ANEMIA, IRON DEFICIENCY, AND IRON DEFICIENCY ANEMIA IN 12–36-MO-OLD CHILDREN FROM LOW-INCOME FAMILIES

Julie M Schneider, Mary L Fujii, Catherine L Lamp, Bo Lonnerdal, Kathryn G Dewey and Sheri Zidenberg-Cherr

American Journal of Clinical Nutrition, Vol. 82, No. 6, 1269-1275, December 2005

Background

Iron deficiency (ID) is the most common nutritional deficiency in the world and remains relatively common in at-risk groups in the United States. The actual prevalence of anemia, ID, and iron deficiency anemia (IDA) in California remains unclear.

Objective

The objective was to determine the prevalence of anemia, low iron stores, ID, and IDA in children participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) population, and to assess the value of using hemoglobin to predict ID.

Design

This was a cross-sectional study of a convenience sample of 12–36-mo-old children from WIC clinics in 2 California counties.

Results

The prevalence of anemia was 11.1% (hemoglobin <110 g/L at 12–24 mo or <111 g/L at 24–36 mo). Study- and literature-determined abnormal values for iron measures were as follows: serum ferritin 8.7 or <10.0 µg/L, serum transferrin receptor 8.4 or >10.0 µg/mL, and transferrin saturation 13.2% or <10.0%, respectively. The prevalences of low iron stores (low ferritin) were 24.8% and 29.0%, of ID (2 abnormal iron measures) were 16.2% and 8.8%, and of IDA (ID with low hemoglobin) were 3.4% and 3.2% on the basis of study- and literature-determined cutoffs, respectively. Hemoglobin concentration was used to predict study- and literature-determined ID on the basis of receiver operating characteristic curves. The sensitivity of low hemoglobin in predicting study- and literature-determined ID was low (23.2% and 40.0%, respectively).

Conclusions

Anemia and ID were prevalent in this WIC sample, but IDA was uncommon. Low hemoglobin is a poor predictor of ID.

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