The Overlooked Factor: Iron Deficiency Anemia in Children with Obesity

Objective: Childhood obesity is a growing public health concern associated with a wide range of metabolic and hematologic disturbances. Among these, iron deficiency anemia (IDA) may be underrecognized. This study aimed to compare hematologic and biochemical profiles between children with obesity and healthy peers. Materials and Methods: In this retrospective study, 84 children with obesity were compared with 101 age- and sex-matched healthy controls. Anthropometric and laboratory parameters-including hemoglobin(HGB), mean corpuscular volume (MCV), red cell distribution width (RDW), serum iron, total iron-binding capacity (TIBC), ferritin, and vitamin B12-were analyzed between groups. Results: Children with obesity demonstrated a higher frequency of anemia, with low HGB observed in 22.6% compared to 10.9% in controls (P = .031). Microcytosis, indicated by decreased MCV, was more prevalent in the obesity group (53.6% vs. 32.7%, P = .004), as was elevated RDW (40.5% vs. 18.8%, P = .001). Median serum iron levels were significantly lower (51 vs. 66 µg/dL, P < .001), and TIBC was higher (330 vs. 299 µg/dL, P = .002) in children with obesity. Ferritin levels showed no significant difference between groups (23.7 vs. 18.3 ng/mL, P = 0.101). ALT levels were also elevated in the obesity group (30 vs. 18 U/L, P = .001). Conclusion: The prevalence of IDA and related hematologic abnormalities is higher among children with obesity compared to healthy peers. These findings highlight the value of routine hematologic screening in pediatric obesity management to enable early detection and appropriate clinical intervention.