Advertisement

Biological Trace Element Research

, Volume 155, Issue 2, pp 184–189 | Cite as

Blood Manganese Concentration is Elevated in Infants with Iron Deficiency

  • Sangkyu Park
  • Chang-Sun Sim
  • Heun Lee
  • Yangho KimEmail author
Article

Abstract

The present study was done to determine whether blood Mn concentration is elevated in iron-deficient infants. Thirty-one infants with iron deficiency and thirty-six control subjects (6–24 months of age) were tested for blood Mn concentration, complete blood counts, serum ferritin, and serum iron/transferring iron-binding capacity (Fe/TIBC). All the 31 iron-deficient infants were treated with iron supplement; however, 19 of them underwent blood Mn checkup again in compliance with follow-up schedule when their ferritin levels returned to the normal range. Iron therapies were done for 1–6 months (mean, 2.8; standard deviation, 1.6) using ferric hydroxide-polymaltose complex (6 mg/kg Fe3+ daily). Infants with iron deficiency had a higher mean blood Mn concentration than controls (2.550 vs. 1.499 μg/dL, respectively). After iron therapy, the blood Mn levels of iron-deficient infants significantly decreased compared to their pre-therapy levels (2.045 vs. 2.971 μg/dL, respectively), and their hemoglobin and ferritin levels significantly increased. After adjustment for covariates (e.g., age and breast-feeding), multiple linear regression models showed that increased blood Mn levels were significantly associated with low serum ferritin and hemoglobin levels, whereas with Fe/TIBC there was only a tendency. Our results indicate that iron deficiency increases blood Mn levels in infants, presumably by increasing Mn absorption.

Keywords

Iron Deficiency Manganese Anemia 

References

  1. 1.
    Lucchini RG, Kim Y (2009) Health effects of manganese. In: Vojtisek M, Prakash R (eds) Metals and neurotoxicity. Society for Science and Environment, India, pp 119–147Google Scholar
  2. 2.
    Freeland-Graves C, Lanes C (1994) Models to study manganese deficiency. In: Klimis-Tavantzis D (ed) Manganese in health and disease. CRC Press, Boca Raton, pp 59–86Google Scholar
  3. 3.
    Hurley LS, Keen CL (1987) Manganese. In: Underwood E, Mertz W (eds) Trace elements in human health and animal nutrition. Academic Press, New York, pp 185–223Google Scholar
  4. 4.
    Sarić M, Lucchini R (2007) Manganese. In: Nordberg GF (ed) Handbook on the toxicology of metals, 3rd edn. Elsevier, Amsterdam, pp 645–674Google Scholar
  5. 5.
    Barbeau A, Inoue N, Cloutier T (1976) Role of manganese in dystonia. Adv Neurol 14:339–352PubMedGoogle Scholar
  6. 6.
    Calne DB, Chu NS, Huang CC, Lu CS, Olanow W (1994) Manganism and idiopathic Parkinson's disease: similarities and differences. Neurology 44:1583–1586PubMedCrossRefGoogle Scholar
  7. 7.
    Olanow CW (2004) Mn-induced parkinsonism and Parkinson's disease. Ann N Y Acad Sci 1012:209–223PubMedCrossRefGoogle Scholar
  8. 8.
    Kim Y, Kim JW (2012) Toxic encephalopathy. Saf Health Work 3:243–256PubMedCrossRefGoogle Scholar
  9. 9.
    Karki P, Lee E, Aschner M (2013) Manganese neurotoxicity: a focus on glutamate transporters. Ann Occup Environ Med 25:4CrossRefGoogle Scholar
  10. 10.
    Bellinger DC (2013) Prenatal exposures to environmental chemicals and children's neurodevelopment: an update. Saf Health Work 4:1–11PubMedCrossRefGoogle Scholar
  11. 11.
    Claus Henn B, Ettinger AS, Schwartz J, Téllez-Rojo MM, Lamadrid-Figueroa H, Hernández-Avila M et al (2010) Early postnatal blood manganese levels and children's neurodevelopment. Epidemiology 21:433–439PubMedCrossRefGoogle Scholar
  12. 12.
    Bouchard MF, Sauvé S, Barbeau B, Legrand M, Brodeur ME, Bouffard T et al (2011) Intellectual impairment in school-age children exposed to manganese from drinking water. Environ Health Perspect 119:138–143PubMedCrossRefGoogle Scholar
  13. 13.
    Bouchard M, Laforest F, Vandelac L, Bellinger D, Mergler D (2007) Hair manganese and hyperactive behaviors: pilot study of school-age children exposed through tap water. Environ Health Perspect 115:122–127PubMedCrossRefGoogle Scholar
  14. 14.
    Khan K, Factor-Litvak P, Wasserman GA, Liu X, Ahmed E, Parvez F et al (2011) Manganese exposure from drinking water and children's classroom behavior in Bangladesh. Environ Health Perspect 119:1501–1506PubMedCrossRefGoogle Scholar
  15. 15.
    Hauser RA, Zesiewicz TA, Rosemurgy AS, Martinez C, Olanow CW (1994) Manganese intoxication and chronic liver failure. Ann Neurol 36:871–875PubMedCrossRefGoogle Scholar
  16. 16.
    Butterworth RF, Spahr L, Fontaine S, Layrargues GP (1995) Manganese toxicity, dopaminergic dysfunction and hepatic encephalopathy. Metab Brain Dis 10:259–267PubMedCrossRefGoogle Scholar
  17. 17.
    Park NH, Park JK, Choi Y, Yoo C-I, Lee CR, Lee H et al (2003) Whole blood manganese correlates with high signal intensities on T1-weighted MRI in patients with liver cirrhosis. Neurotoxicology 24:909–915PubMedCrossRefGoogle Scholar
  18. 18.
    Davis CD, Wolf TL, Greger JL (1992) Varying levels of manganese and iron affect absorption and gut endogenous losses of manganese by rats. J Nutr 122:1300–1308PubMedGoogle Scholar
  19. 19.
    Finley JW (1999) Manganese absorption and retention by young women is associated with serum ferritin concentration. Am J Clin Nutr 70:37–43PubMedGoogle Scholar
  20. 20.
    Finley JW, Johnson PE, Johnson LK (1994) Sex affects manganese absorption and retention by humans from a diet adequate in manganese. Am J Clin Nutr 60:949–955PubMedGoogle Scholar
  21. 21.
    Chua AC, Morgan EH (1996) Effects of iron deficiency and iron overload on manganese uptake and deposition in the brain and other organs of the rat. Biol Trace Elem Res 55:39–54PubMedCrossRefGoogle Scholar
  22. 22.
    Kwik-Uribe CL, Gietzen D, German JB, Golub MS, Keen CL (2000) Chronic marginal iron intakes during early development in mice result in persistent changes in dopamine metabolism and myelin composition. J Nutr 130:2821–2830PubMedGoogle Scholar
  23. 23.
    Erikson KM, Shihabi ZK, Aschner JL, Aschner M (2002) Manganese accumulates in iron-deficient rat brain regions in a heterogeneous fashion and is associated with neurochemical alterations. Biol Trace Elem Res 87:143–156PubMedCrossRefGoogle Scholar
  24. 24.
    Kim Y, Lee BK (2011) Iron deficiency increases blood manganese level in the Korean general population according to KNHANES 2008. Neurotoxicology 32:247–254PubMedCrossRefGoogle Scholar
  25. 25.
    Boojar MM, Goodarzi F, Basedaghat MA (2002) Long-term follow-up of workplace and well water manganese effects on iron status indexes in manganese miners. Arch Environ Health 57:519–528PubMedCrossRefGoogle Scholar
  26. 26.
    Brna P, Gordon K, Dooley JM, Price V (2011) Manganese toxicity in a child with iron deficiency and polycythemia. J Child Neurol 26:891–894PubMedCrossRefGoogle Scholar
  27. 27.
    Sahni V, Léger Y, Panaro L, Allen M, Giffin S, Fury D, Hamm N (2007) Case report: a metabolic disorder presenting as pediatric manganism. Environ Health Perspect 115:1776–1779PubMedCrossRefGoogle Scholar
  28. 28.
    Centers for Disease Control and Prevention (1998) Recommendations to prevent and control iron deficiency in the United States. MMWR 47(RR-3):5Google Scholar
  29. 29.
    Baldwin S, Deaker M, Maher W (1994) Low volume microwave digestion of marine biological tissues for the measurement of trace elements. Analyst 119:1701–1704PubMedCrossRefGoogle Scholar
  30. 30.
    Baruthio F, Guillard O, Arnaud J, Pierre F, Zawislak R (1988) Determination of manganese in biological materials by electrothermal atomic absorption spectrometry, a review. Clin Chem 34:227–234PubMedGoogle Scholar
  31. 31.
    de Benoist B, McLean E, Egli I, Cogswell M (eds) (2008) Worldwide prevalence of anaemia. World Health Organization, GenevaGoogle Scholar
  32. 32.
    NHANES (2013) Key statistics from NHANES (data are for 2003–2006). http://www.cdc.gov/nchs/fastats/anemia.htm. Accessed 5 May 2013
  33. 33.
    Lonnerdal B (1994) Manganese nutrition of infants. In: Klimis-Tavantzis DJ (ed) Manganese in health and disease. CRC Press, Boca Raton, pp 175–191Google Scholar
  34. 34.
    Lonnerdal B, Keen CL, Bell JG, Sandstrom B (1987) Manganese uptake and retention: experimental animal and human studies. In: Kies C (ed) Nutritional bioavailability of manganese. ACS Symposium Series 354. American Chemical Society, Washington, pp 9–20CrossRefGoogle Scholar
  35. 35.
    Conrad ME, Umbreit JN, Moore EG, Hainsworth LN, Porubcin M, Simovich MJ et al (2002) Separate pathways for cellular uptake of ferric and ferrous iron. Am J Physiol Gastrointest Liver Physiol 279:G767–G774Google Scholar
  36. 36.
    Garrick MD, Dolan KG (2002) An expression system for a transporter of iron and other metals. Methods Mol Biol 196:147–154PubMedGoogle Scholar
  37. 37.
    Zoller H, Koch RO, Theurl I, Obrist P, Pietrangelo P, Montosi G et al (2001) Expression of the duodenal iron transporters divalent-metal transporter 1 and ferroportin 1 in iron deficiency and iron overload. Gastroenterology 120:1412–1429PubMedCrossRefGoogle Scholar
  38. 38.
    Kim Y, Park JK, Choi Y, Yoo C-I, Lee CR, Lee H et al (2005) Blood manganese concentration is elevated in iron deficiency anemia patients, whereas globus pallidus signal intensity is minimally affected. Neurotoxicology 26:107–111PubMedCrossRefGoogle Scholar
  39. 39.
    Mena I, Horiuchi K, Burke K, Cotizias G (1969) Chronic manganese poisoning. Individual susceptibility and absorption of iron. Neurology 19:1000–1003PubMedCrossRefGoogle Scholar
  40. 40.
    Meltzer HM, Brantsaeter AL, Borch-Iohnsen B, Ellingsen DG, Alexander J, Thomassen Y et al (2010) Low iron stores are related to higher blood concentrations of manganese, cobalt and cadmium in non-smoking, Norwegian women in the HUNT 2 study. Environ Res 110:497–504PubMedCrossRefGoogle Scholar
  41. 41.
    ATSDR (2012) Toxicological profile for manganese. Agency for Toxic Substances & Disease Registry, AtlantaGoogle Scholar
  42. 42.
    Burguera JL, Burguera M, Alarcon OM (1992) Blood levels of zinc cobalt iron and manganese in children from Mérida, Venezuela. Trace Elem Med 9:194–197Google Scholar
  43. 43.
    Alarcon OM, Reinosa-Fuller JA, Silva T, Ramirez de Fernandez M, Gamboa J (1996) Manganese levels in serum of healthy Venezuelan infants living in Mérida. J Trace Elem Med Biol 10:210–213PubMedCrossRefGoogle Scholar
  44. 44.
    Rukgauer M, Klein J, Kruse-Jarres JD (1997) Reference values for the trace elements copper, manganese, selenium, and zinc in the serum/plasma of children, adolescents, and adults. J Trace Elem Med Biol 11:92–98PubMedCrossRefGoogle Scholar
  45. 45.
    Rice DC, Lincoln R, Martha J, Parker L, Pote K, Xing S et al (2010) Concentration of metals in blood of Maine children 1–6 years old. J Expo Sci Environ Epidemiol 20:634–643PubMedCrossRefGoogle Scholar
  46. 46.
    Maguire JL, Salehi L, Birken CS, Carsley S, Mamdani M, Thorpe KE et al (2013) Association between total duration of breastfeeding and iron deficiency. Pediatrics 131(5):e1530–e1537PubMedCrossRefGoogle Scholar
  47. 47.
    Dee DL, Sharma AJ, Cogswell ME, Grummer-Strawn LM, Fein SB, Scanlon KS (2008) Sources of supplemental iron among breastfed infants during the first year of life. Pediatrics 122(Suppl 2):S98–S104PubMedCrossRefGoogle Scholar
  48. 48.
    Gabay C, Kushner I (1999) Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340:448–454PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sangkyu Park
    • 1
  • Chang-Sun Sim
    • 2
  • Heun Lee
    • 2
  • Yangho Kim
    • 2
    Email author
  1. 1.Department of Pediatrics, Ulsan University HospitalUniversity of Ulsan College of MedicineUlsanSouth Korea
  2. 2.Department of Occupational and Environmental Medicine, Ulsan University HospitalUniversity of Ulsan College of MedicineUlsanSouth Korea

Personalised recommendations