Abstract
Introduction Iron deficiency (ID) is the most common nutritional deficiency found in pediatric practice. A higher prevalence of ID may be found in children with obesity. Obesity is a chronic low-grade inflammatory condition. It is postulated that inflammation increases hepcidin, a regulator of iron homeostasis. The aim of this study was to investigate the associations between iron status, hepcidin, and BMI-standard deviation score (BMI-SDS) in children with and without obesity. Methods A cross-sectional study of Thai children with obesity (5 to 15 years old) versus age- and sex-matched, nonobese controls was conducted. A total of 63 children with obesity and 27 controls were enrolled. Complete blood count, serum iron, ferritin, transferrin saturation, and total iron binding capacity were analyzed. Serum hepcidin-25 was assayed using a hepcidin ELISA Kit (Human Hepc25). Results There were 63 children with obesity, the median age (IQR) being 10 (9–13) years, and 27 controls. The median (IQR) BMI-SDS of the obese group was 2.3 (2.0–2.6) vs. −0.5 ((−1.3)−0.4) of the control group. ID was diagnosed in 27 children in the obese group (42.9%); 4 of the children with obesity and ID had anemia. Serum hepcidin-25 levels of the children with ID vs. without ID in the obese group were not significantly different (median (IQR) 25 (12.9–49.2) and 26.4 (12.6–43.6), respectively) but both of them were significantly higher than controls (19.7 (8.3–25.5) ng/ml, p = 0.04). BMI-SDS was positively correlated with hepcidin-25 (r = 0.28, p = 0.001). Conclusion Prevalence of iron deficiency in Thai children with obesity and serum hepcidin-25 was higher than controls. Further study in a larger population, preferably with interventions such as weight loss program, is warranted to clarify this association.
Highlights
Iron deficiency (ID) is the most common nutritional deficiency found in pediatric practice
Gender, anthropometry, and iron profiles were compared between the groups (Table 1). e median BMI-standard deviation score (BMI-SDS) of the obese group was 2.3 (2.0–2.6) versus -0.5 ((-1.3)-0.4) for the nonobese group. ere were no significant differences in age and gender between the two groups
Discussion e prevalence of ID in children with obesity in this study was 42.9%. is prevalence was consistent with previous studies [2,8] but higher than the prevalence of ID in 6- to 12year-old ai children (32.4%) from the SEANUTS study [26]. e proportion of ID with anemia in the obese group in this study was 6.3% which was higher than in normal school-aged ai children (5.1% from the SEANUTS study)
Summary
Iron deficiency (ID) is the most common nutritional deficiency found in pediatric practice. E aim of this study was to investigate the associations between iron status, hepcidin, and BMI-standard deviation score (BMI-SDS) in children with and without obesity. Serum hepcidin-25 levels of the children with ID vs without ID in the obese group were not significantly different (median (IQR) 25 (12.9–49.2) and 26.4 (12.6–43.6), respectively) but both of them were significantly higher than controls (19.7 (8.3–25.5) ng/ml, p 0.04). Prevalence of iron deficiency in ai children with obesity and serum hepcidin-25 was higher than controls. E 3rd US National Health and Nutrition Examination survey found a higher prevalence of ID in children that were overweight [6]. A previous study reported a prevalence of ID in children with obesity (38.8%) was much higher than children of normal weight (4.4%) [2]. Yimyaem et al demonstrated that 28% of the children with obesity (n 50) had ID and 8% had iron deficiency anemia (IDA) [8]
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