Evaluation of Hematological Parameters and Iron Level in Obese Children and Adolescents

Abstract

Objectives: The aim of the study was to investigate hematological parameters and iron level in obese children and adolescents in different age groups.
Materials and Methods: The study population consisted of hundred-fifty four obese children and adolescents aged between 3 and 18 years, who were being followed at the Cumhuriyet University Faculty of Medicine Hospital, Pediatric Endocrinology Clinic. As the control group, 158 healthy age and sex-matched children were also included. The children were divided into three groups according to age: Group 1 (3-7 years), Group 2 (7-12 years), and Group 3 (12-18 years). Hematological parameters, serum iron, total iron-binding capacity, and ferritin levels were compared, and their correlations with body mass index(BMI) were investigated.
Results: The mean ages of the control (10,66±3,40; %55,80 girls) and case (10± 4,16; %62 girls) groups were similar. When compared serum iron, total iron-binding capacity, transferrin saturation and ferritin levels, in obese children aged between 12-18 years, serum iron and transferrin saturation was lower whereas ferritin level and total iron-binding capacity were higher (p<0,001). On the other hand, the ferritin level and total iron-binding capacity were higher in obese children aged between 7-12 years, while the other parameters were similar. When the correlations between BMI-SDS and hematological parameters were evaluated; positive correlations with white blood cell count (r = 0.46, p< 0.001), absolute neutrophil count (r = 0.40, p< 0.001) and ferritin levels (r = 0.36, P <0.001), while a negative correlation with transferrin saturation percentage (r = -0.22, p = 0.02) were found.
Conclusion: Obese adolescents are prone to iron deficiency with low saturation index. Therefore ferritin level may be misled for investigating iron deficiency status in obese adolescents

Keywords

• Children,Obesity,Iron deficiency,ferritin

Obez Çocuk ve Adolesanlarda Hematolojik Parametreler ve Demir Düzeyinin Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı farklı yaş gruplarındaki obez çocuk ve adolesanlarda hematolojik parametreler ve demir düzeylerini araştırmaktır.
Materyal ve Metot: Bu çalışmaya Cumhuriyet Üniversitesi Tıp Fakültesi, Çocuk Endokrinoloji Polikliniğinde takip edilen, 3-18 yaş arası yüz ellidört çocuk ve adolesan dahil edilmiştir. Kontrol grubu olarak ise, yaş ve cinsiyetleri benzer, sağlıklı 158 çocuk alınmıştır. Çocuklar yaş gruplarına göre, Grup 1 (3-7 yaş), Grup 2 (7-12 yaş) ve Grup 3 (12-18 yaş) olmak üzere 3’e ayrıldı. Hematolojik parametreler, serum demir, demir bağlama kapasitesi(FeBK) ve ferritin düzeyleri karşılaştırıldı, Vücut Kitle İndeksi(VKI) ile olan korelasyonları araştırıldı.
Bulgular: Kontrol (10,66±3,40; %55,8 kız) ve vaka (10± 4,16; %62 kız) gruplarında yaş ortalamalrı benzerdi. Serum demir, FeBK, transferrin saturasyonu ve ferritin düzeyleri karşılaştırıldığında ise 12-18 yaş grubunda, obez çocuklarda, serum demiri ve transferrin saturasyonu daha düşükken, ferritin düzeyi ve FeBK daha yüksekti (p<0,001). 7-12 yaş grubunda ise obez çocuklarda ferritin düzeyi ve FeBK daha yüksekken diğer parametreler benzerdi. Vücut kitle indeksi standart sapma (VKI-SDS) ile hematolojik parametrelerin korelasyonları karşılaştırıldığında, VKI-SDS Beyaz Küre Sayısı (r=0,46, p<0,001), Absolü Nötrofil Sayısı (r=0,40, p<0.001) ve Ferritin (r=0,36, p<0,001) ile pozitif korelasyon gösterirken, Transferrin Saturasyon Yüzdesi ile negatif bir korelasyon ( r=-0,22, p=0,02 ) gösteriyordu.
Sonuç: Obez adolesanlar düşük saturasyon indeksi nedeni ile demir eksikliğine yatkındırlar. Obezlerde demir durumu araştırılırken ferritin düzeyi tek başına yanıltıcı olabilir.

Anahtar Kelimeler

• Çocuklar,obezite,demir eksikliği,ferritin

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