Aim. To determine trace element status and aetiologic factors for development of trace elements deficiencies in children with iron-deficiency anaemia (IDA) aged 0 to 3 years. Contingent and Methods. 30 patients of the University Hospital, Pleven, Bulgaria—I group; 48 patients of the Sumy Regional Child's Clinical Hospital, Sumy, Ukraine—II group; 25 healthy controls were investigated. Serum concentrations of iron, zinc, copper, chromium, cobalt, and nickel were determined spectrophotometrically and by atomic absorption spectrophotometry. Results. Because the obtained serum levels of zinc, copper, and chromium were near the lower reference limits, I group was divided into IA and IB. In IA group, serum concentrations were lower than the reference values for 47%, 57%, and 73% of patients, respectively. In IB group, these were within the reference values. In II group, results for zinc, cobalt, and nickel were significantly lower (P < 0.05), and results for copper were significantly higher in comparison to controls. Conclusion. Low serum concentrations of zinc, copper, cobalt, and nickel were mainly due to inadequate dietary intake, malabsorption, and micronutrient interactions in both studied groups. Increased serum copper in II group was probably due to metabolic changes resulting from adaptations in IDA. Data can be used for developing a diagnostic algorithm for IDA.

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Summary Anemia is an important public health problem worldwide. Although iron (Fe) deficiency is considered the main factor in the pathogenesis of anemia, only 40-60% of anemia cases are responsive to Fe supplementation. Considerable data exist that other micronutrient deficiencies, such as selenium (Se), could be possible causes of anemia. The issue of Se deficiency as a risk factor for the development of anemia is of particular interest to our country since the Balkan region is known by a low Se content of soils. The aim of the study was to examine the contemporary conception of the influence of Se deficiency on the development of anemia by a review of the scientific literature. Most animal studies have shown a significant relation between Se deficiency and anemia, but one study indicates that there is no impact of Se deficiency on the hematological parameters. Associations of low serum Se with anemia have been found in a number of human studies including subjects of various age groups and pathological conditions. Three possible biological mechanisms have been suggested for the involvement of Se deficiency in the development of anemia: increased oxidative stress, modulation of inflammation through induction of interleukin-6, and increased expression of heme oxygenase-1. A more categorical clarification of the relationships between Se deficiency and development of anemia is needed with respect to appropriate trace element supplementation in cases of anemia with insufficient or absent therapeutic response to Fe treatment.

Iron deficiency anaemia (IDA) is associated with increased morbidity, mortality, impaired growth and cognitive development of children. PURPOSE: to evaluate the effect of nutrition and severity of IDA on growth in children from 2 to 24 months of age. METHODS 172 children aged 2-24 months with IDA were categorized into two groups: G1 (0-12 months) and G2 (13-24 months). Diet was studied through interview. Anthropometric parameters: height-for-age (HA) and weight-for-age were assessed by standardized methods. IDA was defined as haemoglobin (Hb), mean corpuscular volume, serum iron, and transferrin saturation below age-related reference values of the World Health Organization. Anaemia was classified as severe, moderate, and mild according to Hb concentration. Associations between variables were analyzed by logistic regression. RESULTS High proportions of children predominantly fed on cow's milk with scarce or absent intake of meat, eggs, vegetables were found in G1 (30.2%) and G2 (19.8%). Predominant cow's milk feeding was significantly associated with growth retardation (HA<3rd percentile). In G2, severe anemia (Hb<70 g/l) exhibited significant (p=0.0344) association with stunting. CONCLUSIONS Inadequate nutrition and severe IDA increase risk of growth retardation in the first two years of life. Promotion of appropriate feeding practices is important in prevention and control of IDA.