• Journal of Nutrition and Health
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• 제7권3호
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• pp.1-13
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• 1974

The relative state of human iron storage may be ascertained more reliably through determination of the serum iron, iron binding capacity, transferrin saturation and absorption of radioactive iron in conjunction with studies of red cell morphology than from the study of red cell morphology alone. Recent investigations have shown that there is an increase in red cell protoporphyrin concentration in iron deficiency anemia. The significance of the red cell protoporphyrin has been discussed greatly during the years since its discovery. Two of the main factors which appear to influence the amaunt of protoporphyrin are increased erythropoiesis and factors interfering with the utilization of iron in the synthesis of hemoglobin, and iron deficiency. Recently Heller et al. have described a simplified method for blood protoporphyrin assay and this technique could be used assess nutritional iron status, wherein even minor insufficiencies are detectable as increased protoporphyrin concentrations. Based on the evaluation of the relationship between nutritional iron status and red cell protoporphyrin as an index suitable for the detection of the iron deficiency is described in this paper. RESULTS 1. Hemoglobin Concentrations and Anthropometric Measurements. The mean and standard deviations of the various anthropometric measurements of different age and sex groups are shown in table 1. There measurements have been compared with the Korean Standard. In the absence of local standards for arm circumference and skin-fold thickness over triceps, they have been compared with the standard from Jelliffe. Table 2,3, and 4 give anthropometric measurements and frequency (%) of anemia in children surveyed. The mean height of the children studid was 10 to 20 percent; below the Korean Standard. The distribution of height below 80 percent of the Standard was 21.2 percent, however, among anemic group this percentage was 27.7 percent. In general, the mean weight of the children was 10 to 15 percent below the Korean Standard. The percentage of children with weight less than 80 percent of the Standard was about 35 percent. But in the anemic group of the children, this percentage was 44 percent. The mean arm circumference was about 15 percent lower than the Jelliffe's standard. 61.2 percent of the children had values of arm circumference below 80 percent of the standard. Children with low hemoglobin levels, this percentage was 80 percent. The mean skinfold thickness over the triceps of the children studied was about 25 Percent lower than the Jelliffe's standard and 61.2 percent of the children had the value less than 80 percent of the standard. Among anemic children, this percentage was 70.8%. As may be seen from table 5, the mean hemoglobin concentration of the total group was 11.3g/100ml. Hemoglobin concentration was less than 11.0g/100ml. in 65(36.5%) of the 178 children. The degree of anemia in most of these children was mild with a hemoglobin level of less than 8.0g/100ml. found in only one child. In general, the prevalence of anemia was high in female children than male and decreased its frequency with increasing age. Relatively close relationship was observed between hemoglobin level and anthrophometric measurements especially high between arm circumference and skinfold thickness and hemoglobin but very low in height and low in weight and hemoglobin level, estimated by chi-square value. II. Serum iron, Transferrin saturation (1) Serum iron, and transferrin saturation Serum iron, transferrin saturation and red cell protoporphyrin concentrations were estimated in sub-sample of 84 children from 1 to 6 years and 24 older children between 7 and 13 years of age. The findings are presented in table 6. The mean serum iron concentration of the total group was 59ug/100ml. However, the level incrased with age from 36.6ug/100ml. (1-3years) to 80.8ug/100ml. (7-13 years). 60 percent of these children had a serum iron level less than 50ug/10ml. in the 1-3 years age group and 31.4 percent for 4-6 years group. These contrast with the finding of 12.5 percent anemic children in the 7-13 years age group. The mean transferrin saturation for the total group was 18.1 percent and frequency of anemia by transferrin saturation was observed same pattern as serum iron concentration. (2) Red cell protoporphyrin concentrations. (a) Red cell protoporphrin levels of children: Red cell protoporphyrin and other biochemical data are shown in table 4. The mean concentration in red cell of all children was fround 46.3ug/100ml. RBC. and differences with age groups were observed; in the age group 1-3 years, the mean concentration was $59.5{\pm}32.14$ ug/100ml. RBC; 4-6 years $44.1{\pm}22.57$ ug/100ml. RBC. and 7-13 years, $39.0{\pm}13.56$ ug/100ml. RBC. (b) Normal protoporphyrin values in adults: It was observed that in 10 normal adult males studied here the level of protoporphyrin in red cell ranged from 18 to 54 ug/100ml. RBC. and the mean concentration was $47.5{\sim}14.47$ ug/100ml. RBC. Other biochemical determination made on the same subjects are presented in table 8. (c) Red tell protoporphyrin concentration of occupational blood donors: The results of analyses for red cell protoporphyrin as well as serum iron, transferrin saturation and hemoglobin in the 76 blood donors are presented in table 7 and 8. In this experiment, donors were selected at random, however, most of them bled repeatedly because of poor economic situation, I doubt. Table 9 shows the distribution of red cell protoporphyrin concentration and hemoglobin concentration of occupational donors. The mean hemoglobin value for the total was 11.9 g/100 ml. When iron deficiency anemia is defined as a transferrin saturation below 15%, prevalence of anemia was 47.4 percent and the mean serum iron was 27.1ug/100ml. and red cell protoporphyrin, 168.3ug/100ml. RBC. However, mean serum iron and protoporphyrin concentration of above 15% transferrin saturation were 11.6 ug/100 ml. and 58.8 ug/100 ml. RBC. respectively. The mean Protoporphyrin concentration of non-anemic (above 15% transferrin saturation) donors was slightly higher than the results of normal adult males.

• Clinical and Experimental Pediatrics
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• 제46권3호
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• pp.271-276
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• 2003

목 적 : G-CSF와 GM-CSF는 과립구생성에 중요한 사이토카인으로서, 각각의 수용체 G-CSFr과 GM-CSFr에 결합하여 기능을 하게 되며, 이들 수용체들은 미성숙 골수 세포로부터 성숙 된 말초 과립구까지 발현된다. 일반적으로 혈중 G-CSF와 GM-CSF의 농도 및 이들 수용체의 발현은 과립구가 증가하는 감염질환에서 변화한다고 알려져 있으나, 백혈구 증가증에서 과립구수 증가와 관련된 변화에 대해서는 아직 연구된 바가 없다. 본 연구에서는 백혈구 증가증 환아와 정상아의 혈중 G-CSF와 GM-CSF의 농도를 측정하고 말초혈액의 과립구 표면에 존재하는 이들의 수용체를 정량분석하였으며, 활동성이 있는 수용체 발현 양에는 어떤 변화가 있는 지를 분석하여 백혈구 증가증 환아의 과립구 수 증가와 G-CSF와 GM-CSF 및 이들 수용체 변화의 관련성을 규명하고자 하였다. 방 법 : 정상 대조군으로서 비감염성 질환으로 입원한 같은 연령대의 아동 중 말초혈액 백혈구 수 및 중성구 수가 정상인 아동 13명과 급성기 초기의 백혈구 증가증 환아 14명, 총 27명의 혈중 G-CSF와 GM-CSF의 농도를 측정하였고 세포표면 G-CSFr와 GM-CSFr의 발현양은 각각 항 G-CSF 수용체 단 클론항체, 항 GM-CSF 수용체 단클론항체와 혼합 후 유세포 분석기를 이용하여 정량적으로 분석하였으며, 활동성 G-CSFr, GM-CSFr의 양적변화를 유세포 분석기를 이용하여 측정하였다. 결 과 : 백혈구 증가증 환아의 총 백혈구 수는 $24,100{\pm}6960/{\mu}L$로 정상 대조군 $8,680{\pm}378/{\mu}L$에 비해 유의하게 증가되었으며 중성구 수는 백혈구 증가증 환아에서 유의하게 증가되어 있었으나($20,800{\pm}2120/{\mu}L$ vs $3,360{\pm}2,120/{\mu}L$) 단구수는 차이가 없었다. 혈중 G-CSF의 농도 $164.0{\pm}187.5pg/mL$는 정상 대조군 $71.9{\pm}94.1pg/mL$과 감소된 경향을 보였으나 통계적으로 유의한 차이가 없었고(P=0.217) 혈중 GM-CSF의 농도도 유의한 차이가 없었다(P=0.968). 백혈구 증가증 환아의 중성구의 G-CSFr 발현양 $963.6{\pm}575.7$은 정상대조군 $1711.1{\pm}452.6$에 비해 유의한 감소를 보였으며(P=0.012), 백혈구 증가증 환아의 중성구의 GM-CSFr의 발현양 $471.7{\pm}217.0$은 정상 대조군의 $854.8{\pm}383.0$과 통계적으로 유의한 차이가 없었다(P=0.220). 항 G-CSFr항체는 수용체가 G-CSF와 결합하고 나면 수용체에 결합하지 못하는 epitope에 대한 항체로 보여지며, 수용체를 포화시키기에 충분한 과량의 CSF와 배양시킨 후 포화농도에도 결합하지 않은 수용체의 양을 측정하면 남은 수용체 즉, 활동성 수용체 수는 감소하게 되는데, 백혈구 증가증 환아에서 과량의 G-CSF에 배양한 후 감소된 중성구 G-CSFr의 발현양은 $407.8{\pm}405.1$로 정상 대조군의 $1,012.2{\pm}488.5$에 비해 유의한 감소를 보였고(P=0.050), 혈중 G-CSF 농도 및 혈중 GM-CSF 농도와 무관하였다(P=0.735, P=0.087). 백혈구 증가증 환아와 정상대조군에서 수용체를 포화시키기에 충분한 과량의 GM-CSF에 배양한 후 중성구의 GM-CSFr의 발현양을 분석한 결과는 발현이 증가된 소견을 보였다. 증가된 중성구의 GM-CSFr의 발현 양은 정상아 및 백혈구 증가증 환아에서 유의한 차이가 없었다(P=0.828). 결 론 : 백혈구 증가증에서는 중성구 수 증가에 의하여 총 백혈구 수가 증가되고 혈중 G-CSF의 농도는 중성구 증가의 원인으로 생각되며 G-CSFr과 결합하여 백혈구 증가증을 일으키는 것으로 보인다. GM-CSF 농도 및 GM-CSFr은 백혈구 증가에 영향을 주지 않음을 알 수 있었다.