Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Medical Biochemistry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Am J Clin Nutr. 2019 Mar 1;109(3):566-575. doi: 10.1093/ajcn/nqy366.
Which blood-based indicator best reflects the iron status in pregnant women is unclear. Better assessments of iron status in today's multiethnic populations are needed to optimize treatment and clinical recommendations.
We aimed to determine the prevalence of anemia (hemoglobin <11.0 g/dL in first and <10.5 g/dL in second trimester) and iron deficiency (ID) by the iron indicators serum ferritin <15 µg/L, serum soluble transferrin receptor (sTfR) >4.4 mg/L, and calculated total body iron <0 mg/kg, and their associations with ethnicity.
This was a population-based cross-sectional study from primary antenatal care of 792 healthy women in early pregnancy in Oslo, Norway. We categorized the women into 6 ethnic groups: Western European, South Asian, Middle Eastern, Sub-Saharan African, East Asian, and Eastern European.
Anemia was found in 5.9% of women (Western Europeans: 1.8%; non-Western: 0-14%, P < 0.05). ID from ferritin was found in 33% (Western Europeans: 15%; non-Western: 27-55%, P < 0.05). ID from sTfR was found in 6.5% (Western Europeans: 0.3%; non-Western: 0-20%, P < 0.01). Calculated total body iron indicated ID in 11% (Western Europeans: 0.6%, non-Western: 7.0-28%, P < 0.01). The prevalence of ID was significantly higher by all measures in South Asian, Sub-Saharan African, and Middle Eastern than in Western European women, and the ethnic differences persisted after adjusting for confounders. South Asians, Sub-Saharan Africans, and Middle Easterners had lower iron concentrations by all measures for all hemoglobin intervals. Anemia related to ID varied from 35% (sTfR) to 46% (total body iron) and 72% (ferritin) depending on the iron indicator used.
Women at the highest risk of ID and anemia were of South Asian, Middle Eastern, and Sub-Saharan African origin. The prevalence of ID differed considerably depending on the iron indicator used.
哪种血液指标最能反映孕妇的铁状况尚不清楚。为了优化治疗和临床建议，需要更好地评估当今多种族人群的铁状况。
我们旨在确定贫血（孕早期血红蛋白<11.0 g/dL，孕中期血红蛋白<10.5 g/dL）和缺铁（ID）的发生率，其铁指标包括血清铁蛋白<15μg/L、血清可溶性转铁蛋白受体（sTfR）>4.4mg/L 和计算的总铁量<0mg/kg，并探讨其与种族的关系。
这是一项基于人群的横断面研究，纳入了挪威奥斯陆早期妊娠的 792 名健康孕妇。我们将这些女性分为 6 个种族群体：西欧、南亚、中东、撒哈拉以南非洲、东亚和东欧。
5.9%的女性存在贫血（西欧：1.8%；非西欧：0-14%，P<0.05）。铁蛋白提示 ID 的占 33%（西欧：15%；非西欧：27-55%，P<0.05）。sTfR 提示 ID 的占 6.5%（西欧：0.3%；非西欧：0-20%，P<0.01）。计算的总铁量提示 ID 的占 11%（西欧：0.6%，非西欧：7.0-28%，P<0.01）。与西欧女性相比，南亚、撒哈拉以南非洲和中东女性的所有 ID 指标的发生率均显著更高，且在调整混杂因素后差异仍然存在。所有种族女性的所有血红蛋白区间的铁浓度均低于所有指标提示的 ID。与 ID 相关的贫血发生率因铁指标而异，范围为 35%（sTfR）至 46%（总铁量）和 72%（铁蛋白）。
ID 和贫血风险最高的女性来自南亚、中东和撒哈拉以南非洲。ID 的发生率因所用铁指标而异。
