Prevalence and Association between Obesity and Iron Deficiency in Children

Abstract

Background: Excessive body fat accumulation is a known risk factor for a variety of comorbidities including iron-related disorders such as iron deficiency and iron deficiency anemia. However, only minor investigations, particularly in Thailand, have established a link between obesity and iron-related disorders among children. Objective: To examine the association between weight status, specifically overweight, obese, and morbidly obese children, and their iron levels, as well as to determine the prevalence of children who were overweight/obese and having iron deficiency and iron deficiency anemia. Materials and Methods: The authors conducted a cross-sectional-research at Naresuan University Hospital in Phitsanulok, Thailand, on 99 overweight and obese pediatric outpatients aged 5 to 15 years between July 2020 and March 2021. Baseline characteristics and anthropometric measurements of the subjects were recorded, and blood samples were collected to determine hemoglobin concentration (Hb), serum iron (SI) levels, serum ferritin (SF), total iron-binding capacity (TIBC), mean corpuscular volume (MCV), and transferrin saturation. All data were entered into SPSS software and evaluated using analyses of variance (ANOVA), chi-square, Fisher’s exact, Pearson’s correlation, and odds ratio to identify the relationship between overweight/obesity and iron status. Results: The findings revealed a 51.52% (95% CI 41.25 to 61.68) prevalence of iron deficiency in the study population, whereas 3% (95% CI 0.60 to 8.60) of the participants had iron deficiency anemia. The present research demonstrates unequivocally that individuals with iron deficiency and iron deficiency anemia had low SI level and low transferrin saturation. Additionally, all overweight and obese subjects had elevated SF levels but normal TIBC. Conclusion: Iron deficiency is significantly more common in overweight and obese children. Serum iron and transferrin saturation levels serve as indicators of iron deficiency and iron deficiency anemia. Excess body fat results in elevated SF levels and normal TIBC levels. Therefore, SF and TIBC levels are not indicative of iron deficiency. Keywords: Overweight; Obesity; Children; Iron deficiency; Iron deficiency anemia; Serum iron; Serum ferritin; Serum TIBC; Thalassemia, Anemia