The association between iron deficiency anemia and obesity in children

Objectives: To examine the association between obesity and iron status and the presence of iron deficiency anemia in children. Methods: This case-control study included 100 children between 2-14 years of age who were divided into two age- and sex- matched equal groups of 50 children each. Children with a body mass index (BMI) greater than or equal to 95th centile were categorized as obese while the other 50 children with a BMI greater than or equal to 5th centile but less than 95th centile were considered the normal weight group. Children with cardiac disease, liver disease, chronic gastrointestinal disease and chronic hematologic disorders except iron deficiency (with or without anemia) and those taking Vitamin or mineral supplements regularly during the previous year were excluded.  Each participant was sent for serum iron, ferritin, total iron binding capacity (TIBC), transferrin saturation TS and complete blood count. Iron deficiency is defined as Transferrin Saturation (TS) lower than 16% and IDA is defined as TS lower than 16% and hemoglobin (Hb) concentration lower than 120 g/l or 12 mg/dl for children. The data were analyzed using SPSS-23 software and for all data normal distribution was tested so that P-value<0.05 is the level of threshold for statistical significance. Results: The gender distribution between the both group is reversed with male being more common in obese group but no statistical difference. The age distribution shows dominance of the age group 5-10 years in the both group with some differences which are of no statistical significance (P=0.294). The values of Hemoglobin, serum iron, serum ferritin, total iron binding capacity and transferrin saturation are obviously similar between the both genders of the whole study population with no statistically significant differences (P=0.084, 0.469, 0.48,0.4, 0.571 respectively). Obese children have higher level of Hemoglobin(P=0.069), Ferritin(P=0.5) and total iron binding capacity(P=0.449) but lower levels of serum iron (P =0.234) and transferrin saturation(P=0.45) but with no statistical significance. Conclusion: There is no significant association between obesity and iron status and the presence of iron deficiency anemia despite a lower level of serum iron and lower transferrin saturation in obese than normal weight children.