| Prevalences of anemia, low iron stores, iron deficiency (ID), iron deficiency anemia (IDA), and marginal zinc status were determined in a cross-sectional study of children 12--36 months of age participating in the Supplemental Nutrition Program for Women, Infants and Children (WIC) in two California counties. Additional objectives were to assess the value of using hemoglobin to predict ID, and to determine factors associated with anemia, ID, serum zinc and copper.; The prevalence of anemia was 11.1% (hemoglobin <110 g/L at 12--24 mo, <111 g/L at 24--36 mo). Hemoglobin was regressed on ferritin, transferrin receptors, and transferrin saturation to determine abnormal values (study-determined), using a two phase segmented linear regression model. Study- or literature-determined abnormal values were: serum ferritin ≤8.7 or <10.0 mug/L, serum transferrin receptor ≥8.4 or >10.0 mug/mL, and transferrin saturation ≤13.2% or <10.0%, respectively. The prevalence of low iron stores (ferritin) was 24.8% or 29.0%, ID (≥2 abnormal iron measures) was 16.2% or 8.8%, and IDA (ID with low hemoglobin) was 3.4% or 3.2% using study-or literature-determined cut-offs, respectively. Hemoglobin concentration was used to predict study- and literature-determined ID using receiver operator characteristic (ROC) curves. The sensitivity of low hemoglobin in predicting study- and literature-determined ID was low (23.2% and 40.0%, respectively).; Children currently participating in WIC, and maternal WIC participation during pregnancy were protective against anemia and ID, respectively. Children with a greater rate of weight gain were less likely, and children of pregnant mothers were more likely to be anemic. Males, children living in an urban location, children of pregnant mothers, and children consuming <125 ml/day of orange/tomato juice were more likely to be ID.; The prevalence of low serum zinc (<10.7 muM) was 42.8%. Consumption of sweetened beverages and maternal pica during pregnancy were negatively, and consumption of >15 g/day of meat was positively associated with serum zinc. Prevalence of low serum copper (<14.2 muM) was <1%. Mean serum copper was 23.6 (+/-3.5) and 22.1 (+/-3.8) muM for anemic and non-anemic children, respectively (t-test, P = 0.026). Factors positively associated with serum copper were current consumption of breastmilk and consumption of >15 g/day of beans. |
