• 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.35 no.9
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• pp.943-951
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• 2002

This study was designed to investigate the effects of iron supplementation and nutrition education on the iron status and anemia of high school girls. The subjects resided in Ulsan city in Korea and were already diagnosed as having anemia or iron deficiency. Over a period of three months, one iron tablet (80 mg Fe as ferrous sulfate/day) was administered to the iron deficient subjects and two tablets (160 mg Fe as ferrous sulfate/day) were administered to the anemia subjects. The average height and weight of anemia subjects were 161.24 $\pm$ 4.50 cm and 50.87 $\pm$ 5.86 kg, respectively. The average BMI (kg/$m^2$ )was 19.58 $\pm$ 2.03 and the PIBW(percent ideal body weight) were 92.52 $\pm$ 9.84%. Except for vitamin A and vitamin C intakes, the intake levels of all other nutrients were below the RDA. Total calorie intakes of anemia subjects were 73.5% of RDA. The iron intakes of subjects from food were 69. 1% of RDA and the Ca intakes were 59.1% of RDA. The basal hemoglobin(Hb) concentration of anemia subjects averaged 10.77 $\pm$ 1.33 g/dl, and this increased significantly (p < 0.001) to 12.12 $\pm$ 1.08 g/dl, after iron supplementation. The basal ferritin, and transferrin saturations ｛TS (%)｝of anemia subjects were 12.51 $\pm$ 15.19 ng/$m\ell$ and 8.43 $\pm$ 7.56%, respectively, and these significantly increased to 20.59 $\pm$ 22.39 ng/$m\ell$ and 15.56 $\pm$ 12.87%, respectively. The level of total iron binding protein (TIBC) significantly decreased from the initial 486.80 $\pm$ 70.16 $\mu\textrm{g}$/dl to 417.86 $\pm$ 67.73 $\mu\textrm{g}$/dl (p < 0.001) after iron supplementation. For the iron deficiency subjects, the ferritin, iron and TS(%) levels were increased significantly (p < 0.001) and the TIBC levels were significantly (p <0.001) decreased after iron supplementation. Anemia symptoms such as 'Feeling blue (p<0.05)', 'Decreased ability to concentrate (p<0.001)' and 'Poor memory (p<0.05)' improved significantly after iron supplementation in the anemia subjects. The number of tablets administered was positively correlated with changes in serum hemoglobin (t=0.194, p< 0.01), serum ferritin (t=0.181, p<0.01), TS(%) (t=0.141, p<0.05), and hematocrit (t=0.254, p<0.01), and was negatively correlated with changes in TIBC (t=-0.143. p<0.05) and red cell distribution width (RDW, t=-0.140, p<0.05). In conclusion, daily iron supplementation was effective in improving the iron status and reducing symptoms of anemia in high school girls. (Korean J Nutrition 35 (9) : 943~951,2002)

• Preventive Nutrition and Food Science
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• v.8 no.4
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• pp.406-411
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• 2003

The objective of this study was to investigate the effects of iron supplementation and nutrition education on the iron status and anemia of middle school girls in Ulsan city in Korea. The subjects were already diagnosed as having anemia (hemoglobin < 12 g/dL) or iron deficiency (ferritin < 12 ng/mL and/or transferrin sataturation < 14 %). Over a period of three months, one iron tablet (80 mg Fe as ferrous sulfate/day) was administered to the iron deficient subjects and two tablets (160 mg Fe as ferrous sulfate/day) were administered to the anemia subjects. Total calorie intake of subjects was 82.1 % of RDA. The iron intake of subjects was 91.3 % of RDA and the Ca intake was 78.8 % of RDA. The basal hemoglobin concentration of subjects averaged 12.8 1.2 g/dL, and this increased significantly (p < 0.001) to 13.2 0.9 g/dL after iron supplementation. The basal ferritin concentrations were 14.9 14.2 ng/mL and these significantly increased to 26.6 19.8 ng/mL (p < 0.001). The level of total iron binding protein (TIBC) significantly decreased from the initial 523.1 108.7 $\mu\textrm{g}$/dL to 462.2 90.2 $\mu\textrm{g}$/dL (p < 0.001) after iron supplementation. Anemia symptoms such as‘Being bruised easily’, ‘Inflamed inner mouth’, and ‘Pale face’ improved significantly after iron supplementation in the subjects. There was a negative correlation between their class & year ranking and serum iron level, transferrin saturation after nutritional education and iron supplementation. It was shown, therefore, that the higher the improvement of their anemia level after iron supplementation, the higher their academic performance. It was shown that there was some improvement of their dietary attitudes after nutritional education, and that their serum level related to anemia symptoms and iron nutrition was improved after iron supplementation.

• Nutrition Research and Practice
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• v.5 no.1
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• pp.40-45
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• 2011

Hemoglobin and zinc protoporphyrin (ZPP) tests are commonly used to screen for iron deficiency, but little research has been done to systematically evaluate the sensitivity and specificity of these two tests. The goal of this study was to evaluate the effectiveness of zinc protoporphyrin/heme (ZPP/H) ratio as a point-of-service screening test for iron deficiency among preschool-aged children by comparing the sensitivity and specificity of hemoglobin, ZPP/H ratio, and serum ferritin (SF). Also completed were assessments for the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) with indicators of ferritin models. This study was carried out with 95 children ages 3 to 6 y. Anthropometric measurements were assessed and blood samples were analyzed for hemoglobin, SF, transferrin saturation (TS), and ZPP. Anemia was common and the prevalences of anemia, ID, and IDA were 14.7%, 12.6%, and 5.2%, respectively. The ZPP/H ratio was strongly and significantly correlated with hemoglobin. And ZPP/H ratio was a more sensitive test for ID than hemoglobin or SF measurement, correctly identifying more than twice as many iron-deficient children (sensitivity of 91.7%, compared to 41.7% for hemoglobin and SF). However, ZPP/H ratio had lower specificity (60.2%, compared to 89.1% for hemoglobin or 96.4% for SF) and resulted in the false identification of more subjects who actually were not iron deficient than did hemoglobin or SF. Low hemoglobin concentration is a late-stage indicator of ID, but ZPP/H ratio can detect ID at early stages and can be performed easily at a relatively low cost. Therefore, ZPP/H ratio can serve as a potential screening test for pre-anemic iron deficiency in community pediatric practices.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.152-161
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• 2019

Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

• Journal of Nutrition and Health
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• v.40 no.5
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• pp.428-434
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• 2007

Cham-dang-gui (Angelica gigas nakai) has been used in traditional Korean medicine to treat hemotological disorders. The purpose of this study is to investigate the hematological effects of water extracts of Cham-dang-gui in rats with anemia induced by iron-free diets. Rats were divided into two groups, a regular diet group (RD) and an iron-free diet group (FeD). The iron-free diet group was then subdivided into the following three treatment groups: saline (1.0 ml/kgBW/day, FeDS), Cham-dang-gui (1.0 g/kgBW/day, FeDA), and iron (iron succinylate 14 mg/kgBW/day, FeDFe) groups. Rats were fed an iron-free diet for 6 weeks to induce iron-deficient anemia, and subsequently underwent the treatments, during which they were fed an iron-free diet for 3 weeks followed by a regular diet for 3 weeks. Body weights of the iron-diet groups (FeDS, FeDA, FeDFe) were lower than that of RD group. The blood levels of Hgb, Hct, MCV, MCH and TIBC were significantly higher in RD and FeDFe groups than those of other groups. The water extract of Cham-dang-gui with iron-free diet has no hematological effects. A regular diet followed by iron-free diets significantly increased blood levels of Hgb, Hct, and MCH.

• Journal of Community Nutrition
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• v.6 no.2
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• pp.86-90
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• 2004

This study was designed to assess the iron nutritional status and anemia of middle school girls in Ulsan City, who were evaluated with a questionnaire, measurement of hematological indices. The average height and weight of respondents were 154.81$\pm$6.28cm and 48.51$\pm$8.80kg, respectively. Mean daily energy intake was 1815.72$\pm$328.04kcal and iron intake was 15.13$\pm$4.50mg. The average hemoglobin concentration of subjects was 11.98$\pm$0.78g/dl, and the average hematocrit level was 36.62$\pm$2.21%. Transferrin saturationTS (%) was 25.58$\pm$9.82%, and the ferritin level was 40.45$\pm$23.03ng/ml. Iron deficiency anemia among the subjects was estimated as 54.2% by using hemoglobin(<12g/이), 33.9% by hematocrit (<36%). The clinical symptoms relating anemia were measured with 4 Likert scale (1 : never, 4 : often), 'tired out easily (2.34$\pm$0.92)' was the highest, followed by 'feel dizzy always (2.26$\pm$0.85)', 'decreasing ability to concentrate (2.23$\pm$0.77)', 'get a cold easily (2.19$\pm$0.82)', 'have a headache (2.10$\pm$0.79)', 'poor memory (2.09$\pm$0.83)', 'no appetite (1.99$\pm$0.85)', As for the correlation between iron parameter and clinical symptoms related to anemia, the hematocrit rate was negatively correlated with 'get a cold easily', 'pale face', 'feeling blue', 'difficult digestion' (p<0.05). The level of iron was negatively correlated with 'tired out easily', 'get a cold easily' (p<0.05) and TS (%) were negatively correlated with 'tired out easily (p<0.05)', 'get a cold easily (p<0.01). Our study resulted that the prevalence of a iron deficiency of a middle school girl is very high, therefore the guidelines for iron supplementation and nutritional education to improve their iron status should be provided.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.168-174
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• 1995

The Plummer - Vinson syndrome Is characteristic difficulty In swallowing, iron defeciency anemia, and upper esophageal or hypopharyngeal web. It is rarely disease in Korea. We have experienced a case of the Plummer-Vinson syndrome, complaining of dysphagia with iron deficient anemia, hypopharyngeal web who was thirty - two years old woman has treated with bullous pemphigoid. The patient has treated sucessfully in the fasion with microsuspentional CO2 Laser for removal of hypopharyngeal web. We report one case with review of the literature.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.7
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• pp.1120-1126
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• 2007

An iron-fortified whey protein concentrate (Fe-WPC) was prepared by addition of ferric chloride to concentrated whey. A large part of the iron in the Fe-WPC existed as complexes with proteins such as ${\beta}$-lactoglobulin. The bioavailability of iron from Fe-WPC was evaluated using iron-deficient rats, in comparison with heme iron. Rats were separated into a control group and an iron-deficiency group. Rats in the control group were given the standard diet containing ferrous sulfate as the source of iron throughout the experimental feeding period. Rats in the iron-deficiency group were made anemic by feeding on an Fe-deficient diet without any added iron for 3 wk. After the iron-deficiency period, the iron-deficiency group was separated into an Fe-WPC group and a heme iron group fed Fe-WPC and hemin as the sole source of iron, respectively. The hemoglobin content, iron content in liver, hemoglobin regeneration efficiency (HRE) and apparent iron absorption rate were examined when iron-deficient rats were fed either Fe-WPC or hemin as the sole source of iron for 20 d. Hemoglobin content was significantly higher in the rats fed the Fe-WPC diet than in rats fed the hemin diet. HRE in rats fed the Fe-WPC diet was significantly higher than in rats fed the hemin diet. The apparent iron absorption rate in rats fed the Fe-WPC diet tended to be higher than in rats fed the hemin diet (p = 0.054). The solubility of iron in the small intestine of rats at 2.5 h after ingestion of the Fe-WPC diet was approximately twice that of rats fed the hemin diet. These results indicated that the iron bioavailability of Fe-WPC was higher than that of hemin, which seemed due, in part, to the different iron solubility in the intestine.

• Journal of Nutrition and Health
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• v.35 no.9
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• pp.919-925
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• 2002

Iron deficiency is a severe nutritional problem in the world. Coffee intake of the people is increasing every year and it can increase the loss of several essential body minerals including iron. Either iron deficiency or coffee intake may increase the oxidative stress of the body. However, the effect of iron deficiency and/or coffee intake on peroxidation have not been studied much. Therefore, the aim of this study was to investigate the effect of coffee intake on oxidative stress and antioxidative enzyme activities of iron-deficient rats. Forty-eight male rats of Sprague-Dawley strain were divided into two groups by dietary iron levels. Iron deficient group were fed 5 ppm iron diet and iron-sufficient group were fed 50 ppm iron diet. Each iron group were divided into three sub-groups by coffee levels (0%, 1%, 4%) included in the experimental diet. The experimental diets were fed for 4 weeks. The hemoglobin level was significantly low in iron deficient group and the level was exacerbated by high coffee intake. The malondialdehyde concentration of the plasma and liver were not affected by iron or coffee level in this study. However, plasma aspartate aminotransferase and alanine aminotransferase, the indicator of the liver damage, were increased by high coffee intake. The erythrocyte and liver superoxide dismutase (SOD) activities were elevated in iron deficient groups. Coffee intake increased erythrocyte SOD activity in iron sufficient groups. Glutathione peroxidase and catalase activities were not influenced much by either iron or coffee intake. In conclusion, high coffee intake in iron deficiency may not only increase the anemia symptoms, but also may increase the oxidative stress of the body.(Korean J Nutrition 35(9) : 919~925, 2002)