Domellöf Magnus
Department of Clinical Sciences, Pediatrics, Umeå University, SE-90185 Umeå, Sweden.
Curr Opin Clin Nutr Metab Care. 2007 May;10(3):329-35. doi: 10.1097/MCO.0b013e3280523aaf.
Iron deficiency is a significant public health problem in young children due to their high iron requirements, and iron supplements are therefore often recommended. During the time period in focus for this review (2005-2006), there have been additional advances in our understanding of the molecular mechanisms of iron absorption and metabolism. It has also been suggested that iron supplements may have adverse effects in children.
Recently discovered molecules, for example hepcidin, lactoferrin receptor and heme carrier protein may be important for iron metabolism in children. There are possible metabolic interactions between iron and several other minerals. Many studies show that iron deficiency in young children is associated with impaired neurodevelopment but it is not clear whether this can be prevented by iron supplementation. Oral iron supplements given to young children in malarious regions may lead to increased risk of death or severe infections, especially in those who are iron replete.
More research is needed to identify those children who will benefit from iron supplementation and to better determine iron requirements during early life. Clinical trials should include functional outcomes. Better knowledge about molecular mechanisms and nutrient interactions may lead to new diagnostic tests and preventive strategies.
由于幼儿对铁的需求量较高，缺铁是幼儿群体中一个重大的公共卫生问题，因此常推荐补充铁剂。在本次综述所关注的时间段（2005 - 2006年）内，我们对铁吸收和代谢的分子机制的理解又有了新进展。也有人提出铁剂补充可能对儿童有不良影响。
最近发现的分子，如铁调素、乳铁蛋白受体和血红素载体蛋白，可能对儿童的铁代谢很重要。铁与其他几种矿物质之间可能存在代谢相互作用。许多研究表明，幼儿缺铁与神经发育受损有关，但尚不清楚补充铁剂是否能预防这种情况。在疟疾流行地区给幼儿口服铁剂可能会增加死亡或严重感染的风险，尤其是在那些铁储备充足的儿童中。
需要更多研究来确定哪些儿童将从铁剂补充中获益，并更好地确定生命早期的铁需求量。临床试验应纳入功能结局指标。对分子机制和营养相互作用的更深入了解可能会带来新的诊断测试和预防策略。
