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Prevalence of iron deficiency and related factors in Spanish adolescents

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Abstract

Iron deficiency anaemia continues to be the world’s most important cause of years lived with disability in children and adolescents. Assessment of iron deficiency traditionally depended on laboratory parameters that may be modified by inflammation states, including obesity, which is nowadays a current condition in adolescent population of high-income countries. The present study ascertains the prevalence of iron deficiency and its related factors in adolescents, using the serum transferrin receptor and the reticulocyte haemoglobin content, in order to avoid this confusing effect of classical parameters. A cross-sectional study was conducted on a population-based representative sample for teenagers in Almería (Spain), of 405 subjects aged 12 to 16 years. Iron deficiency was present in 13.3% of adolescents, but iron deficiency anaemia only in 1.2%. Multivariate logistic regression analyses showed that being part of an immigrant family, a low iron bioavailability diet, meat consumption below four times a week and fish consumption below twice a week, were independent risk factors for iron deficiency.

Conclusion: This study provides an estimate iron deficiency prevalence of 13.3% in Spanish healthy adolescents, avoiding potential confounding factors through the use of new iron status parameters, based on a wide representative sample of adolescents from the city of Almería.

What is Known:

• For children and adolescents, iron deficiency anaemia continues to be the world’s most important cause of years lived with disability.

• Assessment of iron deficiency has traditionally depended on laboratory parameters that may be modified by inflammatory states, including obesity.

What is New:

• Iron deficiency prevalence and their related factors were analysed in Spanish adolescents, avoiding potential confounding factors through the use of sTfR and CHr.

• Being part of an immigrant family and consuming a low iron bioavailability diet are independent risk factors for iron deficiency.

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Abbreviations

BMI:

Body mass index

CHr:

Reticulocyte haemoglobin content

CI:

Confidence intervals

CRP:

C-reactive protein

EP:

Erythrocyte protoporphyrin

ID:

Iron deficiency

IDA:

Iron deficiency anaemia

IDE:

Iron-deficient erythropoiesis

ISD:

Iron store depletion

MCV:

Mean corpuscular volume

OR:

Odds ratio

SD:

Standard deviation

sEPO:

Serum erythropoietin

sTfR:

Serum transferrin receptor

TS:

Transferrin saturation

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Authors and Affiliations

  1. Department of Pediatrics, Poniente Hospital, Avenida Almerimar s/n., El Ejido, 04700, Almería, Spain

    María Mercedes Ibáñez-Alcalde

  2. Department of Pediatrics, Torrecárdenas Hospital, Paraje Torrecárdenas s/n., 04009, Almería, Spain

    María Ángeles Vázquez-López, Encarnación López-Ruzafa, Francisco Javier Lendínez-Molinos & Antonio Bonillo-Perales

  3. Health Delegation of Almería, University of Almería, Carretera de Ronda 101, 04071, Almería, Spain

    Tesifón Parrón-Carreño

Authors
  1. María Mercedes Ibáñez-Alcalde
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  2. María Ángeles Vázquez-López
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  3. Encarnación López-Ruzafa
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  4. Francisco Javier Lendínez-Molinos
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  5. Antonio Bonillo-Perales
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  6. Tesifón Parrón-Carreño
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Contributions

MMIA contributed to analysis and interpretation of the data and writing of the manuscript; MAVL contributed to conception and design, analysis and interpretation of the data and writing of the manuscript; ELR contributed to the acquisition of data and drafting of the manuscript; FJLM, ABP and TPC critically revised the manuscript and contributed with their final suggestions. All the authors approved the final manuscript for publication.

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Correspondence to María Mercedes Ibáñez-Alcalde.

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The authors declare that they have no conflict of interest.

Ethical approval

The Ethics and Research Committee of Torrecárdenas Hospital (Almería) approved the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Helsinki Declaration, and its later amendments or comparable ethical standards.

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Informed written consent was obtained from parents or legal guardians as well as from the participants themselves if they were > 12 years.

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Communicated by Gregorio Paolo Milani

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Ibáñez-Alcalde, M.M., Vázquez-López, M.Á., López-Ruzafa, E. et al. Prevalence of iron deficiency and related factors in Spanish adolescents. Eur J Pediatr 179, 1587–1595 (2020). https://doi.org/10.1007/s00431-020-03651-2

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