Milman N, Clausen J, Byg K E
Department of Medicine, Naestved Hospital, Denmark.
Ann Hematol. 1998 Jul-Aug;77(1-2):13-9. doi: 10.1007/s002770050405.
The aim of the present study was to evaluate the influence of menstruation, method of contraception, and iron supplementation on iron status in young Danish women, and to assess whether iron deficiency could be predicted from the pattern of menstruation. Iron status was examined by measuring serum (S-) ferritin and hemoglobin (Hb) in 268 randomly selected, healthy, menstruating, nonpregnant Danish women aged 18-30 years. Iron deficiency (S-ferritin <16 microg/l) was observed in 9.7%, of the women, iron deficiency anemia (S-ferritin < 13 microg/l and Hb < 121 g/l) in 2.2%. Iron supplementation, predominantly as vitamin-mineral tablets containing 14-20 mg of ferrous iron was used by 35.1%. The median serum ferritin was similar in non-iron users and in iron users, whereas the prevalence of iron deficiency was 12.6% in nonusers vs. 4.3% in users, the prevalence of iron deficiency anemia 3.4% in nonusers vs. 0%, in users (p=0.17) In non-iron-supplemented women, S-ferritin levels were inversely correlated with the duration of menstrual bleeding (rs= -0.25, p<0.001) and with the women's assessment of the intensity of menstrual bleeding (r(s)= -0.27, p<0.001), whereas no such correlations were found in iron-supplemented women. The results demonstrate that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores. Women using hormonal contraceptives had menstrual bleeding of significantly shorter duration than those using intrauterine devices (IUD) or other methods. There was a high prevalence of small and absent body iron stores in young women, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors.
本研究的目的是评估月经、避孕方法和铁补充剂对丹麦年轻女性铁状态的影响，并评估是否可以根据月经模式预测缺铁情况。通过测量268名随机选取的、健康的、处于月经期的、年龄在18至30岁之间的非妊娠丹麦女性的血清铁蛋白（S-铁蛋白）和血红蛋白（Hb）来检测铁状态。9.7%的女性存在缺铁（S-铁蛋白<16微克/升），2.2%的女性存在缺铁性贫血（S-铁蛋白<13微克/升且Hb<121克/升）。35.1%的女性主要使用含14 - 20毫克亚铁的维生素 - 矿物质片进行铁补充。非铁补充剂使用者和铁补充剂使用者的血清铁蛋白中位数相似，然而，非使用者的缺铁患病率为12.6%，使用者为4.3%，非使用者的缺铁性贫血患病率为3.4%，使用者为0%（p = 0.17）。在未补充铁剂的女性中，S-铁蛋白水平与月经出血持续时间呈负相关（rs = -0.25，p<0.001），与女性对月经出血强度的评估呈负相关（r(s)= -0.27，p<0.001），而在补充铁剂的女性中未发现此类相关性。结果表明，即使是每日中等剂量的亚铁也会影响铁储备较少的女性的铁状态。使用激素避孕的女性月经出血持续时间明显短于使用宫内节育器（IUD）或其他方法的女性。年轻女性中存在少量或无体内铁储备的情况很普遍，这表明预防措施应侧重于月经持续5天或更长时间、月经出血强度大、使用不含孕激素的IUD以及献血的女性。
