The Effects of High Energy and Micronutrient Supplementation on Iron Status in Nutritionally at Risk Infants

The study assessed the effects of supplementary feeding over 180 consecutive days on iron status of infants and toddlers at six tea plantation in West Java, Indonesia. The design used was a clinical trial: two eohorts (i.e., 12 and 18 months old children) and three treatment groups (i.e., energy + micronutrient, micronutrient alone, and placebo) per cohort. Every day except Sunday, the infants attended day-care centers. Twenty four centers and 136 infants were selected. The infants were screened for weight and length and those meeting the criteria (i.e., <-1 SD of length-for-age, and between -1 and -2 SD of weight-for-length of the NCHS reference) were included. The experimental unit was the day-care centers (DCC), where each DCC was randomly assigned to one of the three treatment. As expected, groups of energy + micronutrient and micronutrient alone of the 12 months cohort experienced a significant upward shift in hemoglobin, ferritin and TS and a downward change in FEP, while the values for the group of placebo remain about the same as at base line. In the first 6 month of treatments, the ANOVA for each iron indicator yielded significant main effects of treatment (P<0.01) and for Hb with (P =0.059) on 12 months cohort. On the other hand, the main effects of treatment on hemoglobin, TS, ferritin and FEP were not significant for the 18 months cohort. In the second 6 month of treatments, the only significant of the treatment effect (P<0.01) was in serum ferritin on 18-month cohort. Under these circumstances, energy has a positive role in improving iron stores. It is likely that the equilibrium of hemoglobin and each iron indicators were reached in 6 months of treatment except ferritin still continued to increase up to 12 month. The effects of treatment on the improvement of iron status was stronger in 12 months than in 18 months

Study on Iron Nutritional Status in Adolescence

A study on iron-deficiency anemia (IDA) in adolescence was conducted among 478 teen-age students in Shanghai. The study indicated that the intake of nutrients among the students was generally insufficient. The lack of protein, calcium, Vitamin A, Vitamin B_1, and Vitamin B_2 was more serious. The morbidities of IDA among male and female students were 15.8 and 32.6%, respectively, higher in the female group (P<0.01). The iron-deficiency sufferers among male and female students were 46.8 and 61.8%, respectively, also higher in the female group (P<0.01). The causes of IDA were analyzed by the method of stepwise regression. In a study of the effect of IDA on intelligence and physical development in adolescents, we found that there was no significant effect of IDA on intelligence quotient (IQ) and school performance. However, the speed and endurance capabilities of students of both sexes were correlated directly with hemoglobin level. In female students, the speed capability was correlated directly with the serum ferritin content. On the basis of these findings, a special 3-month school lunch program was initiated. The results indicate that a comprehensive, rational, and balanced diet is beneficial to hemoglobin, free erythrocyte porphyrin, and serum ferritin contents and improves adolescent development. 1990 Academic Press. Inc.

Serum Hepcidin Predicts Uremic Accelerated Atherosclerosis in Chronic Hemodialysis Patients with Diabetic Nephropathy

Background：Hepcidin,as a regulator of body iron stores,has been recently discovered to play a critical role in the pathogenesis of anemia of chronic disease.Atherosclerotic cardiovascular disease is the most common complication and the leading cause of death in chronic hemodialysis （CHD） patients.In the current study,we aimed to explore the relationship between serum hepcidin and uremic accelerated atherosclerosis （UAAS） in CHD patients with diabetic nephropathy （CHD/DN）.Methods：A total of 78 CHD/DN and 86 chronic hemodialyzed nondiabetic patients with chronic glomerulonephritis （CHD/non-DN） were recruited in this study.The level of serum hepcidin-25 was specifically measured by liquid chromatography-tandem mass spectrometry.Serum levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were measured by enzyme-linked immunosorbent assay.Results：High serum level ofhepcidin-25 was seen in CHD patients.Serum hepcidin-25 in CHD/DN was significantly higher than that in CHD/non-DN patients.Serum hepcidin-25 was positively correlated with ferritin,high-sensitivity C-reactive protein （hs-CRP）,TNF-α,and IL-6 in CHD/DN patients.CHD/DN patients exhibited higher common carotid artery intima media thickness （CCA-IMT）,hs-CRP,and hepcidin-25 levels than that in CHD/non-DN patients.Moreover,in CHD/DN patients,CCA-IMT was positively correlated with serum hepcidin,hs-CRP,and low-density lipoprotein-cholesterol.On multiple regression analysis,serum hepcidin and hs-CRP level exhibited independent association with IMT in CHD/DN patients.Conclusions：These findings suggest possible linkage between iron metabolism and hepcidin modulation abnormalities that may contribute to the development of UAAS in CHD/DN patients.