Neurocognitive Function Is Associated With Serum Iron Status in Early Adolescents

Objective: The association between iron and neurocognition remains underexplored in adolescents, and the neurocognitive effects of low and high iron levels have yet to be established. The aim of this study was to investigate the relationships of low and high iron levels with neurocognitive domains in early adolescents. Method: The sample comprised 428 adolescents (12.0 ± 0.4 years) from Jintan, China. Serum iron concentrations were analyzed from venous blood samples and classified into low, normal, and high levels according to the clinical reference range 75–175 μg/dl. Neurocognition was measured by the Penn Computerized Neurocognitive Battery and Wechsler Intelligence Scale. Generalized linear regression was used to analyze relationships. Results: Prevalence rates of iron deficiency, normal iron, and high iron were 13.8%, 76.4%, and 9.8%, respectively. Compared with normal levels, iron deficiency was associated with slower performance in tasks that measured abstraction and mental flexibility (β = 107.5, p = .03) and spatial processing ability (β = 917.2, p = .04). High serum iron was associated with less accuracy in the spatial processing ability task (β = −2.2, p = .03) and a longer reaction time in the task assessing abstraction and mental flexibility (β = 702.8, p = .046) compared to normal levels. Conclusion: Both iron deficiency and high iron levels contribute to reduced neurocognitive performance in a domain-specific manner in early adolescents. The dual burden of iron under- and overnutrition should be incorporated into future interventions for improving brain development and cognitive function in adolescents, especially in a Chinese context.

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Serum Iron Level as a Potential Predictor of Coronavirus Disease 2019 Severity and Mortality: A Retrospective Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa250 ◽

2020 ◽

Vol 7 (7) ◽

Cited By ~ 9

Author(s):

Kang Zhao ◽

Jucun Huang ◽

Dan Dai ◽

Yuwei Feng ◽

Liming Liu ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Iron ◽

Iron Status ◽

Iron Concentration ◽

Iron Level ◽

Serum Iron Level ◽

Amyloid A ◽

Significant Difference ◽

Before And After ◽

Low Serum

Abstract Background Various types of pulmonary diseases are associated with iron deficiency. However, information on iron status in coronavirus disease 2019 (COVID-19) is scarce. Methods This study included 50 hospitalized patients with confirmed COVID-19. The role of serum iron in predicting severity and mortality of COVID-19 was evaluated. Results The most common symptoms of COVID-19 patients in this study were cough (82%), fever (64%), and chest distress (42%). Of the 50 patients, 45 (90%) patients had abnormally low serum iron levels (<7.8 μmol/L). The severity of COVID-19 was negatively correlated with serum iron levels before and after treatment and was positively correlated with C-reactive protein, serum amyloid A, D-dimer, lactate dehydrogenase, urea nitrogen, and myoglobin levels. Decreased serum iron level could predict the transition of COVID-19 from mild to severe and critical illness. Seven (53.8%) patients with a lower serum iron level after treatment in the critical group had died. There was a significant difference in posttreatment serum iron levels between COVID-19 survivors and nonsurvivors. Conclusions Serum iron deficiency was detected in the patients with COVID-19. The severity and mortality of the disease was closely correlated with serum iron levels. Low serum iron concentration was an independent risk factor for death in COVID-19 patients.

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High Prevalence of Iron Deficiency In Anemic and Non Anemic Patients with Various Types of Cancer

Blood ◽

10.1182/blood.v116.21.5145.5145 ◽

2010 ◽

Vol 116 (21) ◽

pp. 5145-5145

Author(s):

Heinz Ludwig ◽

Georg Endler ◽

Brigitte Klement ◽

Wolfgang Hüubl ◽

Tim Cushway

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Multiple Testing ◽

Serum Iron ◽

Iron Supplementation ◽

Complete Blood Count ◽

Clinical Symptoms ◽

Iron Status ◽

Transferrin Saturation ◽

Patients With Cancer

Abstract Abstract 5145 Introduction and aims: Iron deficiency as a major component in the pathogenesis of anemia in cancer is not acknowledged by most oncologists, possibly except when arising from GI blood loss. Iron deficiency is associated with clinical symptoms such as cognitive impairment, fatigue, and reduced exercise performance. New iron formulations are available that allow rapid iron supplementation with single infusions. This treatment could ameliorate symptoms of iron deficiency and correct anemia. Here, we studied iron parameters and their correlation with erythropoiesis and inflammatory markers in a large unselected cohort of patients with cancer. In addition, we investigated the suitability of serum ferritin and transferrin saturation (TSAT) as parameter for assessment of the iron status. Patients and methods: Data from 1627 patients (median age: 66.4 years, range: 20–97 years) presenting sequentially at the Center for Oncology and Hematology, Wilhelminenspital, Vienna between October 01, 2009 and January 26, 2010, have retrospectively been analyzed. Patients were at different stages of their disease or may not have had an established diagnosis at the time of testing. In patients with multiple testing during this period only the first sample taken was included. TSAT (n=1516), serum ferritin (n=887), serum iron, CRP, and complete blood count, were determined by using standard techniques. Commonly used definitions for absolute iron deficiency (AID), [TSAT <20% and serum ferritin <30ng/ml, in case serum ferritin was not available TSAT <10%] and for functional iron deficiency (FID), [TSAT <20% and serum ferritin ≥30ng/ml, in case serum ferritin was not available TSAT between 10 and 20%] have been applied. Fisher's exact test was used for comparison of frequencies and Pearson's product moment correlation coefficient for evaluation of correlation. Results: Table 1 shows the distribution of TSAT and serum ferritin categories in 1627 patients with cancer. AID was found in 116 patients (7.7%) of the 1516 patients for whom TSAT was available. Eighty-three (72%) of the AID patients presented with anemia (defined by hemoglobin <12g/dl). AID was most common in patients with colorectal and pancreatic cancer (12% and 11%, respectively), and not present in patients with testicular and prostate cancer (p=0.013). FID was diagnosed in 530 patients (35%) and 222 (42%) of them were found to be also anemic. Multivariate analysis revealed a statistically significant correlation between TSAT and serum ferritin (R=0.286, p<0.001), serum iron (R=0.874, p<0.001), hemoglobin (R=0.201, p<0.001) and CRP (R=-0.205, p<0.001) (figure 1). Serum ferritin, in contrast, did not correlate with serum iron (R=0.051, p=0.132), but correlated with hemoglobin (R=-0.259, p<0.001), TSAT (R=0.286, p<0.001), and CRP (R=0.396, p<0.001). Conclusion: AID (7.7%) and even more so FID (35%) are frequent co-morbidities in patients with various types of cancer. Seventy-two percent of patients with AID and 42% with FID presented with overt anemia. TSAT correlated closely with serum iron and hemoglobin levels and seems to be the preferred parameter for assessment of iron status in patients with chronic diseases often complicated by increased inflammation. Serum ferritin was found to be an inadequate parameter for assessment and monitoring of iron status. As iron deficiency has been linked with various symptoms, the question arises whether iron supplementation would benefit patients with FID without overt anemia. Future studies should evaluate the role of novel intravenous iron preparations in ameliorating the symptoms of iron deficiency with or without anemia. Disclosures: Klement: Vifor Pharma Ltd: Employment. Cushway:Vifor Pharma Ltd.: Employment.

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Iron Status of Highly Active Adolescents: Evidence of Depleted Iron Stores in Gymnasts

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.10.1.62 ◽

2000 ◽

Vol 10 (1) ◽

pp. 62-70 ◽

Cited By ~ 36

Author(s):

Naama W. Constantini ◽

Alon Eliakim ◽

Levana Zigel ◽

Michal Yaaron ◽

Bareket Falk

Keyword(s):

Iron Deficiency ◽

Female Athletes ◽

Iron Status ◽

Ferritin Level ◽

Venous Blood ◽

Transferrin Saturation ◽

Adolescent Athletes ◽

Male And Female ◽

Tennis Players ◽

Iron Stores

Much attention has focused on the nutrition and hematological profile of female athletes, especially gymnasts. The few studies on iron status of male adolescent athletes found a low incidence of iron deficiency. The present study investigated the iron status of male and female gymnasts (G) and compared it with athletes of other sports. Subjects were 68 elite athletes (43 M, 25 F) ages 12-18, of four sports: gymnasts (11 M, 12 F), swimmers (11 M, 6 F), tennis players (10 M, 4 F), and table tennis players (11 M, 3 F). All lived in the national center for gifted athletes, trained over 25 hr a week, ate in the same dining room, and shared a similar lifestyle. Mean levels of hemoglobin (Hb), red blood cell indexes, serum ferritin, serum iron, and transferrin were measured in venous blood. There was no difference in mean Rb among gymnasts (G) and nongymnasts (NG). However, Hb was less than 14 g/dL in 45% of M G vs. only 25% in NG, and less than 13 g/dL in 25% of premenarcheal FG vs. 15% in NG. Low transferrin saturation (< 20%) was detected in 18% of M G and 25% of FG vs. 6% and 8% in male and female NG, respectively (p < .05). The percentage of males suffering from low ferritin level (< 20 ng/ml) was twice as high in G (36%) vs. NG (19%), and about 30% in all females. In summary, iron stores were consistently lower in M G vs. NG. Adolescent athletes of both genders, G in particular, are prone to nonanemic iron deficiency, which might compromise their health and athletic performance.

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Iron Age or New Age: Ironing out the Diagnosis of Anaemia of Inflammation from Iron Deficiency Anaemia

Blood ◽

10.1182/blood.v126.23.3354.3354 ◽

2015 ◽

Vol 126 (23) ◽

pp. 3354-3354

Author(s):

Nicola J Svenson ◽

Russell Patmore ◽

Heidi J Cox ◽

James R Bailey ◽

Stephen Holding

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Serum Iron ◽

Iron Status ◽

Diagnostic Testing ◽

Transferrin Saturation ◽

Oral Iron ◽

Gastrointestinal Disorders ◽

Serum Hepcidin ◽

Iron Parameters

Abstract Introduction Iron deficiency anaemia (IDA) and anaemia of chronic inflammation (AI) are the most prevalent causes of iron related anaemia in subjects with gastrointestinal disorders contributing significantly to morbidity and mortality. Diagnosis of IDA and AI is not always straight forward and currently a combination of several serum parameters (ferritin, transferrin, transferrin saturation, iron and C-reactive protein) is required. Subjects with a mixed aetiology can be difficult to interpret using traditional serum parameters, particularly in the presence of an inflammatory process. Hepcidin (a 25 amino-acid peptide hormone) in conjunction with reticulocyte haemoglobin equivalent (RetHe) has the potential to differentiate IDA from AI and in cases of mixed aetiology replacing the traditional laboratory parameters (serum iron, CRP, transferrin saturation and ferritin). Aim The aim of the study was to evaluate the performance of a commercially available ELISA assay and investigate whether hepcidin and RetHe can differentiate AI from mixed aetiology. Method The study investigated 77 patients with gastrointestinal disorders associated with anaemia in a secondary care setting using a traditional pathway of 6 tests (figure 1): Complete Blood Count (CBC), Reticulocytes, serum ferritin, CRP, transferrin, serum Iron. Hepcidin concentration was measured using a commercially available ELISA method (DRG Diagnostic GmbH, Marburg, Germany), CBC and RetHe using a Sysmex XE-2100 CBC analyser, iron parameters and CRP using Beckman Coulter platforms. Results Hepcidin correlated well with ferritin R2 = 0.79, p<0.0001. The results were compared to traditional parameters with Receiver Operator Curves (ROC) used to determine diagnostic cut off concentrations (table 1). Table 1. Sensitivity and specificity of serum ferritin and serum hepcidin used to determine diagnostic cut off values. Selected cut off values IDA AI Serum ferritin 30.0µg/L Sensitivity 83% Specificity 64% Sensitivity 55% Specificity 75% Serum hepcidin 8ng/mL Sensitivity 73% Specificity 72% Sensitivity 70% Specificity 67% Serum hepcidin 40ng/mL Sensitivity 98% Specificity 32% Sensitivity 25% Specificity 91% Ferritin was unable to distinguish IDA from AI in mixed aetiology situations. This gives rise to a new proposed 2 step pathway (figure 2) using 3 tests: CBC, RetHe and hepcidin differentiating IDA from AI in mixed aetiology cases indicating the cause of the anaemia. The RetHe value can then be used to predict the response to oral iron. Conclusion Serum hepcidin may not yet replace serum ferritin as the preferred iron status marker, but in conjunction with RetHe it may distinguish mixed aetiology subjects. This offers the potential development of a clearer clinical pathway for investigation of difficult subjects, including reduction in the number of tests required during anaemia investigations and shorter diagnosis times. The advantage of hepcidin together with RetHe over traditional iron parameters is both as a real time marker of iron status and an indication of likelihood of response to iron therapy. The patient would benefit from a shorter recovery time, unnecessary testing, reduction in ineffective treatment and overall reduction in costs. Figure 1. Current diagnostic testing pathway using 6 independent tests with serum ferritin used as the primary indicator of iron stores. Figure 1. Current diagnostic testing pathway using 6 independent tests with serum ferritin used as the primary indicator of iron stores. Figure 2. Suggestion of a new 2 step diagnostic testing pathway with serum hepcidin as the primary indicator and reticulocyte haemoglobin equivalent as the predictor of iron deficiency and response to oral iron. Figure 2. Suggestion of a new 2 step diagnostic testing pathway with serum hepcidin as the primary indicator and reticulocyte haemoglobin equivalent as the predictor of iron deficiency and response to oral iron. Disclosures Patmore: Janssen: Honoraria; Gilead: Honoraria.

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Evaluation of Iron Status in Diabetic CKD Stage 5 Pre- Dialysis Patients

BIRDEM Medical Journal ◽

10.3329/birdem.v3i1.17120 ◽

2013 ◽

Vol 3 (1) ◽

pp. 5-10

Author(s):

Wasim Md. Mohosinul Haque ◽

Arif Mahmud ◽

Muhammad Abdur Rahmin ◽

Jesmin Jahan ◽

Sarker Mohammad Sajjad ◽

...

Keyword(s):

Iron Deficiency ◽

Haemoglobin Level ◽

Serum Ferritin ◽

Serum Iron ◽

Iron Status ◽

Ferritin Level ◽

Negative Relationship ◽

Diabetic Patients ◽

Number Of Patients ◽

Ckd Stage

Objective: To evaluate the iron status among patients with diabetes mellitus and CKD stage 5, who have not started dialysis yet. Methodology: This cross-sectional study was carried on a total of 50 adult diabetic patients with stage 5 CKD, in the Department of Nephrology, BIRDEM General Hospital, Dhaka over 6 months. Results: Total number of patients was 50. Sixty two percent were male and 38% were female. Mean age was 55.22 (range 33-75) years. Mean± SD hemoglobin and ferritin levels were 7.61±2.54 mg/dl and 155.22±92.32 ng/ml respectively. Seventy percent of the study subjects had haemoglobin level d 9 mg/dl. In 48% of the study subjects, ferritin level was less than 100ng/ml. Fourty six percent of the study subjects had TSAT level below 20%. Haemoglobin, serum ferritin and TSAT level in the study subjects had negative relationship with duration of CKD. Haemoglobin and serum ferritin levels were positively correlated with eGFR of the study population. TIBC level had negative relationship with haemoglobin level which was statistically significant. Serum iron, ferritin and TSAT level in the study subjects were positively correlated with haemoglobin level. Relationship of haemoglobin with serum iron and TSAT level was statistically significant. Statistical analysis showed relationship between eGFR with haemoglobin and serum ferritin level was significant (P<0.05). Conclusion: Most of the diabetic CKD stage 5 patients had reduced hemoglobin level and iron deficiency is one of the contributory factors and TSAT is the better indicator for iron deficiency than serum iron, TIBC and ferritin level. Birdem Med J 2013; 3(1): 5-10 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17120

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Serum Iron Profile in Chronic Renal Failure Patients

Ibrahim Cardiac Medical Journal ◽

10.3329/icmj.v2i2.52849 ◽

2012 ◽

Vol 2 (2) ◽

pp. 8-13

Author(s):

Md Helal Miah ◽

Md Zakir Hossain ◽

Bidhu Bhusun Das ◽

Md Mokhlesur Rahman Sarker ◽

Sumanta Kumar Saha ◽

...

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Iron Deficiency ◽

Renal Insufficiency ◽

Serum Iron ◽

Binding Capacity ◽

Iron Status ◽

Research Centre ◽

Iron Deficient ◽

Iron Profile

Background & objective: Chronic Renal Failure (CRF) is a serious condition with a worldwide impact. Anemia is a common complication of CRF leading to significant morbidity. Iron deficiency may be a contributing factor for developing anemia in CRF patients. It may be particularly problematic during erythropoietin therapy. This study was intended to find the serum iron status in CRF patients. Method: This cross sectional study was conducted on 100 consecutive patients of CRF in the Department of Medicine, Rangpur Medical College & Hospital, Rangpur and Hypertension & Research Centre, Rangpur between July 2010 to June 2012. Result: 40% of the patients were 40-59 years old, 28% were 20 - 39 years and 32% >60 years old. Males were predominant (64%) than the females (36%). None of the biochemical variables (serum creatinine, haemoglobin and serum iron profile), except total iron binding capacity (TIBC) differ by sex. TIBC was significantly higher in females than that males (p = 0.029). Of the 100 patients 40% were iron deficient; of them 12(30%) had absolute iron deficiency and 28(70%) relative iron deficiency. Iron deficiency was not influenced by sex (p = 0.519). It was not even affected by the degree of renal insufficiency (p = 0.524). However, the incidence of severe anemia increases significantly with the degree of renal insufficiency (p = 0.037). Conclusion: Serum iron profile remains normal in most of the cases of CRF patients. It should be investigated in every CRF patients before deciding for iron therapy. Ibrahim Cardiac Med J 2012; 2(2): 8-13

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Correlation between vivax malaria infection and iron deficiency in children

Paediatrica Indonesiana ◽

10.14238/pi55.1.2015.44-9 ◽

2015 ◽

Vol 55 (1) ◽

pp. 44

Author(s):

Desmansyah Desmansyah ◽

Rini Purnamasari ◽

Theodorus Theodorus ◽

Sulaiman Waiman

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Vivax Malaria ◽

Malaria Infection ◽

Serum Iron ◽

Iron Status ◽

Transferrin Saturation ◽

Hemoglobin Level ◽

Ferritin Concentration ◽

Iron Deficient

Background Iron deficiency is considered to be a major public health problem around the world due to its high prevalence as well as its effect on growth, development, and infection-resistance in children. In malaria-endemic areas, malaria infection is thought to contribute to the occurrence of iron deficiency, by means of hepcidin and hemolysis mechanisms. Objective To assess the prevalence of asymptomatic vivax malaria, compare hemoglobin levels and iron status parameters between vivax malaria-infected and uninfected children, assess the prevalence of iron deficiency, and evaluate a possible correlation between vivax malaria infection and iron deficiency. Methods This cross-sectional study was conducted from February to April 2013 at Sanana City of Sula Islands District, North Maluku. Six parameters were evaluated in 5-11-year-old children: malaria parasite infection, hemoglobin level, serum iron concentration, total iron-binding capacity (TIBC), serum transferrin saturation, and serum ferritin concentration. Results Among 296 children aged 5-11 years, 75 (25.3%) were infected with Plasmodium vivax. In infected children, hemoglobin, serum iron, transferrin saturation, TIBC and serum ferritin were significantly lower than in non-infected children (P<0.01). Using a serum ferritin cut-off of <15 μg/dL, 142 (48.0%) of the children were found to be iron deficient. There was a strong correlation between vivax malaria infection and iron deficiency (OR 3.573; 95%CI 2.03-6.29). ConclusionThe prevalence of asymptomatic vivax malaria infection was 25.3%. The hemoglobin level and iron status parameters in vivax malaria-infected subjects were significantly lower than in uninfected children. The prevalence of iron deficiency was 48.0% for all study subjects. Malaria vivax infection was correlated with iron deficiency in 5-11-year-old children at Sanana City.

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The iron content of finger-nails in iron deficient patients

Clinical Science ◽

10.1042/cs0720669 ◽

1987 ◽

Vol 72 (6) ◽

pp. 669-672 ◽

Cited By ~ 11

Author(s):

M. Djaldetti ◽

P. Fishman ◽

J. Hart

Keyword(s):

Iron Deficiency ◽

Iron Content ◽

Serum Iron ◽

Distribution Curve ◽

Iron Status ◽

X Ray ◽

Healthy Women ◽

Iron Deficient ◽

Cu And Zn

1. The content of S, Ca, Fe, Cu and Zn in the finger-nails of 17 women with iron deficiency was examined by X-ray microanalysis and compared with that of 17 healthy women. 2. The values for all these elements were similar in both groups. The distribution curve for iron was also similar in both patients and controls. There was no correlation between the iron content of the finger-nails and the serum iron or haemoglobin levels. 3. It is suggested that the iron content of the finger-nails in iron deficient patients does not reflect their iron status.

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Schistosoma japonicum Reinfection after Praziquantel Treatment Causes Anemia Associated with Inflammation

Infection and Immunity ◽

10.1128/iai.00757-06 ◽

2006 ◽

Vol 74 (11) ◽

pp. 6398-6407 ◽

Cited By ~ 58

Author(s):

Tjalling Leenstra ◽

Hannah M. Coutinho ◽

Luz P. Acosta ◽

Gretchen C. Langdon ◽

Li Su ◽

...

Keyword(s):

Iron Deficiency ◽

Schistosoma Japonicum ◽

Iron Status ◽

Venous Blood ◽

The Philippines ◽

Hemoglobin Level ◽

Deficiency Anemia ◽

Old Patients ◽

Positive Treatment ◽

The Impact

ABSTRACT There is a relationship between schistosomiasis and anemia, although the magnitude and exact mechanisms involved are unclear. In a cohort of 580 Schistosoma japonicum-infected 7- to 30-year-old patients from Leyte, The Philippines, we evaluated the impact of reinfection with S. japonicum after treatment with praziquantel on the mean hemoglobin level, iron-deficiency (IDA) and non-iron-deficiency anemia (NIDA), and inflammatory markers. All participants were treated at baseline and followed up every 3 months for a total of 18 months. At each follow-up, participants provided stools to quantify reinfection and venous blood samples for hemograms and measures of iron status and inflammation. After 18 months, reinfection with S. japonicum was associated with a lower mean hemoglobin level (−0.39 g/dl; 95% confidence interval [95% CI], −0.63 to −0.16) and 1.70 (95% CI, 1.10 to 2.61) times higher odds of all-cause anemia than those without reinfection. Reinfection was associated with IDA for high reinfection intensities only. Conversely, reinfection was associated with NIDA for all infection intensities. Reinfection was associated with serum interleukin-6 responses (P < 0.01), and these responses were associated with NIDA (P = 0.019) but not with IDA (P = 0.29). Our results provide strong evidence for the causal relationship between S. japonicum infection and anemia. Rapidly reinfected individuals did not have the positive treatment effect on hemoglobin seen in nonreinfected individuals. The principle mechanism involved in S. japonicum-associated anemia is that of proinflammatory cytokine-mediated anemia, with iron deficiency playing a role in high-intensity infections. Based on the proposed mechanism, anemia is unlikely to be ameliorated by iron therapy alone.

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Reducing iron deficiency anaemia due to heavy menstural blood loss in Nigerian rural adolescents. Reprinted from Public Health Nutrition Volume 1 (4), 249–257, 1998

Public Health Nutrition ◽

10.1079/phn2005818 ◽

2005 ◽

Vol 8 (5) ◽

pp. 451-460

Author(s):

Fiona Barr ◽

Loretta Brabin ◽

Shola Agbaje ◽

Feikumo Buseri ◽

John Ikimalo ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Iron ◽

Iron Deficiency Anaemia ◽

Iron Status ◽

Transferrin Saturation ◽

Cultural Barriers ◽

Menstrual Disorders ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Deficiency Anaemia

AbstractObjectiveMenstrual disorders are common in young women, and heavy menstrual blood losses (MBL) are an important cause of anaemia. Menstrual morbidity normally goes untreated in developing countries where cultural barriers also serve to make the problems. We investigated the prevelance of menstrual morbidity, and measured MBL and its relationship to iron deficiency in a rural adolescent population. The rationale was to assess whether or not reducing heavy MBL could be part of a strategy to reduce iron deficiency anaemia.SettingRural village in south-east Nigeria.DesignCross-sectional survey.SubjectsThe studdy included all non-pregnant, unmarried nulliparous girls (< 20 years) who had menstruated, and who lived in K'Dere village.MethodsA field worker allocated to each girl completed a questionnaire, and supervised recovery and collection of soiled pads and ensured blood sampling. MBL was measured using the standard alkaline haematin method. Haemoglobin (HB), serum iron, transferin saturation and protoporphyrin levels (ZPP) were also measured.Results307 girls completed MBL measurements; 11.9% refused to participate. 12.1% had menorrhagia (> 80 ml);. median MBL was 33.1 ml. Menorrhagia was more frequent in girls who had menstruated for > 2 years (p = 0.048), and had longer duration of meneses (p < 0.001). Iron status as measured by haematocrit, serum iron, transferrin saturation and ZPP values was inversely related to MBL. Neither height nor body mass index for age was associated with current iron status.ConclusionsThe level of menorrhagia detected (12%) may be an ‘expected’ level for a condition which often has no underlying pathology. Heavy MBL is one of the most important factors contributing to iron deficiency anaemia. Measures are needed to alleviate menstrual disorders and improve iron status. Oral contraceptives can be part of a strategy to reduce anaemia, particularly for adolescents at high risk of unwanted pregnancies.

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