• Korean Journal of Veterinary Research
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• v.46 no.4
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• pp.387-393
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• 2006

Progressing to the iron deficiency anemia was experimentally induced in 4 clinically healthy dogs by repeated phlebotomy to characterize hematologic features, serum iron values, and RBC indices. Abnormal RBC morphologies were also evaluated semiquantitatively on Wright's-stained blood films. Hematologic abnormalities in early stage of anemia included decreased both hematocrit and hemoglobin, and reticulocytosis, with no changes in mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) were represented. In intermediate stage, decreased serum iron concentration with microcytosis and hypochromia were prominent. In late stage, red cell distribution width and Mentzer's index were out of reference ranges in the majority of dogs. In this study microcytic anemia was appeared at the hemoglobin range of 5.1-7.2 g/dl. On most sampling days, platelet counts and white blood cells were within the reference ranges, with some minor variations. Iron deficiency was not necessarily associated with microcytic anemia. Judging from the sequential changes of both MCV and MCHC, 3 patterns of anemia were sequentially observed: initially normocytic normochromic, intermediate normocytic hypochromic or normocytic normochormic, and finally microcytic hypochromic. The most frequent morphologic abnormalities were target cells. Occasional elliptocyte, acanthocyte, stomatocyte, kinzocyte, dacrocyte and schistocyte were also noted on the blood films.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.820-826
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• 2008

Purpose : This study was conducted to evaluate the red cell indices and frequency of iron deficiency anemia based on the feeding patterns of nine-month-old infants. Methods : Blood tests were performed on 253 nine-month-old infants, who visited Il Sin Christian Hospital for health check-ups from January to December 2007. Their parents answered telephonic questions regarding their feeding patterns and weaning foods. Results : Three infants groups were created according to feeding patterns before they started weaning foods. One group was exclusively breast-fed (48.6%), another had mixed feeding (27.3%), and the third had artificial milk feeding (24.1%). Red cell indices (hemoglobin, hematocrit, MCV, MCH) of the breast-fed group were comparatively lower than those of the other two groups (P<0.05). Twenty-five infants (9.9%) were diagnosed with iron-deficiency anemia. According to feeding patterns, the frequency of anemia was highest in the breast-fed group. Six infants who started weaning foods before six months of age (113 infants) were diagnosed with iron-deficiency anemia (5.3%), and nineteen who started after six months of age (140 infants) were diagnosed with iron-deficiency anemia (13.6%). Conclusion : When nine-month old infants visit hospitals for health check-ups, pediatricians must consider their feeding pattern and weaning foods histories, and then recommend screening blood tests for iron-deficiency anemia.

• 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.

• 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.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.15-19
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• 2015

Purpose: Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. We investigated whether serum sTfR levels can aid in diagnosis and treatment of iron deficiency anemia (IDA) in children. Methods: Ninety-eight patients with IDA were enrolled and were classified according to age at diagnosis. Group 1 comprised 78 children, aged 6-59 months, and group 2 comprised 20 adolescents, aged 12-16 years. Results: In group 1, patients' serum sTfR levels correlated negatively with mean corpuscular volume; hemoglobin (Hb), ferritin, and serum iron levels; and transferrin saturation and positively with total iron binding capacity (TIBC) and red cell distribution width. In group 2, patients' serum sTfR levels did not correlate with ferritin levels and TIBC, but had a significant relationship with other iron indices. Hb and serum sTfR levels had a significant inverse relationship in both groups; however, in group 1, there was no correlation between Hb and serum ferritin levels. In 30 patients of group 1, serum sTfR levels were significantly decreased with an increase in Hb levels after iron supplementation for 1 month. Conclusion: Serum sTfR levels significantly correlated with other diagnostic iron parameters of IDA and inversely correlated with an increase in Hb levels following iron supplementation. Therefore, serum sTfR levels can be a useful marker for the diagnosis and treatment of IDA in children.

• 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.

• Korean Journal of Community Nutrition
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• v.6 no.3
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• pp.495-506
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• 2001

This study was conducted to investigate the nutrient intake, dietary and weight control behaviors and iron deficiency of adolescent girls. The subjects were 216 female middle school students living in urban and rural areas of Inchon. Thin cross- sectional study was conducted by questionnaires and data were analyze by SAS program. Nutrient intakes collected from 3 day-recalls were analyzed by the Computer Aided Nutritional Analysis Program(CAN-pro). The mean height, weight. BMI and obesity index for the subjects were 158.2 cm, 51.1kg, 20.4 and -5.3 % in urban students and 155.9 cm, 49.3 kg 21.1 and -8.2% in rural students, respectively. Easting blood samples were obtained and analyzed for iron nutritional status. The mean obesity index of the urban students was higher than that of the rural students. The proportion of the overweight group was higher in urban students compared to rural students, However, over 10% of both area students belonged to the low weight group, respectively. Most students of both areas skipped breakfast and the main reason was on appetite and lack of time. Urban students were more concerned with body image. The nutrients which showed a lower mean intake as percentile of RDA were Ca, iron, vit A an Vit B$_2$ and most nutrient intakes of urban students were significantly higher compared to those of rural students. These results indicate that nutrient intakes in the female middle school students were considerably lower than the RDA. Also they had undesirable food habits and lower self-satisfaction with their body image, There were significant differences in the mean MCV, TIBC and serum ferritin between urban and rural area subjects. Mean Hb, Hct, MCH, MCHC and TS, bowaver, were not significantly different. Prevalence of iron deficiency greatly varied by indices from urban(11.5%) and rural (8.7%) when judged by Hb to urban(23.1) and rural (23.3%) by serum ferrition. Therefore, proper nutrition education is required for good nutrition desirable food habits, weight control, and guidance for iron deficiency in anemic female of adolescents.

• Korean Journal of Community Nutrition
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• v.2 no.1
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• pp.23-32
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• 1997

To evaluate iron nutritional status of female college students, fasting blood samples were taken from 76 female students of Kangnung National University. Hemoglobin(Hb), hematocrit(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin concentrations were measured and transferrin saturation was calculated. Mean values for Hb, Hct, Fe, TIBC, TS and serum freeitin were 13.64$\pm$1.42g/dl, 40.99$\pm$4.31%, 103.0$\pm$33.3$\mu\textrm{g}$/이, 395.3$\pm$9.07$\mu\textrm{g}$/dl, 26.58$\pm$9.07$\%$and 26.76$\pm$17.5ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 6.8% when judged by Hct to 26.0$\%$ by serum ferritin concentration. The Hb concentration was positively correlated with hematocrit (r=0.5402), serum iron(r=0.2819) and transferrin saturation(r=0.2777)(p<0.05). on the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.3196). Two-day dietary intake records were collected from subjects to estimate mean daily iron intake and bioavailability of dietary iron. Mean daily intake of iron was 13.15mg and heme iron intake was 0.83mg which was 6.4% of total iron intake. Total absorbable iron calculated by the method of Monsen was 1.27mg and bioavailability of dietary iron was 9.6%. In the light of high prevalence of iron deficiency based of serum ferritin concentration and low bioavailability of iron in the diet, guidelines about diet should be made to increase the content and bioavailability of iron in the diet if female college students.

• Korean Journal of Community Nutrition
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• v.4 no.2
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• pp.139-148
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• 1999

This study was designed to assess the iron nutritional status of girls at puberty in Kangnung area. The subjects consisted of 161 adolescents in sixth-grade in primary school and first-grade in middle school girls. Anthropometric measurements were taken for body weight, height, percentage of body fat, and circumferences of waist and hip. Nutrient intakes were assessed by modified 24-hour recall method. Food models and other measuring tools were also used. Fasting blood samples were obtained and analyzed for hemoglobin(Hb) concentration, hematocrit(Hct), serum iron(FE) and total iron binding capacity(TIBC). Mean values for Hb, Hct, Fe, TIBC, TS and serum ferritin were $13.6{\pm}0.9g/dl$, $39.6{\pm}3.9%, 91.3{\pm}36.3{\mu}g/dl$, $327.9{\pm}45.2{\mu}g/dl$, $28.3{\pm}11.8%$ and $37.4{\pm}24.2ng/ml$, respectively. Prevalence of iron deficiency greatly varied by indices from 4.8% when judged by Hb to 18.4% by serum Fe concentration. The Hb concentration was positively correlated with Hct(r=0.641), serum iron(r=0.266) and transferrin saturation(r=0.237)(p<0.05). On the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.572). Mean daily intake of iron was 14.94mg and heme iron intake was 1.13mg and which was 7.6% of total iron intake. Total absorbable iron calculated by the method of Mosen was 1.38mg and bioavailability of dietary iron was 9.3%. These results suggest that the prevalence of iron deficiency of pubertal girls is very high, therefore the guidelines for diet and social supports, such as, school food service system should be provided to improve their iron status in middle school students.

• Journal of the Korean Society of Food Science and Nutrition
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• v.28 no.5
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• pp.1151-1157
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• 1999

The purpose of this study is to investigate the iron nutritional status and anemia of university female students. Seventy female subjects in Ulsan city were evaluated with questionnaire, measurement of hematological indices. The mean height and weight of 70 subjects were 160.76±0.48cm, 52.80±0.72kg and BMI(body mass index: kg/m2), %IBW(ideal body weight) were 21.0±0.29, 100.2±12.41. The mean values of hemoglobin(Hgb), hematocrit(Hct), serum iron(S Fe), serum ferritin(SF), TIBC(total iron binding capacity), transferrin saturation(TS(%)) and RBC were 12.7±11.10g/dl, 39.0± 2.61%, 96.9±41.98 g/dl, 28.9±24.78 g/dl, 369.6±54.36 g/dl, 27.1±12.40% and 4.4± 0.27(106/mm3), respectively. Iron deficiency anemia among the subjects was estimated as 15.7% by using Hgb(<12g/dl), 11.4% by Hct(<36%), 22.9% by S Fe(<60 g/dl), 34.3% by SF(<15 g/dl), 48.6% by TIBC(>360 g/dl) and 20.0% by TS(%)(<15%). 15 subjective symptoms were measured and the high prevalence symptoms were 'cold hands and feet' and 'tired out easily'. The correlation between hemotological indices and subjective symptoms was evaluated. The hemoglobin level was negatively correlated with 'cold hands and feet', 'short breath when climbing', 'fragile nail', 'inflammed inner mouth', 'pale face' and 'scaly tetter'.