• Journal of Nutrition and Health
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• 제33권5호
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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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• 제32권8호
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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.

• 대한수의학회지
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• 제46권4호
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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.

• 대한핵의학회지
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• 제1권1호
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• pp.79-82
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• 1967

Patients with aplastic anemia were treated with a combination of depo-testosterone cyclopentylpropionate(Upjohn) and dexamethasone. In 7 of 15 patients treated, there was response in which either a significant increase in hemoglobin concentration, a prolonged interval or a cessation of blood transfusion requirement developed during androgen therapy. Younger patients with cellular marrow appeared to be better responding to androgen. EEI(Effective Erythropoietic Index) formulated by Gardner & Nathan(1966) which was a helpful measurement as to whether patients with myelofibrosis whould respond to androgen, was evaluated in patients with aplastic anemia. It was concluded that EEI as well as ferrokinetics indices (Plasma-$^{59}Fe$-disappearance rate, RBC $^{59}Fe$ net incorporation) did not significantly correlate with the degree of response to androgen in aplastic anemia.

• 한국식품영양과학회지
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• 제28권5호
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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'.

• 대한핵의학회지
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• 제5권2호
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• pp.41-56
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• 1971

The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseass were studied by various methods. Only patients without previous blood loss were included: 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and $T_{50}Cr$. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

• Journal of Nutrition and Health
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• 제32권7호
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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.

• Clinical and Experimental Pediatrics
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• 제51권8호
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• pp.820-826
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• 2008

목 적 : 9개월 영아의 수유방법에 따른 철결핍빈혈의 빈도와 적혈구 혈액상을 알아보고자 이 연구를 시행하였다. 방 법 : 2007년 1월부터 12월까지 생후 9개월의 특이병력이 없는 영아 253명의 혈액검사를 시행하고 부모를 대상으로 수유방법과 이유식에 대한 설문조사를 하여 결과를 얻었다. 결 과 : 총 253명 중 모유수유 123명(48.6%), 혼합수유 69명(27.3%), 인공수유 61명(24.1%)였다. 수유방법에 따른 적혈구 혈액상은 모유수유군에서 혼합수유군이나 인공수유군에 비하여 유의하게 낮았다(P<0.05). 253명 영아 중 25명에서 철결핍빈혈로 판명되어 9.9% 빈도를 보였고 수유방법에 따라서는 모유수유군에서 18.7%, 혼합수유군에서 1.4%, 인공수유군에서 1.6%의 빈도를 보여 모유수유군에서 빈혈 발생빈도가 유의하게 높았다(P< 0.05). 이유식 시작 시기에 따른 철결핍빈혈의 빈도는 생후 6개월 이내에 이유식을 시작한 영아 113명 중 6명(5.3%), 6개월 이후에 이유식을 시작한 영아는 140명 중 19명(13.6%)로 이유식을 늦게 시작한 군에서 철결핍빈혈의 빈도가 유의하게 높았다(P<0.05). 결 론 : 생후 9개월의 영아가 내원하였을 때 수유 방법이나 이유식에 대한 문진을 통하여 철분 등을 포함한 영양 상태에 관하여 알아보고 선별적 빈혈 검사를 통하여 철결핍빈혈의 예방과 치료에 힘써야 할 것이다.

• Journal of Yeungnam Medical Science
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• 제10권1호
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• pp.58-67
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• 1993

1986년 5월부터 1991년 6월까지 약 5년간 영남대학교 외과대학 부속병원에 내원하여 혈액학적 소견상 빈혈이 동반된 환자 210명과 정상인 200명 도합 410명을 대상으로 Coulter Counter S-plus II로 일반혈액검사를 실시하여 MCV와 RDW 및 여러 적혈구 지수를 얻어서 빈혈의 새로운 분류를 시도하였고 외국인에 비하여 빈혈의 병인 양상이 다른 한국인의 혈액질환의 감별진단에 도움이 되는 가를 알아 보고자 본 연구를 시행하였다. 거의 모든 경우에 MCV의 증감은 MCH와 MCHC의 증감을 동반하였으나 RDW와는 무관하였다. 따라서 저색소성빈혈 혹은 정색소성빈혈등의 용어보다는 이질성빈혈 혹은 동질성빈혈의 용어를 사용함이 빈혈의 형태학적 분류에 더욱 의미있는 것으로 사료되었다. 이질성소구성빈혈에는 철결핍성빈혈이 속하였고 이질성정구성빈혈에는 급성백혈병과 골수로성빈혈이 여기에 속하였으며 이질성대구성빈혈에는 거대적아구성빈혈과 용혈성빈혈이 속하였다. 동질성소구성빈혈에는 만성질환에 의한 빈혈이 여기에 속하였으며 동질성정구성빈혈에는 급성출혈, 만성백혈병 및 다발성 골수종등에 의한 빈혈이 여기에 속하고 동질성대구성빈혈에는 재생활량성빈혈이 여기에 속하였다. 진단적인 의의가 큰 혈색소병은 본 연구에는 관찰되지 않았지만 한국인에 가장 많은 빈혈의 원인인 철결핍성빈혈과 만성질환에 의한 빈혈의 감별진단에 RDW가 유용한 것으로 생각되었다.

• 동아시아식생활학회지
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• 제9권3호
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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.