scholarly journals Prevalence of iron, folate, and vitamin B12 deficiencies in 20 to 49 years old women: Ensanut 2012

2015 ◽  
Vol 57 (5) ◽  
pp. 385 ◽  
Author(s):  
Teresa Shamah-Levy ◽  
Salvador Villalpando ◽  
Fabiola Mejía-Rodríguez ◽  
Lucía Cuevas-Nasu ◽  
Elsa Berenice Gaona-Pineda ◽  
...  

 Objective. To describe the prevalence of iron, folate, and B12 deficiencies in Mexican women of reproductive age from the National Health and Nutrition Survey (Ensanut) 2012.Materials and methods. Data came from a  ationalprobabilistic survey, representative from rural and urban areas,and different age groups. Blood samples were obtained from 4 263, 20 to 49 years old women for serum ferritin, vitamin B12 and serum folate oncentrations. The prevalence of deficiencies, was assessed using adjusted logistic regression models. Results. The deficiency of folate was 1.9% (95%CI1.3-2.8), B12 deficiency was 8.5% (95%CI 6.7-10.1) and iron deficiency was 29.4% (95%CI 26.5-32.2). No differences were found when compared with 2006, 24.8% (95%CI 22.3-27.2).Conclusions. The vitamin B12 deficiency is still a problem for women of reproductive age and their offspring in Mexico,while folate deficiency disappeared as a problem. Iron deficiency needs prevention and fortification strategies. 

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Reena Das ◽  
Mona Duggal ◽  
Manmeet Kaur ◽  
Hari Kishan Senee ◽  
Gursharan Singh Dhanjal ◽  
...  

Abstract Objectives To conduct a household and biomarker survey to assess the baseline prevalence of folate deficiency and insufficiency and vitamin B12 deficiency in women of reproductive age prior to the start of a wheat flour fortification program in the Ambala District in Haryana, India. Methods A multistage cluster probability household and biomarker survey was conducted. Participants were women of reproductive age (18–49 y) who were not pregnant and resided in rural areas of two subdistricts in Ambala District in Haryana. Venous blood samples were collected among 866 women. Plasma, serum, and red blood cells (RBC) were separated by centrifugation, processed, and stored at <-80ºC until analysis. RBC and serum folate concentrations were measured using microbiologic assay and serum vitamin B12 was measured via chemiluminescence. Serum folate deficiency was defined as serum folate <7 nmol/L and RBC folate deficiency and insufficiency were defined as RBC folate <305 nmol/L and <748 nmol/L, respectively. Vitamin B12 deficiency was defined as vitamin B12 <200 pg/mL and vitamin B12 marginal deficiency was defined as vitamin B12 ≥200 and <300 pg/mL. Results The geometric mean concentrations for serum folate, RBC folate, and serum vitamin B12 were 12.3 (95% confidence interval [CI]: 11.8, 12.9) nmol/L, 544 (95% CI: 516, 573) nmol/L, and 190 (95% CI: 176, 206) pg/mL, respectively. The prevalence of folate deficiency was 11.3% (95% CI: 9.2, 13.9) for serum folate and 9.7% (95% CI: 7.8, 12.0) for RBC folate, and the prevalence of RBC folate insufficiency was 78.6% (95% CI: 74.8, 82.5). A total of 58.3% (95% CI: 54.2, 62.5) of women were vitamin B12 deficient (<200 pg/mL) and an additional 22.9% (95% CI: 19.7, 26.1) were marginally deficient for vitamin B12. Conclusions The magnitude of folate insufficiency and vitamin B12 deficiency in this Northern Indian population is a substantial public health concern. The findings from the survey help establish the baseline for a planned wheat flour fortification program aimed at reducing these micronutrient deficiencies. Funding Sources Centers for Disease Control and Prevention.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Julia Finkelstein ◽  
Cristina Guitron Leal ◽  
Winnie Chu ◽  
Jesse Krisher ◽  
Jere Haas ◽  
...  

Abstract Objectives To examine the burden of anemia and deficiencies of iron, vitamin B12, and folate in women of reproductive age (WRA) in Ecuador. Methods Data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-ECU) were analyzed to examine the burden of anemia and micronutrient deficiencies among 7658 women of reproductive age (12–49 y; n = 7383 non-pregnant, n = 275 pregnant). Venous blood samples were collected, and hemoglobin (Hb) was assessed viathe sodium lauryl sulfate method. Samples were centrifuged, processed, and stored < -50ºC until analysis. Serum ferritin (SF), vitamin B12, serum folate, and red blood cell (RBC) folate were measured viachemiluminescence. Hemoglobin was adjusted for altitude; and anemia was defined as Hb <11.0 g/dL in pregnant women and <12.0 g/dL in non-pregnant women. Iron deficiency and insufficiency were defined as SF <15.0 µg/L and <20.0 µg/L, respectively. Vitamin B12 deficiency and insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L; and folate deficiency was defined as serum folate <7.0 nmol/L and RBC folate <342.0 nmol/L. Survey logistic and linear regression were used to examine associations of micronutrients with hemoglobin concentrations and anemia. Results In analyses among non-pregnant women, 11.3% were anemic, 14.4% were iron deficient, and 21.1% had iron insufficiency. A total of 4.3% of women had vitamin B12 deficiency, 23.9% had vitamin B12 insufficiency; and <1% of women were folate deficient. The prevalence of micronutrient deficiencies was higher in pregnant women, compared to non-pregnant women: 31.1% of pregnant women were iron deficient, 43.0% were iron insufficient, 21.3% were vitamin B12 deficient, and 55.4% were vitamin B12 insufficient. In non-pregnant WRA, higher SF (P < 0.0001), vitamin B12 (P < 0.01), and serum folate (P < 0.0001) concentrations were associated with higher Hb concentrations; and higher SF (OR: 0.96, 95% CI: 0.95, 0.97; P < 0.0001) and serum folate (OR: 0.98, 95% CI: 0.97, 0.98; P < 0.0001) concentrations were associated with lower odds of anemia. In pregnant women, SF (P < 0.01) and serum folate (P = 0.002) concentrations were associated with higher hemoglobin concentrations. Conclusions Findings suggest that the burden of anemia, iron deficiency, and vitamin B12 insufficiency is high among women of reproductive age in Ecuador. Funding Sources Not applicable.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 646-646
Author(s):  
Heather Guetterman ◽  
Krista Crider ◽  
Amy Fothergill ◽  
Beena Bose ◽  
Christina Johnson ◽  
...  

Abstract Objectives To examine the burden of metabolic outcomes and associations of vitamin B12 status with metabolic health in women of reproductive age (WRA), as part of a population-based biomarker survey in Chittoor, India. Methods Participants (980 WRA; 15–40y nonpregnant or lactating) were assessed for glycated hemoglobin (HbA1c; nephelometry) and serum vitamin B12 concentrations (chemiluminescence). Anthropometric measurements and systolic (SBP) and diastolic (DBP) blood pressures were collected in triplicate. Bioelectrical impedance analysis was used to evaluate whole body (WF%) and trunk (TF%) fat among women ≤ 18y. We defined elevated HbA1c as ≤ 6.5% and ≤ 5.7-&lt; 6.5%, and hypertension as stage 1 (SBP 130–139 or DBP 80–89 mmHg) and stage 2 (SBP ≤ 140 or DBP ≤ 90 mmHg). Vitamin B12 was natural logarithmically transformed prior to analyses; vitamin B12 deficiency was defined as &lt; 148 pmol/L. Linear and binomial regression models were used to examine associations of vitamin B12 status with metabolic outcomes. Results A total of 23.3% of adult WRA were overweight (body mass index (BMI): 25.0 to &lt; 30.0 kg/m2) and 9.7% had obesity (≤30.0 kg/m2). Waist circumference (WC; ≤88.9 cm) and waist-hip ratio (WHR; ≤0.85) were elevated in 13.4% and 20.1% of adult WRA. One-fourth of WRA had elevated HbA1c (≤6.5%: 5.0%; ≤5.7-&lt; 6.5%: 20.0%), and 18.6% had hypertension (stage 1: 16.4%; stage 2: 2.2%); 48.3% of WRA were vitamin B12 deficient. Higher continuous vitamin B12 concentrations were associated with lower BMI (β [standard error (SE)] -0.65 [0.28]) and WF% (-1.01 [0.50]); lower risk of elevated WC (risk ratio (RR) [95% confidence interval] 0.64 [0.49–0.85]); and higher risk of HbA1c ≤ 5.7% (1.19 [1.00–1.41]). Vitamin B12 deficiency was associated with higher BMI (β [SE] 0.98 [0.34], p = 0.004), WC (1.96 [0.76]), WF% (1.75 [0.59]), and TF% (2.03 [0.73]); and higher risk of having overweight (RR: 1.31 [1.09–1.58]), elevated WC (1.85 [1.32–2.60]), and WHR (1.38 [1.07–1.78]). Conclusions The burden of adverse metabolic outcomes was substantial in this population, and vitamin B12 deficiency was associated with central adiposity and overweight. Evaluating the role of vitamin B12 in the development of metabolic outcomes in future studies could inform screening and interventions to improve vitamin B12 status and metabolic health in WRA. Funding Sources Centers for Disease Control and Prevention.


Blood ◽  
1971 ◽  
Vol 38 (5) ◽  
pp. 591-603 ◽  
Author(s):  
J. D. COOK ◽  
J. ALVARADO ◽  
A. GUTNISKY ◽  
M. JAMRA ◽  
J. LABARDINI ◽  
...  

Abstract A collaborative study of nutritional anemia in third trimester pregnancy was performed in seven Latin American countries. Laboratory measurements included hemoglobin level, mean corpuscular hemoglobin concentration (MCHC), serum iron and iron-binding capacity, serum folate, vitamin B12 and albumin. Iron deficiency (transferrin saturation below 15%) was found in 48% of pregnant women, as compared with 21% of nonpregnant females and 3% of male controls of comparable age. The prevalence of folate deficiency (serum folate below 3 ng/ml.) was 10%, 10% and 9% in these three groups, respectively. Vitamin B12 deficiency (serum level below 80 pg/ml.) was found in 15% of pregnant women, but in less than 1% of both control groups. Anemia, as defined by current WHO criteria, was found in 38.5% of pregnant women, 17.3% of nonpregnant women and 3.9% of men. Analysis of the frequency distribution for hemoglobin levels, based on a Gaussian distribution in normal subjects, suggested that a large portion of subjects considered anemic by WHO criteria were normal and that the true incidence of anemia in pregnant and nonpregnant females was 22 and 12% respectively. Correlation analysis indicated that iron deficiency was of major importance as a cause of anemia, while folate lack was contributory only in pregnancy; no relationship could be demonstrated between vitamin B12 deficiency and anemia.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 835-835
Author(s):  
Cristina Güitrón Leal ◽  
Teresa Shamah-Levy ◽  
Juan Rivera Dommarco ◽  
Salvador Villalpando ◽  
Jere Haas ◽  
...  

Abstract Objectives To examine the burden of anemia, iron deficiency, and vitamin B12 deficiency in children under 5 in Mexico. Methods Data from the recently completed National Health and Nutrition Survey (ENSANUT 2018) were analyzed to examine the burden of anemia and micronutrient deficiencies in children under 5 (1 to &lt;5 years). Hemoglobin (Hb) concentrations werequantified in capillary blood samples (n = 3144) via HemoCue.Venous blood samples (n = 1019) were collected, centrifuged, processed, and stored &lt;−80°C until analysis of micronutrient biomarkers. Serum ferritin (SF), C-reactive protein (CRP), and vitamin B12 concentrations were measured via immunoassays. Hemoglobin was adjusted for altitude; anemia was defined as hemoglobin &lt;11.0 g/dL. Iron deficiency was defined as serum ferritin &lt;12.0 µg/L and iron insufficiency was defined as serum ferritin &lt;20.0 µg/L; inflammation was defined as CRP concentrations &gt; 5.0 mg/L (and CRP &gt; 1.0 mg/L). Iron deficiency anemia was defined as hemoglobin &lt;11.0 g/dL and serum ferritin &lt;12.0 μg/L. Vitamin B12 deficiency and vitamin B12 insufficiency were defined as &lt;148.0 and &lt;221.0 pmol/L, respectively. Survey frequency procedures were used to examine the prevalence of anemia and micronutrient deficiencies; survey linear and logistic regression were used to examine associations of micronutrient biomarkers with hemoglobin concentrations and odds of anemia. Results A total of 22.9% of children were anemic in this population. In the biomarker sub-sample, 10.0% of children were iron deficient (SF &lt; 12.0 µg/L), and 29.9% had serum ferritin concentrations &lt;20.0 µg/L. A total of 9.5% of children had CRP concentrations &gt;5.0 mg/L, and 34.7% had CRP &gt; 1.0 mg/L. The prevalence of vitamin B12 deficiency (vitamin B12 &lt; 148.0 pmol/L) was 5.4% and 21.5% of children had vitamin B12 insufficiency (vitamin B12 &lt; 221.0 pmol/L). Conclusions Findings suggest that the burden of anemia and iron and vitamin B12 insufficiency is high in young children in Mexico. Funding Sources ENSANUT was funded by The Ministry of Health of Mexico.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Heather Guetterman ◽  
Bryan Gannon ◽  
Saurabh Mehta ◽  
Marshall Glesby ◽  
Julia Finkelstein

Abstract Objectives To 1) examine the burden of vitamin B12 deficiency, 2) determine the effects of recombinant growth hormone and rosiglitazone on vitamin B12 status, and 3) investigate vitamin B12 status as a risk factor for changes in insulin sensitivity (SI) and visceral adipose tissue (VAT), among HIV-infected patients with insulin resistance and visceral adiposity participating in a randomized controlled trial. Methods Participants were 72 HIV-infected adults (median [IQR]: 48 [43, 53] y) with insulin resistance and visceral adiposity who participated in a 12-week randomized trial of recombinant growth hormone (GH) and rosiglitazone (R). Venous blood samples were collected at baseline, 4, and 12 weeks, and samples were centrifuged, processed, and stored <−80°C until analysis. Total vitamin B12, methylmalonic acid (MMA), homocysteine, and serum folate were measured in a subset. Vitamin B12 deficiency and insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L, respectively. Elevated MMA was defined as >0.26 µmol/L.Generalized estimating equations were used to evaluate the effects of treatment on vitamin B12 status. Generalized linear models were used to assess the associations of vitamin B12 concentrations with SI and VAT. Results A total of 2.3% of patients were vitamin B12 deficient and 13.6% were vitamin B12insufficient at baseline (median [IQR]: 419.8 [287.0, 538.6] pmol/L); 5.4% had elevated MMA concentrations. The GH + R intervention significantly lowered vitamin B12 concentrations at 4 (β: −66.6, 95% CI: −119.6, −13.6, P = 0.01) and 12 (β: −73.3, 95% CI: −117.8, −28.7, P = 0.001) weeks, compared to placebo. The GH-only intervention significantly lowered vitamin B12concentrations at 12 weeks (β: −89.1, 95% CI: −143.0, −35.3, P = 0.001), compared to placebo. Vitamin B12 concentrations did not significantly change in the R-only group. There were no significant changes in MMA concentrations. Vitamin B12 concentrations at baseline were not significantly associated with changes in SI or VAT (P > 0.05). Conclusions The prevalence of vitamin B12 deficiency was low in HIV-infected individuals with insulin resistance and visceral adiposity. However, interventions containing recombinant growth hormone decreased vitamin B12 status during follow-up. Funding Sources BG was supported by NIH/NCATS Grant # TL1-TR-002386; Division of Nutritional Sciences, Cornell University.


2017 ◽  
Vol 55 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Mahmoud Arshad ◽  
Sara Jaberian ◽  
Abdolreza Pazouki ◽  
Sajedeh Riazi ◽  
Maryam Aghababa Rangraz ◽  
...  

Abstract Background. The association between obesity and different types of anemia remained uncertain. The present study aimed to assess the relation between obesity parameters and the occurrence of iron deficiency anemia and also megaloblastic anemia among Iranian population. Methods and Materials. This cross-sectional study was performed on 1252 patients with morbid obesity that randomly selected from all patients referred to Clinic of obesity at Rasoul-e-Akram Hospital in 2014. The morbid obesity was defined according to the guideline as body mass index (BMI) equal to or higher than 40 kg/m2. Various laboratory parameters including serum levels of hemoglobin, iron, ferritin, folic acid, and vitamin B12 were assessed using the standard laboratory techniques. Results. BMI was adversely associated with serum vitamin B12, but not associated with other hematologic parameters. The overall prevalence of iron deficiency anemia was 9.8%. The prevalence of iron deficiency anemia was independent to patients’ age and also to body mass index. The prevalence of vitamin B12 deficiency was totally 20.9%. According to the multivariable logistic regression model, no association was revealed between BMI and the occurrence of iron deficiency anemia adjusting gender and age. A similar regression model showed that higher BMI could predict occurrence of vitamin B12 deficiency in morbid obese patients. Conclusion. Although iron deficiency is a common finding among obese patients, vitamin B12 deficiency is more frequent so about one-fifth of these patients suffer vitamin B12 deficiency. In fact, the exacerbation of obesity can result in exacerbation of vitamin B12 deficiency.


Blood ◽  
1976 ◽  
Vol 48 (5) ◽  
pp. 669-677 ◽  
Author(s):  
DR Clarkson ◽  
EM Moore

Abstract Alterations in reticulocyte size occur 2–3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2–3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size.


Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2557 ◽  
Author(s):  
Martín-Masot ◽  
Nestares ◽  
Diaz-Castro ◽  
López-Aliaga ◽  
Alférez ◽  
...  

Celiac disease (CD) is a multisystemic disorder with different clinical expressions, from malabsorption with diarrhea, anemia, and nutritional compromise to extraintestinal manifestations. Anemia might be the only clinical expression of the disease, and iron deficiency anemia is considered one of the most frequent extraintestinal clinical manifestations of CD. Therefore, CD should be suspected in the presence of anemia without a known etiology. Assessment of tissue anti-transglutaminase and anti-endomysial antibodies are indicated in these cases and, if positive, digestive endoscopy and intestinal biopsy should be performed. Anemia in CD has a multifactorial pathogenesis and, although it is frequently a consequence of iron deficiency, it can be caused by deficiencies of folate or vitamin B12, or by blood loss or by its association with inflammatory bowel disease (IBD) or other associated diseases. The association between CD and IBD should be considered during anemia treatment in patients with IBD, because the similarity of symptoms could delay the diagnosis. Vitamin B12 deficiency is common in CD and may be responsible for anemia and peripheral myeloneuropathy. Folate deficiency is a well-known cause of anemia in adults, but there is little information in children with CD; it is still unknown if anemia is a symptom of the most typical CD in adult patients either by predisposition due to the fact of age or because biochemical and clinical manifestations take longer to appear.


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