Suteerojntrakool Orapa, Khongcharoensombat Tharida, Chomtho Sirinuch, Bongsebandhu-Phubhakdi Chansuda, Tempark Therdpong, Fewtrell Mary
Ambulatory Division, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Paediatric Nutrition Research Unit, Division of Nutrition, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
J Nutr Metab. 2021 Apr 13;2021:9629718. doi: 10.1155/2021/9629718. eCollection 2021.
Obesity may be associated with poor iron status. The objective of this study was to investigate the association between different indices of iron status and anthropometric measurements in Thai children.
Anthropometry (weight, height, waist circumference (WC), and body composition assessed by bioelectrical impedance analysis) and iron indices were measured in 336 Thai children aged 6-12 years. Iron deficiency (ID) was defined using two or more of the following: (1) %transferrin saturation (%Tsat) < 16%; (2) serum ferritin (SF) < 15 g/mL; and (3) soluble transferrin receptor (sTfR) > 5 mg/L. Iron deficiency anaemia (IDA) was defined as haemoglobin < WHO age cutoff combined with ID. Overweight and obesity were defined as body mass index (BMI) standard deviation score (SDS) ≥ +1 SDS or +2 SDS, respectively (WHO growth reference).
BMI SDS was significantly positively correlated with sTfR and SF (sTfR, : 0.209, < 0.001; SF, : 0.214, < 0.001) and negatively correlated with %Tsat (: -0.132, = 0.013). Correlations between WC SDS and %fat mass and each iron marker were similar. The percentage with low SF was significantly lower than that using other individual markers. ID prevalence was not significantly different between normal-weight and overweight/obesity groups although a significantly higher proportion of overweight/obese children had sTfR >5 mg/L. Puberty and menarche were significant predictors of ID (puberty adjusted OR: 2.20, 95% CI: 0.43, 11.25; menarche adjusted OR: 6.11, 95% CI: 1.21, 30.94).
Greater adiposity was associated with poorer iron status. However, SF may not be a good indicator of iron status in Thai children, particularly in those who are overweight/obese, whereas sTfR merits further investigation.
肥胖可能与铁状态不佳有关。本研究的目的是调查泰国儿童铁状态的不同指标与人体测量指标之间的关联。
对336名6至12岁的泰国儿童进行了人体测量（体重、身高、腰围（WC）以及通过生物电阻抗分析评估的身体成分）和铁指标测量。缺铁（ID）的定义采用以下两项或更多项标准：（1）转铁蛋白饱和度（%Tsat）<16%；（2）血清铁蛋白（SF）<15μg/mL；（3）可溶性转铁蛋白受体（sTfR）>5mg/L。缺铁性贫血（IDA）的定义为血红蛋白低于世界卫生组织年龄临界值且伴有ID。超重和肥胖分别定义为体重指数（BMI）标准差评分（SDS）≥+1 SDS或+2 SDS（世界卫生组织生长参考标准）。
BMI SDS与sTfR和SF显著正相关（sTfR，r：0.209，P<0.001；SF，r：0.214，P<0.001），与%Tsat负相关（r：-0.132，P=0.013）。WC SDS与体脂百分比及各铁指标之间的相关性相似。SF水平低的儿童百分比显著低于使用其他单项指标的情况。正常体重组和超重/肥胖组的ID患病率无显著差异，尽管超重/肥胖儿童中sTfR>5mg/L的比例显著更高。青春期和月经初潮是ID的显著预测因素（青春期校正OR：2.20，95%CI：0.43，11.25；月经初潮校正OR：6.11，95%CI：1.21，30.94）。
更高的肥胖程度与更差的铁状态相关。然而，SF可能不是泰国儿童铁状态的良好指标特别是在超重/肥胖儿童中，而sTfR值得进一步研究。
