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. 2022 Jul 1;14(1):e2022054.
doi: 10.4084/MJHID.2022.054. eCollection 2022.

Prevalence of Anemia, Iron Deficiency, Iron Deficiency Anemia and Diagnostic Performance of Hematologic and Biochemical Markers of Sideropenia in 1- to 5-Year-Old Children in Thrace Greece

Panagiota Zikidou  1 , Christina Tsigalou  2 , Gregorios Trypsianis  3 , Alexandros Karvelas  2 , Aggelos Tsalkidis  1 , Elpis Mantadakis  1
Affiliations

Prevalence of Anemia, Iron Deficiency, Iron Deficiency Anemia and Diagnostic Performance of Hematologic and Biochemical Markers of Sideropenia in 1- to 5-Year-Old Children in Thrace Greece

Panagiota Zikidou et al. Mediterr J Hematol Infect Dis. .

Abstract

Background and objective: Iron deficiency (ID) is a major public health problem with high prevalence in early childhood. We assessed the prevalence of anemia, ID, and iron deficiency anemia (IDA) in healthy children of Thrace, Greece, its correlation with several factors, and evaluated the diagnostic performance of hematologic and biochemical markers of sideropenia.

Patients and methods: For 202 healthy children 1-5 years old, a questionnaire was filled out describing their nutritional habits during infancy and early childhood. Venous hemograms along with serum ferritin, TIBC, %TS, and CRP were obtained from all studied children. In a subset of 156 children, the concentration of sTfR was also determined.

Results: Children with ID and IDA had significantly lower beef consumption than children without sideropenia (p=0.044). Using the WHO cutoff values of Hb <11g/dl and ferritin <12μg/l, the prevalence of anemia, ID, and IDA was 9.41%, 6.44%, and 3.47%, respectively. If Hb <12g/dl and ferritin<18μg/l were used as cutoffs, the prevalence of anemia, ID, and IDA was 26.73%, 16.33%, and 5.94%, respectively. ROC analysis revealed that at ferritin <12μg/l, the AUC of sTfR alone (0.827) was substantially better than that of TIBC (0.691), while at serum ferritin cutoff of 18μg/l, the AUC of TIBC (0.770) was better than that of sTfR (0.716).

Conclusions: The prevalence of ID and IDA in children 1-5 years old in Thrace is like in other developed countries. The chosen cutoff of serum ferritin affects the evaluation of the diagnostic significance of the different sideropenia markers.

Keywords: Anemia; Ferritin; Iron deficiency; Iron deficiency anemia; Sideropenia biomarkers.

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Conflict of interest statement

Competing interests: The authors declare no conflict of Interest.

Figures

Figure 1
Figure 1
ROC analysis for the evaluation of the diagnostic significance of transferrin saturation (%TS), total iron binding capacity (TIBC), soluble transferrin receptors (sTfR), ratio of soluble transferrin receptors to log ferritin (sTfR/Fer index), and hemoglobin (Hb) in children 1–5 years old, when ferritin < 12μg/l was used to define iron deficiency.
Figure 2
Figure 2
ROC analysis for the evaluation of the diagnostic significance of transferrin saturation (%TS), total iron binding capacity (TIBC), soluble transferrin receptors (sTfR), ratio of soluble transferrin receptors to log ferritin (sTfR/Fer index), and hemoglobin (Hb) in children 1–5 years old, when ferritin <18μg/l was used to define iron deficiency.
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