Agudelo Gloria M, Cardona Olga L, Posada Miriam, Montoya Martha N, Ocampo Norma E, Marín Claudia M, Correa María C, López Claudia
Escuela de Nutrición y Dietética, Universidad de Antioquia, Medellín, Colombia.
Rev Panam Salud Publica. 2003 Jun;13(6):376-86. doi: 10.1590/s1020-49892003000500006.
This research had two objectives: (1) to determine the prevalence of iron-deficiency anemia and describe iron consumption in the diet of schoolchildren and adolescents enrolled in public and private schools of the urban area of the city of Medellín, Colombia, in the 1999-2000 school year and (2) to explore the associations that age group, sex, socioeconomic class, and intestinal parasitism show with iron-deficiency anemia and iron deficiency.
A cross-sectional study was carried out among 960 students from 6 to 18 years old who were selected by simple random sampling after stratified multistage sampling and clustering in public and private schools in districts of Medellín. Body iron content was evaluated by determining ferritin and hemoglobin levels, average corpuscular volume, and amplitude of the erythrocyte distribution; the presence of intestinal parasites was evaluated through stool analysis; nutritional status was evaluated by means of anthropometric measurements; and consumption of iron and vitamin C was evaluated using a semiquantitative questionnaire on food intake. In order to define the cases of iron-deficiency anemia and of iron deficiency we used the standard definitions of the World Health Organization, based on ferritin and hemoglobin values. We used nonparametric tests, with a significance level of 0.05, to examine the associations between age group, sex, socioeconomic class, and the presence of intestinal parasites on the one hand and the presence of anemia on the other hand.
The prevalence of iron deficiency was 4.9%, and the prevalence of iron-deficiency anemia was 0.6%. The prevalence of both was higher among adolescent women (P < 0.05) than in the rest of the sample studied. No significant association was found between the presence of intestinal parasites and the presence of anemia. The average daily consumption of iron (+/- standard deviation) was 5.5 mg (+/- 2.3 mg) (32% +/- 15% of the recommended dietary intake for the studied age group); the average contribution of serum iron in the diet was 0.7 mg (+/- 0.7 mg). Comparing the children who did and who did not have anemia, there were no significant differences in iron consumption and the type of iron consumed. The anthropometric parameter that showed the greatest association with the presence of anemia was height for age.
The prevalences of iron deficiency and of iron-deficiency anemia found in the population studied were low, according to the parameters for hemoglobin and ferritin as defined by the World Health Organization as being normal for these population groups. The low prevalence of blood-sucking parasites, adequate consumption of vitamin C, and the refined mechanisms with which the body regulates iron homeostasis may have contributed to these results. Adequate iron content in the diet of adolescents should be maintained, and education campaigns should be implemented to help prevent iron deficiency in this population group.
本研究有两个目的：（1）确定缺铁性贫血的患病率，并描述1999 - 2000学年就读于哥伦比亚麦德林市市区公立和私立学校的学童及青少年饮食中的铁摄入量；（2）探讨年龄组、性别、社会经济阶层和肠道寄生虫感染与缺铁性贫血和缺铁之间的关联。
在麦德林市各行政区的公立和私立学校中，通过分层多阶段抽样和整群抽样后进行简单随机抽样，选取了960名6至18岁的学生进行横断面研究。通过测定铁蛋白和血红蛋白水平、平均红细胞体积以及红细胞分布宽度来评估体内铁含量；通过粪便分析评估肠道寄生虫的存在情况；通过人体测量评估营养状况；并使用关于食物摄入量的半定量问卷评估铁和维生素C的摄入量。为了定义缺铁性贫血和缺铁的病例，我们采用了世界卫生组织基于铁蛋白和血红蛋白值的标准定义。我们使用显著性水平为0.05的非参数检验来研究年龄组、性别、社会经济阶层和肠道寄生虫感染情况与贫血存在情况之间的关联。
缺铁的患病率为4.9%，缺铁性贫血的患病率为0.6%。在青少年女性中，这两种情况的患病率均高于所研究的其他样本（P < 0.05）。未发现肠道寄生虫感染与贫血存在之间有显著关联。铁的平均每日摄入量（±标准差）为5.5毫克（±2.3毫克）（占所研究年龄组推荐膳食摄入量的32%±15%）；饮食中铁的平均血清贡献量为0.7毫克（±0.7毫克）。比较患贫血和未患贫血的儿童，铁摄入量和所摄入铁的类型无显著差异。与贫血存在情况关联最大的人体测量参数是年龄别身高。
根据世界卫生组织为这些人群定义的血红蛋白和铁蛋白正常参数，在所研究人群中发现的缺铁和缺铁性贫血患病率较低。吸血寄生虫患病率低、维生素C摄入充足以及人体调节铁稳态的精细机制可能促成了这些结果。应保持青少年饮食中充足的铁含量，并开展教育活动以帮助预防该人群中的缺铁情况。
