• Title/Summary/Keyword: Anemia, Iron-Deficiency

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Preoperative and Postoperative Anemia in Patients with Gastric Cancer (위암환자의 위절제술 전후의 빈혈)

  • Sohn, Jun-Ho;Yu, Wan-Sik
    • 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.

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The Iron Status and Diet Quality of Pregnant Women during the First Five Months of Pregnancy (임신 전반기 여성의 철분 영양상태와 식사의 질)

  • 윤지숙;박정아;손숙미
    • Korean Journal of Community Nutrition
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    • v.8 no.6
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    • pp.803-813
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    • 2003
  • Literature suggests that iron deficiency anemia is prevalent among pregnant women all over the world. This study was designed to evaluate the iron status of pregnant women during the fist five months, with the intention of determining ways to reduce the prevalence of iron deficiency anemia among pregnant women in Korea. We collected dietary information and measured the biochemical status of iron in 171 pregnant women over 16 weeks of gestation (=16.7$\pm$2.34 week). Dietary intakes for 3 days were collected using the 24 hour recall and food record methods. The daily Fe intake was measured using the food frequency method. The Body Mass Index (BMI), calculated by using the pre-pregnancy weight and height, indicated that 31.3% of subjects were under-weight. We divided the subjects into normal and anemic group by using the serum ferritin levels. It appeared that the mean dietary intake of iron was 52.3% of the recommended level for pregnant women. The dietary quality evaluation showed that pregnant women ate only 58% of the recommended amount in the food groups of meat, fish, eggs, beans and milk and dairy products. The hematological indices showed that the mean Hemoglobin (Hb) was 11.9 g/dl, Hematocrit (Hct) was 35.1%, ferritin was 23.9 $ng/ml$, and transferrin was 297.3 ${\mu}g/dl$. The dietary intake of iron was significantly lower and the vitamin C intake was significantly higher in the anemic group. The pre-pregnancy BMI was significantly lower in the anemic group. Variables affecting iron intake were the Fe intake frequency index and the food group score. The Fe index showed significantly positive correlation with the pre-pregnancy food intake and the food group score. Hb showed a significantly positive correlation with the pre-pregnancy food intake. We concluded that strategies to improve iron status be implemented in the pre-pregnant stage so as to reduce the prevalence of iron deficiency and that we should stress on the importance of an adequate diet as well as the maintenance of a heathy weight.

Effects of Maternal Anemia on the Iron Status of the Cord Blood and Pregnancy Outcomes (모체 빈혈이 제대 혈의 철영양상태와 임신의 결과에 미치는 영향)

  • 임현숙;김희아
    • Korean Journal of Community Nutrition
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    • v.3 no.4
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    • pp.565-573
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    • 1998
  • Iron deficiency anemia in pregnant women has been of great concern because of its negative effects on the outcomes of pregnancy. Much of evidence has shown that there are associations between pregnancy outcomes and maternal iron status. Maternal iron status might affect pregnancy outcomes through the iron status of the cord blood. In this study, we divided 91 subjects into two groups : the anemic and the normal groups. The groups were classified according to their hemoglobin(Hb) and hematocrit(Hct) values of the maternal blood in the third trimester of the pregnancies. We determined the parameters for the iron status of the cord blood and then analyzed the correlations between these parameters and the pregnancy outcomes. Mothers in the anemic group had a significantly higher parity number and a lower dietary score as well as a shorter duration of iron supplements consumed compared to those in the normal group. Maternal Hb values in the third trimester had positive correlations with the infant's head and chest circumferences, and the Hct values related positively to the infant's chest circumferences. On the other hand, Hb concentrations of the cord blood had positive correlations with the infant's height and head and chest circumferences. The Hct values of the cord blood had positive correlations with gestational periods and the cord lengths. These results suggest that the maternal iron status might influence fetal development through the iron status of the cord blood.

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Effects of Nutrition Counseling on Quality of Diet, Iron Status and Hematic Parameters in College Women Who Have Self-Recognized Anemic Symptoms (빈혈 자각증상이 있는 여대생에서 영양상담이 식사의 질, 철분 영양상태 및 혈액학적 지표에 미치는 영향)

  • Jeong, Sook-Hyun;Park, Jin-Hee;Lee, Hye-Ok;Cho, Ryo-Won
    • Korean Journal of Community Nutrition
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    • v.12 no.1
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    • pp.68-79
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    • 2007
  • Iron deficiency is the most common nutritional problem that affects people of all ages in both industrialized and developing countries. Especially, college women are the target population for dietary iron deficiency. Recent study showed that the nutritional status of college women was poor because of insufficient food consumption and repeatabled weight reduction. The purpose of this study was to investigate the effects of nutrition counseling on the diet quality, nutritional status of iron and hematic parameters in college women who have self-recognized anemic symptoms. Anthropometric and dietary assessments as well as blood analysis, were carried out before and after the 8 weeks of nutrition counseling. During the experimental period, the 31 subjects were given nutrition education by a clinical dietitian. Nutrition counseling consisted of pathology of anemia, nutrition information for iron deficient anemia, diet information of balanced meals and menu choices for eating out. As a result, the frequencies of consumption of legumen and vegetables significantly increased after nutrition counseling(p<0.05). Daily intakes of protein, especially animal protein, vitamin E, niacin, heme iron, and zinc significantly increased(p<0.05). After nutrition counseling, some self-reported clinical symptoms such as 'dizziness', 'fatigue', 'short of breath', 'headache', 'sleeplessness', and 'beating heart' were significantly improved. Serum levels of transferrin(p<0.01) and total iron binding capacity levels(p<0.05) significantly increased. It could be concluded that the 8 weeks of nutrition counseling might be effective on quality of diet as well as iron status and it might also improve the some hematic parameters in college women who have self-recognized anemic symptoms.

Effects of Iron Supplementation on Iron Status of Anomic High School Girls (철 보충제 섭취가 빈혈 여고생의 철 영양상태에 미치는 영향)

  • 홍순명;황혜진
    • Korean Journal of Community Nutrition
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    • v.6 no.5
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    • pp.726-733
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    • 2001
  • This study was designed to investigate the effect of iron supplementation on the iron nutritional status and anemia of high school girls in Korea. One hundred thirty-five female students residing in Ulian metropolitan city in Korea diagnosed as having anemia or iron deficiency participated in this study. One or two tablets of iron medicine(80-160 mg Fe as ferrous sulfate/day) were administered to all participants for 3 months. Subjects were evaluated with a questionaire, measurement of hematological indices before and after iron supplementation. The average height and weight of respondents were 161.62 $\pm$ 4.68 cm and 53.87 $\pm$ 6.10 kg, respectively. Daily intakes of energy were 1597.8 $\pm$ 302.35 kcal(76.0% RDA). Iron intakes were 13.72 $\pm$ 4.17 mg (76.3% of RDA) and calcium intakes were 580.74 $\pm$ 177.21(72.5% of RDA) before iron supp]ementation. At baseline, 63% of all participants had depleted store(serum ferritin 12 ug/ml and/or transferrin saturation(TS) < 14%). After iron supplementation, this proportion declined to 19.3%. 55.6% of subjects had 12 ug/m1 of basal ferritin concentration before iron supplementation, and this proportion declined to 16.3% after iron supplementation. The basal hemoglobin(Hb) concentrations were 12.13 $\pm$ 1.01 g/dl and they increased to 12.79 $\pm$ 0.81 g/dl, which showed significant difference artier iron supplementation(p < 0.001). The basal ferritin and TS(%) were 13.24 $\pm$ 11.66 ng/ml, 18.42 $\pm$ 10.12% and they significantly increased to 32.95 $\pm$ 21.14 ng/ml, 33.53 $\pm$ 16.64%, respectively(p < 0.001). The basal total iron binding protein(TIBC) were 467.81 $\pm$ 97.24 ug/dl and they significantly decreased to 325.05 $\pm$ 48.89 ug/dl(p < 0.001) after iron supplementation. The number of tablets administered was positively correlated with serum iron(t = 0.553, p < 0.01), serum ferritin(t = 0.557, p < 0.01), TS(%)(t = 0.588, p < 0.01) and negatively correlated with TIBC(t= -0.409, p <0.01). The anemia symptoms such as ‘Shortening of breath when going upstairs(p < 0.01)’, ‘Tired out easily(p < 0.01)’, ‘Feeling blue(p < 0.001)’, ‘Decreased ability to concentrate(p < 0.01)’, and ‘Poor memory(p < 0.001)’improved significantly after iron supplementation. In this study, daily iron supplementations were efficacious in improving the iron status and anemic symptoms of female high school students. Regular check-ups and nutrition education for adolescents are necessary because of their vulnerability to iron deficiency. Further studies are needed to determine the minimum effective dose of iron and to examine the adverse effect of long-term iron supplementation.

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Reticulocyte hemoglobin content for the diagnosis of iron deficiency in young children with acute infection (급성 감염성 질환을 가진 영유아에서 철결핍 진단 지표로서의 망상적혈구혈색소량)

  • Kim, Jon Soo;Choi, Jun Seok;Choi, Doo Young;You, Chur Woo
    • 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.

Iron Nutritional Status of Infants and Young Children in the Seoul Area

  • Um, Sung-Sin;Ahn, Hong-Seok;Kim, Soon-Ki;Ha, Jung-Hun
    • Journal of Community Nutrition
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    • v.4 no.1
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    • pp.3-11
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    • 2002
  • The purpose of this study is to evaluate the iron nutritional status by investigating dietary intake and analyzing the hematological iron status indices including serum transferrin receptor (sTfR) in 8 to 28 month old infants md young children taking supplementary foods. The nutrient intake of 60 healthy infants and young children from 8 to 24 months of age was investigated by means of a 24-hour recall method, and the subjects were divided into 2 groups (8- 12 months and 13-28 months) according to age. Venous blood samples from these groups were collected and measured for the following : hemoglobin(Hb), hematocrit(Hct) , mean corpuscular volume (MCV), mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), serum ferritin, serum iron, total iron binding capacity (TIBC), and sTfR. Anemia is defined as hemoglobin < 11g /dl , serum ferritin level < 10ng1m1 for iron deficiency , serum transferring receptor(sTfR) > 4.5mg / 1 for iron deficient erythropoiesis. Total daily calorie intake was 934.6 ${\pm}$ 284.5kcal (98.32% of RDA) on average. Average daily iron intake in infants aged 8 to 12 months was 8.92 ${\pm}$ 3.32mg. The mean daily iron intake in infants aged 13 to 28 months was 7.15 ${\pm}$ 3.35mg (90% of Recommended Dietary Allowance, RDA). Mean values for Hb, Hct sew ferritin and sTfR were 12.10 ${\pm}$ 0.77g141,36.02 ${\pm}$ 2.31%,20.91 ${\pm}$ 11.58ng/m1 and 3.78 ${\pm}$ 1.47mg /1, respectively. In the young children from 13 to 28 months of age, the prevalence of anemia was 5.6%. The prevalence of iron deficiency was 9.5% in those from 8 to 12 months of age, and 27.8% in those from 13 to 28 months of age. The prevalence of iron deficient erythropoiesis was 16.7% in infants aged 8 to 12 months and 44.4% in those aged 13 to 28 months. The prevalence of both serum ferritin level < 10ng/m1 sTfR > 4.5mg/1 was 22% in the young children aged 13 to 28 months. The measureand ment of sTfR may be a promising new tool in diagnosis of iron deficiency in early childhood when the iron deficiency is prevalent. It seems appropriate to emphasize nutritional education and evaluation to promote the iron nutritional status of infants and young children.