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Increased whole blood manganese concentrations observed in children with iron deficiency anaemia

Elisabeth Anne Smith1, Paul Newland, Keith George Bestwick

  • 1Department of Clinical Biochemistry, Alder Hey Children's Foundation Trust, Liverpool, England L12 2AP, UK. lis.smith@alderhey.nhs.uk

Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS)
|September 4, 2012
PubMed

Insights

Children with iron deficiency anemia show higher blood manganese levels, indicating a potential risk for manganese toxicity and neurological issues. Treating iron deficiency is crucial for both iron status and preventing manganese toxicity in children.

Area of Science:

  • Pediatric Health
  • Toxicology
  • Nutritional Science

Background:

  • Iron deficiency anemia is prevalent in children.
  • Elevated manganese exposure is a concern for neurodevelopment.
  • The relationship between iron status and manganese levels in children requires further investigation.

Purpose of the Study:

  • To investigate the association between blood manganese concentrations and iron status in children aged 1-6 years.
  • To identify key factors influencing blood manganese levels in pediatric subjects.
  • To assess the risk of manganese toxicity in children with iron deficiency anemia.

Main Methods:

  • Prospective observational study at Alder Hey Children's Hospital.
  • Measurement of whole blood manganese and iron status markers (hemoglobin, MCV, MCH, RBC count, ferritin, transferrin saturation, soluble transferrin receptors).
  • Multiple regression analysis to determine relationships between variables.

Main Results:

  • A significant relationship was found between blood manganese and iron deficiency (adjusted R(2)=34.3%, p<0.001).
  • Hematological indices and soluble transferrin receptors were primary contributors to this association.
  • Children with iron deficiency anemia had significantly higher median blood manganese concentrations (16.4 μg/L) compared to iron-sufficient children (11 μg/L, p<0.001).

Conclusions:

  • Iron deficiency in children is strongly associated with elevated blood manganese levels.
  • Children with iron deficiency anemia may be at risk of manganese toxicity (whole blood manganese >20 μg/L), potentially leading to neurological problems.
  • Effective treatment of iron deficiency in children is vital for improving iron status and mitigating the risk of manganese toxicity.

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