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Iron Deficiency Without Anemia Is Associated with Anger and Fatigue in Young Japanese Women

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An Erratum to this article was published on 21 October 2015

Abstract

Iron deficiency without anemia (IDNA), the most prevalent nutritional deficiency worldwide, affects young women of reproductive age. This study aimed to elucidate the relationship between IDNA and mental and somatic symptoms including anger and fatigue using the Japanese version of the Cornell Medical Index Health Questionnaire (CMI–J). Data regarding demographic characteristics, anthropometry, hematological, and biochemical indices of the iron status, frequencies of selected food intakes assessed by self-administered food frequency questionnaires (FFQs), frequencies of nonspecific symptoms, and grades of neurotic tendencies assessed by CMI–J were collected from 76 young women aged 18–22 years living in the metropolitan area of Tokyo, Japan. The subjects were classified as having IDNA (hemoglobin (Hb) ≥ 12 g/dL and serum ferritin < 20 ng/mL; n = 29), having iron deficiency anemia (IDA) (Hb < 12 g/dL and serum ferritin < 20 ng/mL; n = 10), or having a normal iron status (Hb ≥ 12 g/dL and serum ferritin ≥ 20 ng/mL; n = 36). One subject was excluded from the analyses because of Hb < 12 g/dL and serum ferritin ≥ 20 ng/mL. Fisher’s protected least significant difference and the Dwass–Steel–Chritchlow–Fligner multiple comparison tests were used to compare the data of the three groups. P values <0.05 were considered significant. Sections M–R (mental complaints) were significantly higher in the IDNA subjects than in the normal subjects. No significant difference in CMI scores was found between the normal and IDA subjects. Sections I (fatigability), Q (anger), and R (tension) were significantly higher in the IDNA subjects than in the normal subjects, regardless of no significant differences between the normal and IDA subjects in those sections. Young women with IDNA demonstrated a significantly higher proportion of neurotic tendencies (grades II–IV). The intake frequency score of canned or bottled green tea fortified with vitamin C was significantly higher in the IDNA subjects than the IDA subjects. The findings suggest that IDNA may be a risk factor for anger, fatigue, and tension in women of childbearing age.

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Abbreviations

ID:

Iron deficiency

IDA:

Iron deficiency anemia

IDNA:

Iron deficiency without anemia

CMI:

Cornell Medical Index

CMI–J:

Cornell Medical Index Japanese version

FFQ:

Food frequency questionnaire

UIBC:

Unsaturated iron binding capacity

TIBC:

Total iron binding capacity

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Acknowledgments

This study was supported in part by the Japan Society Sasakawa Science Foundation (2006) and the Ito Foundation (2003–2007). T.S. and K.Y. designed and initiated the study; T.S., A.K., and K.Y. collected the data; T.S. and K.Y. interpreted the data; T.S. drafted the manuscript; and K.Y. supervised the entire study and provided critical revision of the manuscript. None of the authors had any conflicts of interest.

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Authors and Affiliations

  1. Faculty of Food and Nutritional Sciences, Toyo University, Gunma, Japan

    Takako Sawada

  2. Faculty of Health and Medical Sciences, Teikyo Heisei University, Tokyo, Japan

    Aki Konomi

  3. Department of Human Nutrition, Seitoku University Graduate School, Matsudo, Chiba, 271-8555, Japan

    Katsuhiko Yokoi

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  1. Takako Sawada
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  2. Aki Konomi
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  3. Katsuhiko Yokoi
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Correspondence to Katsuhiko Yokoi.

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Sawada, T., Konomi, A. & Yokoi, K. Iron Deficiency Without Anemia Is Associated with Anger and Fatigue in Young Japanese Women. Biol Trace Elem Res 159, 22–31 (2014). https://doi.org/10.1007/s12011-014-9963-1

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