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Query: UMLS:C0240066 (iron deficiency)
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The association between iron deficiency anaemia and cognitive function impairment has been widely reported in young children, but whether the impairment is a result of iron deficiency per se or a combination of iron deficiency and anaemia, and how these conditions interact, is still questionable. Four hundred and twenty-seven school children from two schools in socioeconomically deprived communities were selected in southern Thailand. Iron status was determined by haemoglobin and serum ferritin concentrations. Cognitive function in this study was measured by IQ test and school performance, including Thai language and mathematics scores, using z-scores based on distributions within the same grade and school. Data on demography and socioeconomic status were collected by questionnaire answered by the parents. Linear regression models were used to investigate the effect of anaemia and iron deficiency, reflected by haemoglobin and serum ferritin concentration, on cognitive function and school performance. We found that cognitive function increased with increased haemoglobin concentration in children with iron deficiency, but did not change with haemoglobin concentration in children with normal serum ferritin level. Children with iron deficiency anaemia had consistently the poorest cognitive function (IQ, 74.6 points; Thai language score, 0.3 SD below average; and mathematics score, 0.5 SD below average). Children with non-anaemic iron deficiency but with high haemoglobin levels had significantly high cognitive function (IQ, 86.5 points; Thai language score, 0.8 SD above average; and mathematics score, 1.1 SD above average). This study found a dose-response relationship between haemoglobin and cognitive function in children with iron deficiency, whereas no similar evidence was found in iron sufficient children.
Asia Pac J Clin Nutr 2002
PMID:Effects of haemoglobin and serum ferritin on cognitive function in school children. 1207 77

Surveys in Australia, New Zealand and other industrialised countries report that many adolescent girls have dietary intakes of iron and zinc that fail to meet their high physiological requirements for growing body tissues, expanding red cell mass, and onset of menarche. Such dietary inadequacies can be attributed to poor food selection patterns, and low energy intakes. Additional exacerbating non-dietary factors may include high menstrual losses, strenuous exercise, pregnancy, low socioeconomic status and ethnicity. These findings are cause for concern because iron and zinc play essential roles in numerous metabolic functions and are required for optimal growth, immune and cognitive function, work capacity, sexual maturation, and bone mineralization. Moreover, if adolescents enter pregnancy with a compromised iron and zinc status, and continue to receive intakes of iron and zinc that do not meet their increased needs, their poor iron and zinc status could adversely affect the pregnancy outcome. Clearly, intervention strategies may be needed to improve the iron and zinc status of high risk adolescent subgroups in Australia and New Zealand. The recommended treatment for iron deficiency anaemia and moderate zinc deficiency is supplementation. Although dietary intervention is often recommended for treating non-anaemic iron deficiency and mild zinc deficiency, it is probably more effective and appropriate for prevention than for the treatment of suboptimal iron and zinc status. Many of the strategies for enhancing the content and bioavailability of dietary iron are also appropriate for zinc.
Asia Pac J Clin Nutr 2002
PMID:Risk of suboptimal iron and zinc nutriture among adolescent girls in Australia and New Zealand: causes, consequences, and solutions. 1249 46

Dietary habits, especially micronutrient intake, and nutritional status of Vietnamese primary school girls were investigated in a cross-sectional survey. We interviewed 284 girls aged 7 to 9 years old, randomly selected from three rural (N=148) and two urban (N=136) primary schools. Dietary data were calculated from the results of 24-h recall interviews over three consecutive days. The dietary micronutrient pattern of the rural group showed deficiency of iron, calcium, phosphorus, potassium, magnesium, beta-carotene, vitamin A and vitamin C. On the contrary, adequate consumption of these elements, except low beta-carotene, was observed in the urban group. Despite a low prevalence of anaemia, the prevalence of rural children with iron deficiency was close to the level regarded as being a public health problem. In contrast, 7.7% of urban children were found to have excessive iron status. Children with exhausted retinol stores (7.1%) requiring immediate retinol supplementation were only found in the rural group. Furthermore, the prevalence of children with marginal retinol stores in both the rural (35.7%) and urban (21.4%) groups was above the level of being a public health problem (20%). In both groups, more than 50% and 20% of children showed beta-carotene and tocopherol levels in the range of severe deficiency, respectively. Thus, nutritional education to improve the dietary habits of the two groups is necessary for Vietnamese primary school children.
Asia Pac J Clin Nutr 2003
PMID:Micronutrient status of primary school girls in rural and urban areas of South Vietnam. 1281 Apr 8

The recognition that nutritional status plays a role in altering susceptibility to lead absorption and toxicity has triggered the development of this review. There has been a significant increase worldwide in awareness and concern about the effects of lead on human health and the environment over the last two decades. Both occupational and environmental exposures to lead remain a serious problem in many developing and industrialising countries, as well as in some developed countries. Port Pirie (South Australia) has the world's largest lead smelter and the surrounding population continues to be exposed to environmental lead. The increased awareness of the detrimental impacts of 100 years of smelting at Port Pirie led in 1984 to the development of the Lead Implementation Program, run by the Environmental Health Centre (EHC), Department of Human Services (DHS). The major focus of the program is to reduce household lead exposure for pregnant women and children below the age of five years. Despite intervention efforts by all stakeholders in Port Pirie, 55% of children less than 4 years old have blood lead levels above the National Health and Medical Research Council (NH&MRC) goal of 10 microg/dl. The Port Pirie Lead Implementation Program includes components on nutrition education aimed at reducing lead absorption and toxicity. However, nutritional intake and nutritional status of Port Pirie residents, in particular children under five years, has not been evaluated. This review focuses on nutrition as a component of intervention in lead toxicity and it discusses the nutritional concerns in relation to lead exposure. Fortunately most food patterns that reduce susceptibility to lead toxicity are consistent with recommendations for a healthy diet. The relationship between nutritional status and lead uptake and toxicity is most clearly established for irregular food intake (i.e. periods of fasting), marginal calcium ingestion and (subtle) iron deficiency.
Asia Pac J Clin Nutr 2003
PMID:Lead exposure, interactions and toxicity: food for thought. 1467 61

Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 +/-2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb <12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of iron deficiency in adolescents from low-income areas by dietary modification and micronutrient supplementation amongst female adolescents.
Asia Pac J Clin Nutr 2004
PMID:Iron status and dietary iron intake of adolescents from a rural community in Sabah, Malaysia. 1500 14

Zinc and copper deficiency is associated with anaemia or iron deficiency and affects fetus growth and pregnant women during pregnancy. To examine iron, zinc and copper status of Chinese pregnant women with and without anaemia in the third trimester, 1185 subjects were enrolled for measurements of Hb, ferritin, transferrin, soluble transferrin receptor (sTfR), and serum iron, zinc and copper. The results showed that there were lower levels of ferritin (14.1 microg/L) and transferrin (3.33 g/L) in subjects with Hb<or=100g/L as compared with subjects with Hb>or=101 g/L. sTfR levels in subjects with Hb<or=100g/L were significantly higher than those in subjects with Hb>or=120 g/L (38.5 nmol/L vs. 25.04 nmol/L, P<0.001). Serum iron was lower in subjects with Hb<or=100 g/L than those with Hb>or=120 g/L (871 microg/L vs. 990 microg/L, P<0.01). Lower levels of serum iron and zinc were also found in anaemic (Hb<110 g/L) as compared with non-anaemic women (Hb>or=110 g/L). Frequencies of marginal deficiencies in serum iron and zinc were 41.58% and 51.05% respectively higher in anaemic than in non-anaemic subjects. Distribution of serum zinc and iron showed a decreasing trend as Hb decreased. Few anaemic as well as non-anaemic subjects had copper deficiency although copper and Hb levels were found inversely correlated and the ratio of copper/iron was higher in anaemic than in non-anaemic group. In conclusion, a lower level of serum zinc in anaemic pregnant women might be related to anaemia and iron deficiency during pregnancy. Therefore, combined zinc and iron supplementation should be recommended to Chinese pregnant women, especially those with anaemia.
Asia Pac J Clin Nutr 2004
PMID:Comparison of serum levels of iron, zinc and copper in anaemic and non-anaemic pregnant women in China. 1556 39

Iron status, prevalence of iron deficiency and elevated iron stores, and the effect of gastrointestinal ulceration on iron status in free-living Taiwanese elderly persons were all assessed in a nationally representative, cross-sectional nutrition survey--the Elderly NAHSIT. The survey included blood measurements of iron indices. Data were collected from 1202 elderly men and 1152 elderly women aged 65 years and older. Multiple iron measures, including serum ferritin (SF), transferrin saturation (Tsat), and hemoglobin were used to evaluate the prevalence of iron deficient erythropoiesis (ID) and iron deficiency anemia (IDA). Despite no routine practice of iron fortification in Taiwan, elderly subjects had a low prevalence of ID and IDA. The prevalence of ID was 2.3% in men and 1.4% in women. The prevalence of IDA was 2.5% in men and 2.0% in women. In contrast, 15.7% of men and 9.8% of women had elevated iron stores as diagnosed by SF>300 microg/L. Subjects with a history of gastrointestinal ulceration had significantly lower serum ferritin than those without ulcers, but the prevalence of anemia, ID and IDA was unaffected. In conclusion, elderly people in Taiwan are an iron-replete population with a high prevalence of elevated iron stores and a low prevalence of iron deficiency.
Asia Pac J Clin Nutr 2005
PMID:Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores. 1616 40

Extensive data from animal and human studies indicate that iron deficiency impairs thyroid metabolism. The aim of this study was to determine thyroid hormone status in iron-deficient adolescent girls. By stepwise random sampling from among all public high schools for girls in Lar and its vicinity in southern Iran, 103 out of 431 iron deficient subjects were selected. Urine and serum samples were collected and assayed for urinary iodine and serum ferritin, iron, total iron binding capacity (TIBC), thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroid hormones (fT4 and fT3), triiodothyronine resin uptake (T3RU), reverse triiodothyronine (rT3), selenium and albumin concentrations. Hematological indices for iron status confirmed that all subjects were iron-deficient. There was a significant correlation between T4 and ferritin (r = 0.52, P < 0.001) and between TSH and ferritin (r = -0.3, P < 0.05). Subjects with low serum ferritin had a higher ratio of T3/T4 (r = -0.42, P < 0.01). Using stepwise regression analysis, only ferritin contributed significantly to the rT3 concentration (r = -0.35, P < 0.01). The results indicate that the degree of iron deficiency may affect thyroid hormone status in iron-deficient adolescent girls.
Asia Pac J Clin Nutr 2006
PMID:The relationship between iron status and thyroid hormone concentration in iron-deficient adolescent Iranian girls. 1650 Aug 78

Anaemia due to iron deficiency is still a widespread problem. Among adolescent girls, it will bring negative consequences on growth, school performance, morbidity and reproductive performance. This cross sectional study aimed to identify the different nutritional and iron status characteristics of young adolescent girls 10-12 years old with iron deficiency anaemia and anaemia without iron deficiency in the rural coastal area of Indonesia. Anaemic girls (N =133) were recruited out of 1358 girls from 34 elementary schools. Haemoglobin, serum ferritin, serum transferrin receptor and zinc protophorphyrin were determined for iron status, whilst weight and height were measured for their nutritional status. General characteristics and dietary intake were assessed through interview. Out of 133 anaemic subjects, 29 (21.8%) suffered from iron deficiency anaemia, which was not significantly related to age and menarche. About 50% were underweight and stunted indicating the presence of acute and chronic malnutrition. The proportion of thinness was significantly higher (P < 0.05) among subjects who suffered from iron deficiency anaemia (51.7% vs. 29.8%). Furthermore, thin subjects had a 5 fold higher risk of suffering from iron deficiency anaemia (P< 0.05) than non-thin subjects (OR: 5.1; 95%CI 1.34-19.00). Further study was recommended to explore other factors associated with anaemia and iron deficiency anaemia, such as the thalassemia trait and vitamin A deficiency. The current iron-folate supplementation program for pregnant women should be expanded to adolescent girls.
Asia Pac J Clin Nutr 2006
PMID:Anaemia and iron deficiency anaemia among young adolescent girls from the peri urban coastal area of Indonesia. 1683 27

We conducted a cross sectional study to examine the association of intestinal parasitic infections and protein energy malnutrition (PEM) with iron-status indicators and anaemia among Orang Asli children in Selangor, Malaysia. A total of 281 children aged 2 - 15 years were studied. The data were collected using structured questionnaires, anthropometric measurements and laboratory analysis for blood and faecal samples. All children were infected either by A. lumbricoides, T. trichiura or hookworm and almost 19%, 26% and 3% of the children had severe infection of ascariasis, trichuriasis and hookworm infection respectively. The prevalence of giardiasis among them was 24.9%. Overall, 41.5% of the children were anaemic (haemoglobin < 11.0 g/dL). Of these 61.0% of the children had iron deficiency and 36.5% had iron deficiency anaemia (IDA), which accounted for 88.0% of anaemia in this population. Severe trichuriasis had the most significant correlation with anaemia and iron deficiency in this population. It contributed to low concentrations of haemoglobin, serum iron and serum ferritin and high total iron binding capacity (TIBC). Significant underweight and stunting were associated with low concentrations of haemoglobin and serum iron while significant wasting was significantly associated with low concentration of serum ferritin. Logistic regression analysis confirmed that severe trichuriasis was a strong predictor of IDA. It also confirmed that children who were significantly underweight and whose mother was working were independent predictors of IDA in this population.
Asia Pac J Clin Nutr 2007
PMID:Serum iron status in Orang Asli children living in endemic areas of soil-transmitted helminths. 1804 35


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