Iron status and inflammation in women of reproductive age: A population-based biomarker survey and clinical study*

Details

• Alternative Title:
  Clin Nutr ESPEN
• Personal Author:
  Finkelstein, Julia L. ; Fothergill, Amy ; Guetterman, Heather M. ; Johnson, Christina B. ; Bose, Beena ; Qi, Yan Ping ; Rose, Charles E. ; Williams, Jennifer L. ; Mehta, Saurabh ; Kuriyan, Rebecca ; Bonam, Wesley ; Crider, Krista S.
• Description:
  Background:
  
  Women of reproductive age (WRA) are at increased risk for anemia and iron deficiency. However, there is limited population-level data in India, which could help inform evidence-based recommendations and policy.
  
  Aims:
  
  To conduct a population-based biomarker survey of anemia, iron deficiency, and inflammation in WRA in Southern India.
  
  Methods:
  
  Participants were WRA (15-40 y) who were not pregnant or lactating. Blood samples (n = 979) were collected and analyzed for hemoglobin (Hb), serum ferritin (SF), soluble transferrin receptor (sTfR), C-reactive protein (CRP), and alpha-1 acid glycoprotein (AGP). Anemia and severe anemia were defined as Hb < 12.0 and < 8.0 g/dL. Serum ferritin was adjusted for inflammation using BRINDA methods. Iron deficiency was defined as SF <15.0 μg/L, iron insufficiency was defined as SF < 20.0 and < 25.0 μg/L, and iron deficiency anemia was defined as Hb < 12.0 g/dL and SF < 15.0 μg/L. Inflammation was defined as CRP > 5.0 mg/L or AGP > 1.0 g/L. Restricted cubic spline regression models were also used to determine if alternative SF thresholds should be used t to classify iron deficiency.
  
  Results:
  
  A total of 41.5% of WRA had anemia, and 3.0% had severe anemia. Findings from spline analyses suggested a SF cut-off of < 15.0 μg/L, consistent with conventional cut-offs for iron deficiency. 46.3% of WRA had SF < 15.0 μg/L (BRINDA-adjusted: 61.5%), 55.0% had SF < 20.0 μg/L (72.7%), 61.8% had SF < 25.0 μg/L (81.0%), and 30.0% had IDA (34.5%). 17.3% of WRA had CRP > 5.0 μg/L and 22.2% had AGP > 1.0 g/L. The prevalence of ID (rural vs. urban: 49.1% vs. 34.9%; p = 0.0004), iron insufficiency (57.8% vs. 43.8%; p = 0.0005), and IDA (31.8% vs. 22.4%; p = 0.01) were significantly higher in rural areas, although CRP levels were lower and there were no differences in elevated CRP or AGP.
  
  Conclusions:
  
  The burden of anemia and iron deficiency in this population was substantial, and increased after adjusting for inflammation, suggesting potential to benefit from screening and interventions.
  
  Registration number:
  
  NCT04048330.
  
  
• Keywords:
  Adolescent Adult Anemia Biomarkers C-Reactive Protein Female Ferritins Hemoglobins Humans India Inflammation Iron Iron Deficiencies Iron Status Lactation Periconceptional Pregnancy Woman Of Reproductive Age Young Adult

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• Source:
  Clin Nutr ESPEN. 49:483-494
• Pubmed ID:
  35623855
• Pubmed Central ID:
  PMC10878764
• Document Type:
  Journal Article
• Funding:
  T32 DK007158/DK/NIDDK NIH HHSUnited States/ ; T32 HD087137/HD/NICHD NIH HHSUnited States/ ; U01 DD001007/DD/NCBDD CDC HHSUnited States/ ; U01DD001007/ACL/ACL HHSUnited States/
• Volume:
  49
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5c5c5cee9c03a11238f8625bb24f81c9b46d5941b59fd56e6a721a81fb61b0dd
• Download URL:
  https://stacks.cdc.gov/view/cdc/150292/cdc_150292_DS1.pdf
• File Type:
  [PDF - 407.16 KB ]