title: The effect of alcohol consumption on the prevalence of iron overload, iron deficiency, and iron deficiency anemia.
abstract: OBJECTIVE
  Our aim was to investigate the relationship between alcohol consumption and iron overload, iron deficiency, or iron deficiency anemia in the U.S. population.
  
  
  METHODS
  Adult participants of the Third National Health and Nutrition Examination Survey who did not consume alcohol (n = 8839) were compared with participants who consumed < or =1 (n = 4976), >1 to < or =2 (n = 1153), or >2 (n = 915) alcoholic drinks/day during the preceding 12 months. We examined the following markers of iron overload: elevated serum transferrin-iron saturation (TS) level (>45%, >50%, and >60%), elevated serum ferritin level (>300, >400, >500, and >600 ng/mL), and combinations of both elevated serum TS and ferritin levels. Iron deficiency was defined as the presence of at least 2 of the following: serum ferritin level <12 ng/mL, serum TS level <15%, and erythrocyte protoporphyrin level >1.24 micromol/L. Iron deficiency anemia was defined as the presence of both iron deficiency and anemia.
  
  
  RESULTS
  Compared with nondrinkers, the prevalence of all markers of iron overload was significantly elevated among those who consumed >2 alcoholic drinks/day after adjusting for potential confounders. Consumption of any amount of alcohol was associated with a 40% reduction in the risk of iron deficiency anemia.
  
  
  CONCLUSIONS
  Consumption of up to 2 alcoholic drinks/day seems to be associated with reduced risk of iron deficiency and iron deficiency anemia without a concomitant increase in the risk of iron overload. Consumption of >2 alcoholic drinks/day is associated with a significant elevation in the risk of iron overload.
authors.affiliation: Department of Medicine and Division of Gastroenterology, University of Washington Medical Center, and VA Medical Center, 1660 S. Columbian Way, Seattle, WA 98108, USA. georgei@medicine.washington.edu
authors.forename: George N
authors.initials: GN
authors.lastname: Ioannou
authors.forename: Jason A
authors.initials: JA
authors.lastname: Dominitz
authors.forename: Noel S
authors.initials: NS
authors.lastname: Weiss
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Heagerty
authors.forename: Kris V
authors.initials: KV
authors.lastname: Kowdley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D003677:Deficiency Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D000090463:Iron Deficiencies; D019190:Iron Overload / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers