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西班牙 1 至 11 岁儿童缺铁症的流行情况及其相关因素。

Prevalence and associated factors of iron deficiency in Spanish children aged 1 to 11 years.

机构信息

Department of Pediatrics, Torrecárdenas Hospital, Hermandad de Donantes de Sangre s/n, 04009, Almería, Spain.

出版信息

Eur J Pediatr. 2021 Sep;180(9):2773-2780. doi: 10.1007/s00431-021-04037-8. Epub 2021 Mar 23.

DOI:10.1007/s00431-021-04037-8
PMID:33759019
Abstract

Iron deficiency (ID) is the most common nutritional deficiency affecting children worldwide. Most traditional laboratory parameters to assess ID can be altered by infections or other inflammatory states, including obesity. The aims of this study were to determine the prevalence of ID in healthy children and to analyse associated factors, avoiding potential confounding factors through the use of serum transferrin receptor (sTfR), reticulocyte haemoglobin content and sTfR/log ferritin index. A cross-sectional population-based study was conducted on 951 children aged 1 to 11 years in Almería (Spain). ID was detected in 7.7% of children and iron deficiency anaemia in 0.9%. Multivariate analysis identified the following as independent risk factors: age under 5 years (OR: 2.2, 95% CI: 1.35-3.6); excessive consumption of cow's milk and dairy products (OR: 1.87, 95% CI: 1.13-3.1); and insufficient consumption of vegetables (OR: 2.7, 95% CI: 1.2-6.1).Conclusions: Using a combination of iron status parameters with greater discriminatory power than classical measures, this study detected a considerable iron deficiency prevalence in Spanish children. Younger children and specific dietary habits exhibit a particular risk for ID, so special attention should be paid to this population. What is Known: • Iron deficiency remains the most prevalent nutritional deficit worldwide, and children aged under 3 years are the most vulnerable to this condition. • Accurate assessment of iron status, based on a combination of biochemical indicators, can often be complicated. What is New: • Iron deficiency continues to present a health problem in Spanish children aged 1 to 11 years, considering the serum transferrin receptor and reticulocyte haemoglobin content for diagnosis. • Excessive consumption of dairy products and low consumption of vegetables are independent risk factors for iron deficiency.

摘要

缺铁(ID)是全球儿童最常见的营养缺乏症。大多数评估 ID 的传统实验室参数都会受到感染或其他炎症状态的影响,包括肥胖。本研究的目的是确定健康儿童中 ID 的患病率,并分析相关因素,通过使用血清转铁蛋白受体(sTfR)、网织红细胞血红蛋白含量和 sTfR/铁蛋白指数来避免潜在的混杂因素。在西班牙阿尔梅里亚进行了一项横断面人群基础研究,纳入了 951 名 1 至 11 岁的儿童。研究发现 7.7%的儿童存在 ID,0.9%的儿童存在缺铁性贫血。多变量分析确定以下因素为独立危险因素:年龄小于 5 岁(OR:2.2,95%CI:1.35-3.6);过量食用牛奶和奶制品(OR:1.87,95%CI:1.13-3.1);蔬菜摄入不足(OR:2.7,95%CI:1.2-6.1)。结论:使用具有比经典指标更高鉴别力的铁状态参数组合,本研究在西班牙儿童中发现了相当高的缺铁患病率。年龄较小的儿童和特定的饮食习惯具有特定的缺铁风险,因此应特别关注这一人群。已知:•缺铁仍然是全球最普遍的营养缺乏症,3 岁以下儿童最容易出现这种情况。•基于生化指标的组合对铁状态进行准确评估,往往会很复杂。新内容:•考虑到血清转铁蛋白受体和网织红细胞血红蛋白含量的诊断价值,西班牙 1 至 11 岁儿童的缺铁问题仍然是一个健康问题。•过量食用奶制品和蔬菜摄入不足是缺铁的独立危险因素。

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本文引用的文献

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Diagnosis and management of iron deficiency in children with or without anemia: consensus recommendations of the SPOG Pediatric Hematology Working Group.儿童缺铁症(伴或不伴贫血)的诊断与管理:SPOG 儿科学血液学工作组的共识推荐意见。
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The usefulness of reticulocyte haemoglobin content, serum transferrin receptor and the sTfR-ferritin index to identify iron deficiency in healthy children aged 1-16 years.
植物微量营养素稳态:实现更可持续农业和更健康人类营养
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