Iron deficiency in blood donors: analysis of enrollment data from the REDS-II Donor Iron Status Evaluation (RISE) study.
BACKGROUND
Regular blood donors are at risk of iron deficiency, but characteristics that predispose to this condition are poorly defined.


METHODS
A total of 2425 red blood cell donors, either first-time (FT) or reactivated donors (no donations for 2 years) or frequent donors, were recruited for follow-up. At enrollment, ferritin, soluble transferrin receptor (sTfR), and hemoglobin were determined. Donor variables included demographics, smoking, dietary intake, use of iron supplements, and menstrual and/or pregnancy history. Models to predict two measures of iron deficiency were developed: Absent iron stores (AIS) were indicated by a ferritin level of less than 12 ng/mL and iron-deficient erythropoiesis (IDE) by a log(sTfR/ferritin) value of 2.07 or greater.


RESULTS
A total of 15.0% of donors had AIS and 41.7% IDE. In frequent donors, 16.4 and 48.7% of males had AIS and IDE, respectively, with corresponding proportions of 27.1 and 66.1% for females. Donation intensity was most closely associated with AIS and/or IDE (odds ratios from 5.3 to 52.2 for different donation intensity compared to FT donors). Being female, younger, and/or menstruating also increased the likelihood of having AIS and/or IDE, as did having a lower weight. Marginally significant variables for AIS and/or IDE were being a nonsmoker, previous pregnancy, and not taking iron supplements. Dietary variables were in general unrelated to AIS and/or IDE, as was race and/or ethnicity.


CONCLUSIONS
A large proportion of both female and male frequent blood donors have iron depletion. Donation intensity, sex and/or menstrual status, weight, and age are important independent predictors of AIS and/or IDE. Reducing the frequency of blood donation is likely to reduce the prevalence of iron deficiency among blood donors, as might implementing routine iron supplementation.
Cable
Ritchard G
RG
New England Region, American Red Cross Blood Services, Farmington, Connecticut 06032 USA. cabler@usa.redcross.org
Glynn
Simone A
SA
Kiss
Joseph E
JE
Mast
Alan E
AE
Steele
Whitney R
WR
Murphy
Edward L
EL
Wright
David J
DJ
Sacher
Ronald A
RA
Gottschall
Jerry L
JL
Vij
Vibha
V
Simon
Toby L
TL
D000328:Adult; D000368:Aged; D001782:Blood Donors; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D011990:Receptors, Transferrin / Q000097:blood
D006454:Hemoglobins; D011990:Receptors, Transferrin; D005293:Ferritins
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