The diagnostic criteria for iron deficiency in infants should be reevaluated

Magnus Domellöf, Kathryn G. Dewey, Bo Lönnerdal, Roberta J. Cohen, Olle Hernell

Research output: Contribution to journalArticle

169 Citations (Scopus)

Abstract

Diagnostic criteria for iron deficiency (ID) and iron deficiency anemia (IDA) in infants are poorly defined. Our aim was to establish appropriate cut-off values for hemoglobin (Hb), plasma ferritin, erythrocyte mean cell volume (MCV), zinc protoporphyrin (ZPP) and soluble transferrin receptors (TfR) in infancy. Exclusively breast-fed infants (n = 263) in Honduras and Sweden were randomly assigned to receive iron supplementation or placebo, and blood samples were obtained at 4, 6 and 9 mo of age. Reference ranges were determined using three different approaches for defining iron-replete infants. The usefulness of several variables for predicting the Hb response to iron was evaluated. We found the following 2 SD cut-off values in iron-replete infants: Hb <105 g/L at 4-6 mo and <100 g/L at 9 mo; ZPP >75 μmol/mol heme at 4-6 mo and β90 μ mol/mol heme at 9 mo; ferritin α20 μg/L at 4 mo, α9 μg/L at 6 mo and α5 μg/L at 9 mo; and TfR β11 mg/L at 4-9 mo. The Hb response to iron was not a useful definition of IDA at 4 mo of age. Hb, MCV and ZPP at 6 mo as well as growth variables predicted the Hb response at 6-9 mo, but ferritin and TfR at 6 mo did not. We conclude that there is need for a reevaluation of the definitions of ID and IDA in infants.

Original languageEnglish (US)
Pages (from-to)3680-3686
Number of pages7
JournalJournal of Nutrition
Volume132
Issue number12
StatePublished - Dec 1 2002

Fingerprint

Iron
hemoglobin
iron
Hemoglobins
iron deficiency anemia
Transferrin Receptors
Iron-Deficiency Anemias
ferritin
transferrin
protoporphyrin
Erythrocyte Indices
heme
Ferritins
Heme
receptors
zinc
Honduras
infancy
Sweden
placebos

Keywords

  • Ferritin
  • Hemoglobin
  • Infants
  • Iron deficiency anemia
  • Reference values
  • Transferrin receptors

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Domellöf, M., Dewey, K. G., Lönnerdal, B., Cohen, R. J., & Hernell, O. (2002). The diagnostic criteria for iron deficiency in infants should be reevaluated. Journal of Nutrition, 132(12), 3680-3686.

The diagnostic criteria for iron deficiency in infants should be reevaluated. / Domellöf, Magnus; Dewey, Kathryn G.; Lönnerdal, Bo; Cohen, Roberta J.; Hernell, Olle.

In: Journal of Nutrition, Vol. 132, No. 12, 01.12.2002, p. 3680-3686.

Research output: Contribution to journalArticle

Domellöf, M, Dewey, KG, Lönnerdal, B, Cohen, RJ & Hernell, O 2002, 'The diagnostic criteria for iron deficiency in infants should be reevaluated', Journal of Nutrition, vol. 132, no. 12, pp. 3680-3686.
Domellöf M, Dewey KG, Lönnerdal B, Cohen RJ, Hernell O. The diagnostic criteria for iron deficiency in infants should be reevaluated. Journal of Nutrition. 2002 Dec 1;132(12):3680-3686.
Domellöf, Magnus ; Dewey, Kathryn G. ; Lönnerdal, Bo ; Cohen, Roberta J. ; Hernell, Olle. / The diagnostic criteria for iron deficiency in infants should be reevaluated. In: Journal of Nutrition. 2002 ; Vol. 132, No. 12. pp. 3680-3686.
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