Gloria Cabañas Pujadas1, Honorato Ortiz-Marrón2, Maira Alejandra Ortiz-Pinto1, Adelaida García Gscheidle3, Paloma de la Calle Tejerina4, Encarnación Donoso-Navarro5, María Ordobás Gavín1, Iñaki Galán6,7. 1. Department of Epidemiology, General Directorate of Public Health, Ministry of Health, Community of Madrid (Spain), Madrid, Spain. 2. Department of Epidemiology, General Directorate of Public Health, Ministry of Health, Community of Madrid (Spain), Madrid, Spain. honorato.ortiz@salud.madrid.org. 3. Pediatrician at Reyes Católicos Health Center, Northern Area of Primary Care of Madrid, Community of Madrid (Spain), Madrid, Spain. 4. Pediatrician at Torres de la Alameda Health Center, Eastern Area of Primary Care of Madrid, Community of Madrid (Spain), Madrid, Spain. 5. Clinical Analysis and Biochemistry Service, Puerta de Hierro University Hospital, Majadahonda, Community of Madrid (Spain), Madrid, Spain. 6. National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. 7. Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain.
Abstract
BACKGROUND: Recent studies revealed that children who are overweight have a higher risk of iron deficiency, although the etiology of this relationship remains unclear. The aim of the study was to evaluate the association between changes in obesity status between 4 and 9 years of age and iron deficiency. SUBJECTS: This population-based cohort study included 1347 children from the ELOIN study, conducted in Madrid, Spain. Follow-up with physical examinations and a computer-assisted telephone interview were carried out at 4, 6 and 9 years of age, and a blood test was performed at 9 years. METHODS: Changes in obesity were estimated based on body mass index and waist circumference, according to the persistence or variation in obesity rates at 4, 6 and 9 years and were classified as follows: (1) Stable without obesity; (2) Remitting obesity at 9 years; (3) Incident obesity or relapse at 9 years; and (4) Stable with obesity. Iron deficiency was defined as transferrin saturation value below 16%. Odds ratios (ORs) for iron deficiency were estimated according to obesity status using logistic regression and adjusted for confounding variables, including C-reactive protein (CRP). RESULTS: The prevalence of iron deficiency in the stable general obesity (GO) and abdominal obesity (AO) groups was 38.2% and 41.2%, versus 23.6% and 23.4% in the stable without obesity groups, respectively. The ORs for iron deficiency were 1.85 (95% CI: 1.03-3.32) in the stable GO group and 2.34 (95% CI: 1.29-4.24) in the stable AO group. This association disappeared when CRP was included in the analysis. CONCLUSIONS: An extended state of obesity during the first stages of life is associated with iron deficiency, and this association may be mediated by CRP. Prevention and early detection of obesity in children should be a priority to avoid a double burden of malnutrition.
BACKGROUND: Recent studies revealed that children who are overweight have a higher risk of iron deficiency, although the etiology of this relationship remains unclear. The aim of the study was to evaluate the association between changes in obesity status between 4 and 9 years of age and iron deficiency. SUBJECTS: This population-based cohort study included 1347 children from the ELOIN study, conducted in Madrid, Spain. Follow-up with physical examinations and a computer-assisted telephone interview were carried out at 4, 6 and 9 years of age, and a blood test was performed at 9 years. METHODS: Changes in obesity were estimated based on body mass index and waist circumference, according to the persistence or variation in obesity rates at 4, 6 and 9 years and were classified as follows: (1) Stable without obesity; (2) Remitting obesity at 9 years; (3) Incident obesity or relapse at 9 years; and (4) Stable with obesity. Iron deficiency was defined as transferrin saturation value below 16%. Odds ratios (ORs) for iron deficiency were estimated according to obesity status using logistic regression and adjusted for confounding variables, including C-reactive protein (CRP). RESULTS: The prevalence of iron deficiency in the stable general obesity (GO) and abdominal obesity (AO) groups was 38.2% and 41.2%, versus 23.6% and 23.4% in the stable without obesity groups, respectively. The ORs for iron deficiency were 1.85 (95% CI: 1.03-3.32) in the stable GO group and 2.34 (95% CI: 1.29-4.24) in the stable AO group. This association disappeared when CRP was included in the analysis. CONCLUSIONS: An extended state of obesity during the first stages of life is associated with iron deficiency, and this association may be mediated by CRP. Prevention and early detection of obesity in children should be a priority to avoid a double burden of malnutrition.
Authors: Sophie Waldvogel-Abramowski; Gérard Waeber; Christoph Gassner; Andreas Buser; Beat M Frey; Bernard Favrat; Jean-Daniel Tissot Journal: Transfus Med Hemother Date: 2014-05-12 Impact factor: 3.747