title: Prevalence and Relationships of Iron Deficiency Anemia with Blood Cadmium and Vitamin D Levels in Korean Women.
abstract: Anemia, iron deficiency (ID), and iron deficiency anemia (IDA) are common disorders. This study was undertaken to determine the prevalence of anemia, ID, and IDA in Korean females. We examined the associations between IDA, heavy metals in blood, vitamin D level and nutritional intakes. The study was performed using on data collected from 10,169 women (aged ≥ 10 yr), including 1,232 with anemia, 2,030 with ID, and 690 with IDA during the fifth Korea National Health and Nutrition Examination Survey (KNHANES V; 2010-2012). Prevalence and 95% confidence intervals were calculated, and path analysis was performed to identify a multivariate regression model incorporating IDA, heavy metals in blood, vitamin D level, and nutritional intakes. The overall prevalence of anemia, ID and IDA was 12.4%, 23.11%, and 7.7%, respectively. ID and IDA were more prevalent among adolescents (aged 15-18 yr; 36.5% for ID; 10.7% for IDA) and women aged 19-49 yr (32.7% for ID; 11.3% for IDA). The proposed path model showed that IDA was associated with an elevated cadmium level after adjusting for age and body mass index (β=0.46, P<0.001). Vitamin D levels were found to affect IDA negatively (β=-0.002, P<0.001). This study shows that the prevalence of anemia, ID, and IDA are relatively high in late adolescents and women of reproductive age. Path analysis showed that depressed vitamin D levels increase the risk of IDA, and that IDA increases cadmium concentrations in blood. Our findings indicate that systematic health surveillance systems including educational campaigns and well-balanced nutrition are needed to control anemia, ID, and IDA.
authors.affiliation: Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Young Ju
authors.identifier: 0000-0002-6816-8067
authors.initials: YJ
authors.lastname: Suh
authors.affiliation: Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Ji Eun
authors.identifier: 0000-0002-7386-0015
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Future Strategy Team, Inha University Hospital, Incheon, Korea.
authors.forename: Dae Hyung
authors.identifier: 0000-0002-0284-0519
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Hyeon Gyu
authors.identifier: 0000-0002-3710-0959
authors.initials: HG
authors.lastname: Yi
authors.affiliation: Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Moon Hee
authors.identifier: 0000-0002-5965-1815
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Chul Soo
authors.identifier: 0000-0002-1760-0155
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jeung Weon
authors.identifier: 0000-0001-7498-8398
authors.initials: JW
authors.lastname: Nah
authors.affiliation: Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Soon Ki
authors.identifier: 0000-0002-4785-1705
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000453:epidemiology*; D015992:Body Mass Index; D002104:Cadmium / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015592:Immunoradiometric Assay; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012044:Regression Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012306:Risk; D014807:Vitamin D / Q000097:blood*; D055815:Young Adult
chemical_list: D002104:Cadmium; D014807:Vitamin D
keywords: Anemia; Cadmium; Iron Deficiency; Korean; Prevalence; Vitamin D; Women