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Iron status of inner-city elementary school children: lack of correlation between anemia and iron deficiency
1Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia.
Insights
Inner-city children show lower hemoglobin but higher serum ferritin, indicating potential shifts in iron status. Current anemia screening may miss many iron-deficient children, suggesting a need for better methods.
Area of Science:
- Pediatric Nutrition
- Public Health
- Hematology
Background:
- Iron deficiency remains a significant public health concern in children.
- Previous studies indicate varying iron status indicators among urban youth.
- Anemia screening in children often relies on hemoglobin, which may not fully capture iron status.
Purpose of the Study:
- To evaluate the iron status of inner-city third and fourth graders.
- To compare current iron status indicators with previously reported values.
- To assess the effectiveness of current screening methods for iron deficiency.
Main Methods:
- Assessed iron status in 103 inner-city children (grades 3-4).
- Measured hemoglobin, serum ferritin, erythrocyte protoporphyrin, and mean corpuscular volume.
- Analyzed data for anemia and iron deficiency indicators, considering blood lead levels.
Main Results:
- Children exhibited significantly lower hemoglobin and higher serum ferritin levels than historical data.
- Mean erythrocyte protoporphyrin aligned with previous findings; mean corpuscular volume was lower.
- Anemia was present in 10.7% of children, but few showed other iron status abnormalities.
- Low serum ferritin with other abnormalities was found in 2.9%; 3.9% had multiple abnormal measures without elevated lead.
Conclusions:
- Findings suggest a potential trend of increasing iron stores in school-aged children.
- Hemoglobin alone is insufficient for identifying iron-deficient children.
- Alternative screening methods for iron status in children are warranted.
Abstract:
The iron status of 103 inner-city third and fourth graders was evaluated. These children had significantly lower hemoglobin concentrations and significantly higher serum ferritin concentrations than values previously reported. Mean erythrocyte protoporphyrin concentrations agree with previous results whereas mean corpuscular volume was significantly lower than in some previous studies. Though 11 children (10.7%) were anemic, only 1 anemic child had another abnormal measure of iron status. Three children (2.9%) had a low serum ferritin concentration along with another abnormal measure of iron status. Four children (3.9%) had at least two abnormal measurements of iron status without an elevated blood lead concentration. These results agree with recent observations of decreasing rates of anemia in preschool children. The poor utility of hemoglobin measures to identify iron-deficient children suggests the need for alternate screening methods, and the relatively high serum ferritin concentration suggests a trend of rising iron stores in school-age children.