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Correcting for the influence of inflammation improves the accuracy for estimation of iron status among preschoolers in western Kenya
Author(s) -
Grant Frederick,
Suchdev Parmi,
Cole Conrad R,
Ramakrishnan Usha,
FloresAyala Rafael,
Martorell Reynaldo
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.208.2
Subject(s) - soluble transferrin receptor , medicine , zinc protoporphyrin , c reactive protein , ferritin , hemoglobin , transferrin , gastroenterology , iron deficiency , population , serum ferritin , acute phase protein , anemia , subclinical infection , iron status , inflammation , chemistry , heme , biochemistry , environmental health , enzyme
Iron status (IS) estimation in high infection areas is difficult due to the effects of infection on indicators of IS. Using data on indicators of IS [(hemoglobin (Hb), zinc protoporphyrin (ZP), ferritin (Ft), transferrin receptors (TfR), and TfR/Ft index)] and subclinical infection [(acute phase proteins; C‐reactive protein (CRP) and alpha glycoprotein (AGP)] on preschoolers, we examined if the use of a correction factor (CF) will improve the accuracy of estimations of iron deficiency (ID). Methods We recruited 2340 children (aged 6–59 mos) in cross sectional surveys and obtained blood for Hb, Ft, TfR, ZP, CRP, and AGP measurements. Results CRP correlated with AGP ( r =0.62; p <0.001), Ft ( r =0.40; p<0.001), Hb (r=−0.21; p<0.001) and ZP (r=0.17; p<0.001); AGP correlated with Ft (r= 0.38; p<0.001), Hb (r=−0.2; p<0.001) and ZP (r=0.16; p<0.001). Use of CFs (ratios of median for reference group over each inflammatory group) improved the estimation of IS of the population (p<0.001) when median iron indicators [Hb (108 vs. 111 g/L ), Ft (19.4 vs. 13.9 μg/L ), and ZP (142 vs. 126 μmol/mol )] and estimated anemia (Hb<110 g/ L: 54 vs. 45%) and ID prevalences [(Ft<12 μg/L : 32 vs. 43%), (ZP>80 μmol/mol : 89 vs. 83%)] of uncorrected and corrected IS indicators were compared. Conclusion CRP and AGP have an impact on the estimation of IS among preschoolers, but the use of a CF is indicated to improve the accuracy for diagnosis of ID. Sources of research support: CDC, Atlanta, GA; and International Nutrition Foundation, Boston, MA. Grant Funding Source : NUTRITION (ASN)