title: Iron deficiency in blood donors: analysis of enrollment data from the REDS-II Donor Iron Status Evaluation (RISE) study.
abstract: 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.
authors.affiliation: New England Region, American Red Cross Blood Services, Farmington, Connecticut 06032 USA. cabler@usa.redcross.org
authors.forename: Ritchard G
authors.initials: RG
authors.lastname: Cable
authors.forename: Simone A
authors.initials: SA
authors.lastname: Glynn
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kiss
authors.forename: Alan E
authors.initials: AE
authors.lastname: Mast
authors.forename: Whitney R
authors.initials: WR
authors.lastname: Steele
authors.forename: Edward L
authors.initials: EL
authors.lastname: Murphy
authors.forename: David J
authors.initials: DJ
authors.lastname: Wright
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Sacher
authors.forename: Jerry L
authors.initials: JL
authors.lastname: Gottschall
authors.forename: Vibha
authors.initials: V
authors.lastname: Vij
authors.forename: Toby L
authors.initials: TL
authors.lastname: Simon
mesh_terms: 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
chemical_list: D006454:Hemoglobins; D011990:Receptors, Transferrin; D005293:Ferritins
references.citation: Blood. 1990 May 1;75(9):1870-6
references.pmid: 2331526
references.citation: Blood. 1977 Sep;50(3):441-7
references.pmid: 884321
references.citation: Womens Health Issues. 2004 Nov-Dec;14(6):242-7
references.pmid: 15589775
references.citation: Transfus Med. 1999 Jun;9(2):131-4
references.pmid: 10354382
references.citation: Transfusion. 2002 Jun;42(6):798-805
references.pmid: 12147035
references.citation: Blood. 2006 Mar 1;107(5):1747-50
references.pmid: 16189263
references.citation: Transfusion. 1989 Mar-Apr;29(3):268-72
references.pmid: 2922794
references.citation: JAMA. 1990 Sep 26;264(12):1556-9
references.pmid: 2395196
references.citation: Blood. 1997 Feb 1;89(3):1052-7
references.pmid: 9028338
references.citation: Public Health Nutr. 2009 Oct;12(10):1775-82
references.pmid: 19105865
references.citation: Transfusion. 2006 Oct;46(10):1667-81
references.pmid: 17002622
references.citation: Nat Genet. 1996 Aug;13(4):399-408
references.pmid: 8696333
references.citation: Can Med Assoc J. 1978 Apr 22;118(8):945-6
references.pmid: 647567
references.citation: Transfusion. 2010 Aug;50(8):1794-802
references.pmid: 20412525
references.citation: N Engl J Med. 2005 Apr 28;352(17):1769-78
references.pmid: 15858186
references.citation: Br J Haematol. 2001 Nov;115(2):329-33
references.pmid: 11703331
references.citation: Arterioscler Thromb Vasc Biol. 2005 Aug;25(8):1532-5
references.pmid: 16055755
references.citation: Blood. 1990 Jan 1;75(1):102-7
references.pmid: 2294984
references.citation: JAMA. 1981 May 22-29;245(20):2038-43
references.pmid: 7230400
references.citation: Am J Clin Nutr. 1984 Mar;39(3):437-45
references.pmid: 6695843
references.citation: Transfusion. 2005 Jan;45(1):5-10
references.pmid: 15647011
references.citation: Transfusion. 2008 Oct;48(10):2197-204
references.pmid: 18657084