Serum ferritin and haematological variables were determined in 476 healthy French students (21.3 +/- 0.2 years). Information was collected on the duration of menses and contraceptive uses. Dietary intakes were assessed by the dietary history method in a randomized subsample of 157 women. The proportion of anaemic subjects was low, but 16 per cent of women had exhausted iron stores (serum ferritin less than or equal to 12 micrograms/l). Duration of menses was negatively correlated with serum ferritin concentration. The mean iron intake was 10.92 +/- 0.02 mg/d. Only fewer than 5 per cent of the students had daily iron intakes corresponding to the recommended dietary allowances for menstruating women (greater than or equal to 16 mg/d). There was a positive correlation between energy consumption and iron intake (r = 0.79, P less than 10(-9) ). Tea and dairy products intakes appeared to have a significant negative correlation with serum ferritin. The positive correlation between serum ferritin and haemoglobin suggests that decreased or depleted iron stores are associated with suboptimal haemoglobin values. This raises the problem of the definition of normal serum ferritin and haemoglobin values in menstruating women.
Dietary iron intake has been estimated in 337 healthy, menstruating women, of high social conditions by dietary histories. The mean daily iron intake was 11 +/- 0.13 mg, of which 33% was supplied by meat and fish, whereas fruits and vegetables supplied 29%. The mean daily energy intake was 2,088 +/- 27 kcal (8,723 +/- 113 kJ). In 96.5% of the women, iron intake was lower than the Recommended Dietary Allowances (16-18 mg daily). There was a significantly positive correlation between energy intake and iron intake (r = 0.77; p less than 10(-9]. Therefore, the low iron intake may be considered as a consequence of a decrease in the energy intake observed during the last decades in industrialized countries. Iron fortification of one or several foods seems to be advisable to compensate, at least, partly iron intake deficiency.
Further collaborators: Camille Pouchieu, Emmanuelle Kesse-Guyot<br/>Further collaborators: Camille Pouchieu, Emmanuelle Kesse-Guyot
An assessment of iron and folacin status was performed on 222 pregnant women presenting for delivery at the maternity wards of Biskra (eastern Algeria). Anaemia (according to the WHO references) was observed in 41.9% of pregnant women. Iron depletion defined only by a low serum ferritin concentration (12 μg/1 or less) was observed in 9.5% of women. Iron deficiency was defined by the presence of abnormalities of 2 or more independent indicators of iron status (transferrin saturation less than 16%, mean corpuscular volume less than 80 fl, serum ferritin of 12 μg/1 or less). According to this definition, 75 (33.8%) women were iron deficient, while 50 were anaemic. The frequency of folate deficiency (defined by red cell concentration below 100 μg/1) was 51.9%. Biological evidence of folate deficiency was associated with anaemia in 18.2% of women. Iron and folate deficiencies may be explained by poor iron and folate intakes and particularly by the low bioavailability of dietary iron. If these data are confirmed, it will be necessary to develop strategies for combating iron and folacin deficiency in pregnant women using supplementation, fortification of foods and nutritional education.
Indicators of iron status, markers of inflammatory processes, serum immunoglobulins and C3 and C4 components of complement were assessed in 142 children 10-months old. All the iron parameters and most of the indicators of humoral immunity were correlated with markers of inflammation. Sixty-two children presented biochemical indications of inflammation (high CRP or orosomucoid level, or hyperleukocytosis), while 80 children were free of it. In the latter group, the use of a combination of iron indicators enabled separation of iron-sufficient children from those with different degrees of iron deficiency, ranging from iron depletion to iron-deficiency anemia. Serum IgG and IgA were significantly lower only in the group of iron-depleted children. Serum ferritin was significantly positively correlated with IgA, IgM and C4. Iron depletion may be responsible for a decrease humoral immunity. This effect was not visible at more advanced stages of iron deficiency.
Indicators of iron status and protein status as well as markers of inflammatory processes were determined in 164 apparently healthy children 4 years old (±3 months) undergoing a free medical check-up in a Parisian Children's Health Examination Center. Biochemical evidence of inflammatory syndrome (without clinical signs) was observed in 32 children. Among the indicators of protein status, only the mean thyroxine-binding prealbumin was significantly lower in the group of children with inflammation than in the inflammation-free group. Among indicators of iron status, mean serum iron and transferrin saturation were significantly lower, and mean serum ferritin, significantly higher, in children with inflammatory processes. Seventy-eight percent of children with biochemical inflammatory processes had serum ferritin levels higher than 50μg/liter, and 42% had serum ferritin levels higher than 80μg/liter.Our study shows that mild inflammatory processes are not uncommon in young, apparently healthy children and may affect the capacity of prealbumin to reflect protein status as well as the capacity of most iron parameters to assess iron status. Serum ferritin, serum iron, and transferrin saturation seem to be most affected by the presence of a mild inflammatory reaction.
Read moreThe iron levels were evaluated in 124 pregnant women towards the end of their pregnancies and in their newborn babies in 4 maternity units in Paris and in the surroundings. Two-third of the women studied had total absence of iron reserves (shown by a serum ferritin level less than or equal to 12 micrograms/l). Those who were at the greatest risk of having iron deficiency or anaemia were immigrant, non continental french and multiparous women. The tissue reserves of iron in the newborn are not directly linked to the levels of iron in the mother but are probably linked to the foetal and maternal haemoglobin-synthesis.
Read moreSerum ferritin, hemoglobin, serum iron and transferrin iron-binding capacity were evaluated in 107 healthy female students. 21 women had a serum ferritin of 12 micrograms/l or less, corresponding to an exhaustion of body iron stores. After 1 month of iron supplementation, significant increase of hemoglobin concentration and decrease of total iron-binding capacity were observed. Mean serum ferritin had increased from 24 to 41 micrograms/l, and all women had a serum ferritin above 12 micrograms/l. 1 month after the end of the trial, serum ferritin fell significantly. This study points out the problem of serum ferritin reference values and the definition of normal iron stores in menstruating women.
Read moreSensitivity analysis: association between neighborhood education, distance to work* and the probability of reporting any active commuting (N = 1169). (DOCX 14 kb)
Read moreSerum ferritin, haemoglobin, serum iron and total iron binding capacity were determined in 203 healthy menstruating women (32.9 +/- 0.6 years). Demographic and medical data were collected in the whole sample. Dietary intakes were evaluated by the dietary history method in a randomized subsample of 127 women. One fifth of the women had exhausted iron stores, as defined by a serum ferritin of 12 micrograms/l or less. The duration of menses influenced the serum ferritin concentration but contraception did not. Most of women had daily iron intake below the recommended dietary allowances for menstruating women. Serum ferritin was not correlated with daily total iron intake. But a relationship was found between serum ferritin and dietary intakes; intakes of meat, dairy products and coffee had a significant effect of serum ferritin concentration.
Read moreIron status, folacin status, haemoglobinopathies, malarial infection and intestinal parasitosis frequencies were assessed in a representative sample of 586 subjects living in a rural district of South Benin. Anaemia according to WHO reference values for haemoglobin was observed in 42 per cent of subjects. The prevalence was higher in children and menstruating women. Iron deficiency, defined by two or more abnormal values in the four independent indicators of iron status used (transferrin saturation, erythrocyte protoporphyrin, serum ferritin, and mean corpuscular volume) was present in 30 per cent of subjects. Half of the anaemias were associated with iron deficiency. Folate deficiency was associated with anaemia in 20 per cent of subjects. Anaemia, iron and folacin status were not significantly related to the degree of malarial infection nor to the type of haemoglobin. Although hookworm infection was very common, there was no significant relationship between egg count and haemoglobin level or haematological parameters of iron and folacin status. The lack of correlation can be explained by the low wormload observed.
Read moreIron deficiency constitutes a major problem of Public Health affecting 10 to 20% of the world population. Although developing countries are specially susceptible, developed countries are also at risk. The use of reliable indicators of iron status is essential for assessing the magnitude and the distribution of iron deficiency in populations, and for developing effective public health measures. In this paper, the different indicators of iron status are briefly reviewed. The signification of these indicators, as reflect of a change in different body iron compartmentalization is also presented. In addition, their limitations in epidemiological surveys have been evaluated. It appears that no single iron parameter monitors the entire spectrum of iron deficiency. A combination of indicators, depending on the objectives of the study, the characteristics of the study population and the working conditions is required to measure the body iron content of individuals and to evaluate the iron status of the population.
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