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Grosse-Thie C, Vogel M, Baber R, Ceglarek U, Kiess W. Bilirubin Levels in Infancy and Their Associations with Body Weight, Levels of Iron-Related Parameters and Steroid Hormone Levels. Metabolites 2024; 14:393. [PMID: 39057716 PMCID: PMC11279372 DOI: 10.3390/metabo14070393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/13/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
It is assumed that bilirubin is hormonally regulated and influences weight development by preventing weight gain. However, studies in healthy infants are limited. The present study established reference values for bilirubin and investigated whether bilirubin levels are significantly associated with body weight, levels of ferritin and transferrin as well as steroid hormone levels in a study population of three- and six-month-old healthy infants. Data from a total of 411 study visits from the LIFE Child study (Leipzig, Germany) were analyzed. Associations were examined using linear regression analyses. Besides laboratory parameters, anthropometric data were gathered. We found statistically significant associations between body weight and bilirubin levels. In girls, we observed additional associations between bilirubin levels and both ferritin and transferrin concentrations at three months of age. At six months, steroid hormone levels were significantly associated with concentrations of total and indirect bilirubin, with effects differing by sex. Our study thus confirms associations already reported from animal studies and studies in adult populations. Furthermore, we showed that these associations already exist in the first year of life, are influenced by sex and age and, further, depend on the bilirubin type. Our results provide reference values for bilirubin and assist, therefore, in interpreting bilirubin levels in infancy.
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Affiliation(s)
- Charlotte Grosse-Thie
- LIFE Child, LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany; (M.V.); (R.B.); (U.C.); (W.K.)
- Center for Pediatric Research (CPL), Department of Women and Child Health, Hospital for Children and Adolescents, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Mandy Vogel
- LIFE Child, LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany; (M.V.); (R.B.); (U.C.); (W.K.)
- Center for Pediatric Research (CPL), Department of Women and Child Health, Hospital for Children and Adolescents, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Ronny Baber
- LIFE Child, LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany; (M.V.); (R.B.); (U.C.); (W.K.)
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), Leipzig University, Paul-List Str. 13/15, 04103 Leipzig, Germany
| | - Uta Ceglarek
- LIFE Child, LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany; (M.V.); (R.B.); (U.C.); (W.K.)
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), Leipzig University, Paul-List Str. 13/15, 04103 Leipzig, Germany
| | - Wieland Kiess
- LIFE Child, LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany; (M.V.); (R.B.); (U.C.); (W.K.)
- Center for Pediatric Research (CPL), Department of Women and Child Health, Hospital for Children and Adolescents, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
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Guo Y, Yu L, Wu ZY, Deng YH, Wu JL. Gender-specific association between serum ferritin and neurodevelopment in infants aged 6 to 12 months. Sci Rep 2023; 13:2490. [PMID: 36781973 PMCID: PMC9925425 DOI: 10.1038/s41598-023-29690-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Early iron deficiency has detrimental consequences on neurodevelopment; whether male and female infants are equally susceptible to the functional outcomes of iron deficiency is unclear. This study aimed to investigate the sex differences in the association between serum ferritin levels and neurodevelopment in infants. Data for this cross-sectional study were drawn from hospital information and early childhood development program service systems at Guangdong Women and Children's Hospital, Guangzhou, China. In total, 4579 infants aged 6-12 months were included from July 2018 to March 2020. Their neurodevelopment was assessed using the Children Neuropsychological and Behavior Scale-Revision 2016. Serum ferritin levels were measured by chemiluminescence assay. The association between serum ferritin levels and neurodevelopmental delay in each domain was estimated using logistic regression models adjusted for potential confounders. The mean concentration of serum ferritin was 35.56 ± 21.57 ng/mL. Serum ferritin levels were significantly higher in female than in male infants (P < 0.001). Iron deficiency (serum ferritin levels < 12 ng/mL) was significantly more prevalent in male than in female infants (P < 0.001). Linear regression revealed a positive association between serum ferritin levels and general quotient, gross motor, fine motor, language, and adaptive behavior in females. Iron deficiency was significantly associated with an increased risk of adaptive behavior delay in females (adjusted odds ratio (OR), 2.22; 95% confidence interval (CI): 1.17-4.20). Iron deficiency anemia was associated with an increased risk of developmental delay for general quotient (adjusted OR, 4.88; 95% CI: 1.74-13.65), fine motor (adjusted OR = 2.58, 95%: CI: 1.13-5.94) and adaptive behavior (adjusted OR, 3.38; 95% CI: 1.51-7.57) among females, but not in males. Associations between serum ferritin levels and neurodevelopment in infants aged 6-12 months were sex-related. Females with iron deficiency, especially those with iron-deficiency anemia, were more susceptible to neurodevelopmental delay than males.
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Affiliation(s)
- Yong Guo
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Li Yu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Zi-Yu Wu
- Department of Medical Ultrasound, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Yu-Hong Deng
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Jie-Ling Wu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China.
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DelRosso LM, Mindell J, Bruni O, Mogavero MP, Ferri R. Periodic leg movements during sleep and iron status in infants with prematurity, Down syndrome and Prader-Willi syndrome. J Sleep Res 2022:e13813. [PMID: 36567415 DOI: 10.1111/jsr.13813] [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: 09/09/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022]
Abstract
Sleep disturbances including bedtime problems and night awakenings are common during infancy. Polysomnography during the first years of life is performed mainly to rule out sleep-disordered breathing; however, sleep-related movement disorders can constitute a significant contributor to sleep disruption in this age group. Almost no studies have investigated the presence of periodic limb movements during sleep and underlying iron deficiency in infants, especially in those born preterm or with an underlying genetic syndrome. In this retrospective study we included infants 3-24 months referred for polysomnography for snoring or frequent nocturnal awakenings. All children had bloodwork (ferritin and haemoglobin) conducted within 3 months of the overnight sleep study. We studied 79 infants, including 31 (39.2%) full-term without diagnosis, 10 (12.7%) born premature, 16 (20.3%) with Down syndrome, 15 (19.0%) with Prader-Willi syndrome, and the remaining seven (8.9%) had various disorders. Compared with those with Down syndrome, Prader-Willi syndrome and full-term infants, those with prematurity showed a statistically significant elevated periodic limb movement index and lower ferritin levels than the other groups. Both ferritin (r = -0.18) and haemoglobin (r = -0.30) were negatively correlated with periodic limb movement index; however, this correlation reached statistical significance only for haemoglobin. Iron deficiency is associated with increased periodic leg movements during sleep in infants. Infants with prematurity had higher periodic limb movement index and lower ferritin levels than infants with Down syndrome, Prader-Willi syndrome or without diagnosis.
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Affiliation(s)
- Lourdes M DelRosso
- Pulmonary and Sleep Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Jodi Mindell
- Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA.,Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Maria P Mogavero
- Vita-Salute San Raffaele University, Milan, Italy.,Sleep Disorder Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy
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Chouraqui JP. Dietary Approaches to Iron Deficiency Prevention in Childhood—A Critical Public Health Issue. Nutrients 2022; 14:nu14081604. [PMID: 35458166 PMCID: PMC9026685 DOI: 10.3390/nu14081604] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 12/15/2022] Open
Abstract
Iron is an essential nutrient, and individual iron status is determined by the regulation of iron absorption, which is driven by iron requirements. Iron deficiency (ID) disproportionately affects infants, children, and adolescents, particularly those who live in areas with unfavorable socioeconomic conditions. The main reason for this is that diet provides insufficient bioavailable iron to meet their needs. The consequences of ID include poor immune function and response to vaccination, and moderate ID anemia is associated with depressed neurodevelopment and impaired cognitive and academic performances. The persistently high prevalence of ID worldwide leads to the need for effective measures of ID prevention. The main strategies include the dietary diversification of foods with more bioavailable iron and/or the use of iron-fortified staple foods such as formula or cereals. However, this strategy may be limited due to its cost, especially in low-income countries where biofortification is a promising approach. Another option is iron supplementation. In terms of health policy, the choice between mass and targeted ID prevention depends on local conditions. In any case, this remains a critical public health issue in many countries that must be taken into consideration, especially in children under 5 years of age.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Pediatric Nutrition and Gastroenterology Unit, Woman, Mother and Child Department, University Hospital of Lausanne, 1011 Lausanne, Switzerland
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