Bhargava A, Bouis H E, Scrimshaw N S
Department of Economics, University of Houston, Houston, Texas 77204-5882, USA.
J Nutr. 2001 Mar;131(3):758-64. doi: 10.1093/jn/131.3.758.
Iron deficiency anemia affects a large number of women in developing countries, especially during child-bearing years. The hemoglobin concentration is useful for identifying iron deficiency anemia. The main objectives of this study were, first, to extend algorithms for calculating bioavailable iron from mixed diets, taking into account the enhancers and inhibitors of iron absorption under alternative assumptions on body iron stores. Second, a comprehensive longitudinal model was developed for the proximate determinants of hemoglobin concentration that included the subjects' dietary intakes, nutritional status, morbidity and socioeconomic factors and the unobserved between-subject differences. The model for hemoglobin concentration was estimated using three repeated observations on 514 free living women in Bangladesh. Socioeconomic factors affecting the iron intake from meat, fish and poultry and from all animal sources were also modeled. The main results were that bioavailable iron, women's height and mid upper arm circumference and intake of iron tablets were significant predictors of hemoglobin concentration. Increases in household incomes were associated with higher intake of iron from meat, fish and poultry and from all animal sources. The algorithms for estimating bioavailable iron showed the importance of assumptions regarding body iron stores and underscored the need to develop suitable algorithms for subjects in developing countries.
缺铁性贫血影响着发展中国家的大量女性，尤其是在育龄期。血红蛋白浓度对于识别缺铁性贫血很有用。本研究的主要目标，首先是扩展用于从混合饮食中计算生物可利用铁的算法，同时考虑在关于机体铁储备的不同假设下铁吸收的增强剂和抑制剂。其次，针对血红蛋白浓度的近端决定因素建立了一个综合纵向模型，该模型包括受试者的饮食摄入量、营养状况、发病率和社会经济因素以及未观察到的个体间差异。使用对孟加拉国514名自由生活女性的三次重复观察数据对血红蛋白浓度模型进行了估计。还对影响从肉类、鱼类和家禽以及所有动物来源摄入铁的社会经济因素进行了建模。主要结果是，生物可利用铁、女性身高、上臂中部周长以及铁剂摄入量是血红蛋白浓度的显著预测因素。家庭收入的增加与从肉类、鱼类和家禽以及所有动物来源摄入更多的铁有关。估计生物可利用铁的算法显示了关于机体铁储备假设的重要性，并强调需要为发展中国家的受试者开发合适的算法。
