• Journal of Nutrition and Health
• /
• v.26 no.6
• /
• pp.692-702
• /
• 1993

To evaluate iron nutritional status and to compare biochemical indices used for evaluation of iron nutriture, fasting blood sample was taken from 96 Korean female college student and hemoglobin(Hb) concentration, hematocrit(Hct), serum iron, total iron binding capacity(TIBC) and serum ferritin concentration were measured and transferrin(TF) saturation was calculated. Prevalence of iron deficiency varied from 4.2% when judged from Hb concentration and Hct to 38.5% and 40.6% when TIBC and serum ferritin concentration were used. TIBC was negatively correlated with serum ferritin(r=0.4561, p<0.001), while other indices showed positive but less significant correlations(p<0.05). Regarding iron status judged by serum ferritin was regarded as true iron status, the present cutoff points of Hb, Hct, serum iron, TF saturation were very insensitive in identifying the subjects with iron deficiency. Only TIBC was suitable for detecting iron deficiency in the study subjects. It is concluded from the study results that iron deficiency in young Korean adult women would be significantly underestimated with presently used biochemical measurements except TIBC and new cutoff points of these indices were proposed based on sensitivity, specificity measured prevalence, and positive and negative predictive values.

• Journal of Nutrition and Health
• /
• v.32 no.8
• /
• 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.

• Journal of Nutrition and Health
• /
• v.33 no.5
• /
• pp.532-539
• /
• 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
• /
• v.25 no.5
• /
• pp.404-412
• /
• 1992

Iron intake and nutritional status of 99 female college students of Chungnam Natiional Unive-rsity were estimateed with dietary survey and measurement of hematological indices including the level of serum ferritin Food intake was measured using the weighing method and iron availability per meal was calculated according to Monsen and Hallberg. The average daily intakes of protein vitamin C. total iron and also total available amount of iron were higher than the Korean R.D.A. The blood indices for iron status however showed that iron status of the subjects was inade-quate. Furthermore the serum ferritin levels indicated marginal iron storage in 75% of the subjects.

• Korean Journal of Community Nutrition
• /
• v.7 no.5
• /
• pp.686-695
• /
• 2002

The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships bet-ween the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preform delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in NT group (32.1 $\pm$ 21.1 ng/ml, 68.5 $\pm$ 16.7 $\mu$g/g), than those of NT group (20.8 $\pm$ 11.6 ng/ml, 53.2 $\pm$ 17.4 $\mu$/g) respectively (p<0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 $\pm$ 65.7 ng/ml, NT : 147.0 $\pm$ 56.8 ng/ml) than those of PT group (p<0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.

• Journal of the East Asian Society of Dietary Life
• /
• v.22 no.4
• /
• pp.463-472
• /
• 2012

This study was performed to investigate the iron status and its related factors in female college students residing in Gyeongnam. The prevalence of iron deficiency among subjects ranged from 3.4% in mean corpuscular hemoglobin concentration (MCHC) to 43.7% in ferritin. Weight, lean body mass (LBM) and body mass index (BMI) were positively correlated with ferritin concentration, but negatively correlated with total iron binding capacity (TIBC). Among the nutrients, vitamin A and B2 were major predictors of elevated iron status. Meal regularity was positively correlated with Fe and ferritin concentration, and meal number with transferrin saturation (TS), meal quantity with red blood cell (RBC) and hematocrit (Hct). Consumption of fruit, meat, fish and poultry showed strong positive correlation with hematological indices. Therefore, increasing vitamin A, B2, C, and iron intakes as well as maintenance of a healthy weight may be helpful in preventing iron deficiency in female college students.

• Journal of Nutrition and Health
• /
• v.38 no.7
• /
• pp.533-543
• /
• 2005

The purpose of this study was to determine the iron status of preschool children in Ulsan, Korea. The study was con-ducted using 95 children aged 3 to 6 years by investigating the anthropometric indices and assessing the dietary intakes and biochemical analysis. A questionnaire for dietary intakes using 24-hr recall method were carried out by the mothers of the 95 subjects. And also a study was conducted to assess hematological and biochemical status of iron and prevalence of iron deficiency. The average height and weight were 105.4 $\pm$ 7.0 cm, 18.7 $\pm$ 3.2 kg in boys, 103.8 $\pm$ 6.7 cm, 17.6 $\pm$ 2.7 kg in girls. These were lower than the body growth standard values of Korean pediatrics. There was not a significant difference in both between boys and girls. For the daily nutrient intake, energy was 1201.5 $\pm$ 280.9 kcal (79.3$\%$RDA), protein was 63.8 $\pm$ 28.2 g (219.4$\%$RDA), iron was 11.9 $\pm$ 4.5 mg (133.2$\%$RDA). The iron nutritional status by hematological assay found that Hct was 34.7 $\pm$ 2.0 ($\%$), Hb was 12.0 $\pm$ 0.8 g/dl, RBC was 4.3 $\pm$ 0.3 ($10^6/{\mu}l$), MCV was 80.5 $\pm$ 3.0 fL, MCH was 27.8 $\pm$ 1.1 pg and MCHC was 34.6 $\pm$ 0.6 g/dl. The biochemical measurement of serum iron was 75.6 $\pm$ 30.3 ${\mu}g$/dl, TIBC was 320.3 $\pm$ 34.1 ${\mu}g$/dl, serum ferritin was 30.0 $\pm$ 14.8 ${\mu}g$/dl, Zinc-Protophor-phyrin (ZPP) was 32.7 $\pm$ 8.0 ${\mu}g$/dl, and ZPP/Heme was 71.1 $\pm$ 19.5 ($\mu$mole/mol heme). The prevalence with Hct, Hb, TS and serum ferritin less than cut-off value was $8.4\%,\;9.5\%,\;12.6\%$ and $4.4\%$ respectively. But the prevalence of iron deficiency estimated with ZPP and ZPP/Heme criteria were $25.3\%$ and $27.4\%$, and were higher than in case of any other indices. The prevalence of iron deficiency anemia ((low Hb (< 11.0 g/dl) and low serum ferritin (< 10 ${\mu}g$/L) or low TS (3-4 yews: < $12\%$, 5-6 years: < $14\%$)) was found in only one 3 year old girl. The prevalence of iron deficiency except Hct and Hb was the highest in 3 year group, but the prevalence by Hct and Hb was the highest in 5 year group. Iron deficiency and iron deficiency anemia do not seem to be a major public health problem in preschool children in Ulsan.

• Korean Journal of Community Nutrition
• /
• v.9 no.2
• /
• pp.142-150
• /
• 2004

To increase both iron and enhancers for iron absorption through diets should be a basic strategy to sufficiently provide increased iron for pregnancy. Previous studies reported that iron intakes of Korean pregnant women were short and their iron status deteriorated as pregnancy progressed. However, there is little data about the bioavailability of dietary iron during pregnancy. Therefore, this study was conducted to determine the changes of dietary iron intakes, its bioavailability and iron status during pregnancy longitudinally in Korean women. A total of 151 pregnant women in their first trimester of pregnancy voluntarily participated. Among them, 72 women finished the research protocol during the second trimester and 55 did it during the third trimester. Dietary intakes of total iron, both non-heme and heme iron, as well as enhancers, both MPF (meat, poulty, and fish) and vitamin C, increased significantly as pregnancy progressed. As the results, bioavailability of dietary iron and iron absorbed increased significantly as pregnancy progressed. However, the amount of iron absorbed at each trimester did not meet considerably the iron needed during pregnancy. All five indices examined in the study, Hb level, Hct, serum concentrations of ferritin and sTfR (soluble transferrin receptor), and sTfR: ferritin ratio, showed that iron status of the subjects deteriorated as pregnancy progressed. The rate of anemia of the subjects increased as pregnancy progressed although more than 80% of the subjects took iron supplements after the 20th week of pregnancy. These results imply that it is needed to provide more iron especially, heme iron and dietary enhancers to prevent the deterioration of iron status during pregnancy. Future research on bioavailability of supplemental iron should be performed to determine the iron balance precisely.

• Nutrition Research and Practice
• /
• v.1 no.1
• /
• pp.52-56
• /
• 2007

This research analyzed the iron status, clinical symptoms and physical characteristics between normal and anemic group of middle school girls in the Ulsan metropolitan area. It was carried out with 237 subjects (normal 190, anemic subject 47). They were evaluated with a questionnaire and measurement of hematological indices. BMI $(kg/m^2)$ of the two groups were $19.54{\pm}2.44$ (normal girls) and $19.22{\pm}2.27$ (anemic girls). The hemoglobin concentration of the anemic girls were $10.84{\pm}1.17g/dl$ and the serum iron of the anemic girls represent $35.15{\pm}27.47{\mu}g/100ml$. The TIBC (Total Iron Binding Capacity) of the anemic girls showed significantly high to $449.30{\pm}64.87{\mu}g/100ml$. The serum ferritin of the anemic girls was $20.53{\pm}42.29{\mu}g\ell$, it represented significantly low. The symptom of 'pale face' of the anemic girls were higher than the normal girls. Hemoglobin and serum iron were negatively correlated with 'pale face'. The TIBC was negatively correlated with 'Get a cold easily'. The duration and amount of menstruation were correlated with iron status. This research is to be utilized as basic data for dietary support and nutritional education to improve their iron status.

• Journal of Nutrition and Health
• /
• v.36 no.6
• /
• pp.646-652
• /
• 2003

This study was performed to determine the iron status of the adolescent Korean girls before and after menarche. The 101 subjects aged 11-13 years who attending in an elementary school in Mokpo were recruited. They were divided into pre-menarche (A) group or post-menarche (B) group based on their menstruation status. The latter subjects were sub-divided into one of the four groups according to the times of their menstruation B-I( $\geq$ 3 times), B-II (4-6 times), B-III (7-9 times) or B-W ( $\geq$ 10 times). In the total subjects, dietary iron intake, 11.3 mg/day, was below the Korean RDA for iron, the percentage of heme iron to total iron intake, 15%, and the bioavailability of dietary iron, 12.3%, seemed to be low. And their body iron storage, 140.8 mg, seemed to be insufficient. However, they tended to meet body's iron requirement in the cell level. Red blood cell number (RBC), hematocrit (Hct), and hemoglobin (Hb) level in the total subjects were 4.5 1012/I, 39.3%, and 13.0 g/㎗, respectively. The subjects in B group had lower (p<0.05) RBC and Hct compared to those in A group and the prevalence of iron-deficiency anemia tended to be high. Serum iron, ferritin, and soluble transferrin receptor (sTfR) and sTfR:ferritin ratio were 86.7 $\mu\textrm{g}$/d, 17.6 $\mu\textrm{g}$/l, 3.58 mg/1, and 230, respectively. Those four indices were not significantly different among the groups. The results of this study imply that, although there a tendency to affect negatively iron status, menstrual blood loss in adolescent females does not deteriorate obviously their iron status during the relatively short period up to 1 you. However, it should be better to improve their iron status after starting menarche by increasing iron intake, especially heme-iron, and enhancing factors for iron absorption.