Distribution of anemia associated with micronutrient deficiencies other than iron in a probabilistic sample of Mexican children.
BACKGROUND
This investigation aims to explore the association among anemia and vitamins A, C, and folate deficiencies in a probabilistic sample of Mexican children.


METHODS
Data on hemoglobin, serum vitamins A and C and folate concentrations and percent transferrin saturation (PTS) in children 0.5-11 years (n = 1,770) were extracted from the database of the probabilistic Mexican National Nutrition Survey 1999 (NNS-99).


RESULTS
Overall, 16.6% of children were anemic. Iron deficiency children with or without anemia had more frequent low serum retinol (40.6 vs. 16% and 27.7 vs. 11.9%, p < 0.05, respectively) and lower hemoglobin folate (11.5 vs. 22%, p < 0.05) than their non-iron deficiency counterparts. Mean concentrations of serum iron (p < 0.01), folate (p < 0.001) and retinol (p < 0.0001), but not ascorbic acid (p < 0.6), were significantly lower in anemic than in nonanemic children. In a linear regression model, 15% of hemoglobin variation in children was explained by retinol, folate and PTS, but not vitamin C (p <0.0001).


CONCLUSIONS
Anemia was mostly associated with iron deficiency and with a lesser proportion of folate and vitamin A deficiencies. Vitamin A deficiency might be overestimated since iron deficiency may lower serum retinol concentrations. Interventions aimed to reduce anemia in this population must consider interactions between those micronutrients in designing strategies.
Villalpando
Salvador
S
Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Mexico. svillalp@insp.mx
Pérez-Expósito
Ana Beatriz
AB
Shamah-Levy
Teresa
T
Rivera
Juan A
JA
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology; D001205:Ascorbic Acid / Q000097:blood; D001206:Ascorbic Acid Deficiency / Q000097:blood / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D008800:Mexico / Q000453:epidemiology; D018977:Micronutrients / Q000172:deficiency*; D008875:Middle Aged; D015995:Prevalence; D012494:Sampling Studies; D014168:Transferrin / Q000032:analysis; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology
D006454:Hemoglobins; D018977:Micronutrients; D014168:Transferrin; D014801:Vitamin A; D002097:C-Reactive Protein; D005492:Folic Acid; D007501:Iron; D001205:Ascorbic Acid