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Han, Hong, Son, Choi, Hyun, and Kim: Iron Status in Korean Middle School Students and Possible Association with Obesity
Original Article

Korean J Hematol 2005;40(3):159-166.

Published online: 21 September 2005

DOI: https://doi.org/10.5045/kjh.2005.40.3.159

Iron Status in Korean Middle School Students and Possible Association with Obesity

Seung Jeong Han, M.D.1, Young Jin Hong, M.D.1, Byong Kwan Son, M.D.1, Jong Weon Choi, M.D.2, In Young Hyun, M.D.3, Soon Ki Kim, M.D.1

1Department of Pediatrics, Inha University College of Medicine, Incheon, Korea

2Department of Laboratory Medicine, Inha University College of Medicine, Incheon, Korea

3Department of Nuclear Medicine, Inha University College of Medicine, Incheon, Korea

Correspondence to: Seung Jeong Han, M.D. Department of Pediatrics, Inha University College of Medicine 7-206, 3-ga, Sinheung-dong, Jung-gu, Incheon 400-103, Korea Tel: +82-32-890-2843, Fax: +82-32-890-2844 E-mail: cozyi@freechal.com

Received 13 July 2005       Revised 10 September 2005       Accepted 10 September 2005

Copyright © 2005 Korean Society of Hematology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Iron deficiency (ID) in Korean adolescents still remains a problem. This study aimed to assess the prevalence of iron status and investigate the relationship between the iron status and obesity.

Methods

Hematological examinations were performed on apparently healthy 12～14 year old students (M: F=451: 442) living in Incheon during September, 2004. ID was defined as a serum ferritin concentration ＜10ng/mL. The diagnosis of iron deficiency anemia (IDA) was established when anemia (male ＜12.5g/dL, female ＜12g/dL) was associated with a ferritin level ＜10ng/mL and/or transferrin saturation ＜16%. Using age- and gender-specific BMI percentiles, overweight was defined as a BMI=85th percentile.

Results

The prevalence of ID and IDA were 8.4 and 15.6% and 0.9 and 4.5% in males and females, respectively. Using an analysis based on the BMI, the prevalence of obesity were 21.8 and 16.2% in males and females, respectively. The prevalence of ID in male students was decreased in the obesity (0.0%) compared with the non-obesity group (11.4%). In female students, ID showed a higher frequency in the non-obesity (20.4%) compared with the obesity group (12.0%).

Conclusion

Iron deficiency still remains a major nutritional problem in adolescent females, with the prevalence of obesity significantly increasing. Although no association between the prevalence of iron deficiency and obesity was shownin this study, it is important to screen for iron deficiency and obesity, and provide effective nutritional education. Furthermore, the association of obesity with iron deficiency in relation to eating behavior should be investigated.

Keywords: Anemia, Iron deficiency, Adolescents, Serum ferritin, Transferrin saturation, Obesity

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Fig. 1.
Prevalence of anemia in females aged 12 to 14 years.
kjh-40-159f1.tif
Fig. 2.
Prevalence of iron deficiency in females aged 12 to 14 years.
kjh-40-159f2.tif
Fig. 3.
Prevalence of IDA in females aged 12 to 14 years.
kjh-40-159f3.tif
Table 1.
Trends in iron status among 12～14 year old Korean adolescents between 1996 to 2004
  Hemoglobin (g/dL) Hematocrit (%) Iron (μg/dL) TIBC (μg/dL) TS (%) Ferritin (ng/dL)
1996
 M (n= 79) 13.7± 0.8 40.6± 2.5 127.6± 43.0 387.9± 47.7 29.3± 12.2 26.1± 16.9
 F (n= 87) 13.1± 0.7 39.0± 2.0 99.4± 34.9 387.8± 45.5 36.9± 13.2 22.7± 14.2
2000
 M (n= 193) 13.8± 0.9 40.8± 2.5 n/a n/a 33.6± 12.7 16.8± 9.7
 F (n= 164) 13.0± 0.9 38.6± 2.5 n/a n/a 30.1± 11.9 13.1± 9.2
2004
 M (n= 451) 14.6± 1.0 43.6± 2.7 98.0± 32.6 362.9± 33.8 30.2± 16.8 27.7± 19.0
 F (n= 442) 12.6± 1.2 38.2± 3.0 88.5± 34.2 356.7± 33.4 20.7± 12.2 24.7± 15.6

Mean± SD. Abbreviations: TIBC, total iron binding capacity; TS, transferrin saturation; n/a, not available.

Table 2.
Iron status according to BMI
  Hemoglobin (g/dL) Iron (μg/dL) TIBC (μg/dL) Ferritin (ng/mL) TS (%) C holesterol (mg/dL)
BMI＜85
 M (n= 114) 13.95± 1.2 98.85± 38.1 360.46± 38.1∗ 28.62± 32.8 27.57± 11.2 154.17± 30.3†
 F (n= 129) 13.42± 1.0 93.34± 41.6 365.54± 37.2 22.49± 17.0 25.74± 11.4 172.95± 30.1
BMI≥85
 M (n= 32) 14.18± 1.5 95.72± 45.2 374.75± 37.8∗ 35.46± 19.8 25.68± 12.6 164.69± 37.8†
 F (n= 25) 13.13± 1.2 91.24± 37.9 369.24± 46.3 24.73± 26.8 24.73± 10.0 161.84± 49.2

† P= 0.05. Mean± SD, ∗P= 0.02, Abbreviations: See Table 1; BMI, body mass index.

Table 3.
Prevalence of Iron deficiency according to BMI
  IDA ID without Anemia ID
BMI＜85
 M (n= 114) 2 (1.8%) 11 (9.6%) 13 (11.4%)
 F (n= 129) 6 (4.7%) 20 (15.5%) 26 (20.2%)
BMI≥85
 M (n= 32) 0 (0.0%) 0 (0.0%) 0 (0.0%)
 F (n= 25) 1 (5.0%) 2 (8.0%) 3 (12.0%)

Abbreviations: IDA, iron deficiency anemia; ID, iron deficiency; BMI, body mass index.

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