Iron Deficiency in Childhood Obesity

Abstract

Introduction: Iron deficiency (ID) is one of the most common causes of anemia in children. Although it is frequently encountered in a clinician's daily practice, the multifactorial etiology of ID still represents a challenge in terms of long-term management. In overweight and obese children, adiposity related inflammation causes ID by decreasing transferrin saturation on one hand and by increasing hepcidin production on the other hand, which in turn decreases iron absorption. Dietary uptake of iron and other micronutrients is also impaired in these children. Aim of the study: To investigate the link between overweight, obesity and iron deficiency in pediatric patients. Materials and methods: A retrospective observational study was conducted over a 1-year period (1st April 2018-31th March 2019), in the Endocrinology Department of "Louis Turcanu" Children's Emergency Clinical Hospital Timisoara. After applying the inclusion criteria, a total of 78 overweight and obese children were enrolled in the study. The Ethics Committee of the "Louis Turcanu" Children's Emergency Clinical Hospital approved the study. Results: The CDC BMI-charts matched for age and sex were used in order to define overweight and obesity (overweight 85th -95th and obesity > 95th percentiles). According to age patients were divided in 3 groups: toddlers 6% (age 1-5 years); preadolescents 40% (age 5-12 years) and adolescents 54% (age 12-18 years). Overall, the overweight/ obesity ratio in the studied groups was as follows: 20:80 in toddlers, 13:87 in preadolescents and 45,6:54,4 in adolescents. The highest percentage of ID-patients was found in toddlers (60%), followed by preadolescents with half as much patients (32%), and the lowest percentages was observed in adolescents (14%). Although there was a correlation between iron levels and BMI throughout our sample, these obese and overweight children did not associate significant anemia. Conclusions: The negative correlation between BMI and iron levels, even in the absence of anemia, should raise awareness with regard to the micronutrient imbalance that exists in these children from a very young age. Children with elevated BMI may need to be screened for iron deficiency. There is an acute need to expand the studies to establish the cause of ID among children and adolescents.