• The Korean Journal of Food And Nutrition
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• v.27 no.3
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• pp.406-413
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• 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%.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.82-93
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• 1994

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was $28.8{\pm}2.0pg$, and MCV was $92.4{\pm}4.7fl$. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were $657.4{\pm}292.0ng/ml$ in men and $511.5{\pm}370g$ in women. Mean valuses of serum iron were $145.5{\pm}63.7{\mu}g/dl$. Mean values of transferrin saturation was $61.6{\pm}28.4%$. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT) hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386)(p<0.05). In conclusion, erythropoietin treatment cna reduce requirement of blood transfusion and transfusion related side effects such as iron overload, hemosiderosis and hemochromatosis.

• Journal of Nutrition and Health
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• v.7 no.3
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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.

• International Journal of Human Ecology
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• v.4 no.1
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• pp.35-44
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• 2003

This study investigated the effects of dietary phyate reduction on the apparent absorption and biochemical parameters of iron status in young Korean women. Fourteen healthy, young women consumed low and high phytate diets for ten days of each experimental period. Duplicate diet samples, a fasting blood sample on day 9, and complete fecal samples for five consecutive days starting from day 5 of each diet period were collected. The iron content of diet and fecal samples were analyzed to calculate apparent absorption. Serum samples were analyzed for iron, ferritin, transferrin receptor and TIBC; transferrin saturation was also calculated. The apparent absorption of iron tended to increase in the low phytate period (32.51%) compared to the high phytate period (17.91%), but the difference was not significant (p=0.06). Serum ferritin decreased and serum transferrin receptor increased significantly during the low phytate diet although the mean values were within the normal range. Serum iron and transferrin saturation did not change significantly. In conclusion, the results indicated that reducing dietary phytate for ten days negatively affected iron nutritional parameters, but it moderately and positively affected apparent iron absorption in young Korean women. Further research on the long-term effects of a low phytate diet with an adequate iron content for vows Korean women is necessary.

• Journal of Nutrition and Health
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• v.3 no.3
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• pp.141-147
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• 1970

Nutritional anemias are an important nutritional problem affecting large population groups in most developing countries. Many reports on investigations of nutritional anemias have been published and there is good evidence that prevalence of iron deficiency anemias in vulnerable groups is high in many areas of the world. However, there is a general lack of accurate data on its prevalence throughout the world. Methods used to measure different factors have been variable and often of poor quality. Furthermore recent comparison of values obtained in different laboratories have shown a much greater discrepancy in iron binding capacity measurements as compared with serum iron determinations. Since the major cause of these differences appears related to the technique employed, the efforts of the central laboratory will be directed initially to standardization of methodology. My laboratory has been joined interlaboratory comparison of WHO studies of iron standardization. The determination of serum iron, iron-binding capacity and transferrin saturation was done on healthy adults, 79 males and 20 females, who visited hospital for health certificate from January to July 1970. The serum iron was determined by the method of modification of Bothwell and Mallett and total iron blinding capacity by Ramsay method and Bothwell and Mallett method. The results of this study are as follows; 1) The serum iron concentration of seventy nine adult male by the method presented is $131.5{\pm}37.3{\mu}g/100ml\;(range\;52.5{\sim}225.0{\mu}g/100ml)$ and of twenty female adult is $108.5{\pm}40.2{\mu}g/100ml\;(range\;45.0{\sim}202.5{\mu}g/100ml)$. 2) The adult male level of serum iron-binding capacity is $330.9{\pm}48.9{\mu}g/100ml\;and\;adult\;female\;is\;291.2{\pm}55.2{\mu}g/100ml$. 3) The transferring saturation of healthy male is $35.6{\pm}12.8%\;(range\;15.1{\sim}18.0%)\;and\;of\;female\;as\;25.4{\pm}12.4%\;(range\;10.1{\sim}60.0)$.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.196-203
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• 2012

Objectives: Even though experimental studies have suggested that iron can be involved in generating oxidative stress, epidemiologic studies on the association of markers of body iron stores with cardiovascular disease or cancer remain controversial. This study was performed to examine the association of serum ferritin and transferrin saturation (%TS) with all-cause, cancer, and cardiovascular mortality. Methods: The study subjects were men aged 50 years or older and postmenopausal women of the Third National Health and Nutrition Examination Survey 1988-1994. Participants were followed-up for mortality through December 31, 2006. Results: Serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality for either men or postmenopausal women. However, all-cause, cancer, and cardiovascular mortality were inversely associated with %TS in men. Compared with men in the lowest quintile, adjusted hazard ratios for all-cause, cancer, and cardiovascular mortality were 0.85, 0.86, 0.76, and 0.74 ($p$ for trend < 0.01), 0.82, 0.73, 0.75, and 0.63 ($p$ for trend < 0.01), and 0.86, 0.81, 0.72, and 0.76 ($p$ for trend < 0.01), respectively. For postmenopausal women, inverse associations were also observed for all-cause and cardiovascular mortality, but cancer mortality showed the significantly lower mortality only in the 2nd quintile of %TS compared with that of the 1st quintile. Conclusions: Unlike speculation on the role of iron from experimental studies, %TS was inversely associated with allcause, cancer and cardiovascular mortality in men and postmenopausal women. On the other hand, serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality.

• Journal of Nutrition and Health
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• v.40 no.4
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• pp.362-370
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• 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
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• v.30 no.8
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• pp.1009-1017
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• 1997

This study was designed to assess the iron nutritional status and growth development of children provided with and without the national school -lunch program(NLSP). The subjects consisted of 590 elementary school children (313 boys, 277 girls) in the 2nd, 4th and 6th grades provided with (n=390) and without (n=200) NSLP. anthropometric measurements were taken for body weight, height, triceps skinfold thickness and body fat percentage. Nutrient intakes were assessed by a modified 24 -hour recall method. Fastinig blood samples were obtained and analyzed for hemoglobin concentration, hematocrit, serum iron and total iron binding capacity. The results obtained are summarized as follows. No significant differences between children provided with and without NSLP were found in height and body weight, but triceps skinfold thickness and body fat(%) were significantly higher in children without NSLP than in those with NSLP. There was no significant difference in hemoglobin concentration and hematocrit between children provided with and without NSLP. However, serum iron concentration and transferrin saturation were higher in the children provided with NSLP(81.9$\mu\textrm{g}$/dl and 22.8%) than in the children without NSLP(73.1$\mu\textrm{g}$/dl and 20.9%). When comparing iron and vitamin C intakes , iron intake was significantly higher in children provided with school-lunch, but vitamin C intake was significantly higher in children provided without school-lunch. Percentages of iron -deficient anemia in underweight, normal and obese children when judged by total iron binding capacity were 14.9%, 12.5% and 25.8% respectively.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.15-19
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• 2015

Purpose: Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. We investigated whether serum sTfR levels can aid in diagnosis and treatment of iron deficiency anemia (IDA) in children. Methods: Ninety-eight patients with IDA were enrolled and were classified according to age at diagnosis. Group 1 comprised 78 children, aged 6-59 months, and group 2 comprised 20 adolescents, aged 12-16 years. Results: In group 1, patients' serum sTfR levels correlated negatively with mean corpuscular volume; hemoglobin (Hb), ferritin, and serum iron levels; and transferrin saturation and positively with total iron binding capacity (TIBC) and red cell distribution width. In group 2, patients' serum sTfR levels did not correlate with ferritin levels and TIBC, but had a significant relationship with other iron indices. Hb and serum sTfR levels had a significant inverse relationship in both groups; however, in group 1, there was no correlation between Hb and serum ferritin levels. In 30 patients of group 1, serum sTfR levels were significantly decreased with an increase in Hb levels after iron supplementation for 1 month. Conclusion: Serum sTfR levels significantly correlated with other diagnostic iron parameters of IDA and inversely correlated with an increase in Hb levels following iron supplementation. Therefore, serum sTfR levels can be a useful marker for the diagnosis and treatment of IDA in children.

• Journal of Nutrition and Health
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• v.27 no.5
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• pp.451-459
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• 1994

This study was performed to investigate the effect of sources of protein on iron bioavailability in 10 healthy young Korean women. The 18-day metabolic study consisted of a 6-day adaptation period, 6-day moderate protein(60g protein/day, 18mg Fe/day) and 6-day high protein period(90g protein/day, 18mg Fe/day). During the moderate and high protein period, 5 subjects were fed the high plant protein meals(80% plant protein). Fecal excretion of dietary iron was significantly higher(p<0.05) in high protein high plant diet group(HPP, 9.48$\pm$1.61mg/day) than in high protein high animal diet group (HPA, 14.40$\pm$0.89mg/day). Apparent absorption and bioavailability of iron was also significantly higher(p<0.10) in HPA(40.7$\pm$5.3%, 6.46$\pm$1.61mg/day) than in HPP(14.4$\pm$5.3%, 2.39$\pm$0.89mg/day). But there was no significant difference between the high animal protein group and high plant protein group in moderate protein period. Serum iron concentration and transferrin saturation increased as animal protein intake increased, from 106.0$\pm$5.1ug/이 and 30.6$\pm$1.5% for MPA to 129.1$\pm$6.7ug/이 and 37.1$\pm$1.3% for HPA. Statistically positive correlations were shown not only between the level of dietary heme iron and apparent absorption(r=0.95, p<0.05), but also between serum iron concentration and apparent absorption(r=0.64, p<0.05). Negative iron balance was shown in two subjects fed the moderate protein meals. These results suggest that recommanded dietary allowances of iron may be under the need to maintain the positive balance, and iron bioavaliability increase by only high level of animal protein intake.