Division of Uterine Vascular Biology, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Department of Children Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Biosci Rep. 2020 Dec 23;40(12). doi: 10.1042/BSR20202853.
Iron stores at birth are essential to meet iron needs during the first 4-6 months of life. The present study aimed to investigate iron stores in normal birth weight, healthy, term neonates. Umbilical cord blood samples were collected from apparently normal singleton vaginal deliveries (n=854). Subjects were screened and excluded if C-reactive protein (CRP) > 5 mg/l or α1-acid glycoprotein (AGP) > 1 g/l, preterm (<37 complete weeks), term < 2500g or term > 4000g. In total, 762 samples were included in the study. Serum ferritin, soluble transferrin receptor (sTfR), hepcidin, and erythropoietin (EPO) were measured in umbilical cord blood samples; total body iron (TBI) (mg/kg) was calculated using sTfR and ferritin concentrations. A total of 19.8% newborns were iron deficient (ferritin 35 μg/l) and an additional 46.6% had insufficient iron stores (ferritin < 76 μg/l). There was a positive association between serum ferritin and sTfR, hepcidin, and EPO. Gestational age was positively associated with ferritin, sTfR, EPO, and hepcidin. In conclusion, we demonstrate a high prevalence of insufficient iron stores in a Chinese birth cohort. The value of cord sTfR and TBI in the assessment of iron status in the newborn is questionable, and reference ranges need to be established.
出生时的铁储备对于满足生命最初 4-6 个月的铁需求至关重要。本研究旨在调查正常出生体重、健康、足月新生儿的铁储备情况。从明显正常的单胎阴道分娩中采集脐血样本(n=854)。如果 C 反应蛋白(CRP)>5mg/l 或α1-酸性糖蛋白(AGP)>1g/l、早产(<37 周完整)、足月<2500g 或足月>4000g,则对受试者进行筛查并排除。共有 762 个样本纳入研究。测量脐血样本中的血清铁蛋白、可溶性转铁蛋白受体(sTfR)、铁调素和促红细胞生成素(EPO);使用 sTfR 和铁蛋白浓度计算总铁量(TBI)(mg/kg)。19.8%的新生儿存在缺铁(铁蛋白 35μg/l),另有 46.6%的新生儿铁储备不足(铁蛋白<76μg/l)。血清铁蛋白与 sTfR、铁调素和 EPO之间存在正相关。胎龄与铁蛋白、sTfR、EPO 和铁调素呈正相关。总之,我们在中国出生队列中证明了铁储备不足的高发率。脐带 sTfR 和 TBI 在评估新生儿铁状况中的价值值得怀疑,需要建立参考范围。