Kucuk Nuran, Orbak Zerrin, Karakelloglu Cahit, Akcay Fatih
Faculty of Medicine, Department of Pediatrics, Atatürk University, Erzurum, Turkey.
Faculty of Medicine, Department of Biochemistry, Atatürk University, Erzurum, Turkey.
J Pediatr Endocrinol Metab. 2019 Mar 26;32(3):275-280. doi: 10.1515/jpem-2018-0352.
Background It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite, growth and plasma ghrelin and leptin levels in children aged between 12 and 24 months with isolated nutritional iron deficiency anemia. Methods Iron deficiency anemia was diagnosed by clinic and laboratory findings. All 19 cases were given 5 mg/kg/day iron therapy for 3 months. Results The mean plasma ghrelin level was 936.7±428.8 pg/mL before therapy and it increased to 1284.7±533.3 pg/mL (p<0.001) while the mean plasma leptin level decreased from 3.4±1.6 ng/mL to 1.9±1.0 ng/mL (p<0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p<0.001). Δ body weight was correlated with plasma ghrelin levels before and after therapy significantly. Conclusions In conclusion, the findings of this study indicate that plasma ghrelin level increases and leptin level decreases and growth accelerates because of an increase in appetite and daily calories, carbohydrate and protein amount in children with nutritional iron deficiency anemia after iron therapy. The increase in appetite and acceleration on growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels. The most important finding of this study is significantly increased plasma ghrelin levels after iron therapy, and this finding might be related to both the improved appetite and catch-up growth.
背景 已知缺铁性贫血会对食欲和生长产生负面影响。本研究的目的是调查铁剂治疗对12至24个月患有单纯营养性缺铁性贫血儿童的食欲、生长以及血浆胃饥饿素和瘦素水平的影响。方法 通过临床和实验室检查结果诊断缺铁性贫血。所有19例患儿均接受5mg/kg/天的铁剂治疗，疗程3个月。结果 治疗前血浆胃饥饿素平均水平为936.7±428.8pg/mL，治疗后升至1284.7±533.3pg/mL（p<0.001）；而血浆瘦素平均水平从3.4±1.6ng/mL降至1.9±1.0ng/mL（p<0.01）。治疗后每日热量摄入、碳水化合物和蛋白质摄入量均显著增加（p<0.001）。治疗前后体重变化与血浆胃饥饿素水平显著相关。结论 总之，本研究结果表明，营养性缺铁性贫血患儿经铁剂治疗后，血浆胃饥饿素水平升高，瘦素水平降低，食欲增加，每日热量、碳水化合物和蛋白质摄入量增加，生长加速。缺铁性贫血患儿食欲增加和生长加速可能是由于瘦素减少和血浆胃饥饿素水平升高所致。本研究最重要的发现是铁剂治疗后血浆胃饥饿素水平显著升高，这一发现可能与食欲改善和追赶生长均有关。
