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The influence of inflammation on iron status among young children in the Dominican Republic and Nicaragua
Author(s) -
Perrine Cria G,
Jefferds Maria Elena,
Then Amarilis,
Santos Susana,
Flores Rafael
Publication year - 2016
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.30.1_supplement.668.2
Subject(s) - inflammation , ferritin , medicine , iron deficiency , population , iron status , gastroenterology , anemia , environmental health
Ferritin is often used to assess population iron status. However, ferritin is an acute phase protein that increases with inflammation, which can lead to underestimation of iron deficiency (ID) in areas with prevalent inflammation. Previous research has suggested correcting for inflammation by multiplying ferritin by a correction factor: the ratio of the geometric means of ferritin of the group without inflammation to the group with inflammation. Most data used in developing this method are from sub‐national surveys in Asia and Africa, where prevalence and causes of inflammation and iron deficiency may differ from Latin America. We used data from nationally representative surveys of children 6–59 months in the Dominican Republic (DR, 2009, n=550) and Nicaragua (2004–05, n=962) to describe the prevalence of inflammation (α 1 ‐acid glycoprotein, AGP, >1g/L) and ID (ferritin >12 μg/L), and apply this correction method. In DR, the prevalence of inflammation was 42.4%. The prevalence of ID was 25.9% overall, and did not differ between children without and with inflammation (27.4% vs. 23.7%, p=0.4). The calculated correction factor for DR was 0.886, leading to a corrected overall prevalence of ID of 26.9%. In Nicaragua, the prevalence of inflammation was 26.3%. The prevalence of ID overall was 32.2%, and was higher among children without inflammation (37.9% vs 20.2%, p<0.01). The calculated correction factor for Nicaragua was 0.608, leading to a corrected overall prevalence of ID of 40.3%. Inflammation, as indicated by AGP, was common among young children in these Latin American countries. Inflammation had little effect on the prevalence of ID in the Dominican Republic, but was associated with lower estimates of ID in Nicaragua. The reason for these differences is not clear. The corrected prevalence of ID in Nicaragua was several percentage points higher than the prevalence among children without inflammation. National surveys in different global regions should continue to assess how inflammation impacts estimates of ID.