• Journal of Nutrition and Health
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• v.32 no.8
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• pp.887-896
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• 1999

The purpose of this research is to assess hematological and biochemical status and the prevalence of iron deficiency of pregnant women by gestational age to provide the primary data about iron nutritional status of pregnant women. Pregnant women visiting public health centers in Ulsan participated in study and were divided into 3 trimester by last menstrual period(LMP). Hemoglobin (Hgb), hematocrit(Hct)and mean corpuscular volume(MCV) among iron status indices were not statistically different from normal distribution, however total iron binding capacity(TIBC) and serum ferritin were skewed to left and serum iron and transferrin saturation(TS) were skewed to right. Hgb was positively correlated with Hct(r=0.93, p<0.001) but TIBC was negatively correlated with all indices. Serum ferritin was also correlated with all indices, especially in 3rd trimester but not reached to 1st trimester level. Mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), Red cell distribution width(RDW), serum iron and TS were not significantly different by trimester, however when serum serum iron was adjusted with hematocrit to correct the hemodilution, it significantly decreased in 2nd trimester. MCV increased in 2nd trimester and was maintained until late pregnancy, TIBC continued to increase throughout the trimester. The prevalence of anemic by CDC(Centers for Disease Control) Hgb criteria(Hgb <11.0g/dl in 1st and 3nd trimester, Hgb<10.5g/dl in 2nd trimester) was 2.8% in 1st trimester, 22.5% in 2nd trimester, 27.1% in 3rd trimester and was similar with prevalence by CDC Hct criteria(Hct < 33% in 1st and 3rd, Hct < 32% in 2nd). The prevalence of anemic of total subjects was 32.7% by WHO criteria(Hgb < 11.0g/dl). Although almost iron status indices increased in 3rd trimester, the prevalence of anemia by different criteria of all indices increased throughout the trimester, so iron nutritional status was considered as serious during late pregnancy. However, since factors other than iron deficiency, such as infection, infection, inflammation, other nutrient deficiency may also play a significant role, to differentiate the anemia due to mainly iron deficiency from the anemia due to other factors, serum ferritin is among the more useful indices in distinguishing the two conditions because it is depressed only in iron deficiency. Hgb<11.0g/dl and serum ferritin<12.0ug/L as the criteria of iron deficiency was suggested by CDC. 17.8% of all subjects were classified as iron deficient anemia, 14.9% as anemic from other reasons, 21.2% as iron deficiency any only 46.2% were in normal iron status.

• Journal of Nutrition and Health
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• v.26 no.6
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• pp.692-702
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• 1993

To evaluate iron nutritional status and to compare biochemical indices used for evaluation of iron nutriture, fasting blood sample was taken from 96 Korean female college student and hemoglobin(Hb) concentration, hematocrit(Hct), serum iron, total iron binding capacity(TIBC) and serum ferritin concentration were measured and transferrin(TF) saturation was calculated. Prevalence of iron deficiency varied from 4.2% when judged from Hb concentration and Hct to 38.5% and 40.6% when TIBC and serum ferritin concentration were used. TIBC was negatively correlated with serum ferritin(r=0.4561, p<0.001), while other indices showed positive but less significant correlations(p<0.05). Regarding iron status judged by serum ferritin was regarded as true iron status, the present cutoff points of Hb, Hct, serum iron, TF saturation were very insensitive in identifying the subjects with iron deficiency. Only TIBC was suitable for detecting iron deficiency in the study subjects. It is concluded from the study results that iron deficiency in young Korean adult women would be significantly underestimated with presently used biochemical measurements except TIBC and new cutoff points of these indices were proposed based on sensitivity, specificity measured prevalence, and positive and negative predictive values.

• Journal of Nutrition and Health
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• v.33 no.5
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• pp.532-539
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• 2000

The purpose of this research is to assess th iron nutritional status of pregnant women and to evaluate the appropriateness of the present cut off levels of hemoglobin(Hgb), hematocrit(Hct) and total iron binding capacity(TIBC) for assessing iron deficiency status. Pregnant women who were visiting public helath centers in Ulsan were interviewed and agreed to attend the study. Blood sample was taken and biochemical analysis of blood was performed. The collected data were classified into 3 trimesters by gestational age and then statistical analysis was performed. The prevalence of anemia in all subjects was 32.3% by WHO criteria(Hgb < 11.0g/dl) and 17.8% of all subjects was iron deficient anemia by CDC criteria(Hgb < 11.0/dl and serum ferritin < 12.0ug/l). Since the iron deficient anemia generally occures at the last stage of iron deficiency, it is not efficient to diagnose and prevent the iron deficient anemia in pregnant women by using the present cut off level of Hgb. Therefore, the new cut off level of iron status indices is necessary for assessing iron deficiency in early pregnancy before manifestation of anemia and for reducing the prevalence of anemia in later pregnancy. For this reason, the present cut off levels of iron status indices were estimated and compared by assessing the iron deficiency judged by serum ferritin level (<12.0ug/l)as true iron deficiency. It follows from the results of this research that present cut off levels of Hgb, Hct and TIBC were very insensitive in identifying the subjection with iron deficiency. The appropriate cut off levels of Hgb were 11.5g/dl for total period of pregnancy, 12.0g/dl for 1st and 3rd trimester, and 11.5g/dl for 2nd trimester. The cut off level of Hct was 34.0% for total period for pregnancy, 35.0% for 1st trimester, and 34.0% for 2nd and 3rd trimester. The cut off level of TIBC was 400ug/dl for total period, 360ug/dl for 1st 2nd trimester, and 450ug/dl for 3rd trimester.

• Journal of Nutrition and Health
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• v.32 no.7
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• pp.787-792
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• 1999

The purpose of this study was to estimate the iron availability and to analyze dietary factors which influence hematological indices of 130 female adolescents with iron deficiency anemia. Intakes of iron and other nutrients were estimated using a self-administrated questionnaire combined with the 24-hour recall mehtod and iron availability was calculated by Monsen's method. Mean daily intakes of calorie, protein and vitamin C were 1631.0kcal(77.7% of RDA), 54.7g(84.2% of RDA) and 45.7mg(83.0% of RDA), respectively. In terms of iron, mean daily intake was 8.7mg(48.3% of RDA) and heme iron intake was 3.0mg which correspond to 34% of total iron intake. The amount of total absorbable iron was 1.5mg and the estimated bioavailability of dietary iron was 17.2%. In summary, intake of several nutrients for most of the subjects were under RDA. Dietary factors affecting hematological indices were analyzed by stepwise multiple regression. Intake of vitamin C was a major determinant of Hb level, while both intake of enhancing factor and iron availability were major determinants of serum ferritin level. In conclusion proper nutritional education and guidance for iron deficiency anemic female adoalescent needs to be developed and to improve their iron storage should be increased intakes of enhancing factors, female adoalescents.

• The Korean Journal of Nuclear Medicine
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• v.10 no.1
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• pp.21-34
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• 1976

The diagnosis of iron deficiency rests upon the correct evaluation of body iron stores. Morphological interpretation of blood film and the red cell indices are not reliable and often absent in mild iron deficiency. Serum iron levels and iron-binding capacity are more sensitive indices of iron deficiency, but they are often normal in iron depletion and mild iron deficiency anemia. They are also subject to many variables which may introduce substantial errors and influenced by many pathologic and physiologic states. Examination of the bone marrow aspirate for stainable iron has been regarded as one of the most sensitive and reliable diagnostic method for detecting iron deficiency, but this also has limitations. Thus, there is still need for a more practical, but sensitive and reliable substitute as a screening test of iron deficiency. Pollack et al. (1965) observed that the intestinal absorption of cobalt was raised in iron-deficient rats and Valberg et al. (1969) found that cobalt absorption was elevated in patients with iron deficiency. A direct correlation was demonstrated between the amounts of radioiron and radiocobalt absorbed. Unlike iron, excess cobalt was excreted by the kidney, the percentage of radioactivity in the urine being directly related to the percentage absorbed from the gastrointestinal tract. Recently a test based on the urinary excretion of an oral dose of $^{57}Co$ has been proposed as a method for detecting iron deficiency. To assess the diagnostic value of urinary cobalt excretion test cobaltous chloride labelled with $1{\mu}Ci\;of\;^{58}Co$ was given by mouth and the percentage of the test dose excreted in the urine was measured by a gamma counter. The mean 24 hour urinary cobalt excretion in control subjects with normal iron stores was 6.1% ($1.9{\sim}15.2%$). Cobalt excretion was markedly increased in patients with iron deficiency and excreted more than 29% of the dose. In contrast, patients with anemia due to causes other than iron deficiency excreted less than 27%. Hence, 24 hour urinary cobalt excretion of 27% or less in a patient with anemia suggets that the primary cause of the anemia is not iron deficiency. A value greater than 27% in an anemic subject suggests that the anemia is caused by iron deficiency. The cobalt excretion test is a simple, sensitive and accurate method for the assessment of body iron stores. It may be particularly valuable in the epidemiological studies of iron deficiency and repeated evaluations of the body iron stores.

• Journal of Nutrition and Health
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• v.38 no.7
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• pp.533-543
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• 2005

The purpose of this study was to determine the iron status of preschool children in Ulsan, Korea. The study was con-ducted using 95 children aged 3 to 6 years by investigating the anthropometric indices and assessing the dietary intakes and biochemical analysis. A questionnaire for dietary intakes using 24-hr recall method were carried out by the mothers of the 95 subjects. And also a study was conducted to assess hematological and biochemical status of iron and prevalence of iron deficiency. The average height and weight were 105.4 $\pm$ 7.0 cm, 18.7 $\pm$ 3.2 kg in boys, 103.8 $\pm$ 6.7 cm, 17.6 $\pm$ 2.7 kg in girls. These were lower than the body growth standard values of Korean pediatrics. There was not a significant difference in both between boys and girls. For the daily nutrient intake, energy was 1201.5 $\pm$ 280.9 kcal (79.3$\%$RDA), protein was 63.8 $\pm$ 28.2 g (219.4$\%$RDA), iron was 11.9 $\pm$ 4.5 mg (133.2$\%$RDA). The iron nutritional status by hematological assay found that Hct was 34.7 $\pm$ 2.0 ($\%$), Hb was 12.0 $\pm$ 0.8 g/dl, RBC was 4.3 $\pm$ 0.3 ($10^6/{\mu}l$), MCV was 80.5 $\pm$ 3.0 fL, MCH was 27.8 $\pm$ 1.1 pg and MCHC was 34.6 $\pm$ 0.6 g/dl. The biochemical measurement of serum iron was 75.6 $\pm$ 30.3 ${\mu}g$/dl, TIBC was 320.3 $\pm$ 34.1 ${\mu}g$/dl, serum ferritin was 30.0 $\pm$ 14.8 ${\mu}g$/dl, Zinc-Protophor-phyrin (ZPP) was 32.7 $\pm$ 8.0 ${\mu}g$/dl, and ZPP/Heme was 71.1 $\pm$ 19.5 ($\mu$mole/mol heme). The prevalence with Hct, Hb, TS and serum ferritin less than cut-off value was $8.4\%,\;9.5\%,\;12.6\%$ and $4.4\%$ respectively. But the prevalence of iron deficiency estimated with ZPP and ZPP/Heme criteria were $25.3\%$ and $27.4\%$, and were higher than in case of any other indices. The prevalence of iron deficiency anemia ((low Hb (< 11.0 g/dl) and low serum ferritin (< 10 ${\mu}g$/L) or low TS (3-4 yews: < $12\%$, 5-6 years: < $14\%$)) was found in only one 3 year old girl. The prevalence of iron deficiency except Hct and Hb was the highest in 3 year group, but the prevalence by Hct and Hb was the highest in 5 year group. Iron deficiency and iron deficiency anemia do not seem to be a major public health problem in preschool children in Ulsan.

• Journal of the East Asian Society of Dietary Life
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• v.22 no.4
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• pp.463-472
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• 2012

This study was performed to investigate the iron status and its related factors in female college students residing in Gyeongnam. The prevalence of iron deficiency among subjects ranged from 3.4% in mean corpuscular hemoglobin concentration (MCHC) to 43.7% in ferritin. Weight, lean body mass (LBM) and body mass index (BMI) were positively correlated with ferritin concentration, but negatively correlated with total iron binding capacity (TIBC). Among the nutrients, vitamin A and B2 were major predictors of elevated iron status. Meal regularity was positively correlated with Fe and ferritin concentration, and meal number with transferrin saturation (TS), meal quantity with red blood cell (RBC) and hematocrit (Hct). Consumption of fruit, meat, fish and poultry showed strong positive correlation with hematological indices. Therefore, increasing vitamin A, B2, C, and iron intakes as well as maintenance of a healthy weight may be helpful in preventing iron deficiency in female college students.

• Nutritional Sciences
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• v.7 no.1
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• pp.35-40
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• 2004

This study was performed to evaluate the effect of iron supplementation on iron-deficiency-related indices, oxidative stress and antioxidative enzyme activity in female marathoners. Fourteen teenage female marathoners participated in the study. Subjects were divided into two groups: mild anemic and control, depending on their hemoglobin (Hb) level. The mild anemic group had significantly lower RBC count and hematocrit (Hct) and Hb levels compared to the control group. The mild anemic group (〈12.5g Hb/dI, n=7) was given iron supplements (60mg Fe/day) for four weeks during the summer training period. RBC count, Hct and Hb levels showed an increasing tendency through iron supplementation, and significant differences in these variables between the anemic and control groups disappeared in the post-period. There was no difference in plasma malondialdehyde (MDA) between the anemic and control groups. However, catalase (CAT) and glutathione peroxidase (GPx) activity were significantly higher in the anemic group. The significant difference in enzyme activity between the groups disappeared in the post-period. In addition, superoxide dismutase activity significantly decreased after iron supplementation. In conclusion, antioxidative enzyme activity was up-regulated in an anemic condition and mild iron supplementation decreased the antioxidant enzyme activity of female marathoners while improving their anemic condition.

• Biomedical Science Letters
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• v.17 no.3
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• pp.203-209
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• 2011

Magnesium (Mg) plays an essential role in physiological and metabolic reactions. Recently, there has been an increased interest in the role of Mg deficiency, particularly the relationship between serum Mg value and inflammatory response. This study was designed to determine the relationship between serum Mg deficiency with inflammatory response, electrolytes and hematological alteration over long-term periods. Sixteen male Sprague-Dawley rats were divided into two groups: control (n=8), and Mg deficiency group (MgD group, n=8). Chow and normal water (tap water) were regularly provided to the control group and Mg-depleted chow and third distilled water were regularly provided for 60 days to the MgD group. Body weights, Serum Mg, $K^+$, inorganic phosphorus (IP) and total iron binding capacity (TIBC) levels in the MgD group were lower than those of the control group (P<0.05). Granulocyte fraction and MCV, RDW and PDW levels were higher, whereas lymphocyte fraction, erythrocyte, hemoglobin and MCHC levels were lower in the MgD group than in the control group (P<0.05). MCP-1 and TNF-${\alpha}$ levels in the MgD group were greater than those of the control group (P<0.05). In conclusion, the results of the present study suggest that Mg deficiency over a long-term period had not altered total leukocyte concentration in the blood, but had detrimental effects, including disturbances of electrolytes balance, disturbance of iron indices, potential anemia and elevation of pro-inflammatory cytokine. However, further studies should be performed to determine the relationship between serum Mg deficiency and major organ damage or alteration.

• Journal of the East Asian Society of Dietary Life
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• v.9 no.3
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• pp.302-314
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• 1999

This study was conducted to evaluate nutrient intake, indices of anemia, serum lipids, and their correlations in 40 Korean female college students aged 21 to 25 years. Fasting blood samples were collected in October. 1997 Nutrient intake was investigated by 24-hour recall method for three days. Anthropometric measurements, blood pressure, iron status and serum lipids of the subjects were determined. The mean values for age. height, weight, BMI and blood pressure of the subjects were 22.1 years, 160.6cm, 54.4kg and 109.1/66.9mmHg, respectively. According to the body composition analysis, total body water, % body fat, lean body mass and WHR were 26.7L. 29.5%, 36.5kg and 0.8, respectively. Average daily intake of energy was 1,858.4kcal. Protein, phosphorus, vitamin B$_1$, vitamin B$_2$, niacin and vitamin C intakes were higher than the Korean recommended dietary allowence(RDA), whereas calcium, iron, vitamin A intakes were tower than that. Hemoglobin(Hb), hematocrit(Hct), serum iron(SI) and total iron binding capacity(TIBC) were measured and transferrin saturation (TS%) was calculated from serum. The mean values for Hb, Hct, SI, TIBC and TS were 13.6$\mu\textrm{g}$/㎗, 41.6%,97.8$\mu\textrm{g}$/㎗, 319.6$\mu\textrm{g}$/㎗ and 31.9%, respectively. The Prevalence rates of iron deficiency assessed by Hb and Hct were found to be 10% and 2.5%, respectively. However, when assessed with TIBC, the prevalence rate of iron deficiency was increased to 32.5%. The mean values for serum triglyceride(TG), total cholesterol(TC), HDL-Chol, LDL-Chol concentrations and atherogenic index(AI) were 154.7mg/㎗, 80.0mg/㎗, 47.4mg/㎗, 91.3mg/㎗ and 2.6, respectively. Correlations among indices of anemia. there were positive correlations between Hb and Hct, between SI and TS : negative correlations between TIBC and TS or SI. Correlations among serum lipids, there were positive correlations between TC and TG or LDL-cholesterol. Energy intakes were correlated positively with TIBC(p＜0.05), and vitamin C intakes negatively correlated with Hb(P＜0.05). And vitamin A intakes were negatively correlated with TG(p＜0.01). TC(p＜0.05) and LDL-Chol(p＜0.01). Hb negatively correlated with TG(P＜0.05). Body weights(p＜0.05), lean body mass(p＜0.05) and total body water(p＜0.01) werenegatively correlated with Hb. BMI and WHR correlated with TG and TC(p＜0.01). These results indicated that subjects with higher energy intake and overweight had a tendency to have iron deficiency. Increases in BMI and WHR were related to increases in serum lipids levels and decreases in TIBC. The results also showed that serum lipids were decreased when vitamin A and iron intakes were sufficient.