PREVALENCE OF ANEMIA, IRON DEFICIENCY, AND IRON DEFICIENCY ANEMIA AND DIAGNOSTIC PERFORMANCE OF HEMATOLOGIC AND BIOCHEMICAL MARKERS OF SIDEROPENIA IN 1- TO 5-YEAR-OLD CHILDREN IN THRACE GREECE

Abstract

Background and Objectives: Iron deficiency (ID) is a major public health problem with high prevalence in early childhood. We assessed the prevalence of anemia, ID, and iron deficiency anemia (IDA) in healthy children of Thrace, Greece, its correlation with dietary factors, and evaluated the diagnostic performance of hematologic and biochemical markers of sideropenia. Patients and Methods: For 202 healthy children 1-5 years old, a questionnaire was filled out describing their nutritional habits during infancy and early childhood. Venous hemograms along with serum ferritin, TIBC, %TS, and CRP were obtained from all studied children. In a subset of 156 children, the concentration of sTfR was also determined. Results: Children with ID and IDA had significantly lower beef consumption than children without sideropenia (p=0.044). Using the WHO cut-off values of Hb <11g/dl and ferritin <12μg/l, the prevalence of anemia, ID, and IDA was 9.41%, 6.44%. and 3.47%, respectively. If Hb <12g/dl and ferritin<18μg/l were used as cut-offs, the prevalence of anemia, ID, and IDA was 26.73%, 16.33%, and 5.94%, respectively. ROC analysis revealed that at ferritin <12μg/l, sTfR had the highest specificity and PPV but the lowest sensitivity for ID (93%, 47.4%, and 69.2%, respectively), while sTfR/Fer index had the highest sensitivity and NPV (100%). Conclusions: The prevalence of ID and IDA in children 1-5 years old in Thrace is like in other developed countries. sTfR and sTfR/Fer index have the highest accuracy to diagnose ID, with the sTfR/Fer index being superior irrespective of the ferritin cut-off value used to define ID.