Iron deficiency in infants and children - the current research challenges.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Current Opinion in Clinical Nutrition and Metabolic Care Pub Date : 2025-05-01 Epub Date: 2025-03-29 DOI:10.1097/MCO.0000000000001120

Anna Chmielewska, Magnus Domellöf

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Abstract

Purpose of review: Iron deficiency (ID) affects one in five children before they reach preschool age. Existing evidence on ID contributing to suboptimal development and neurodevelopmental disorders come mostly from mechanistic and observational studies. Recommendations for screening and treatment are diverging, emphasizing the knowledge gap. The purpose of this review is to summarize recent evidence on ID in infants and children, its possible role in developmental disorders, and effects of iron supplementation.

Recent findings: Recent well powered randomized controlled trials showed no effect of early iron supplementation on psychomotor development in infants, neither in populations at high nor low risk of ID. Treatment of nonanemic ID in children 1-3 years did not improve their cognitive scores. Evidence from observational and imaging studies suggests association of brain ID and attention deficit hyperactivity disorder in children (ADHD).

Summary: Universal prophylactic iron supplementation in infants is not supported by current evidence. Whether non anemic ID needs to be treated is uncertain and so is the legitimacy and timing of screening for ID and anemia. The role of ID and iron availability for the brain in pathogenesis of neurodevelopmental conditions such as ADHD requires further studies.

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婴幼儿缺铁——当前研究的挑战。

回顾的目的：缺铁（ID）影响五分之一的儿童在他们到达学龄前。现有的证据表明，ID有助于次优发育和神经发育障碍，主要来自机制和观察性研究。关于筛查和治疗的建议各不相同，强调了知识差距。本综述的目的是总结最近关于婴儿和儿童缺铁的证据，它在发育障碍中的可能作用，以及铁补充剂的作用。最近的发现：最近的有力的随机对照试验显示，无论是在高风险人群还是低风险人群中，早期补充铁对婴儿精神运动发育都没有影响。1-3岁儿童的非贫血性ID治疗并没有改善他们的认知评分。来自观察和影像学研究的证据表明，大脑ID与儿童注意缺陷多动障碍（ADHD）有关。总结：目前的证据不支持在婴儿中普遍预防性补充铁。非贫血性ID是否需要治疗尚不确定，ID和贫血筛查的合法性和时机也不确定。在ADHD等神经发育疾病的发病机制中，缺铁和脑铁可得性的作用有待进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Clinical Nutrition and Metabolic Care 医学-内分泌学与代谢

CiteScore

5.30

自引率

6.50%

发文量

116

审稿时长

6-12 weeks

期刊介绍： A high impact review journal which boasts an international readership, Current Opinion in Clinical Nutrition and Metabolic Care offers a broad-based perspective on the most recent and exciting developments within the field of clinical nutrition and metabolic care. Published bimonthly, each issue features insightful editorials and high quality invited reviews covering two or three key disciplines which include protein, amino acid metabolism and therapy, lipid metabolism and therapy, nutrition and the intensive care unit and carbohydrates. Each discipline introduces world renowned guest editors to ensure the journal is at the forefront of knowledge development and delivers balanced, expert assessments of advances from the previous year.