• 대한핵의학회지
• /
• 제10권1호
• /
• pp.21-34
• /
• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제10권1호
• /
• pp.60-65
• /
• 2007

저자들은 가족 내에서 아동학대로 인해 발생한 치명적인 중증 영양실조를 보인 5세 여아에 동반된 빈혈과 구리 결핍증을 WHO 치료 지침과 구리 보충요법으로 호전시킨 1예를 치험하였기에 보고하는 바이다.

• Journal of Nutrition and Health
• /
• 제32권8호
• /
• pp.887-896
• /
• 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.

• 한국식품영양학회지
• /
• 제27권3호
• /
• pp.406-413
• /
• 2014

The objective of this study was to identify the nutritional risk factors by blood analysis, in 1,083 preschool children of age 3 to 6 years. The frequency of anemic children was 7.3% with Hb<11.1 g/dL, 29.9% with ferritin<20 ng/mL, and 16.7% with transferrin Fe saturation(%)<15%. The prevalence of anemia in these children were 12.8% for those with MCV<79 fL, and it was 71% for those with TIBC> $400{\mu}g/dL$. Serum ferritin concentration was 20 ng/mL in the normal children. Thirty two percent of the children had anemia with Hb<12 g/dL, which is below the normal range of Hb. Exactly 15.4% of the children had serum Fe concentration of $60{\mu}g/dL$. The transferrin Fe saturation of the children (16.3%) was >15%. The serum ferritin concentration showed low correlations with Hb, Fe, transferrin Fe saturation, and MCV. The transferrin Fe saturation, higher Hb concentration, MCV, and Hct values were increased significantly. Consequently, iron-deficiency anaemia was thus defined as having Hb concentration <12 g/dL accompanied by ferritin concentration <20 ng/mL or Hct <33%.

• 대한지역사회영양학회지
• /
• 제6권5호
• /
• pp.726-733
• /
• 2001

This study was designed to investigate the effect of iron supplementation on the iron nutritional status and anemia of high school girls in Korea. One hundred thirty-five female students residing in Ulian metropolitan city in Korea diagnosed as having anemia or iron deficiency participated in this study. One or two tablets of iron medicine(80-160 mg Fe as ferrous sulfate/day) were administered to all participants for 3 months. Subjects were evaluated with a questionaire, measurement of hematological indices before and after iron supplementation. The average height and weight of respondents were 161.62 $\pm$ 4.68 cm and 53.87 $\pm$ 6.10 kg, respectively. Daily intakes of energy were 1597.8 $\pm$ 302.35 kcal(76.0% RDA). Iron intakes were 13.72 $\pm$ 4.17 mg (76.3% of RDA) and calcium intakes were 580.74 $\pm$ 177.21(72.5% of RDA) before iron supp]ementation. At baseline, 63% of all participants had depleted store(serum ferritin 12 ug/ml and/or transferrin saturation(TS) < 14%). After iron supplementation, this proportion declined to 19.3%. 55.6% of subjects had 12 ug/m1 of basal ferritin concentration before iron supplementation, and this proportion declined to 16.3% after iron supplementation. The basal hemoglobin(Hb) concentrations were 12.13 $\pm$ 1.01 g/dl and they increased to 12.79 $\pm$ 0.81 g/dl, which showed significant difference artier iron supplementation(p < 0.001). The basal ferritin and TS(%) were 13.24 $\pm$ 11.66 ng/ml, 18.42 $\pm$ 10.12% and they significantly increased to 32.95 $\pm$ 21.14 ng/ml, 33.53 $\pm$ 16.64%, respectively(p < 0.001). The basal total iron binding protein(TIBC) were 467.81 $\pm$ 97.24 ug/dl and they significantly decreased to 325.05 $\pm$ 48.89 ug/dl(p < 0.001) after iron supplementation. The number of tablets administered was positively correlated with serum iron(t = 0.553, p < 0.01), serum ferritin(t = 0.557, p < 0.01), TS(%)(t = 0.588, p < 0.01) and negatively correlated with TIBC(t= -0.409, p <0.01). The anemia symptoms such as ‘Shortening of breath when going upstairs(p < 0.01)’, ‘Tired out easily(p < 0.01)’, ‘Feeling blue(p < 0.001)’, ‘Decreased ability to concentrate(p < 0.01)’, and ‘Poor memory(p < 0.001)’improved significantly after iron supplementation. In this study, daily iron supplementations were efficacious in improving the iron status and anemic symptoms of female high school students. Regular check-ups and nutrition education for adolescents are necessary because of their vulnerability to iron deficiency. Further studies are needed to determine the minimum effective dose of iron and to examine the adverse effect of long-term iron supplementation.

• Clinical and Experimental Pediatrics
• /
• 제54권7호
• /
• pp.282-286
• /
• 2011

Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children's daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

• Journal of Nutrition and Health
• /
• 제36권2호
• /
• pp.191-199
• /
• 2003

This study was conducted to evaluate nutritional status of Korean women of child-bearing age. A comparison was made between 113 non-pregnant and 200 pregnant women. Pregnant women of 24-28 weeks of gestation were recruited from prenatal clinic in Seoul. Nonpregnant women were included college students, nurses, office employers, and sales women. General characteristics, anthropometric measurements, dietary intakes, and hematological values were assessed. There was no difference in mean BMI for nonpregnant and pregnant (pre-gravid) women, which were 20.2 kg/m$^2$and 20.6 kg/m$^2$respectively. The pregnant women showed a tendency of better health-caring behavior, evidenced by stop smoking and drinking, and in taking nutrient supplements. The mean intakes of energy, vitamin A, vitamin B$_2$, calcium, and iron did not meet Korean RDA for adult women. In particular, calcium and iron intakes of both nonpregnant and pregnant women were under 60% of the Korean RDA. Judging by MDA score, dietary quality was better in pregnant than in nonpregnant women. Mean serum values of albumin, total cholesterol, LDL-cholesterol, HDL-cholesterol, Hb, IgA, IgG were in normal range. However, more than 13% of the nonpregnant subjects showed mild hypercholesterolemia (cholesterol > 200 mg/dl) and anemia (Hb < 12.0 g/dl) . The percentage of anemia in pregnant women were much higher; the subject with Hb < 11.0 g/dl were approximately 30%. The pregnant subjects showed significantly higher serum concentrations of triglycerides and cholesterol, and significantly lower concentrations of albumin, IgA, and IgG compared to nonpregnant women. Correlation analysis showed that Hb concentrations were correlated with the intakes of iron- and protein- containing foods such as meat and vegetables. This study strongly suggest that iron-deficient anemia is a major nutrition problem in Korean child-bearing women and this condition is correlated with dietary intakes.

• Journal of Community Nutrition
• /
• 제5권1호
• /
• pp.37-43
• /
• 2003

Iron deficiency and anemia are severe nutrition problems in most of Korea. Iron intake, especially iron with better bioavailability is insufficient over a total age group. Recent changes in diet and life style of Koreans have been repeatedly suggested problems caused by excess nutrient intake rather than under intake. Despite the changes in diet patterns, iron deficient anemia is still prevalent in many parts of Korea. Eight hundred and fifty subjects (323 male and 527 female subjects) in Asan were recruited from farming, factory and urban area. Each subject was interviewed to assess nutrients intakes according to a 24hr-recall method. Twelve hour fasting blood samples were collected to vacutainer with EDTA for hemoglobin (Hb) and separate the tubes for serum iron (SI) and total iron binding capacity (TIBC). The mean serum iron value of female subjects in the factory area was significantly higher (p < 0.05) than that of the female subjects in the urban area although subjects in urban area showed significantly higher the dietary iron intake for both the men and woman (p < 0.05). Dietary iron intake for the younger women was lowest in the farming area and those in the urban area showed the highest dietary iron intake (p < 0.05). When the dietary iron intake was compared by different the age groups, dietary iron intake of the older women from animal sources was less than that of younger women in the urban area (p < 0.05). Dietary iron intake of Asan residents was not sufficient regardless of age, sex and regions and intake of heme iron was especially lower than nonheme iron. (J Community Nutrition 5(1) : 37∼43, 2003)

• Journal of Nutrition and Health
• /
• 제40권4호
• /
• pp.362-370
• /
• 2007

The study was designed to assess the effect of iron and cereal supplementation on children's iron nutritional status in social welfare institutions. Dietary survey was carried out methods of food weighing and record by interview (n=74). A nutritional intervention study was carried out through supplementing iron supplements and cereal for 4 weeks in 4-12 years old children. Children received daily 40 mg elemental Fe as iron protein succinylate (n=23) and 3.6 mg elemental Fe as 100 g cereal (n=24), respectively. Blood samples were drawn before and after supplementation. Nutrients which children's intake was less than two-thirds of the RDA were vitamin A, vitamin B-1, vitamin B-2, calcium and iron. The mean daily intake of iron was 5.1 mg for male and 4.9 mg for female, and 52.3% for male and 45.4% for female of Korean RDA. The proportion of children with iron depletion assessed by TIBC (> 360 ${\mu}g$/dl) and serum ferritin (< 20 ng/ml) were 56.6% and 58.7%, respectively. The proportion of children with the iron deficient erythropoiesis assessed by serum iron (< 70 ${\mu}g$/dl), Hb (< 12 g/dl), Hct (< 36%) were 76.0%, 58.7%, 64.0%, respectively. After iron supplements treatment, Hb (p<0.001), Hct(p<0.001), serum iron (p<0.001), transferrin saturation (p<0.001) and serum ferritin (p<0.Ol) increase significantly and only TIBC decreased slightly. After cereal supplementation, in anemic children, Hct (p<0.001), serum iron (p<0.001) and transferrin saturation (p<0.001) were significantly increased. The effect of iron supplements and cereal supplementation in children with iron deficient erythropoiesis were more effective to improve the iron nutritional status than children with iron depletion. It was concluded that cereal supplementation program in anemic children was also effective to improve iron nutritional status.

• Journal of Nutrition and Health
• /
• 제29권9호
• /
• pp.971-980
• /
• 1996

The soluble transferrin receptor(TfR) in human serum has been shown recently to be a truncated form of intact membrane bound receptor containing most of the extracellular domain. We purfied the transferin-free TfR from human serum by immounoaffinity chromatography which produced the single protein identity in high resolution gel chormatography. The monoclonal antibodies(MAb) against purifed serum TfR were produced by fusion of spleen cells o fimmunized Balb/c mice and SP2 cells. Ten hybrids producing MAb specific for serum TfR were identifed and determine their iostypes. A immunoraddiometric assay (IRMA) for serum TfR was established using two monoclonal IgG1 antibodies as the coating and indicator antibodies on the bosis of their suitability in sandwich IRMA of serum TfR. The mean serum TfR levels in the 15 normal male, 15 normal female, and 19 iron-deficient subjects were 5.4$\pm$0.98, 4.6$\pm$0/76, and 18.0$\pm$12.8mg/1, respectively, and the difference in mean values between normal and iron deficient subjects was significant(p=0.0005). There existed the inverse logarithmic relationship(r=-0.9336, p<0.0001) between the serum TfR and ferritin levels.