Milman Nils, Pedersen Agnes N, Ovesen Lars, Schroll Marianne
Department of Medicine B, Rigshospitalet, University of Copenhagen, Denmark.
Ann Hematol. 2004 Jul;83(7):423-9. doi: 10.1007/s00277-003-0830-y. Epub 2004 Jan 22.
In Denmark, the intake of dietary iron has decreased since 1987, when the mandatory iron fortification of flour (30 mg carbonyl iron/kg) was stopped. Since there have been no studies of iron status in elderly Danes after the abolishment of iron fortification, there is a need to assess actual iron status in the elderly population. The objective was to evaluate iron status and the relationship with food composition and dietary and supplemental iron intake in an elderly population in Copenhagen County. Participants in this health examination survey were 358 subjects (171 men, 187 women) 80 years of age from a 1914 cohort study. Blood samples included serum ferritin and hemoglobin (Hb). A dietary survey was performed in 232 subjects (120 men, 112 women) using a dietary history method. Median serum ferritin was 100 microg/l in men and 78 microg/l in women ( p<0.001). Ferritin concentrations <16 microg/l (i.e., depleted iron stores) were found in three men (2%) and in ten women (5%). Median Hb was 140 g/l in men and 131 g/l in women ( p<0.001). Three subjects (0.84%) had iron deficiency anemia (i.e., ferritin <13 microg/l and Hb <5th percentile for iron-replete subjects (121 g/l in men, 114 g/l in women). Ferritin concentrations >300 microg/l (i.e., iron overload) were found in 15 (9%) men and in 5 (3%) women. Median dietary iron intake was higher in men (8.7 mg/day) than in women (7.3 mg/day) ( p<0.001). Serum ferritin was positively correlated to dietary intake of iron, meat, and alcohol and to body mass index in men. Serum ferritin displayed a negative correlation to the consumption of tea. The use of vitamin-mineral supplements containing iron had no influence on iron status. Dietary intake of iron and/or the bioavailability of dietary iron were adequate to maintain a favorable iron status in 80-year-old subjects displaying a low prevalence of iron deficiency and a moderate prevalence of iron overload.
在丹麦,自1987年停止对面粉进行强制性铁强化(30毫克羰基铁/千克)以来,膳食铁摄入量有所下降。由于铁强化废除后尚未有针对丹麦老年人铁状况的研究,因此有必要评估老年人群的实际铁状况。目的是评估哥本哈根郡老年人群的铁状况及其与食物成分、膳食和补充铁摄入量的关系。这项健康检查调查的参与者是来自1914年队列研究的358名80岁的受试者(171名男性,187名女性)。血液样本包括血清铁蛋白和血红蛋白(Hb)。对232名受试者(120名男性,112名女性)采用饮食史方法进行了饮食调查。男性血清铁蛋白中位数为100微克/升,女性为78微克/升(p<0.001)。在三名男性(2%)和十名女性(5%)中发现铁蛋白浓度<16微克/升(即铁储备耗尽)。男性Hb中位数为140克/升,女性为131克/升(p<0.001)。三名受试者(0.84%)患有缺铁性贫血(即铁蛋白<13微克/升且Hb低于铁充足受试者的第5百分位数,男性为121克/升,女性为114克/升)。在15名(9%)男性和5名(3%)女性中发现铁蛋白浓度>300微克/升(即铁过载)。男性的膳食铁摄入量中位数(8.7毫克/天)高于女性(7.3毫克/天)(p<0.001)。男性的血清铁蛋白与铁、肉类和酒精的膳食摄入量以及体重指数呈正相关。血清铁蛋白与茶的消费量呈负相关。使用含铁的维生素 - 矿物质补充剂对铁状况没有影响。膳食铁摄入量和/或膳食铁的生物利用度足以使80岁受试者维持良好的铁状况,缺铁患病率低,铁过载患病率中等。