| Research background and aimIron is an essential trace element for human being. Iron deficiency is very common, and it further developed to iron-deficiency anemia. Iron deficiency also causes damage of immune function, fatigue and weak, as well as susceptible to disease. In addition, iron deficiency could result in children’s mental damage and the loss of adult labor ability. Iron overload is the iron metabolic disorder. Excessive iron deposition in the liver, pancreas, heart, spleen, brain and skin could give rise to damages to the extensive fibrosis and the viscera function. Although numerous investigations have already reported that the data related to iron nutrition about some people in China, but on the whole, the data is still insufficient, and there is no national iron nutrition status data. Accordingly, based on the 2010-2012 Nutrition and Health Survey data in China, this study conducted population samplings, blood sample collections and basic information investigation and monitoring of SF, sTfR and hsCRP, and calculates BI, aiming to provide basic representative data on iron nutritional status for population in large cities and poor rural areas in our country using the statistical analysis and assessment.Research object and methodologyThe research objects were sampled according to two methodologies:1) based on the blood sample of Nutrition and Health Survey in China from 2010 to 2012,8 layers was obtained considering gender (male and female) and age groups (6 to 17,18 to 44, 45 to 59,60 or higher) in large cities and poor rural area,4432 people in total. SF, sTfR and hsCRP were measured by the immune turbidimetry; 2) based on the blood samples of Nutrition and Health Survey in China from 2010 to 2012, and referred to the WS/T 441-2013 anemia criterion to judge the anemia subjects. SF, sTfR and hsCRP were measured by the immune turbidimetry in both groups. The population of hsCRP> 5 mg/L with inflammation was excluded. SF and sTfR were used to calculate BI, and analyze the level of SF, sTfR and BI and the percentile distribution. The SF, sTfR and BI levels were analyzed among groups of different age and gender. And the impacts of age, gender, hsCRP, whether being pregnant women and the districts type on SF, sTfR and BI were analyzed.Various systems of standards were adopted to judge the iron deficiency rate:(1) SF < 15 ng/mL. (2) SF< 25 ng/mL. (3) sTfR>sTfRkit, i.e. sTfR> 5.0 mg/L (male) and sTfR> 4.4 mg/L (female). (3) BI< 0 mg/kg. (4) SF< 15 ng/mL or sTfR was greater than the kit cutoff. The consistency of different indicators and cutoff to define iron deficiency was analyzed. Above criteria was used to determine the iron deficiency rate for both sampled groups in large cities and poor rural areas. The impact of age, gender, hsCRP, whether being pregnant and the districts types on SF, sTfR and BI was analyzed, respectively.Based on the SF analysis of the population in large cities and poor rural areas from 2010 to 2012, and the evaluation standards of elevated iron storage recommended by WHO and other organizations, different cutoffs of the SF were used to comprehensively assess the elevated iron store for Chinese population in the survey.Based on hsCRP concentration of the subjects in both sampled groups in the 2010-2012 survey, the hsCRP level and distribution were analyzed among the subgroups of different ages and genders.Research results1. The distribution of SF, sTfR, BI and ID status among the population in Chinese large cities and poor rural areas.The average concentration of SF for population in large cities was 103.2 ng/mL, 146.5 ng/mL for male, and 76.0 ng/mL for female, respectively. The average concentration of SF for population in poor rural area was 98.7 ng/mL,140.0 ng/mL for male, and 72.1 ng/mL for female. There was no statistically significant difference between population living in large cities and poor rural areas. The lowest SF concentration occurred on pregnant women for both large cities and poor rural areas.The average sTfR concentration for population in large cities was 3.00 mg/L,2.93 mg/L for male, and 3.06 mg/L for female. The average sTfR concentration for population in poor rural areas was 3.33 mg/L,3.19 mg/L for male, and 3.46 mg/L for female. The sTfR levels for population in poor rural areas were significantly higher than those of large cities.The average concentration of BI for population in large cities was 9.52±3.93 mg/kg, 10.87±3.40 mg/kg for male, and 8.35±3.98 mg/kg for female, respectively. The average concentration of BI for population in poor rural area was 9.02±4.29 mg/kg, 10.42±3.70 mg/kg for male,7.78±4.40 mg/kg for female. The BI levels for population in large cities were significantly greater compared with those in poor rural areas. The lowest SF concentration occurred on pregnant women for both large cities and rural poor areas.The difference of SF, sTfR and BI among different age and gender groups for population in large cities and poor rural areas were statistically significant.Criteria of SF< 15 ng/mL or sTfR>sTfRkit, one of above two criteria attained can be diagnosed as iron deficiency. The iron deficiency rate in large cities was 7.4%,3.4% for male and 10.8% for female, respectively. The iron deficiency rate in poor rural areas was 14.3%,7.5% for male and 20.5% for female, respectively. Significant difference of iron deficiency rate was found among groups of different ages and genders.According to the WHO standard of determination of suffering the risk of iron deficiency by combining with SF and sTfR, the values were SF< 20% and sTfR> 10%, respectively, for 12-17 years adolescent female, pregnant women in large cities, children, adolescents and nonpregnant adult females in poor rural areas, indicating ID was prevalent and inflammation was prevalent, and the values were SF>30%, sTfR > 10% for pregnant women in poor rural areas, indicating ID was prevalent.2. The distribution of SF, sTfR, BI and iron deficiency anemia rate among the anemia population in Chinese large cities and poor rural areas.The average concentration of SF for anemic population in large cities was 58.6 ng/mL,107.0 ng/mL for anemic male and 45.6 ng/mL for anemic female, respectively. The average concentration of SF for anemic population in poor rural areas was 58.5 ng/mL,109.2 ng/mL for anemic male and 38.9 ng/mL for anemic female, respectively. The SF concentration of anemic female in large cities was significantly greater than that of poor rural areas.The average sTfR concentration for anemic population in large cities was 3.67 mg/L,3.26 mg/L for anemic male and 3.85 mg/L for anemic female. The average sTfR concentration for anemic population in poor rural areas was 4.05 mg/L,3.48 mg/L for anemic male and 4.47 mg/L for anemic female. The sTfR level for anemic population in poor rural areas was significantly higher than that of large cities.The average concentration of BI for anemic population in large cities was 6.80±6.12 mg/kg,9.36±5.05 mg/kg for anemic male and 5.72±6.22 mg/kg for anemic female, respectively. The average concentration of BI for anemic population in poor rural areas was 6.45±6.42 mg/kg,9.22±4.78 mg/kg for anemic male and 4.65±6.71 mg/kg for anemic female. The BI level for anemic female in large cities was significantly greater compared with that in poor rural areas.The difference of SF, sTfR and BI concentration among groups of different ages and genders for population in large cities and poor rural areas were statistically significant.Criteria of SF< 15 ng/mL or sTfR> sTfRkit, one of above two criteria attained can be diagnosed as iron deficiency. The iron deficiency anemia rate for anemic population in large cities was 29.4%,13.7% for anemic male and 36.0% for anemic female, respectively. The iron deficiency anemia rate in poor rural areas was 32.6%, 15.5% for anemic male and 43.7% for anemic female. Significant difference of iron deficiency anemia rate was found among groups of different ages and genders. Among of which, the iron deficiency anemia rates for pregnant and childbearing women aged between 18 and 44 were the highest.3. Preliminary assessment of elevated iron store for population in Chinese large cities and poor rural areas.The criteria of SF>300 ng/mL was regarded as the high iron storage for both male and elderly female, and SF> 200 ng/mL for young female. The elevated iron store rate was 17.3% for the population in large cities,20.8% for male and 14.2% for female, respectively. The elevated iron store rate was 20.7% for the population in poor rural areas,20.7% for male and 15.1% for female, respectively. Significant difference of elevated iron storage can be observed among population in groups of different ages and genders. The results showed that both adult male and elderly female suffered from the risk of high iron storage.4. The distribution of hsCRP for population in large cities and rural areas in ChinaThe average concentration of hsCRP was 0.68 mg/L for population in large cities, and 0.13-5.48 mg/L for P5-P95. The average concentration of hsCRP was 0.72 mg/L for population in poor rural areas, and 0.16-6.09 mg/L for P5-P95.ConclusionThis study adopted the technology of immune biochemical analysis to evaluate SF, sTfR and hsCRP. In addition, the nutritional status of iron for Chinese population was assessed in the survey for the time period of from 2010 to 2012.1. The average concentration of SF, sTfR and BI were 103.2 ng/mL,3.00 mg/L and 9.52±3.93 mg/kg, respectively, for population living in large cities, and 98.7 ng/mL,3.33 mg/L and 9.02±4.29 mg/kg, respectively, for population living in poor rural areas. There was significant difference of SF, sTfR and BI among groups of different ages and genders, respectively.2. The iron deficiency rate was 7.4% and 14.3% for large cities and poor rural areas, respectively. The difference among groups of different ages and genders was significant. Female aged between 12 and 17 years old and pregnant female in large cities suffered iron deficiency with high risk. Children, adolescent female and all adult women in poor rural areas suffered iron deficiency at high risk. Results suggested that the above mentioned people was the emphasis of prevention and curing of iron deficiency, especially for pregnant female, childbearing female aged between 18 and 44 years old, and female aged between 12 and 17 years old. Male were at low risk for iron deficiency.3. The average concentration of SF, sTfR and BI were 58.6 ng/mL,3.67 mg/L and 6.80±6.12 mg/kg, respectively, for anemia population living in large cities, and 58.5 ng/mL,4.05 mg/L and 6.45±6.42 mg/kg, respectively, for anemia population living in poor rural areas. There was significant difference of SF, sTfR and BI among groups of different ages and genders, respectively.4. The iron deficiency anemia rate was 29.4% and 32.6% for anemia population living in large cities and poor rural areas, respectively. The iron deficiency anemia rate was significantly different among groups of different ages and genders. And especially for pregnant female, childbearing female aged between 18 and 44 years old, indicating IDA was the main cause of anemia.5. The average hsCRP concentration was 0.68 mg/L, and 0.13-5.48 mg/L for P5-P95 for population living in large cities. The average concentration of hsCRP was 0.72 mg/L, and 0.16-6.09 mg/L for P5-P95 for population living in poor rural areas. |
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