Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

Gonzáles, Gustavo F.; Tapia, Vilma; Vásquez‐Velásquez, Cinthya

doi:10.1111/nyas.14520

Cited by 9 publications

(7 citation statements)

References 42 publications

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“…A systematic analysis study has shown that the platelet counts of a chronic mountain sickness group were lower compared with the healthy altitude control group [ 45 ]. In addition, the observation that the platelet count is higher in pregnant women at HA than at LA is consistent with the suggestion that populations living in the Southern Andes in Peru are more adapted than those from the central Andes [ 46 ]. These data suggest that adapted people (with higher generational time residing at high altitudes) have, compared to sea level counterparts or non-adapted HA residents, less Hb concentration and higher platelet counts.…”

Section: Discussionsupporting

confidence: 85%

A Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status

Figueroa-Mujica

Ccahuantico

Ccorahua-Ríos

et al. 2022

Life

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The objectives of the study were to determine differences in the parameters of red blood cells (RBC), white blood cells (WBC), and platelets at low altitude (LA) and at high altitude (HA) and with the gestation being advanced, and to determine correlations between parameters of RBC and platelets. We also studied the association of RBC and platelets with markers of iron status. In addition, markers of iron status and inflammation were measured and compared at each trimester of gestation in pregnant women at LA and HA. A cross-sectional comparative study was conducted at Lima (150 m above sea level) and Cusco at 3400 m above sea level from May to December 2019. Hematological parameters in pregnant women (233 at LA and 211 at HA) were analyzed using an automated hematology analyzer. Serum ferritin levels, soluble transferrin receptor (sTfR), hepcidin, erythropoietin, testosterone, estradiol, and interleukin-6 (IL6) levels were measured by ELISA. One-way ANOVA supplemented with post hoc test, chi-square test, and Pearson correlation test statistical analyses were performed. p < 0.05 was considered significant. Pregnant woman at HA compared to LA had significantly lower WBC (p < 0.01), associated with higher parameters of the RBC, except for the mean corpuscular volume (MCV) that was no different (p > 0.05). Platelets and mean platelet volume (MPV) were higher (p < 0.01), and platelet distribution width (PDW) was lower at HA than at LA (p < 0.01). A higher value of serum ferritin (p < 0.01), testosterone (p < 0.05), and hepcidin (p < 0.01) was observed at HA, while the concentration of sTfR was lower at HA than at LA (p < 0.01). At LA, neutrophils increased in the third trimester (p < 0.05). RBC parameters decreased with the progress of the gestation, except RDW-CV, which increased. The platelet count decreased and the MPV and PDW were significantly higher in the third trimester. Serum ferritin, hepcidin, and serum testosterone decreased, while sTfR and serum estradiol increased during gestation. At HA, the WBC and red blood cell distribution width- coefficient of variation (RDW-CV), PCT, and serum IL-6 did not change with gestational trimesters. RBC, hemoglobin (Hb), hematocrit (Hct), mean corpuscular hemoglobin concentration (MCHC), and platelet count were lower as gestation advanced. MCV, MPV, and PDW increased in the third trimester. Serum ferritin, testosterone, and hepcidin were lower in the third trimester. Serum estradiol, erythropoietin, and sTfR increased as gestation progressed. Direct or inverse correlations were observed between RBC and platelet parameters and LA and HA. A better number of significant correlations were observed at HA. Hb, Hct, and RDW-CV showed a significant correlation with serum ferritin at LA and HA. Of these parameters, RDW-CV and PDW showed an inversely significant association with ferritin (p < 0.05). In conclusion, a different pattern was observed in hematological markers as well as in iron status markers between pregnant women at LA and HA. In pregnant women a significant correlation between several RBC parameters with platelet marker parameters was also observed. Data suggest that pregnant women at HA have adequate iron status during pregnancy as reflected by higher serum ferritin levels, lower sTfR levels, and higher hepcidin values than pregnant women at LA.

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Section: Discussionsupporting

confidence: 85%

A Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status

Figueroa-Mujica

Ccahuantico

Ccorahua-Ríos

et al. 2022

Life

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“…In addition, we found that older children exhibited higher Hb levels and a lower prevalence of anaemia, which is following previous findings (40)(41)(42) . The current observation could be partly explained by the significantly lower levels of vitamin A in children aged <10 years, as vitamin A plays a vital role in modulating Fe metabolism and erythropoiesis (43) .…”

Section: Discussionsupporting

confidence: 92%

High prevalence of malnutrition and vitamin A deficiency among schoolchildren of rural areas in Malaysia using a multi-school assessment approach

et al. 2022

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Childhood malnutrition is known as a public health concern globally. The present study aims to assess the anthropometry and blood biochemical status of rural primary school children in Malaysia. A total of 776 children (7-11 years old) from 10 rural primary schools from 5 states were included in this study. Nutritional outcomes were assessed based on gender, age group and school categories among the children (median age: 9 years [P25:8, P75:10]). The overall prevalence of malnutrition was 53.4%. Vitamin A deficiency (VAD) was recorded at 20.6% and 39.8% based on retinol and retinol-binding protein (RBP) levels, respectively. Anaemia, iron deficiency (ID), iron-deficiency anaemia (IDA) and elevated inflammation were found at 14.9%, 17.9%, 9.1% and 11.5%, respectively. Malnutrition, VAD, anaemia, ID, IDA, and elevated inflammation were more prevalent among Orang Asli (OA) school children compared to Non-Orang Asli (NOA) school children. Higher occurrence of VAD and anaemia were also found among children aged <10 years. Retinol, RBP, alpha-carotene, ferritin, and haemoglobin levels were lower among undernourished children. Besides, overweight/obese children exhibited a higher level of high-sensitivity C-reactive protein. Multivariate analysis demonstrated that children from OA schools (AOR:6.1; 95% CI: 4.1-9.0) and iron-deficiency anaemia (AOR:3.6; 95% CI:1.9-6.6) were associated to stunting among this population. The present study revealed that malnutrition, micronutrient deficiencies, and anaemia are prevalent among rural primary school children in Malaysia, especially those from OA schools and younger age children (<10 years). Hence, more appropriate and targeted measures are needed to improve the nutritional status of these children.

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“…Contrary to our findings, previous studies found no sex-related difference in Hb among young children [38][39][40], but were all in agreement with our findings of higher Hb in older compared to younger age. Unlike those studies which looked at 'healthy' young children in the general population, our children were stunted.…”

Section: Discussionsupporting

confidence: 87%

Micronutrient Status and Other Correlates of Hemoglobin among Children with Stunting: A Cross-Sectional Study in Uganda

Mutumba,

Mbabazi,

Pesu

et al. 2023

Nutrients

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In low-income countries, undernutrition and infections play a major role in childhood anemia. Stunted children may be at particular risk of anemia. In a cross-sectional study nested in a nutrition trial among 12–59-month-old stunted children in eastern Uganda, we measured hemoglobin (Hb) and markers of iron, cobalamin, folate and vitamin A status. We assessed low micronutrient status, socio-demography, stunting severity, inflammation and malaria as correlates of Hb and anemia using linear and logistic regression analyses, respectively. Of 750 stunted children, the mean ± SD age was 32.0 ± 11.7 months and 55% (n = 412) were male. The mean Hb was 104 ± 15 g/L and 65% had anemia, Hb < 110 g/L. In a multivariable model with age, sex and inflammation, the following were associated with lower Hb: serum ferritin < 12 µg/L (−5.6 g/L, 95% CI: −8.6; −2.6), transferrin receptors > 8.3 mg/L (−6.2 g/L, 95% CI: −8.4; −4.0), plasma folate <20 nmol/L (−4.6 g/L, 95% CI: −8.1;−1.1), cobalamin < 222 pmol/L (−3.0 g/L, 95% CI: −5.4; −0.7) and serum retinol-binding protein < 0.7 µmol/L (−2.0 g/L, 95% CI: −4.1; 0.2). In addition, severe stunting, inflammation and malaria were negative correlates. Anemia is common among stunted children in eastern Uganda; micronutrient deficiencies, inflammation and malaria are associated with low Hb.

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Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

Cited by 9 publications

References 42 publications

A Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status

A Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status

High prevalence of malnutrition and vitamin A deficiency among schoolchildren of rural areas in Malaysia using a multi-school assessment approach

Micronutrient Status and Other Correlates of Hemoglobin among Children with Stunting: A Cross-Sectional Study in Uganda

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