Influence Of Iron Status Research Articles

An 8-Week Vitamin D3–Fortified Fruit Drink Supplementation Increases Serum Ferritin Concentration: A Randomized Controlled Trial in Malaysian Women With Low Iron Stores

BackgroundThere is limited randomized controlled trial evidence to support the association between vitamin D deficiency and anemia risk, highlighting the necessity for further investigations into the role of vitamin D in influencing iron status. ObjectiveThe aim of this study was to determine the effect of vitamin D3–fortified fruit drink consumption (4,000 IU) on vitamin D and iron status biomarkers among iron-deficient women (serum ferritin of <20 μg/L [to convert μg/L ferritin to ng/mL, multiply by 1]). DesignAn 8-week double-blind randomized controlled trial was conducted. Subjects/settingA total of 45 healthy, nonpregnant, nonlactating subjects aged 18 through 40 years (mean [SD] 25.3 [4.6] years) were included in the study, excluding those who donated blood 6 months prior, regularly consumed nutritional supplements, or had gastrointestinal or iron metabolic disorders. InterventionSubjects were randomly assigned to receive either vitamin D3–fortified fruit drink or a placebo. Main outcome measuresMeasurements of 25-hydroxyvitamin D (25[OH]D), serum ferritin, high-sensitivity C-reactive protein, and full blood count concentrations were obtained at baseline, interim, and post intervention. Statistical analysesA mixed model, repeated measures analysis of variance was used to analyze the intervention effect. ResultsAttrition rate for the study was 13%, with 6 dropouts, and 39 subjects completed the study. Daily consumption of vitamin D3–fortified fruit drink in the intervention group resulted in significant increases in 25(OH)D and serum ferritin concentrations compared with the placebo group. The intervention group showed significantly higher mean (SD) changes (Δ) in both 25(OH)D (Δ 76.4 [30.2] nmol/L [to convert nmol/L 25(OH)D to ng/mL, multiply by .4] vs Δ –1.3 [10.7] nmol/L; P = .001) and serum ferritin concentrations (Δ 2.2 [4.2] μg/L vs Δ –0.3 [3.4] μg/L; P = .048) between baseline and post intervention. The other iron status biomarkers were not affected by the intervention. ConclusionsOur study found that daily vitamin D3–fortified fruit drink supplementation for 8 weeks effectively improved 25(OH)D and iron stores, indicated by increased serum ferritin concentrations, in iron-deficient women. Further research is needed to evaluate its safety, efficacy, feasibility, and optimal food fortification in diverse populations.

The association between different nutrients and the risk of iron deficiency: NHANES 2017-2020

Iron homeostasis is important in the human health system. Abnormal iron homeostasis, such as iron deficiency (ID), may cause diseases such as anemia. Iron status is a complex phenomenon that is influenced by a variety of factors, including nutrient intake. This research is needed to understand better the different nutrients which influence iron status and to develop effective strategies for improving iron status in at-risk populations. NHANES 2017-2020 data was used to simulate the linear regression model to predict the relationship between different nutrients the iron status. Results revealed that the positive association was not strong between selected nutrients (Magnesium, Protein.1, Sodium) and ferritin level (r=0.09723); the positive relationship was not strong as well between selected nutrients (Protein.1, Cholesterol, Magnesium) and transferrin. (r=0.2202).

Iron status in women with infertility and controls: a case-control study.

Iron deficiency is a common problem in subfertile women. The influence of iron status on unexplained infertility is unknown. In a case-control study, 36 women with unexplained infertility and 36 healthy non-infertile controls were included. Parameters of iron status including serum ferritin and a serum ferritin <30 µg/dL served as main outcome parameters. Women with unexplained infertility demonstrated a lower transferrin saturation (median 17.3%, IQR 12.7-25.2 versus 23.9%, IQR 15.4-31.6; p= 0.034) and a lower mean corpuscular hemoglobin concentration (median 33.6 g/dL, IQR 33.0-34.1 versus 34.1 g/dL, IQR 33.2-34.7; p= 0.012). Despite the fact that there was no statistically significant difference in median ferritin levels (p= 0.570), women with unexplained infertility had ferritin levels <30µg/L more often (33.3%) than controls (11.1%; p= 0.023). In a multivariate model, unexplained infertility and abnormal thyroid antibodies were associated with ferritin <30µg/L (OR 4.906, 95%CI: 1.181-20.388; p= 0.029 and OR 13.099; 2.382-72.044; p= 0.029, respectively). Ferritin levels <30µg/L were associated with unexplained infertility and might be screened in the future. Further studies with a focus on iron deficiency and iron treatment on women with unexplained infertility are warranted.

A contemporary understanding of iron metabolism in active premenopausal females.

Iron metabolism research in the past decade has identified menstrual blood loss as a key contributor to the prevalence of iron deficiency in premenopausal females. The reproductive hormones estrogen and progesterone influence iron regulation and contribute to variations in iron parameters throughout the menstrual cycle. Despite the high prevalence of iron deficiency in premenopausal females, scant research has investigated female-specific causes and treatments for iron deficiency. In this review, we provide a comprehensive discussion of factors that influence iron status in active premenopausal females, with a focus on the menstrual cycle. We also outline several practical guidelines for monitoring, diagnosing, and treating iron deficiency in premenopausal females. Finally, we highlight several areas for further research to enhance the understanding of iron metabolism in this at-risk population.

Prebiotics, Probiotics, and Postbiotics in the Prevention and Treatment of Anemia.

Iron deficiency anemia (IDA) is very common and affects approximately 1/3 of the world’s human population. There are strong research data that some probiotics, such as Lactobacillus acidophilus and Bifidobacterium longum improve iron absorption and influence the course of anemia. Furthermore, prebiotics, including galactooligosaccharides (GOS) and fructooligosaccharides (FOS), increase iron bioavailability and decrease its destructive effect on the intestinal microbiota. In addition, multiple postbiotics, which are probiotic metabolites, including vitamins, short-chain fatty acids (SCFA), and tryptophan, are involved in the regulation of intestinal absorption and may influence iron status in humans. This review presents the actual data from research studies on the influence of probiotics, prebiotics, and postbiotics on the prevention and therapy of IDA and the latest findings regarding their mechanisms of action. A comparison of the latest research data and theories regarding the role of pre-, post-, and probiotics and the mechanism of their action in anemias is also presented and discussed.

Impacts of insect consumption on human health

Edible insects represent an understudied food resource that may promote human health. They characteristically contain ample protein, healthy fatty acids, minerals, and vitamins, and have been touted for their environmental benefits given their efficient resource use. While numerous in vitro, animal, and nutrient quantification studies have elucidated a framework of potential health impacts of entomophagy, few have measured direct health outcomes. This review investigates and summarises existing evidence on health impacts derived exclusively from human interventions. A systematic literature search was conducted in three databases: SCOPUS, Web of Science, and PubMed. Out of 1,691 initial results, only nine studies met the inclusion criteria. In these limited studies, insects were shown to have potential to: (1) promote growth and influence iron status when added to complementary foods; (2) modulate gut microbiota with some prebiotic effects; and (3) provide amino acids similar to soya protein. One study also provided isolated evidence that an insect-herb mixture could possibly reduce symptoms of chronic obstructive pulmonary disease when added to routine treatment. Importantly, results reveal a significant lack of human subjects research directly measuring health outcomes from insect consumption. Findings from the included studies indicate that insects are generally safe and offer both beneficial and neutral outcomes compared to other foods. These discoveries, in tandem with extensive evidence from non-human studies, support claims that insect consumption could further enhance health by addressing micronutrient deficiencies or promoting gut health. There are also other plausible health promoting properties of insects that could help ameliorate complications with hypertension and other non-communicable disease. More rigorous and better controlled human intervention trials are fundamental to confirm health benefits and better assess risks associated with entomophagy, while also addressing unanswered questions regarding nutrient bioavailability, the fate of dietary chitin, and in vivo activity of bioactive peptides.

Clinical analysis of peritonitis in peritoneal dialysis patients

Introduction/Objective. Peritoneal dialysis is a method of treating patients in the terminal phase of renal failure (end-stage renal disease). Peritonitis represents most severe and most common complication of peritoneal dialysis. The most common peritonitis causes are Gram negative microorganisms: Staphylococcus-coagulase-negative, Staphylococcus aureus, Streptococcus sp, Neisseria sp. Gram negative microorganisms are: Pseudomonas sp, Enterococcus, Klebsiella sp, Proteus sp, Acinetobacter sp. The aim of the study was to examine the incidence of peritonitis and to determine the differences between patients with and without peritonitis and catheter infection. Other goals of the work were: the most frequent causes of peritonitis, the outcome of treatment, the influence of the length of treatment on the development of peritonitis, the influence of the peritoneal dialysis adequacy on the development of peritonitis, the influence of anemia, nutritional status, iron status, secondary hyperparathyroidism (Ca, P, CaxPO4, parathormone), protein status ? albumin and the effect of acid uricum on the development of peritonitis. Methods. Retrospectively, 84 patients were analyzed of peritoneal dialysis (2012?2016) at the Kragujevac Center for Nephrology and Dialysis of Clinical Center. The diagnosis of peritonitis was based on clinical picture, biochemical analyses, leukocyte in sediment of dialysis, findings of peritoneal-culture, signs of inflammation (C-reactive protein, leukocytes). The analysis included: the most common causes, the outcome of treatment, the influence of the length of treatment, the influence of the peritoneal dialysis adequacy, the influence of anemia, the influence of iron status, the influence of secondary hyperparathyroidism, the influence of protein status - albumin, and the effect of acid uricum on the development of peritonitis. Results. In total, 22 patients had one, six patients had two, six patients had three, six patients more than three episodes of peritonitis. The difference in mean values of the number of erythrocytes, hemoglobin, hematocrit, iron, albumin, diastolic pressure, systolic pressure between patients with peritonitis, and those without it, were statistically significant (p &lt; 0.05). The difference in mean values of calcium (Ca), phosphor (P), CaxPO4, uricum value, parathormone, peritoneal dialysis adequacy, systolic pressure was not statistically significant (p &gt; 0.05). The incidence of peritonitis and death were not associated (p = 1.000). Conclusion, Peritonitis is severe complication of peritoneal dialysis. Anemia and nutritional status are risk factors that affect the development of peritonitis in patients on peritoneal dialysis.

Effect of Helicobacter pylori, black tea and sodium bicarbonate on iron metabolism and MDCK cell survival

Background: Iron deficiency anemia is the most common nutritional disorder in the world. Diet and Helicobacter pylori infection are among the main causes of this disorder. Objective: In this study, the effect of black tea extract and sodium bicarbonate with Helicobacter pylori on the genes involved in iron absorption and storage, as well as cell proliferation, were studied. Methods: Simultaneous cultivation of MDCK and Helicobacter pylori cell lines was performed at concentrations of 10, 20, 40 and 80 μg/ml of tea extract and 30, 40, 60 and 100 mM sodium bicarbonate at 24 and 48 hours. The effect of treatment on cell survival was investigated by trypan blue staining and expression of MYC, TFRC, FTH1, IRP2, IRP1, and NDRG1 genes by real-time PCR and analyzed by ANOVA and independent T-test. Findings: There was no significant change in the expression of the genes involved in iron metabolism under the influence of tea, sodium bicarbonate and Helicobacter pylori treatment in MDCK cell line. Upregulation MYC gene expression was observed in the presence of Helicobacter pylori after 24 hours treatment with tea extract, and sodium bicarbonate, and in the absence of Helicobacter pylori upregulation with tea extract after 48 hours (P<0.05). Also upregulation NDRG1 gene expression was seen after tea extract treatment of cells with or without Helicobacter pylori in both 24 and 48 h (P<0.05). Conclusion: Sodium bicarbonate and tea each one alone didn’t not influence iron status. This study suggests that reduction of tea intake could be served as a risk prevention strategy.

Associations between Common Variants in Iron-Related Genes with Haematological Traits in Populations of African Ancestry.

BackgroundLarge genome-wide association (GWA) studies of European ancestry individuals have identified multiple genetic variants influencing iron status. Studies on the generalizability of these associations to African ancestry populations have been limited. These studies are important given interethnic differences in iron status and the disproportionate burden of iron deficiency among African ancestry populations.MethodsWe tested the associations of 20 previously identified iron status-associated single nucleotide polymorphisms (SNPs) in 628 Kenyans, 609 Tanzanians, 608 South Africans and 228 African Americans. In each study, we examined the associations present between 20 SNPs with ferritin and haemoglobin, adjusting for age, sex and CRP levels.ResultsIn the meta analysis including all 4 African ancestry cohorts, we replicated previously reported associations with lowered haemoglobin concentrations for rs2413450 (β = -0.19, P = 0.02) and rs4820268 (β = -0.16, P = 0.04) in TMPRSS6. An association with increased ferritin concentrations was also confirmed for rs1867504 in TF (β = 1.04, P = <0.0001) in the meta analysis including the African cohorts only.ConclusionsIn all meta analyses, we only replicated 4 of the 20 single nucleotide polymorphisms reported to be associated with iron status in large GWA studies of European ancestry individuals. While there is now evidence for the associations of a number of genetic variants with iron status in both European and African ancestry populations, the considerable lack of concordance highlights the importance of continued ancestry-specific studies to elucidate the genetic underpinnings of iron status in ethnically diverse populations.

Iron status in 72 Congolese patients with sickle cell anemia

Multiple blood transfusions, intestinal parasites, and high iron needs during the growth period are all factors that influence iron status in African children. To determine their iron status and its association with these factors, we studied 72 homozygous sickle-cell patients in a steady state in Kinshasa. Iron status was determined by a combination of several indicators: ferritin, transferrin, blood count, total iron binding capacity, transferrin saturation, and C-reactive protein. These results were compared with those from a matched control group without sickle-cell disease. Compared to the control group, 5 patients (11%) were iron-deficient, while 18 (35%) had an iron overload, probably due to multiple blood transfusions. This study shows the importance of periodic assessments of iron status in homozygous sickle cell patients to prevent and manage any iron imbalance.

Influence of iron status on risk of maternal or neonatal infection and on neonatal mortality with an emphasis on developing countries

Infection is a major cause of neonatal death in developing countries. This review investigates whether host iron status affects the risk of maternal and/or neonatal infection, potentially contributing to neonatal death, and summarizes the iron acquisition mechanisms described for pathogens causing stillbirth, preterm birth, and congenital infection. In vitro evidence shows that iron availability influences the severity and chronicity of infections that cause these negative outcomes of pregnancy. In vivo evidence is lacking, as relevant studies of maternal iron supplementation have not assessed the effect of iron status on the risk of maternal and/or neonatal infection. Reducing iron-deficiency anemia among women is beneficial and should improve the iron stores of babies; moreover, there is evidence that iron status in young children predicts the risk of malaria and, possibly, the risk of invasive bacterial diseases. Caution with maternal iron supplementation is indicated in iron-replete women who may be at high risk of exposure to infection, although distinguishing between iron-replete and iron-deficient women is currently difficult in developing countries, where a point-of-care test is needed. Further research is indicated to investigate the risk of infection relative to iron status in mothers and babies in order to avoid iron intervention strategies that may result in detrimental birth outcomes in some groups of women.

Factors That Influence Iron Status of Pregnant Women in Nsukka Local Government Area of Enugu State, Nigeria

Iron deficiency, the commonest nutritional disorder worldwide, has serious impact on pregnant women. The prevalence of anaemia among pregnant women in Africa ranges from 47% in East Africa to 56% in West Africa. Among Nigerian women, South-eastern Nigeria has the highest prevalence (61%) of iron deficiency anaemia. The study investigated the factors that influence iron status of pregnant women in Nsukka Local Government Area of Enugu State, Nigeria. The respondents comprised 386 pregnant women randomly selected in Nsukka Local Government Area. A validated structured questionnaire was used to collect information on respondents’ socio-economic and obstetric characteristics. Determination of haemoglobin concentration (Hb) was used to assess the respondents’ iron status. The result showed that less than half (44.1%) of the respondents had normal iron status, while 55.9% of the respondents had varying degrees of iron deficiency. Mean Hb of the respondents was 10.87±0.99g/dl. Iron status of the respondents was significantly (P&lt;0.05) influenced by age, occupation, educational and income levels. Respondents below 20 years had significantly lower Hb (P&lt;0.05) than other ages. Artisans, farmers and traders had significantly lower Hb (P&lt;0.05) than other occupational groups. Hb significantly increased with increase in educational and income levels (P&lt;0.05). Women’s nutritional/health status hinges on improved educational/economic empowerment, and is further impaired by early marriage and teenage pregnancy. Women’s education must be highly prioritized, and community-based approaches employed for promotion of girl-child education and prevention of adolescent marriage/pregnancy. More income generating activities/entrepreneurial skills for women are imperative to boost their income and spending on family food.Key words: iron status, influencing factors, pregnant women, Nsukka.

A Randomized Controlled Trial in Young Women of the Effects of Consuming Pork Meat or Iron Supplements on Nutritional Status and Feeling of Well-being

Objectives: Limited information is available on the role of pork meat in influencing iron status. The aim of this study was to determine the effect of consuming pork meat as compared to iron supplementation on nutritional status and feeling of well-being.Methods: Young women were randomly assigned to a control diet (CG), a pork-containing diet (PG), or a control diet with iron supplementation (SG) for 12 weeks. Sixty-five women aged 24.6 ± 4.4 years (mean ± SD) completed the trial.Results: Serum ferritin concentrations were increased significantly (p = 0.001) in participants assigned to the SG as compared with the other groups, as assessed by repeated-measures analysis of variance. At week 12, hemoglobin concentrations were significantly higher in PG and SG as compared with CG. Plasma zinc concentrations at the end of the intervention were similar to baseline concentrations for individuals in the CG and PG but were decreased significantly (p < 0.05) in SG. Plasma-, erythrocyte-folate, and serum vitamin B6 and B12 concentrations were not significantly affected by the intervention, although the concentrations of vitamins B6 and B12 tended to increase in PG. Well-being, as measured using the Health Survey Short Form (SF-36) and its 8 multi-item scales, showed significant improvement in vitality in SG (p < 0.05) and bodily pain in PG (p < 0.05). No significant relationships were observed between these health concept scores and biomarkers of nutritional status.Conclusions: Consumption of pork meat by young women maintains hemoglobin levels to the same extent as low-dose iron supplementation and enhances the components of well-being, mainly their perception of bodily pain.

An association study of HFE gene mutation with idiopathic male infertility in the Chinese Han population

Mutations in the haemochromatosis gene (HFE) influence iron status in the general population of Northern Europe, and excess iron is associated with the impairment of spermatogenesis. The aim of this study is to investigate the association between three mutations (C282Y, H63D and S65C) in the HFE gene with idiopathic male infertility in the Chinese Han population. Two groups of Chinese men were recruited: 444 infertile men (including 169 with idiopathic azoospermia) and 423 controls with proven fertility. The HFE gene was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The experimental results demonstrated that no C282Y or S65C mutations were detected. Idiopathic male infertility was not significantly associated with heterozygous H63D mutation (odds ratio=0.801, 95% confidence interval=0.452-1.421, χ(2)=0.577, P=0.448). The H63D mutation frequency did not correlate significantly with the serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) levels in infertile men (P=0.896, P=0.404 and P=0.05, respectively). Our data suggest that the HFE H63D mutation is not associated with idiopathic male reproductive dysfunction.

The influence of iron status and genetic polymorphisms in the HFE gene on the risk for postoperative complications after bariatric surgery: a prospective cohort study in 1,064 patients

BackgroundGastric bypass surgery is a highly effective therapy for long-term weight loss in severely obese patients, but carries significant perioperative risks including infection, wound dehiscence, and leaks from staple breakdown. Iron status can affect immune function and wound healing, thus may influence peri-operative complications. Common mutations in the HFE gene, the gene responsible for the iron overload disorder hereditary hemochromatosis, may impact iron status.MethodsWe analyzed 1064 extremely obese Caucasian individuals who underwent open and laparoscopic Roux-n-Y gastric bypass surgery at the Geisinger Clinic. Serum iron, ferritin, transferrin, and iron binding capacity were measured pre-operatively. All patients had intra-operative liver biopsies and were genotyped for the C282Y and H63D mutations in the HFE gene. Associations between surgical complications and serum iron measures, HFE gene status, and liver iron histology were determined.ResultsWe found that increased serum iron and transferrin saturation were present in patients with any post-operative complication, and that increased serum ferritin was also increased in patients with major complications. Increased serum transferrin saturation was also associated with wound complications in open RYGB, and transferrin saturation and ferritin with prolonged lengths of stay. The presence of 2 or more HFE mutations was associated with overall complications as well as wound complications in open RYGB. No differences were found in complication rates between those with stainable liver iron and those without.ConclusionSerum iron status and HFE genotype may be associated with complications following RYGB surgery in the extremely obese.

In silico QTL mapping of basal liver iron levels in inbred mouse strains

Both iron deficiency and iron excess are detrimental in many organisms, and previous studies in both mice and humans suggest that genetic variation may influence iron status in mammals. However, these genetic factors are not well defined. To address this issue, we measured basal liver iron levels in 18 inbred strains of mice of both sexes on a defined iron diet and found ∼4-fold variation in liver iron in males (lowest 153 μg/g, highest 661 μg/g) and ∼3-fold variation in females (lowest 222 μg/g, highest 658 μg/g). We carried out a genome-wide association mapping to identify haplotypes underlying differences in liver iron and three other related traits (copper and zinc liver levels, and plasma diferric transferrin levels) in a subset of 14 inbred strains for which genotype information was available. We identified two putative quantitative trait loci (QTL) that contain genes with a known role in iron metabolism: Eif2ak1 and Igf2r. We also identified four putative QTL that reside in previously identified iron-related QTL and 22 novel putative QTL. The most promising putative QTL include a 0.22 Mb region on Chromosome 7 and a 0.32 Mb region on Chromosome 11 that both contain only one candidate gene, Adam12 and Gria1, respectively. Identified putative QTL are good candidates for further refinement and subsequent functional studies.

HFE Genotype Influences Erythropoiesis Support Requirement in Hemodialysis Patients: A Prospective Study

Background/Aims: HFE protein controls iron absorption and cycling, and HFE mutations influence iron status. The aim was to evaluate the effect of the HFE genotype on the need for iron and erythropoietin in Italian hemodialysis patients. Methods: Ninety-six prevalent patients were evaluated at the time of enrolment and prospectively followed for 3 years. Patients were given r-HuEPO and Fe³⁺-gluconate according to guidelines. The HFE genotype was determined by restriction analysis. Results: Three patients (3%) carried the C282Y mutation, 4 (4%) were homozygous and 18 (19%) heterozygous for the H63D mutation, and 71 (74%) were negative for both. At enrolment, subjects positive for HFE mutations had higher iron stores (ferritin 617 ± 663 vs. 423 ± 386 ng/ml, p = 0.05), were receiving less iron (82.5 ± 66 vs. 110 ± 154 mg/month, p = 0.05) and a lower r-HuEPO dosage (98 ± 83 vs. 142 ± 138 U/kg/week, p = 0.03). Consistently during the study period, patients positive for HFE mutations received a lower amount of r-HuEPO (94.5 ± 63 vs. 186 ± 344 U/kg/week, p = 0.01) and iron (97 ± 63 vs. 121 ± 68 mg/month, p = 0.07). Upon Cox regression analysis, after adjustment for confounding variables, the presence of HFE mutations was associated with a reduced risk of death (HR 0.6, 95% CI 0.34–1.03, p = 0.06). Conclusion:HFE mutations reduce the amount of r-HuEPO and iron necessary to support erythropoiesis in hemodialysis.

Ferritin levels during structured treatment interruption of highly active antiretroviral therapy

The aim of the study was to investigate the influence of highly active antiretroviral therapy (HAART) on iron status and, conversely, the influence of iron status on the response to HAART. Ferritin levels were retrospectively determined in stored plasma from 138 HAART-naïve, moderately immunosuppressed HIV-infected Thai patients participating in a structured treatment interruption trial. Ferritin levels were determined at three predefined time-points: (1) HAART initiation; (2) HAART discontinuation; and (3) HAART resumption. At baseline, 31% and 16% of the HIV-infected patients included in the study had high (>200 ng/mL) and low (<30 ng/mL) ferritin levels, respectively. Ninety-five per cent of patients with low ferritin levels were female. Ferritin decreased significantly during the interruption phase of HAART (-8.8 ng/mL; P=0.0005) but remained elevated in 62% of the patients with high baseline levels. A low baseline ferritin level was associated with a shorter time (P=0.041) to reach the CD4 cell target for HAART interruption (350 cells/microL), compared with a normal or high baseline ferritin level. Moreover, in a multivariate model, the relative risk (RR) of arriving at this CD4 cell target was significantly higher [RR 1.81; 95% confidence interval (CI) 1.05-3.14] in patients with low baseline ferritin. It is unlikely that inflammation affected ferritin in our patients, as mean levels of C-reactive protein were not elevated in patients with either high or low ferritin levels. Both high and low ferritin levels were highly prevalent in moderately immunosuppressed HIV-positive Thai patients. Structured treatment interruption of HAART resulted in a significant decrease in overall ferritin levels. Furthermore, subjects with low baseline ferritin levels had a faster and greater CD4 response to HAART, suggesting a potential beneficial effect of iron deficiency on immunological recovery after initiation of HAART.

Population prevalence and risk factors for iron deficiency in Auckland, New Zealand

Previous prevalence estimates of iron deficiency (ID) in young New Zealand children are inaccurate because of sampling bias and imprecise definition of ID. The aim of this study was to estimate the prevalence of ID in children aged 6-23 months and the factors associated with ID. An ethnically stratified sample identified from random residential address start points. Children resident in Auckland, New Zealand were enrolled from 1999 to 2002. Children with elevated C-reactive protein (>4 mg/L) were excluded. Iron status was determined in 324 (78%) of 416 enrolled children. Analyses adjusted for clustering and weighted for ethnic stratification. ID defined as abnormal values for two or more of serum ferritin (<10 microg/L), iron saturation (<10%) and mean cell volume (<73 fl). ID was present in 14% (95% confidence interval (CI) 9-17%). ID prevalence varied with ethnicity (Maori 20%, Pacific 17%, other 27%, New Zealand European 7%, P = 0.005), but not with social deprivation. In a multivariate analysis that adjusted for low birthweight, there was an increased risk of ID associated with a body mass index >or= 18.5 kg/m(2) (RR = 4.34, 95% CI 1.08-10.67), and with receiving no infant or follow on formula (RR = 3.60, 95% CI 1.56-6.49). ID is prevalent in young New Zealand children. Variance in ID prevalence with ethnicity but not social deprivation implies that cultural practices influence iron status. Young children with more rapid growth are at increased risk of ID as are those receiving milk other than that specifically modified for them.

The Influence of Iron Status on Iodine Utilization and Thyroid Function

Despite significant progress, deficiencies of iron and iodine remain major public health problems affecting > or =30% of the global population. These deficiencies often coexist in children. Recent studies have demonstrated that a high prevalence of iron deficiency among children in areas of endemic goiter may reduce the effectiveness of iodized salt programs. These findings argue strongly for improving iron status in areas of overlapping deficiency, not only to combat anemia but also to increase the efficacy of iodine prophylaxis. The dual fortification of salt with iodine and iron may prove to be an effective and sustainable method to accomplish these important goals.