title: The influence of vitamin A status on iron-deficiency anaemia in anaemic adolescent schoolgirls in Myanmar.
abstract: OBJECTIVE
  The present study was conducted to investigate reasons for the high prevalence of anaemia among adolescent schoolgirls and to elucidate the role of vitamin A in contributing to Fe-deficiency anaemia (IDA).
  
  
  METHODS
  Among 1269 schoolgirls who were previously screened for anaemia (Hb < 120 g/l), 391 anaemic girls were further assessed for Fe, vitamin A and subclinical inflammation status. Fe and vitamin A indicators were corrected for inflammation and were compared in the Fe-deficient and non-deficient groups as well as between those with and without inflammation. Logistic regression was done to determine whether vitamin A status and subclinical inflammation were risk factors for Fe deficiency. The differences in Fe status among tertiles of vitamin A concentrations were assessed using ANOVA.
  
  
  METHODS
  Myanmar.
  
  
  METHODS
  Adolescent schoolgirls (n 391).
  
  
  RESULTS
  One-third of the anaemia (30·4%) was IDA. Prevalence of low vitamin A status (serum retinol <1·05 μmol/l) was 31·5%. Fe and vitamin A status were significantly different between the IDA and non-IDA groups and also based on their inflammation status. Logistic regression showed that low vitamin A status was a significant predictor for being Fe deficient (OR = 1·81; 95% CI 1·03, 3·19 and OR = 2·31; 1·31, 4·07 in the middle (1·056-1·298 μmol/l) and low (≤1·056 μmol/l) vitamin A tertiles, respectively). ANOVA showed that better Fe status was associated with a higher concentration of serum retinol but only in IDA.
  
  
  CONCLUSIONS
  Fe deficiency was not the main cause of anaemia in the present population. The role of vitamin A as well as other micronutrients should be taken into account in addressing the problem of anaemia.
authors.affiliation: 1South East Asian Ministers of Education Organization,Regional Center for Food and Nutrition,University of Indonesia,Salemba Raya 6,Jakarta 10430,Indonesia.
authors.forename: Min Kyaw
authors.initials: MK
authors.lastname: Htet
authors.affiliation: 1South East Asian Ministers of Education Organization,Regional Center for Food and Nutrition,University of Indonesia,Salemba Raya 6,Jakarta 10430,Indonesia.
authors.forename: Umi
authors.initials: U
authors.lastname: Fahmida
authors.affiliation: 1South East Asian Ministers of Education Organization,Regional Center for Food and Nutrition,University of Indonesia,Salemba Raya 6,Jakarta 10430,Indonesia.
authors.forename: Drupadi
authors.initials: D
authors.lastname: Dillon
authors.affiliation: 3Faculty of Medicine,University of Indonesia,Jakarta,Indonesia.
authors.forename: Arwin
authors.initials: A
authors.lastname: Akib
authors.affiliation: 4Faculty of Public Health,University of Indonesia,Depok,Indonesia.
authors.forename: Budi
authors.initials: B
authors.lastname: Utomo
authors.affiliation: 5Northern Ireland Centre for Food and Health,School of Biomedical Science,University of Ulster,Coleraine,UK.
authors.forename: David I
authors.initials: DI
authors.lastname: Thurnham
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena / Q000208:ethnology; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D015930:Diet Records; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood; D016015:Logistic Models; D002052:Myanmar / Q000453:epidemiology; D009752:Nutritional Status / Q000208:ethnology; D009961:Orosomucoid / Q000032:analysis; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology*
chemical_list: D006454:Hemoglobins; D009961:Orosomucoid; D014801:Vitamin A; D002097:C-Reactive Protein; D007501:Iron