1.Body iron store and prevalence of iron deficiency In Mongolian children aged 6-59 months
Bolormaa N ; Bayasgalan J ; Batjargal J ; Enkhmyagmar D ; Oyundelger D ; Enkhtungalag B ; Munkhtstetseg P
Mongolian Medical Sciences 2020;192(2):18-26
Background:
Iron is an essential mineral needed for physical and cognitive development with iron needs greatest
during pregnancy, infancy, childhood, and adolescence. Iron is vital throughout the lifespan as it
is a component of haemoglobin, the protein responsible for transporting oxygen from the lungs to
body cells for energy production. Iron deficiency results from a depletion of body iron stores due to
increased iron needs, inadequate dietary iron intake, reduced iron absorption, or loss of iron from
infections caused by malaria, hookworms, and other intestinal parasites. In advanced stages, iron
deficiency leads to iron deficiency anaemia, a condition of low red blood cells and reduced oxygen-carrying capacity.
Goal:
This study aimed to determine body iron stores in Mongolian children aged 6-59 months, and estimate
prevalence of iron deficiency among of studied children.
Materials and Methods:
In this study were used materials that collected during the fifth national nutrition survey conducted
in 21 provinces of 4 economic regions and 8 districts of Ulaanbaatar city of Mongolia. The fifth
national nutrition survey was household based survey; therefore sampling unit was household
with 5 year-old child. We had used demographic information collected by interview methods and
laboratory examination results on ferritin, soluble transferrin (sTfR), C reactive protein (CRP) and
α1-acid glycoprotein (AFP) in serum samples collected from 6 to 59 months old children, pregnant
women and 15–49 year-old men living in child’s households. Serum Ferritin and soluble transferrin
(sTfR) were used as a biomarker for iron store and iron deficiency and C reactive protein (CRP)
and AFG were used as indicators for acute and chronic infection. The determination of iron status
is challenging when concomitant infection and inflammation are present because of confounding
effects of the acute-phase response on the interpretation of most iron indicators. Effects of C reactive
protein (CRP) and AGP concentrations on estimates of ID according to serum ferritin (SF) and soluble
transferrin receptor (sTfR) were considered in the study.
Ethical considerations :
The survey protocol was discussed at the scientific committee of the Public health institute and approved by director of scientific committee of PHI on June 28, 2016. Ethical approval for conducting
the survey, including obtaining biological samples was obtained from the Medical ethics committee
under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary,
oral and written informed consent was obtained from each participants and adult caregivers of under
5 year-old children.
Results:
Biomarkers of iron status were adjusted with inflammation indicators and estimated iron deficiency
(ID) and total body iron store in 1732 children 6-59 month-olds. The study findings showed that
adjusted mean concentration of serum ferritin and soluble transferrin receptor was 33.7 µg/l and
8.8 mg/l in children age of 6-59 months, respectively. The calculated total body iron store by using
adjusted SF and soluble transferrin receptor was 2.8 mg/kg among surveyed children. Iron deficiency
was estimated by using 2 different biomarkers among selected population group. The prevalence of
iron deficiency estimated by using SF was 20.7% in children 6-59 months. Iron deficiency in children
defined by using serum soluble transferrin receptor was 27.7%.
Conclusions
1. The average serum ferritin and soluble transferrin receptor concentrations was 33.7 µg/l and 8.8
mg/l in children age of 6-59 months, respectively. Total body iron store estimated by using SF
and soluble transferrin was 2.8 mg/kg among surveyed children.
2. The prevalence of iron deficiency estimated by using SF and sTfR was 20.7% and 27.7% in
children 6-59 months, respectively. According to the WHO recommendation, prevalence of iron
deficiency among Mongolian children aged 6-59 months is classified as “prevalent”.
3. Overall proportion of children with low body iron store was 22.4%. The prevalence of iron
depletion is relatively common in boys, young children aged 6–23 months, and rural children
aged 6-59 months.