There is a significant variation in the prevalence of iron deficiency (ID) in women based on 3 definitions regardless of race, ethnicity, pregnancy, and age, according to a study published in JAMA Network Open.1
Takeaways
- The prevalence of iron deficiency (ID) in women varies significantly depending on the diagnostic criteria used, with rates ranging from 3.12% to 15.33%.
- Over 2 billion people worldwide are affected by ID, with particularly high rates among young women and children, highlighting it as a major global health issue.
- Symptoms of ID include increased fatigue, cold intolerance, poor muscle performance, pica, menstruation disturbances, and adverse pregnancy outcomes.
- There are notable differences in ID prevalence among racial and ethnic groups, with Hispanic and Native American women showing the highest rates and Asian women the lowest, based on different criteria.
- Higher serum ferritin thresholds could potentially diagnose and treat more women with ID, as shown by the substantial increase in prevalence when using WHO and IDE definitions.
Over 2 billion people worldwide are impacted by ID, with high rates reported in young women and children. Symptoms of ID include increased fatigue, cold intolerance, poor muscle performance, pica, mucosal and epithelial abnormalities, menstruation disturbances, and adverse pregnancy outcomes.
In a 2009 study, anemia was reported in approximately one-quarter of the world’s population.2 Concentration was identified in preschool-aged children and women, indicating a global public health concern. Of pregnant women, 41.8% were affected.
ID is often diagnosed based on low serum iron, low transferrin saturation (TS), and low serum ferritin (SF).1 The Hemochromatosis and Iron Overload Screening Study (HEIRS) defined ID as combined TS under 10% and SF under 15 ng/mL.
The World health Organization (WHO) defined ID as SF under 15 ng/ NL. Finally, a study based on National Health and Nutrition Examination Survey data defined iron-deficient erythropoiesis (IDE) as SF under 25 ng/mL in nonpregnant individuals.
Investigators conducted a cross-sectional study to compare ID prevalence in the HEIRS cohort using these 3 definitions. Groups included the entire HEIRS cohort, participants aged 25 to 54 years, those aged 25 to 54 years with self-reported pregnancy, and those from different self-reported racial and ethnic groups.
There were 101,168 individuals aged 25 years and older from the United States and Canada included in the HEIRS study, with enrollment between 2001 and 2003. Participants in the recent analysis included those who had not learned about the HEIRS study from a participating family member or reported prior hemochromatosis or iron overload.
Data on age, sex, race and ethnicity, TS and SF, HFE genotype, genetic screening attitudes, and pregnancy was collected. TS and SF were measured from blood samples obtained at the initial screening.
Investigators measured spectrophotometric serum iron and unsaturated iron-binding capacity, turbidometric immunoassay of SF, and calculated total iron-binding capacity and TS. ID was classified based on HEIRS, WHO, or IDE criteria.
There were 62,685 women aged a mean 49.58 years included in the final analysis. Of participants, 7615 were Asian, 17,272 Black, 8566 Hispanic, 441 Native American, 449 Pacific Islander, 27,049 White, and 1263 other race. A mean TS and SF of 26% and 107 ng/mL, respectively, was reported.
