Vieira Ana Cláudia F, Diniz Alcides S, Cabral Poliana C, Oliveira Rejane S, Lóla Margarida M F, Silva Solange M M, Kolsteren Patrick
Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
J Pediatr (Rio J). 2007 Jul-Aug;83(4):370-6. doi: 10.2223/JPED.1680.
To assess nutritional iron status and anemia prevalence in children less than 5 years old at public daycare centers in the city of Recife, PE, Brazil.
A cross-sectional study, with a systematic random sampling of 162 children aged 6 to 59 months. Nutritional iron status was assessed in terms of body iron reserves (serum ferritin), transferrinemia (serum iron, total iron binding capacity, and transferrin saturation %), erythropoiesis (free erythrocyte protoporphyrin) and hemoglobin production (hemoglobin).
The prevalence of anemia (hemoglobin < 11.0 g/dL) was 55.6% (95%CI 47.3-63.5), evidence was found of depleted iron stocks (serum ferritin < 12.0 ng/mL) in 30.8% (95%CI 22.9-39.3), low transferrinemia levels (transferrin saturation % < 16) in 60.1% (95%CI 51.7-68.0) and deficient erythropoiesis (free erythrocyte protoporphyrin > 40 micromol/mol heme) in 69.6% (95%CI 61.0-77.1) of the children. Iron parameters were not correlated with sex (p > 0.05). However, children < 24 months exhibited lower hemoglobin concentrations (p < 0.00) and higher levels of free erythrocyte protoporphyrin (p < 0.000) and total iron binding capacity (p < 0.001) when compared with children > 24 months. The significant correlation observed between reserves, transferrinemia and erythropoiesis is a finding that is compatible with the expected lifecycle of iron in the body.
Iron deficiency and anemia appear to be an important public health problem among children less than 5 years old at public daycare centers in Recife. Therefore, effective actions aimed at the prevention and control of this deficiency are strongly recommended in this ecological context.
评估巴西伯南布哥州累西腓市公立日托中心5岁以下儿童的营养性铁状况及贫血患病率。
一项横断面研究，对162名6至59个月大的儿童进行系统随机抽样。从机体铁储备（血清铁蛋白）、转铁蛋白血症（血清铁、总铁结合力及转铁蛋白饱和度%）、红细胞生成（游离红细胞原卟啉）及血红蛋白生成（血红蛋白）方面评估营养性铁状况。
贫血（血红蛋白<11.0 g/dL）患病率为55.6%（95%可信区间47.3 - 63.5），30.8%（95%可信区间22.9 - 39.3）的儿童存在铁储备耗竭（血清铁蛋白<12.0 ng/mL）的证据，60.1%（95%可信区间51.7 - 68.0）的儿童转铁蛋白血症水平低（转铁蛋白饱和度%<16），69.6%（95%可信区间61.0 - 77.1）的儿童红细胞生成不足（游离红细胞原卟啉>40 μmol/mol血红素）。铁参数与性别无相关性（p>0.05）。然而，与24个月以上儿童相比，24个月以下儿童的血红蛋白浓度较低（p<0.00），游离红细胞原卟啉水平较高（p<0.000），总铁结合力较高（p<0.001）。在储备、转铁蛋白血症和红细胞生成之间观察到的显著相关性这一发现与机体中铁的预期生命周期相符。
在累西腓市公立日托中心，缺铁和贫血似乎是5岁以下儿童中的一个重要公共卫生问题。因此，在这种生态环境下，强烈建议采取有效行动预防和控制这种缺乏情况。
