Zikidou Panagiota, Tsigalou Christina, Trypsianis Gregorios, Karvelas Alexandros, Tsalkidis Aggelos, Mantadakis Elpis
Department of Pediatrics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Thrace, Greece.
Laboratory of Microbiology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Thrace, Greece.
Mediterr J Hematol Infect Dis. 2022 Jul 1;14(1):e2022054. doi: 10.4084/MJHID.2022.054. eCollection 2022.
Iron deficiency (ID) is a major public health problem with high prevalence in early childhood. We assessed the prevalence of anemia, ID, and iron deficiency anemia (IDA) in healthy children of Thrace, Greece, its correlation with several factors, and evaluated the diagnostic performance of hematologic and biochemical markers of sideropenia.
For 202 healthy children 1-5 years old, a questionnaire was filled out describing their nutritional habits during infancy and early childhood. Venous hemograms along with serum ferritin, TIBC, %TS, and CRP were obtained from all studied children. In a subset of 156 children, the concentration of sTfR was also determined.
Children with ID and IDA had significantly lower beef consumption than children without sideropenia (=0.044). Using the WHO cutoff values of Hb <11g/dl and ferritin <12μg/l, the prevalence of anemia, ID, and IDA was 9.41%, 6.44%, and 3.47%, respectively. If Hb <12g/dl and ferritin<18μg/l were used as cutoffs, the prevalence of anemia, ID, and IDA was 26.73%, 16.33%, and 5.94%, respectively. ROC analysis revealed that at ferritin <12μg/l, the AUC of sTfR alone (0.827) was substantially better than that of TIBC (0.691), while at serum ferritin cutoff of 18μg/l, the AUC of TIBC (0.770) was better than that of sTfR (0.716).
The prevalence of ID and IDA in children 1-5 years old in Thrace is like in other developed countries. The chosen cutoff of serum ferritin affects the evaluation of the diagnostic significance of the different sideropenia markers.
缺铁（ID）是一个主要的公共卫生问题，在幼儿中患病率很高。我们评估了希腊色雷斯地区健康儿童贫血、ID和缺铁性贫血（IDA）的患病率，其与多种因素的相关性，并评估了铁缺乏症血液学和生化标志物的诊断性能。
对于202名1至5岁的健康儿童，填写了一份问卷，描述他们在婴儿期和幼儿期的营养习惯。从所有研究儿童中获取静脉血常规以及血清铁蛋白、总铁结合力（TIBC）、转铁蛋白饱和度（%TS）和C反应蛋白（CRP）。在156名儿童的子集中，还测定了可溶性转铁蛋白受体（sTfR）的浓度。
ID和IDA儿童的牛肉消费量显著低于无铁缺乏症的儿童（P = 0.044）。使用世界卫生组织血红蛋白<11g/dl和铁蛋白<12μg/l的临界值，贫血、ID和IDA的患病率分别为9.41%、6.44%和3.47%。如果将血红蛋白<12g/dl和铁蛋白<18μg/l用作临界值，贫血、ID和IDA的患病率分别为26.73%、16.33%和5.94%。ROC分析显示，在铁蛋白<12μg/l时，单独sTfR的曲线下面积（AUC）（0.827）明显优于TIBC（0.691），而在血清铁蛋白临界值为18μg/l时，TIBC的AUC（0.770）优于sTfR（0.716）。
色雷斯地区1至5岁儿童ID和IDA的患病率与其他发达国家相似。所选的血清铁蛋白临界值会影响对不同铁缺乏症标志物诊断意义的评估。
