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Cohort-Based Reference Values for Serum Ferritin and Transferrin and Longitudinal Determinants of Iron Status in European Children Aged 3–15 Years
Section of Dietetics, Faculty of Agriculture and Food Sciences, Hochschule Neubrandenburg – University of Applied Sciences, Neubrandenburg, Germany ; Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
Institute of Food Sciences, National Research Council, Avellino, Italy.
GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
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2024 (English)In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 154, no 2, p. 658-669Article in journal (Refereed) Published
Abstract [en]

Background: Reference values of ferritin and transferrin for European children do not exist. Objective: We aimed to provide sex-, age-, and body mass index (BMI)-specific serum ferritin and transferrin reference percentiles of 3–15-y-old children based on cohort data and to investigate determinants of iron status. Methods: A total of 3390 ferritin and 3416 transferrin measurements from children residing in 8 European countries participating in the IDEFICS/I.Family cohort (https://www.isrctn.com/ISRCTN62310987) at baseline (W0) and 6 y later (W3) were used to estimate percentiles using the generalized additive model for location, scale and shape. Associations of serum ferritin and transferrin concentrations with total iron intake, total iron intake additionally adjusted for vitamin C intake, and iron from heme sources were investigated separately with adjustment for sex, age, country of residence, parental education, usual energy intake and BMI z-score in regression models using cross-sectional and longitudinal data. Results: The age-specific ferritin and transferrin 5th and 95th reference percentiles ranged from 10.9 to 81.1 μg/L and 2.23 to 3.56 g/L, respectively. A deficient iron status was observed in 3% of children at W0 and 7% of children and adolescents at W3, respectively. At both waves, a higher iron intake from heme sources was positively associated with serum ferritin {W0: β = 3.21 [95% confidence interval (CI): 0.71, 5.71]; W3: β = 4.48 [95% CI: 2.09, 6.87]}, that is, children consuming one mg more heme iron had a 3.21 and 4.48 μg/L higher ferritin concentration. Adherence to a mainly vegetarian diet was associated with a lower chance for sufficient serum ferritin cross-sectionally at W3 [odds ratio (OR) 0.40 (95% CI: 0.21, 0.81)] and longitudinally [OR 0.35 (95% CI: 0.15, 0.93)]. Conclusions: Age-, sex-, and BMI-specific reference percentiles of serum ferritin and transferrin concentrations based on cohort data are provided for European children aged 3–15 y and may be used in clinical practice. 

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 154, no 2, p. 658-669
Keywords [en]
child health, ferritin, iron deficiency, reference percentiles, transferrin
National Category
Pediatrics Nutrition and Dietetics Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Research on Citizen Centered Health, University of Skövde (Reacch US)
Identifiers
URN: urn:nbn:se:his:diva-23527DOI: 10.1016/j.tjnut.2023.12.001ISI: 001188470900001PubMedID: 38048991Scopus ID: 2-s2.0-85181248055OAI: oai:DiVA.org:his-23527DiVA, id: diva2:1826270
Funder
EU Sixth Framework Programme for Research, Contract No. 016181 (FOOD)EU Sixth Framework Programme for Research, Contract No. 266044
Note

CC BY 4.0 DEED

© 2023 The Authors

Correspondence Address: M. Wolters; Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany; email: wolters@leibniz-bips.de; CODEN: JONUA

The IDEFICS study (http://www.idefics.eu) was supported by the European Commission within the Sixth RTD Framework Program [Contract No. 016181 (FOOD)] and the I.Family study (http://www.ifamilystudy.eu) was funded within the Seventh RTD Framework Program [Contract No. 266044].

Available from: 2024-01-11 Created: 2024-01-11 Last updated: 2024-04-02Bibliographically approved

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Eiben, Gabriele

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