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Multicenter Study
. 2011 Mar;65(3):340-9.
doi: 10.1038/ejcn.2010.279. Epub 2011 Jan 19.

Evaluation of iron status in European adolescents through biochemical iron indicators: the HELENA Study

M Ferrari  1 , L Mistura, E Patterson, M Sjöström, L E Díaz, P Stehle, M Gonzalez-Gross, M Kersting, K Widhalm, D Molnár, F Gottrand, S De Henauw, Y Manios, A Kafatos, L A Moreno, C Leclercq; HELENA study group
Collaborators, Affiliations
Free PMC article
Multicenter Study

Evaluation of iron status in European adolescents through biochemical iron indicators: the HELENA Study

M Ferrari et al. Eur J Clin Nutr. 2011 Mar.
Free PMC article

Abstract

Background/objectives: To assess the iron status among European adolescents through selected biochemical parameters in a cross-sectional study performed in 10 European cities.

Subjects/methods: Iron status was defined utilising biochemical indicators. Iron depletion was defined as low serum ferritin (SF<15 μg/l). Iron deficiency (ID) was defined as high-soluble transferrin receptor (sTfR>8.5 mg/l) plus iron depletion. Iron deficiency anaemia (IDA) was defined as ID with haemoglobin (Hb) below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged ≥15 years. Enzyme linked immunosorbent assay was used as analytical method for SF, sTfR and C-reactive protein (CRP). Subjects with indication of inflammation (CRP >5 mg/l) were excluded from the analyses. A total of 940 adolescents aged 12.5-17.49 years (438 boys and 502 girls) were involved.

Results: The percentage of iron depletion was 17.6%, significantly higher in girls (21.0%) compared with boys (13.8%). The overall percentage of ID and IDA was 4.7 and 1.3%, respectively, with no significant differences between boys and girls. A correlation was observed between log (SF) and Hb (r = 0.36, P < 0.01), and between log (sTfR) and mean corpuscular haemoglobin (r = -0.30, P < 0.01). Iron body stores were estimated on the basis of log (sTfR/SF). A higher percentage of negative values of body iron was recorded in girls (16.5%) with respect to boys (8.3%), and body iron values tended to increase with age in boys, whereas the values remained stable in girls.

Conclusions: To ensure adequate iron stores, specific attention should be given to girls at European level to ensure that their dietary intake of iron is adequate.

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Figures

Figure 1
Figure 1
Cumulative percentage distributions of estimated body iron in boys and girls from the HELENA Study. Total body iron was estimated using the formula: body iron (mg/kg)=−(log(sTfR:ferritin ratio)−2.8229)/0.1207 developed by Cook (1999) Positive values indicate the presence of storage iron, whereas negative values indicate tissue ID.
Figure 2
Figure 2
Distribution of body iron stores by age in boys and girls in the HELENA Study.
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