Increased Iron Deficiency and Iron Deficiency Anemia in Children with Zinc Deficiency

Abstract

Objective: The aim of the present study is to determine the presence of iron (Fe) deficiency and Fe deficiency anemia in children with zinc (Zn) deficiency. Materials and Methods: This retrospective study comprised 560 patients aged 6 months to 16 years in whom Zn levels in hair samples were measured concurrently with serum levels of ferritin, Fe, Fe-binding capacity, and blood count analysis. For all patients, we retrospectively assessed serum ferritin, serum Fe, Febinding capacity, transferrin saturation index, red blood cell count, hemoglobin levels, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width (RDW). Patients were divided into two groups according to the level of the hair Zn level as Zn deficiency (hair Zn level <100 µg/g) and without Zn deficiency (hair Zn level >100 µg/g). Data were analyzed to determine whether there was a significant difference between any of these parameters and the presence of Fe deficiency and Fe deficiency anemia between patients with and without Zn deficiency. Results: A total of 238 patients had Zn levels <100 µg/g, and 322 patients had Zn levels >100 µg/g. The median ferritin level was 16.2 (9.8-24.9) ng/mL in the Zn-deficient group and 18.7 (12-29.3) ng/mL in those without Zn deficiency group. The presence of Fe deficiency was higher in the Zn deficiency group (60.1%) than in the without Zn deficiency group (50%; p<0.05). The presence of Fe deficiency anemia was significantly higher in the Zn deficiency group (20.2%) than in the without Zn deficiency group (12.7%; p<0.05). There were very weak negative significant correlation between hair Zn and RDW level (r=−0.24; p<0.001) and weak positive correlation between hair Zn and MCV (r=0.31; p<0.001). Conclusion: Fe deficiency and Fe deficiency anemia increased in patients with zinc deficiency.

Iron and Zinc Homeostasis and Interactions: Does Enteric Zinc Excretion Cross-Talk with Intestinal Iron Absorption?

“…Similarly, a large cross-sectional study among pregnant women ( n = 1185) found low serum zinc levels among anemic subjects, and furthermore, serum zinc levels were significantly and positively correlated with hemoglobin [13]. Other studies have shown that the plasma zinc levels were significantly lower among subjects with iron deficiency anemia [12,13]. In addition, low serum zinc reported to be an independent risk factor for anemia among school-age children in New Zealand [14].…”

“…Clinical studies in human subjects indicated that serum zinc levels correlate with iron status markers. Hemoglobin, plasma ferritin, mean corpuscular volume (MCV), and red cell distribution width (RDW) were found to be higher in zinc sufficient (>100 µg/dL) compared to zinc deficient (<100 µg/dL) subjects [12]. Similarly, a large cross-sectional study among pregnant women ( n = 1185) found low serum zinc levels among anemic subjects, and furthermore, serum zinc levels were significantly and positively correlated with hemoglobin [13].…”

“…On the other hand, zinc deficiency, investigated via experimental animal models and in vitro studies, gives rise to iron deficiency anemia, tissue and cellular iron accumulation [8,9,10,11]. Cross-sectional studies in humans reveal a positive association of serum zinc levels with hemoglobin and markers of iron status [12,13,14,15]. Studies in intestinal cell culture and experimental animal models have also demonstrated modulation of iron transporter expression and iron regulatory proteins by zinc [11,16,17,18,19].…”

Iron-Induced Hepatocarcinogenesis—Preventive Effects of Nutrients

“…The zinc-deficient diet increased plasma hepcidin level, consistent with reduced intestinal iron absorption (109). There might be a physiological crosstalk between iron and zinc in erythropoiesis because clinical studies revealed that patients with iron deficiency anemia were significantly associated with zinc deficiency (110,111). Moreover, zinc supplementation stimulates erythropoiesis while zinc plus iron more efficiently ameliorated anemia than iron alone (112,113).…”

Incidence of iron deficiency anemia among the children with febrile seizures.

“…7 Apprehension and increased parental anxiety due to seizures is found in 2%-4% patients. 8 It puts a burden of cost on the family, society and health system. There is high chance of recurrence of seizures with the frequency of 30% after first episode and 50% after second episode of seizures.…”