Kumari Alka, Obazenu Lawson O, Monis Manahil, Mustapha-Adebiyi Halimah T, Wandala Abali, Venkata Harischandra Thithiksha, Ayuba Person Domshak, Thorani Mahek, Arshad Muhammad Rahim, Shamsi Meera Al, Mohammed A Alzahrani Renad
Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK.
Medicine, University of Ibadan, Ibadan, NGA.
Cureus. 2025 Jul 30;17(7):e89049. doi: 10.7759/cureus.89049. eCollection 2025 Jul.
Iron deficiency without anemia is a potentially serious, under-recognized nutritional problem that may adversely influence children's cognitive and behavioral development. Although the connection is supported globally, there is a lack of localized studies in Pakistan. This research investigates the relationship between iron deficiency without anemia and cognitive-behavioral problems in Pakistani children aged 5-18.
This cross-sectional study was conducted from February to June 2025, using convenience sampling of schools and communities in Islamabad. A total of 385 children participated. A three-part structured questionnaire, an Iron Deficiency Risk Questionnaire (IDRQ), and the Strengths and Difficulties Questionnaire (SDQ) were used to gather demographic data. Statistical analyses were performed using SPSS Version 26 (IBM Corp., Armonk, NY). They consisted of descriptive statistics, t-tests, analysis of variance (ANOVA), Pearson correlation, and linear regression to evaluate associations between the risk of iron deficiency and cognitive-behavioral functioning.
The sample consisted of 385 participants ( = 385), comprising females ( = 199, 52%) and males (= 186, 48%), including both urban and rural children. The results of the correlation between the scores on the IDRQ and the SDQ showed a weak positive association ( = 0.272, < 0.001). While the correlation was statistically significant, it indicates a modest relationship, suggesting that higher levels of iron deficiency risk are weakly associated with greater cognitive-behavioral difficulties. Children with celiac disease and recurring infections recorded the highest scores. Older children (17-18 years) displayed elevated scores on risk and difficulty compared to younger children (5-7 years). Linear regression analysis revealed that SDQ scores were significantly predicted by IDRQ scores ( = 0.669, < 0.001), thereby validating the association.
The results indicate that iron deficiency without anemia is weakly associated with cognitive and behavioral issues among children. Although the correlation is statistically significant, it is modest, indicating the need for further research to fully understand the extent of this relationship. Community-based nutritional interventions are critical in reducing this hidden burden by recognizing that early detection enables better developmental outcomes among Pakistani children.
缺铁但无贫血是一个潜在的严重且未得到充分认识的营养问题，可能会对儿童的认知和行为发展产生不利影响。尽管这种关联在全球范围内都得到了支持，但在巴基斯坦缺乏本地化研究。本研究调查了5至18岁巴基斯坦儿童缺铁但无贫血与认知行为问题之间的关系。
本横断面研究于2025年2月至6月进行，采用对伊斯兰堡学校和社区的便利抽样。共有385名儿童参与。使用一份三部分的结构化问卷、一份缺铁风险问卷（IDRQ）和优势与困难问卷（SDQ）来收集人口统计学数据。使用SPSS 26版（IBM公司，纽约州阿蒙克）进行统计分析。分析包括描述性统计、t检验、方差分析（ANOVA）、皮尔逊相关性分析和线性回归，以评估缺铁风险与认知行为功能之间的关联。
样本包括385名参与者（n = 385），其中女性（n = 199，52%）和男性（n = 186，48%），包括城市和农村儿童。IDRQ得分与SDQ得分之间的相关性结果显示出弱正相关（r = 0.272，p < 0.001）。虽然相关性具有统计学意义，但表明关系较为适度，这表明较高水平的缺铁风险与更大的认知行为困难存在弱关联。患有乳糜泻和反复感染的儿童得分最高。与年幼儿童（5至7岁）相比，年长儿童（17至18岁）在风险和困难方面得分更高。线性回归分析显示，SDQ得分由IDRQ得分显著预测（β = 0.669，p < 0.001），从而验证了这种关联。
结果表明，缺铁但无贫血与儿童的认知和行为问题存在弱关联。尽管相关性具有统计学意义，但较为适度，这表明需要进一步研究以充分了解这种关系的程度。基于社区的营养干预对于减轻这种隐性负担至关重要，因为认识到早期发现能够使巴基斯坦儿童获得更好的发育结果。
