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Prevalence and associated factors of iron deficiency in Spanish children aged 1 to 11 years

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Abstract

Iron deficiency (ID) is the most common nutritional deficiency affecting children worldwide. Most traditional laboratory parameters to assess ID can be altered by infections or other inflammatory states, including obesity. The aims of this study were to determine the prevalence of ID in healthy children and to analyse associated factors, avoiding potential confounding factors through the use of serum transferrin receptor (sTfR), reticulocyte haemoglobin content and sTfR/log ferritin index. A cross-sectional population-based study was conducted on 951 children aged 1 to 11 years in Almería (Spain). ID was detected in 7.7% of children and iron deficiency anaemia in 0.9%. Multivariate analysis identified the following as independent risk factors: age under 5 years (OR: 2.2, 95% CI: 1.35–3.6); excessive consumption of cow’s milk and dairy products (OR: 1.87, 95% CI: 1.13–3.1); and insufficient consumption of vegetables (OR: 2.7, 95% CI: 1.2–6.1).

Conclusions: Using a combination of iron status parameters with greater discriminatory power than classical measures, this study detected a considerable iron deficiency prevalence in Spanish children. Younger children and specific dietary habits exhibit a particular risk for ID, so special attention should be paid to this population.

What is Known:

• Iron deficiency remains the most prevalent nutritional deficit worldwide, and children aged under 3 years are the most vulnerable to this condition.

• Accurate assessment of iron status, based on a combination of biochemical indicators, can often be complicated.

What is New:

• Iron deficiency continues to present a health problem in Spanish children aged 1 to 11 years, considering the serum transferrin receptor and reticulocyte haemoglobin content for diagnosis.

• Excessive consumption of dairy products and low consumption of vegetables are independent risk factors for iron deficiency.

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Abbreviations

BMI:

Body mass index

CHr:

Reticulocyte haemoglobin content

CI:

Confidence interval

CRP:

C-reactive protein

EP:

Erythrocyte protoporphyrin

ID:

Iron deficiency

IDA:

Iron-deficiency anaemia

IDE:

Iron-deficient erythropoiesis

ISD:

Iron stores depletion

MCV:

Mean corpuscular volume

OR:

Odds ratio

SD:

Standard deviation

sTfR:

Serum transferrin receptor

sTfR-F:

sTfR/log ferritin

TS:

Transferrin saturation

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Authors and Affiliations

  1. Department of Pediatrics, Torrecárdenas Hospital, Hermandad de Donantes de Sangre s/n, 04009, Almería, Spain

    Encarnación López-Ruzafa, María A. Vázquez-López, Rafael Galera-Martínez, Francisco Lendínez-Molinos, Sara Gómez-Bueno & Manuel Martín-González

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  1. Encarnación López-Ruzafa
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  6. Manuel Martín-González
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Contributions

Encarnación López-Ruzafa contributed to the analysis and interpretation of the data and writing of the manuscript. María A. Vázquez-López contributed to conception and design, analysis and interpretation of the data and writing of the manuscript. Rafael Galera-Martínez, Francisco Lendinez-Molinos and Sara Gómez-Bueno contributed to the acquisition of data; and Manuel Martín-González critically revised the manuscript and contributed final suggestions. All authors approved the final manuscript for publication.

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Correspondence to Encarnación López-Ruzafa.

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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. The study was approved by the Ethics and Research Committee of Torrecárdenas Hospital (Almería).

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López-Ruzafa, E., Vázquez-López, M.A., Galera-Martínez, R. et al. Prevalence and associated factors of iron deficiency in Spanish children aged 1 to 11 years. Eur J Pediatr 180, 2773–2780 (2021). https://doi.org/10.1007/s00431-021-04037-8

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