Association between iron deficiency and hospitalization rate in community-dwelling older adults: A 3-year prospective observational study of DO-HEALTH.

BACKGROUND: Iron deficiency (ID) is associated with negative health outcomes in older adults. However, data on the impact of ID on the number of hospitalizations and length of hospital stay (LOS) is lacking. OBJECTIVE: To explore the associations between baseline ID and the number of hospitalizations and between baseline ID and at least one LOS ≥5 days in community-dwelling older adults. METHODS: This is a secondary observational analysis of a randomized controlled trial including 2157 community-dwelling adults aged ≥70 years without major diseases at baseline. The main exposure was defined as ID (soluble transferrin receptor [sTfR] concentrations >28.1 nmol/L) at baseline. The primary outcome was the number of hospitalizations over a 3-year follow-up. The secondary outcome was having at least one LOS ≥5 days over the study period among individuals with one or more hospitalizations. Interaction between ID and anemia (hemoglobin <130 g/L for men and <120 g/L for women) was also investigated. RESULTS: Baseline sTfR concentration was determined in 2141 participants (median age 74.0 years). At 3 year, 1497 hospitalizations were reported with an incidence rate of hospitalization of 0.26 per person-year (95% CI: 0.24, 0.28). Overall, baseline ID was associated with a 24% increased incidence rate of hospitalization (incidence rate ratio: 1.24; 95% CI: 1.05, 1.45) over 3 years. This association was independent of anemia status at baseline since the interaction between ID and anemia at baseline was not significant. Moreover, ID was not significantly associated with having a LOS ≥5 days (OR: 1.40; 95% CI: 1.00, 1.97) among participants with at least one hospitalization over 3 years. CONCLUSIONS: ID is associated with increased hospitalization rate and not associated with LOS ≥5 days among generally healthy older adults. Efforts to minimize ID in older adults may improve overall health and optimize healthcare costs.

Effect of single-dose albendazole and vitamin A supplementation on the iron status of pre-school children in Sichuan, China.

The aim of this study was to explore the effect of single-dose albendazole and vitamin A intervention on the anaemic status and Fe metabolism of pre-school children. This study was a randomised, placebo-controlled and double-blinded intervention trial. All eligible anaemic pre-school children were randomly divided into three groups: group 1 received no intervention, which served as the control group, group 2 received 400 mg single-dose albendazole administration and group 3 received a 60000 µg vitamin A capsule combined with 400 mg single-dose albendazole at the beginning of the study. The follow-up period was for 6 months. Anthropometry and biochemical index about Fe metabolism were measured before and after intervention. A total of 209 pre-school anaemic children were randomly divided into three intervention groups (sixty-four, sixty-two and sixty for groups 1, 2 and 3, respectively). The mean age of the children in the study was 4·4 (sd 0·7) years and 50·5 % of the children were female (94/186). After a follow-up period of 6 months, the levels of serum retinol, ferritin, transferrin receptor-ferritin index and body total Fe content of children in group 3 were significantly higher compared with children in groups 1 and 2 (P<0·05). Moreover, the proportion of vitamin A deficiency, marginal vitamin A deficiency and Fe deficiency among children in group 3 were markedly lower compared with children in groups 1 and 2 (P<0·05). Albendazole plus vitamin A administration showed more efficacy on the improvement of serum retinol and Fe metabolic status.

Deficiencia subclínica de hierro en niños menores de cuatro años de edad, ciudad de Valencia, Venezuela / Subclinical iron deficiency in children under four years of age, Valencia city, Venezuela / Deficiencia subclinica de ferro em changas menores de quatro anos de idade, cidade de Valencia, Venezuela

La deficiencia de hierro (DH) se considera un problema de salud pública y afecta principalmente a los niños en las etapas de crecimiento rápido y desarrollo psicomotor. El objetivo del estudio fue identificar la deficiencia subclínica de hierro en niños menores de 4 años, mediante el uso de ferritina sérica (FS), receptor soluble de transferrina (RsTf) e índice RsTf-FS como herramientas diagnósticas. El estudio fue descriptivo, transversal, y se realizó en Valencia, Venezuela, en 2006. Se determinaron en 541 niños las concentraciones de hemoglobina (método automatizado), FS (IRMA), RsTf (ELISA), Proteína C Reactiva y alfa glicoproteína (nefelometría). Se realizaron estadísticos descriptivos, prueba de Mann-Whitney y Fisher, con nivel de significancia de p<0,05. El 72,1% de los niños tenían depósitos de hierro agotados, 25,5% eritropoyesis deficiente de hierro y 27,0% anemia. El índice RsTf-FS identificó mayor porcentaje de niños con DH subclínica; mostrando mayor valor diagnóstico frente a la FS y el RsTf por separado. El índice RsTf-FS podría convertirse en una prueba invaluable para distinguir entre agotamiento de los depósitos corporales de hierro y eritropoyesis deficiente de hierro, fases subclínicas de la DH. Se propone una intervención nutricional con base en la suplementación y la educación como estrategia fundamental para disminuir la prevalencia de DH y anemia.

Iron deficiency is considered a public health problem, especially affecting children at ages of fast growth and psychomotor development. The study was aimed to identify subclinical iron deficiency in children below four years of age, through the use of serum ferritin (FS), soluble transferrin receptor (RsTf) and index RsTf-FS as diagnostic tools. It was a descriptive, transversal study performed at Valencia, Venezuela, 2006. Hemoglobin (Hb) by automated method, FS by IRMA, RsTf by ELISA, C Reactive Protein and alpha glycoprotein by nephelometry were assessed in 541 subjects. Descriptives values and Mann-Whitney and Fisher test results are presented. A p value <0.05 was considered significant. 72.1% of children had iron stores depletion, 25.5% had iron deficient erithropoyesis and prevalence of anemia was 27.0%. The index RsTf-FS allowed to identify a higher percentage of children with subclinical iron deficiency, which indicates that the index is better diagnostic indicator than FS or RsTf by separate. Index RsTf-FS could become a invaluable test in order to distinguish between iron body stores depletion and iron-deficient erythropoiesis, subclinical phases of iron deficiency. Nutritional intervention based on supplementation and education as fundamental tool to diminish anemia and iron deficiency prevalence should be initiated.

A deficiencia de ferro (DF) é considerada um problema de saúde pública e afeta principalmente changas em fases de crescimento rápido e desenvolvimento psicomotor. O objetivo do estudo foi identificar a deficiencia de ferro subclinica em criangas menores de 4 anos, através do uso de ferritina sérica (FS), receptor solúvel de transferrina (sTfR) e índice sTfR-FS como ferramentas de diagnóstico. O estudo foi descritivo, transversal, e foi feito em Valencia, Venezuela, em 2006. Foram determinadas em 541 criangas as con-centragoes de hemoglobina (método automatizado), FS (IRMA), sTfR (ELISA), Proteína C reativa e alfa-gli-coproteína (nefelometria). Foram realizados estatísticos descritivos, testes de Mann-Whitney e Fisher, com um nivel de significancia de p<0,05. 72,1% das criangas tinham os depósitos de ferro esgotados, 25,5% eritropoiese deficiente de ferro e 27,0% anemia. O índice sTfR-FS identificou maior percentagem de crian-gas com DF subclínica mostrando assim maior valor diagnóstico em relagáo a FS e sTfR separadamente. O índice sTfR-FS poderia tornar-se um teste de valor inestimável para a distingáo entre deplegáo de reservas corporais de ferro e eritropoiese deficiente de ferro, estágios subclínicos da deficiencia de ferro. Propoe-se uma intervengáo nutricional com base na suplementagáo e educagáo como estratégia fundamental para diminuir a prevalencia de deficiencia de ferro e anemia.

Deficiencia subclínica de hierro en niños menores de cuatro años de edad, ciudad de Valencia, Venezuela / Subclinical iron deficiency in children under four years of age, Valencia city, Venezuela / Deficiencia subclinica de ferro em changas menores de quatro anos de idade, cidade de Valencia, Venezuela

La deficiencia de hierro (DH) se considera un problema de salud pública y afecta principalmente a los niños en las etapas de crecimiento rápido y desarrollo psicomotor. El objetivo del estudio fue identificar la deficiencia subclínica de hierro en niños menores de 4 años, mediante el uso de ferritina sérica (FS), receptor soluble de transferrina (RsTf) e índice RsTf-FS como herramientas diagnósticas. El estudio fue descriptivo, transversal, y se realizó en Valencia, Venezuela, en 2006. Se determinaron en 541 niños las concentraciones de hemoglobina (método automatizado), FS (IRMA), RsTf (ELISA), Proteína C Reactiva y alfa glicoproteína (nefelometría). Se realizaron estadísticos descriptivos, prueba de Mann-Whitney y Fisher, con nivel de significancia de p<0,05. El 72,1% de los niños tenían depósitos de hierro agotados, 25,5% eritropoyesis deficiente de hierro y 27,0% anemia. El índice RsTf-FS identificó mayor porcentaje de niños con DH subclínica; mostrando mayor valor diagnóstico frente a la FS y el RsTf por separado. El índice RsTf-FS podría convertirse en una prueba invaluable para distinguir entre agotamiento de los depósitos corporales de hierro y eritropoyesis deficiente de hierro, fases subclínicas de la DH. Se propone una intervención nutricional con base en la suplementación y la educación como estrategia fundamental para disminuir la prevalencia de DH y anemia.(AU)

Iron deficiency is considered a public health problem, especially affecting children at ages of fast growth and psychomotor development. The study was aimed to identify subclinical iron deficiency in children below four years of age, through the use of serum ferritin (FS), soluble transferrin receptor (RsTf) and index RsTf-FS as diagnostic tools. It was a descriptive, transversal study performed at Valencia, Venezuela, 2006. Hemoglobin (Hb) by automated method, FS by IRMA, RsTf by ELISA, C Reactive Protein and alpha glycoprotein by nephelometry were assessed in 541 subjects. Descriptives values and Mann-Whitney and Fisher test results are presented. A p value <0.05 was considered significant. 72.1% of children had iron stores depletion, 25.5% had iron deficient erithropoyesis and prevalence of anemia was 27.0%. The index RsTf-FS allowed to identify a higher percentage of children with subclinical iron deficiency, which indicates that the index is better diagnostic indicator than FS or RsTf by separate. Index RsTf-FS could become a invaluable test in order to distinguish between iron body stores depletion and iron-deficient erythropoiesis, subclinical phases of iron deficiency. Nutritional intervention based on supplementation and education as fundamental tool to diminish anemia and iron deficiency prevalence should be initiated.(AU)

A deficiencia de ferro (DF) é considerada um problema de saúde pública e afeta principalmente changas em fases de crescimento rápido e desenvolvimento psicomotor. O objetivo do estudo foi identificar a deficiencia de ferro subclinica em criangas menores de 4 anos, através do uso de ferritina sérica (FS), receptor solúvel de transferrina (sTfR) e índice sTfR-FS como ferramentas de diagnóstico. O estudo foi descritivo, transversal, e foi feito em Valencia, Venezuela, em 2006. Foram determinadas em 541 criangas as con-centragoes de hemoglobina (método automatizado), FS (IRMA), sTfR (ELISA), Proteína C reativa e alfa-gli-coproteína (nefelometria). Foram realizados estatísticos descritivos, testes de Mann-Whitney e Fisher, com um nivel de significancia de p<0,05. 72,1% das criangas tinham os depósitos de ferro esgotados, 25,5% eritropoiese deficiente de ferro e 27,0% anemia. O índice sTfR-FS identificou maior percentagem de crian-gas com DF subclínica mostrando assim maior valor diagnóstico em relagáo a FS e sTfR separadamente. O índice sTfR-FS poderia tornar-se um teste de valor inestimável para a distingáo entre deplegáo de reservas corporais de ferro e eritropoiese deficiente de ferro, estágios subclínicos da deficiencia de ferro. Propoe-se uma intervengáo nutricional com base na suplementagáo e educagáo como estratégia fundamental para diminuir a prevalencia de deficiencia de ferro e anemia.(AU)