Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
Matern Child Nutr. 2018 Jan;14(1). doi: 10.1111/mcn.12458. Epub 2017 Apr 27.
Rapid growth in infancy has been shown to adversely affect iron status up to 1 year; however the effect of growth on iron status in the second year of life has been largely unexplored. We aimed to investigate the impact of growth and body size in the first 2 years on iron status at 2 years. In the prospective, maternal-infant Cork BASELINE Birth Cohort Study, infant weight and length were measured at birth, 2, 6, 12, and 24 months and absolute weight (kg) and length (cm) gain from 0 to 2, 0 to 6, 0 to 12, 6 to 12, 12 to 24, and 0 to 24 months were calculated. At 2 years (n = 704), haemoglobin, mean corpuscular volume, and serum ferritin (umbilical cord concentrations also) were measured. At 2 years, 5% had iron deficiency (ferritin < 12 μg/L) and 1% had iron deficiency anaemia (haemoglobin < 110 g/L + ferritin < 12 μg/L). Weight gain from 6 to 12, 0 to 24, and 12 to 24 months were all inversely associated with ferritin concentrations at 2 years but only the association with weight gain from 12 to 24 months was robust after adjustment for potential confounders including cord ferritin (adj. estimate 95% CI: -4.40 [-8.43, -0.37] μg/L, p = .033). Length gain from 0 to 24 months was positively associated with haemoglobin at 2 years (0.42 [0.07, 0.76] g/L, p = .019), only prior to further adjustment for cord ferritin. To conclude, weight gain in the second year was inversely associated with iron stores at 2 years, even after accounting for iron status at birth. Further examinations of iron requirements, dietary intakes, and growth patterns in children in the second year of life in high-resource settings are warranted.
婴儿期的快速生长已被证明会对 1 年内的铁状态产生不利影响；然而，生长对生命第二年铁状态的影响在很大程度上尚未得到探索。我们旨在研究前 2 年的生长和体型对 2 岁时铁状态的影响。在前瞻性的科克巴斯勒出生队列研究中，在出生、2、6、12 和 24 个月时测量婴儿体重和身长，从 0 到 2、0 到 6、0 到 12、6 到 12、12 到 24 和 0 到 24 个月时计算绝对体重（kg）和身长（cm）的增加。在 2 岁时（n=704），测量血红蛋白、平均红细胞体积和血清铁蛋白（脐带浓度也进行测量）。在 2 岁时，5%的儿童有缺铁（铁蛋白<12μg/L），1%的儿童有缺铁性贫血（血红蛋白<110g/L+铁蛋白<12μg/L）。从 6 到 12 个月、0 到 24 个月和 12 到 24 个月的体重增加均与 2 岁时的铁蛋白浓度呈负相关，但只有在调整包括脐带铁蛋白在内的潜在混杂因素后，与从 12 到 24 个月的体重增加的相关性才具有稳健性（调整后估计值 95%CI：-4.40[-8.43，-0.37]μg/L，p=0.033）。从 0 到 24 个月的身长增加与 2 岁时的血红蛋白呈正相关（0.42[0.07，0.76]g/L，p=0.019），仅在进一步调整脐带铁蛋白之前。总之，即使考虑到出生时的铁状态，第二年的体重增加与 2 岁时的铁储备呈负相关。有必要进一步研究高资源环境下儿童第二年的铁需求、饮食摄入和生长模式。
