Choque-Quispe Benita Maritza, Vásquez-Velásquez Cinthya, Gonzales Gustavo F
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru.
Laboratorio de Endocrinología y Reproducción (Laboratorios de Investigación y Desarrollo), Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru.
BMC Nutr. 2024 Feb 12;10(1):28. doi: 10.1186/s40795-024-00837-x.
The anemia prevalence is higher in highlands populations. It is assumed that iron deficiency anemia (IDA) in children is mainly due to low dietary intake. However, other suggest that high prevalence of anemia is due to an inappropriate hemoglobin (Hb) adjustment for altitude.
Cross-sectional study conducted in 338 preschoolers (PSC) from Puno-Peru. Hb was measured in whole blood, and ferritin, Soluble transferrin receptor, and Interleukin 6 in serum.The dietary iron intake was assessed by 24-h dietary recall, using NutriCap Software. Hb concentration was assessed as adjusted or unadjusted for altitude.
With unadjusted Hb, the anemia prevalence was 4.7%, whereas after Hb correction, the prevalence raised-up to 65.6% (p < 0.001). Reciprocally, erythrocytosis proportion decreased from 20.35 to 0.30% (p < 0.001). Total Body Iron (TBI) showed that 7.44% had ID and 0.32% had IDA. PSC with normal unadjusted Hb levels have more protein and micronutrients intake than anemic ones. PSC with erythrocytosis consumed less fat, and more niacin and ascorbic acid than anemics. Total iron intake was lower in anemic than the other groups, but without statistical significance due to the standard deviation of the data in a small number of anemic PSC (n = 16). TBI, unadjusted Hb, and adjusted Hb were not different between groups consuming or not multimicronutrients.
The consumption of iron and iron status in children who live at high altitude is adequate, and that anemia could be due to other micronutrient deficiencies and/or that the adjustment of Hb by altitude is inappropriate.
高原人群贫血患病率较高。一般认为儿童缺铁性贫血（IDA）主要是由于饮食摄入量低。然而，也有观点认为贫血患病率高是由于对海拔高度的血红蛋白（Hb）调整不当。
对秘鲁普诺的338名学龄前儿童（PSC）进行横断面研究。测量全血中的Hb以及血清中的铁蛋白、可溶性转铁蛋白受体和白细胞介素6。通过24小时饮食回顾法，使用NutriCap软件评估饮食中铁的摄入量。根据是否对海拔高度进行调整来评估Hb浓度。
未调整Hb时，贫血患病率为4.7%，而校正Hb后，患病率升至65.6%（p<0.001）。相反，红细胞增多症比例从20.35%降至0.30%（p<0.001）。总体铁含量（TBI）显示，7.44%的儿童有铁缺乏，0.32%的儿童有IDA。未调整Hb水平正常的PSC比贫血儿童摄入更多的蛋白质和微量营养素。红细胞增多症的PSC比贫血儿童摄入更少的脂肪、更多的烟酸和抗坏血酸。贫血儿童的总铁摄入量低于其他组，但由于少数贫血PSC（n = 16）数据的标准差，差异无统计学意义。摄入或未摄入多种微量营养素的组之间，TBI、未调整Hb和调整后Hb没有差异。
生活在高海拔地区儿童的铁摄入量和铁状态充足，贫血可能是由于其他微量营养素缺乏和/或对海拔高度的Hb调整不当。
