The role of Lactobacillus reuteri DSM 17938 for the absorption of iron preparations in children with iron deficiency anemia

Abstract

Purpose: To determine whether Lactobacillus reuteri DSM 17938 plays a role in absorption of iron preparations given to children with iron deficiency anemia (IDA).

Methods: We performed a quasi-experimental study involving pre- and postintervention tests using a control group in North Sulawesi province, Indonesia, between July and September 2017. We conducted a single-blind controlled trial that included primary school children who were diagnosed with IDA based on reticulocyte hemoglobin equivalent (Ret-He) levels <27.8 pg/L.

Results: A total of 66 children were randomized into 2 groups. Thirty-four children received iron preparations with the addition of L. reuteri DSM 17938 (group 1), whereas the other 32 received iron preparations alone (group 2). The baseline Ret-He levels before intervention were similar in both groups. After 14 days of intervention, mean Ret-He level in group 1 changed from 24.43±1.64 to 28.21±1.72 pg/ L (P=0.000). Mean Ret-He level in group 2 changed from 24.31±1.42 to 27.03±2.14 pg/L (P=0.000). Statistical analysis showed a significant increase in Ret-He levels in both groups; Ret-He levels were significantly higher in the experimental group than in the control group (P<0.05).

Conclusion: Children with IDA receiving iron preparations with L. reuteri DSM 17938 for 14 days show higher Ret-He levels than those receiving iron preparations alone.

Keywords: Anemia; Child; Iron deficiency; Lactobacillus reuteri.

Fig. 1.

Study enrollment. We included 72 children with iron deficiency anemia who were then evaluated for reticulocyte hemoglobin equivalent (Ret-He) levels. Four children were excluded for the reasons mentioned above, leaving a total of 68 children. They were divided into 2 different groups receiving different interventions, as mentioned. After 14 days of intervention, Ret-He levels were examined again. Two children were excluded because their parents refused to allow blood sampling in the second stage. The data of a total of 66 children were finally analyzed.