in subjects with MHO. In addition, hair zinc concentration was associated with decreased systolic blood pressure. The results of this study suggest that mineral status in obese adults may play a role in metabolic abnormalities. Further studies with a larger number of subjects are warranted to identify the nature of the relationship between hair mineral status and metabolic risk in MHO and MUO subjects.
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Affiliation(s)
- Yun-Ah Lee
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Se-Hong Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Ha-Na Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Sang-Wook Song
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
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Higashida K, Takeuchi N, Inoue S, Hashimoto T, Nakai N. Iron deficiency attenuates catecholamine‑stimulated lipolysis via downregulation of lipolysis‑related proteins and glucose utilization in 3T3‑L1 adipocytes. Mol Med Rep 2020; 21:1383-1389. [PMID: 32016466 DOI: 10.3892/mmr.2020.10929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/29/2019] [Indexed: 11/06/2022] Open
Abstract
Iron deficiency has been associated with obesity and related metabolic disorders. The aim of the present study was to evaluate the effect of iron deficiency on fat metabolism, particularly regarding the lipolytic activity, lipolysis‑related protein expression, and glucose utilization of adipocytes. Differentiated 3T3‑L1 adipocytes were incubated with an iron chelator, deferoxamine mesylate (DFO), for 48 h. Subsequently, basal and isoproterenol‑stimulated lipolytic activities, the proteins involved in lipolysis and glucose utilization were compared with a control (CON). The results revealed that treatment with DFO significantly decreased the free iron content but did not affect total protein and lipid contents in adipocytes. Iron deprivation caused a significant reduction in isoproterenol‑stimulated lipolysis, but not basal lipolysis. Lipolysis‑related proteins, including perilipin A, adipose triglyceride lipase, hormone sensitive lipase and comparative gene identification‑58, were decreased in the DFO compared with the CON group. Furthermore, glucose utilization, a major precursor of 3‑glycerol phosphate for micro‑lipid droplet synthesis during lipolysis and the expression of glucose transporter (GLUT) 4 were significantly lower in the DFO group when compared with the CON group. However, hypoxia‑inducible factor‑1α and GLUT1 expressions were upregulated in DFO‑treated adipocytes. In conclusion, the results indicated that low iron availability attenuated catecholamine‑stimulated lipolysis by downregulating lipolytic enzymes and glucose utilization in 3T3‑L1 adipocytes.
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Affiliation(s)
- Kazuhiko Higashida
- Department of Nutrition, Laboratory of Exercise Nutrition, University of Shiga Prefecture, Hikone, Shiga 522‑8533, Japan
| | - Nodoka Takeuchi
- Department of Nutrition, Laboratory of Exercise Nutrition, University of Shiga Prefecture, Hikone, Shiga 522‑8533, Japan
| | - Sachika Inoue
- Department of Nutrition, Laboratory of Exercise Nutrition, University of Shiga Prefecture, Hikone, Shiga 522‑8533, Japan
| | - Takeshi Hashimoto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525‑8577, Japan
| | - Naoya Nakai
- Department of Nutrition, Laboratory of Exercise Nutrition, University of Shiga Prefecture, Hikone, Shiga 522‑8533, Japan
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Anaemia, iron deficiency, iron-deficiency anaemia and their associations with obesity among schoolchildren in Guangzhou, China. Public Health Nutr 2020; 23:1693-1702. [PMID: 31910936 DOI: 10.1017/s1368980019003604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The association of Fe metabolism with obesity in children remains unclear. The present study aimed to assess the status of Fe metabolism parameters, the prevalence of anaemia, Fe deficiency (ID) and Fe-deficiency anaemia (IDA), and the associations of these variables with obesity in Chinese schoolchildren. DESIGN A cross-sectional study conducted in 5295 schoolchildren aged 7-11 years in Guangzhou, China, 2014-2015. Full data of anthropometric and Fe metabolic parameters were collected to assess obesity, anaemia, ID and IDA. Logistic regression models were established to determine the possible associations of anaemia, ID and IDA with obesity. Two-tailed P values of <0·05 was considered statistically significant. SETTING Guangzhou City, China. PARTICIPANTS Schoolchildren aged 7-11 years (n 5295). RESULTS In this sample, mean Hb concentration was 128·1 g/l and the prevalence of anaemia, ID and IDA was 6·6, 6·2 and 0·6 %, respectively. Of the participants, 14·0 % were overweight and 8·8 % were obese. Importantly, obesity was associated with lower anaemia risk (adjusted OR = 0·553; 95 % CI 0·316, 0·968) but higher ID risk (adjusted OR = 1·808; 95 % CI 1·146, 2·853) after adjustment for confounders. No significant relationship was found between obesity and IDA. CONCLUSIONS Our results confirmed that anaemia and ID remain public health concerns among schoolchildren in Guangzhou, while IDA is remarkably less prevalent. Furthermore, obesity was associated with lower anaemia risk, but higher ID risk. More efforts should be made to prevent the onset of ID and obesity in the same individual, thus improving the health and fitness of children.
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Edlow AG, Guedj F, Sverdlov D, Pennings JLA, Bianchi DW. Significant Effects of Maternal Diet During Pregnancy on the Murine Fetal Brain Transcriptome and Offspring Behavior. Front Neurosci 2019; 13:1335. [PMID: 31920502 PMCID: PMC6928003 DOI: 10.3389/fnins.2019.01335] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 11/27/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Maternal over- and undernutrition in pregnancy plays a critical role in fetal brain development and function. The effects of different maternal diet compositions on intrauterine programing of the fetal brain is a lesser-explored area. The goal of this study was to investigate the impact of two chowmaternal diets on fetal brain gene expression signatures, fetal/neonatal growth, and neonatal and adult behavior in a mouse model. METHODS Throughout pregnancy and lactation, female C57Bl/6J mice were fed one of two standard, commercially available chow diets (pellet versus powder). The powdered chow diet was relatively deficient in micronutrients and enriched for carbohydrates and n-3 long-chain polyunsaturated fatty acids compared to the pelleted chow. RNA was extracted from embryonic day 15.5 forebrains and hybridized to whole genome expression microarrays (N = 5/maternal diet group). Functional analyses of significantly differentially expressed fetal brain genes were performed using Ingenuity Pathways Analysis and Gene Set Enrichment Analysis. Neonatal behavior was assessed using a validated scale (N = 62 pellet-exposed and 31 powder-exposed). Hippocampal learning, locomotor behavior, and motor coordination were assessed in a subset of adults using fear conditioning, open field testing, and Rotarod tests (N = 16 pellet-exposed, 14 powder-exposed). RESULTS Comparing powdered to pelleted chow diets, neither maternal weight trajectory in pregnancy nor embryo size differed. Maternal powdered chow diet was associated with 1647 differentially expressed fetal brain genes. Functional analyses identified significant upregulation of canonical pathways and upstream regulators involved in cell cycle regulation, synaptic plasticity, and sensory nervous system development in the fetal brain, and significant downregulation of pathways related to cell and embryo death. Pathways related to DNA damage response, brain immune response, amino acid and fatty acid transport, and dopaminergic signaling were significantly dysregulated. Powdered chow-exposed neonates were significantly longer but not heavier than pelleted chow-exposed counterparts. On neonatal behavioral testing, powdered chow-exposed neonates achieved coordination- and strength-related milestones significantly earlier, but sensory maturation reflexes significantly later. On adult behavioral testing, powdered chow-exposed offspring exhibited hyperactivity and hippocampal learning deficits. CONCLUSION In wild-type offspring, two diets that differed primarily with respect to micronutrient composition had significant effects on the fetal brain transcriptome, neonatal and adult behavior. These effects did not appear to be mediated by alterations in gross maternal nutritional status nor fetal/neonatal weight. Maternal dietary content is an important variable to consider for investigators evaluating fetal brain development and offspring behavior.
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Affiliation(s)
- Andrea G. Edlow
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Faycal Guedj
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Deanna Sverdlov
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States
- Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, United States
| | | | - Diana W. Bianchi
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States
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Ghattas H, Acharya Y, Jamaluddine Z, Assi M, El Asmar K, Jones AD. Child-level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants. MATERNAL AND CHILD NUTRITION 2019; 16:e12923. [PMID: 31828957 PMCID: PMC7083402 DOI: 10.1111/mcn.12923] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 11/05/2019] [Accepted: 11/15/2019] [Indexed: 12/18/2022]
Abstract
Although the prevalence of obesity has rapidly increased in the low‐ and middle‐income countries of the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public‐health challenge. We examined region‐specific sociodemographic determinants of this double burden of malnutrition, specifically, the co‐occurrence of child stunting and overweight, using Demographic and Health Survey and Multiple Indicator Cluster Survey data (2003–2016) from 11 countries in the MENA (n = 118,585) and 13 countries in the LAC (n = 77,824) regions. We used multiple logistic regressions to model region‐specific associations of maternal education and household wealth with child nutritional outcomes (6–59 months). The prevalence of stunting, overweight, and their co‐occurrence was 24%, 10%, and 4.3% in children in the MENA region, respectively, and 19%, 5%, and 0.5% in children in the LAC region, respectively. In both regions, higher maternal education and household wealth were significantly associated with lower odds of stunting and higher odds of overweight. As compared with the poorest wealth quintiles, decreased odds of co‐occurring stunting and overweight were observed among children from the second, third, and fourth wealth quintiles in the LAC region. In the MENA region, this association was only statistically significant for the second wealth quintile. In both regions, double burden was not statistically significantly associated with maternal education. The social patterning of co‐occurring stunting and overweight in children varied across the two regions, indicating potential differences in the underlying aetiology of the double burden across regions and stages of the nutrition transition.
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Affiliation(s)
- Hala Ghattas
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Yubraj Acharya
- Department of Health Policy and Administration, The Pennsylvania State University, Pennsylvania
| | - Zeina Jamaluddine
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Moubadda Assi
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Khalil El Asmar
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Adu P, Attivor W, Nartey ST, Ephraim RKD, Awuku YA. Low iron stores in preconception nulliparous women; a two-center cross-sectional study in peri-urban Ghana. Nutrition 2019; 71:110604. [PMID: 31811997 DOI: 10.1016/j.nut.2019.110604] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The nutritional status of women affects pregnancy outcomes. Preconception care adequately prepares women for the demands of pregnancy. The aim of this study was to evaluate the prepregnancy iron status of nulliparous women in Ghana to provide empirical data to inform policy formulation. METHODS We recruited 336 nulliparous women of reproductive age from Denkyembour District and Ejura Municipal assemblies, respectively, in the Eastern and Ashanti regions of Ghana. Serum ferritin was estimated to assess the women's iron stores. Hemoglobin (Hb) variants and fecal occult blood were determined for participants using cellulose acetate electrophoresis and lateral flow chromatographic immunoassay, respectively. Logistic regression analysis was used to determine factors associated with depleted iron stores (ferritin < 15 ng/dL). RESULTS Whereas 41.5% of the women were anemic (Hb <11.5 g/dL), 34.5% were iron depleted (serum ferritin <15 g/mL; C-reactive protein <5 ng/dL). Also, 17.1% suffered from iron deficiency anemia (concomitant Hb <11.5 g/dL and serum ferritin <15 ng/dL). Serum ferritin significantly differed among the participants with anemia (P < 0.001). Multivariate regression analysis showed that age (<20 y: adjusted odds ratio [AOR], 13.916, P = 0.002; 20-30 y: AOR, 4.304, P = 0.023), moderate anemia (AOR, 3.045, P = 0.004), Ashanti region (AOR, 3.984, P = 0.002), and mean cell volume <80 fL (AOR, 2.546, P = 0.003) were significantly associated with increased odds of having depleted iron stores. However, body mass index, waist-to-hip ratio >0.85, educational status, or inherited Hb type were not significantly associated with depleted iron stores. CONCLUSION The high prevalence of depleted iron stores in nulliparous women is a severe public health problem that requires attention.
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Affiliation(s)
- Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Waldemer Attivor
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Sampson Takyi Nartey
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Richard K D Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Yaw A Awuku
- Department of Medicine and Therapeutics, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
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Iron status and hepcidin levels as potential regulators of haemoglobin homeostasis in overweight and obese women of childbearing age. J Taibah Univ Med Sci 2019; 14:531-537. [PMID: 31908641 PMCID: PMC6940669 DOI: 10.1016/j.jtumed.2019.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/05/2019] [Accepted: 08/14/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives Overweight is considered a risk factor for anaemia. However, the mechanisms underlying anaemia development in overweight and obese people remain unclear. This study analysed the correlation of iron status (soluble transferrin receptor [sTfR]/log ferritin ratio) and hepcidin levels with haemoglobin (Hb) levels in overweight and obese women of childbearing age. Methods In this cross-sectional study, we recruited 66 women aged 20–29 years with a body mass index ≥23 kg/m2. We gathered data on informed consent, demographic characteristics, questionnaire responses, anthropometric and laboratory values. A Spearman correlation test was performed to determine the correlation. Results The mean levels of ferritin and sTfR were 10.2 ± 8.12 and 22.2 ± 7.96 ng/ml, respectively, and the mean sTfR/log ferritin ratio was 29.3 ± 17.65 nmol/L. The mean hepcidin levels were 9.0 ± 3.05 ng/ml. In total, 75.8% of subjects had low ferritin levels, high sTfR (51.5%) levels, and a high sTfR/log ferritin ratio (87.9%). The sTfR levels (r = −0.359; p = 0.003) and sTfR/log ferritin ratio (r = −0.375; p = 0.002) were negatively correlated with Hb levels. There was no correlation between the levels of hepcidin and Hb (r = −0.140; p = 0.264), but there was a positive correlation between ferritin and Hb levels (r = 0.350; p = 0.004). Conclusion This study showed a correlation between iron status and Hb levels in overweight and obese women of childbearing age. All the women had erythropoiesis with iron deficiency anaemia. We recommend that overweight and obese women undergo further iron parameters for the detection of early anaemia. In this group, the consumption of foods that enhance iron absorption, such as ascorbic acid, should be encouraged.
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Shin H, Lee YN, Lee SJ, Jang YK. [Evaluation of a Community-based Child (Infants and Toddlers) Health Promotion Pilot Project in a Migrant Village in Kyrgyzstan]. CHILD HEALTH NURSING RESEARCH 2019; 25:406-416. [PMID: 35004432 PMCID: PMC8650993 DOI: 10.4094/chnr.2019.25.4.406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/19/2019] [Accepted: 03/23/2019] [Indexed: 12/02/2022] Open
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