• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.284-291
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• 2005

Purpose : Flow cytometric automated reticulocyte analysis is a superior method to manual reticulocyte counting, with respect to precision and sensitivity. Furthermore, flow cytometric analysis is able to measure immature reticulocyte fraction(IRF) and reticulocyte cellular indices(RCI : cell hemoglobin content : CHr, mean cell volume : MCVr, cell hemoglobin concentration mean : CHCMr, distribytion width : RDWr, HDWr, CHDWr). In this study, we investigated the mean values and clinical significances of IRF and RCI in healthy children and pediatric anemia patients. Methods : IRF and RCI were measured with an automated blood cell analyzer, ADVIA 120(Bayer, USA) using oxazine 750 dye, in 57 healthy children and 61 children with anemia. The anemia group consisted of 27 iron deficiency anemia(IDA) patients and 34 patients with anemia associated with acute infection(AAI). We compared the mean values of IRF and RCI in the control group classified according to age, between anemia groups and the control group, and between the IDA group and the AAI group. Results : For the normal control group, the mean values of IRF, CHr, MCVr and HDWr were higher in neonates when compared to older children. The mean values of IRF and RDWr were significantly higher, and the mean values of CHr and CHCMr were significantly lower in the IDA group when compared to the control group. The mean value of IRF was significantly higher, and the mean value of CHDWr was significantly lower in the AAI group when compared to the control group. The mean values of IRF, CHr and CHCMr were significantly lower in the IDA group when compared to the AAI group. Conclusion : We could determine the normal mean values of IRF and RCI in healthy children classified according to age for understanding of hematopoietic response differences according to age. The evaluation of IRF and RCI by automated reticulocyte analyzer seemed to be accurate and clinically useful for the early diagnosis of anemia and the differentiation of IDA from AAI.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.129-135
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• 2002

Purpose: The purpose of this study was to investigate the relationship between Helicobacter pylori (H. pylori) infection and iron-deficiency anemia in pubescent children, susceptible to iron deficiency due to the high iron requirements for growth. Methods: Hemoglobin, serum iron, total iron-binding capacity, serum ferritin, and serum IgG antibodies to H. pylori were measured in 937 children (475 boys and 462 girls). Their ages ranged from 10 to 18 years. The prevalences of H. pylori infection were compared between groups, based on the presence or absence of anemia, hypoferritinemia, iron deficiency, and iron-deficiency anemia. The levels of hemoglobin, serum iron, total iron-binding capacity, transferrin saturation, and serum ferritin were obtained according to the presence or absence of H. pylori infection. Results: The prevalences of anemia, iron deficiency, iron-deficiency anemia, and H. pylori infection were 8.1%, 9.1%, 3.1%, and 20.8%, respectively. The H. pylori-positive rates in anemia, hypoferritinemia, and iron-deficiency group were 34.2%, 29.5%, and 35.3%, respectively, compared to 19.6% in the non-anemia group, 19.2% in the non-hypoferritinemia group, and 19.4% in the non-iron deficiency group. The H. pylori-positive rate in the iron-deficiency anemia group was 44.8% in comparison with 20.0% in the non-iron-deficiency anemia group. Hemoglobin and iron levels did not show any significant differences between the H. pylori-positive and -negative groups, whereas the serum ferritin level decreased significantly in the H. pylori-infected group. Conclusion: H. pylori infection is thought to be associated with iron deficiency in pubescent children.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.146-151
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• 2005

Purpose: We have preoperatively and postoperatively investigated the characteristics of anemia in patients with gastric cancer in order to provide optimal medical care for the patients. Materials and Methods: Preoperative hemoglobin, serum iron, serum ferritin, serum vitamin $B_{12}$, and serum folic acid were measured for 321 patients with gastric cancer. These were measured again for 287 patients 6 months postoperatively. Results: Ninety-four patients (29.3%) had preoperative anemia. Preoperative hemoglobin, serum iron, and serum vitamin $B_{12}$ levels were higher in the patients with early gastric cancer than in patients with advanced gastric cancer. Preoperative hemoglobin, serum iron, and serum ferritin levels were higher in male patients than in female patients. The patients who had preoperative anemia showed a high probability of having postoperative anemia (P<0.001), and the patients who had low serum ferritin levels preoperatively showed a high probability of having low serum ferritin levels and iron deficiency anemia postoperatively (P<0.004). Conclusion: Preoperative ferritin deficiency should be improved by iron supplement, even though the patient may not be anemic at that time. Periodic postoperative measurements of the hemoglobin, serum iron, serum ferritin, serum vitamin $B_{12}$, and serum folic acid levels are highly recommended because postgastrectomy anemia is not rare. Finally, if any low hemoglobin, serum iron, serum ferritin, serum vitamin $B_{12}$, or serum folic acid levels are found, they should be treated in an appropriate way.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.112-119
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• 2003

Purpose: Helicobacter pylori infection is thought to be correlated with iron-deficiency anemia (IDA) at puberty. The H. pylori feoB gene, a high-affinity ferrous iron transporter, plays a central role in iron acquisition. This study aims to analyze the H. pylori feoB status according to the presence of antral gastritis with or without IDA. Methods: Fourteen H. pylori-positive patients aged from 10~18 years were categorized into subgroups based on the presence or absence of IDA. Eight patients had IDA, and the other six showed normal hematological findings. Genomic DNA was isolated from cultured H. pylori. Five sets of primers were used for PCR amplification of the feoB gene. The feoB region, 1.93 kb, was generated by linking of the PCR products and sequenced. The feoB gene sequences of H. pylori J99 and 26695 were used to compare with the clinical strains. Sequence comparisons of the feoB regions between the IDA (+) and (-) groups were performed. Results: Sequence analysis of the complete coding region of the feoB revealed 16 sites of polymorphism. Among these, 3 polymorphisms-Glu/Thr254Ala, Ile263Val, and Lys511Gln - were indigenous to Korean strains. Although statistically significant differences appear in 4 sites between IDA (+) and (-), the number of specimens are too low to assess the real differences. Conclusion: The 4 polymorphisms in the feoB gene seem to be related with IDA, but it is unclear yet because of small number of study strains. Further studies are required to prove the correlation of IDA and H. pylori infection.

• Biomedical Science Letters
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• v.1 no.1
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• pp.81-88
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• 1995

RDW and MCV are thought to be the highly sensitive blood cell parameters in the differentiation of iron deficiency anemias. Through the medical records of 227 anemic patients and the physical checking results of 143 healthy persons in a General Hospital during the recent five years, the authors evaluated various blood cell parameters including RDW and MCV. Iron deficiency anemia, aplastic anemia and other anemias associated with chronic disease were shown as the three major causes of anemias in Korea. In the patients of iron deficiency anemia MCV was very low(62.9$\pm$13.7fl), while RDW was very high(19.3$\pm$4.8) showing much lower MCV and much higher RDW in severe IDA compared with in mild IDA. To differentiate iron deficiency anemias form other anemias, a discriminant function was developed from some blood cell parameters like MCV, MCH, MCHC, RDW and platelets(D.F.=0.26-0.012MCV -0.130MCH +0.073MCHC +0.052RDW+0.003PLT).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.169-178
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• 2008

Purpose: The purpose of this study was to determine the efficacy of early low-dose iron supplementation in term breast-fed infants. Methods: Eighty-seven healthy term infants were divided into 3 groups: A, formula-fed; B, breast-fed only; S, breast-fed with iron supplementation (5 mg/day from 2 months of age). We measured ferritin, iron, total iron binding capacity (TIBC), transferrin saturation rate (TFSAT), hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW) at birth, 6 months of age, and 12 months of age. Results: 1) At 6 months of age, ferritin, iron, TFSAT, and Hb in Group B were the lowest among the 3 groups, whereas TIBC and RDW were the highest. The incidences of iron deficiency (ID) and iron deficiency anemia (IDA) in Group B were 33% and 30%, respectively, significantly higher than those seen in Groups A (5% and 8%, respectively) and S (7% and 5%, respectively). 2) At 12 months of age, ferritin, TFSAT, Hb, MCV, and MCH in Group B were the lowest among the 3 groups, whereas TIBC and RDW were the highest. Iron and Hct did not differ among the 3 groups. The incidences of ID and IDA in Group B were 64% and 50%, respectively, again significantly higher than those seen in Groups A (4% and 3%, respectively) and S (9% and 7%, respectively). Conclusion: The prevalences of ID and IDA were higher in breast-fed infants than in formula-fed infants, even at 6 months of age. Early and low-dose iron supplementation in breast-fed infants improved iron status and lowered the incidence of iron deficiency anemia in early infancy.

• Proceedings of the Korean Nutrition Society Conference
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• 2000.11a
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• pp.105-105
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• 2000

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.827-833
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• 2008

Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.544-548
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• 2009

Purpose : To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. Methods : We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. Results : In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. $6.8{\mu}g/L$). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. Conclusion : There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P<0.05).

• Journal of Nutrition and Health
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• v.52 no.6
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• pp.552-558
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• 2019

Purpose: Although vitamin D deficiency is common among Korean adolescent girls and young women, few studies have explored the potential health effects of vitamin D deficiency in this vulnerable population. This study examined the association between vitamin D deficiency and anemia in Korean adolescent girls and young women. Methods: The data from the Korea National Health and Nutrition Examination Survey 2008 ~ 2014 were used. A total of 3,643 girls and adult women aged 12 to 29 who provided all the information (including serum 25-hydroxy vitamin D, hemoglobin, and/or serum ferritin) needed for the analysis were included in the analysis. Demographic, lifestyle, and health data were obtained through survey questionnaires. Anemia and iron deficiency anemia were defined according to the World Health Organization cut-offs. Multivariable logistic regression, and restricted cubic spline regression were used in the analysis. Results: In fully adjusted logistic regression models, the vitamin D deficiency was significantly associated with higher prevalences of anemia (odds ratio (OR): 1.61, 95% confidence interval (CI): 1.04 ~ 2.49) and iron deficiency anemia (OR: 1.43, 95% CI: 1.01 ~ 2.03). In a cubic spline regression model, we observed a dose-response relationship between serum 25(OH)D concentration and anemia, and this linear relationship was also clearly observed between serum 25(OH)D concentration and iron deficiency anemia. Conclusion: Vitamin D deficiency may be associated with a higher prevalence of iron deficiency anemia and anemia in adolescent girls and young women. Alternatively, vitamin D deficiency may be a concurrent event for patients with anemia, which we cannot distinguish in this cross-sectional study. Further studies are needed to verify the causality in this population of low vitamin D levels.