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. 2025 Apr 3;25(1):272.
doi: 10.1186/s12887-025-05639-z.

Impact of inflammation on anemia in children: a cross-sectional study

Luiz Felipe de Paiva Lourenção  1   2 , Fabíola Isabel Suano-Souza  3 , Fernando Luiz Affonso Fonseca  4 , Tânia Mara Rodrigues Simões  5 , Rosangela da Silva  5 , Roseli Oselka Saccardo Sarni  3
Affiliations

Impact of inflammation on anemia in children: a cross-sectional study

Luiz Felipe de Paiva Lourenção et al. BMC Pediatr. .

Abstract

Introduction: The association of inflammation and iron deficiency could be related to up to 40% of anemia in young children.

Objective: To describe the anemia and iron deficiency in children and verify possible associations with dietary practices, nutritional status and inflammatory markers.

Methods: This cross-sectional study was conducted with one hundred and twelve children aged between 6 months and 3 years in Early Childhood Education Centers in Minas Gerais, Brazil. Nutritional status regarding iron and inflammatory markers was assessed using the reference values proposed by the World Health Organization.

Results: Anemia and iron deficiency were observed in 58 (51.8%) and 89 (79.5%), respectively, of children evaluated. Hemoglobin values were directly associated with the z-score of height for age after adjusting for high-sensitivity C-reactive protein values (β-adjusted = 0.375; 95% CI 0.088 to 0.662; p = 0.011). The values of high-sensitivity C-reactive protein correlated directly with RDW (r = 0.202; p = 0.033), ferritin (r = 0.425; p < 0.001) and soluble transferrin receptor (r = 0.446; p < 0.001), and inversely with hemoglobin (r = -0.287; p = 0.002), serum iron (r = -0.580; p < 0.001) and transferrin saturation index (r = -0.528; p < 0.001). The ROC curve shows that RDW (AUC = 0.708; CI 95% 0.612 to 0.803) and soluble transferrin receptor (AUC = 0.588; 95% CI 0.481 to 0.694) were the variables that showed the better level of discrimination of anemia.

Conclusions: The prevalence of anemia was higher than in national studies, and there was a correlation between inflammatory markers and biomarkers of iron nutritional status.

Keywords: Anemia; Food and nutrition security; Inflammation; Nutritional status; Pediatrics.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Federal University of São Paulo Human Research Ethics Committee approved the study under CAAE number 28398719.0.0000.5505, in compliance with the principles of the Declaration of Helsinki. The parents and guardians agreed to participate and signed the Informed Consent Form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for recruiting study participants
Fig. 2
Fig. 2
Association between hemoglobin levels and height-for-age Z score, adjusted for high-sensitivity C-reactive protein values
Fig. 3
Fig. 3
ROC curve of variables associated with anemia
Fig. 4
Fig. 4
Correlation between inflammation biomarkers (High-sensitivity C-reactive protein and Alpha-1 Acid Glycoprotein) with hemoglobin, ferritin, serum iron, transferrin saturation index, soluble transferrin receptor and RDW
See this image and copyright information in PMC

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