1.
The association of elevated serum ferritin concentration in early pregnancy with gestational diabetes mellitus: a prospective observational study.
Cheng, Y, Li, T, He, M, Liu, J, Wu, K, Liu, S, Ma, Z, Lu, J, Zhang, Q, Cheng, H
European journal of clinical nutrition. 2020;(5):741-748
Abstract
BACKGROUND/OBJECTIVES The results linking body iron stores to the risk of gestational diabetes mellitus (GDM) are conflicting. We aimed to measure the serum ferritin level of women in early pregnancy and evaluate the risk of GDM in a Chinese urban population. SUBJECTS/METHODS In total, 851 pregnant women between 10 and 20 weeks of gestation took part in the prospective, observational study conducted. The women were divided into four groups by quartiles of serum ferritin levels (Q1-4). Their blood samples were collected and assayed for several biochemical variables at the beginning of the study, and the women were followed up with a 75-g oral glucose tolerance test at 24-28 weeks of gestation. RESULTS The participants had an average serum ferritin concentration of 65.67 μg/L. GDM prevalence within each serum ferritin quartile was 9.4%, 14.6%, 18.8% and 19.3%, respectively, (P = 0.016). The odds ratio for GDM in the ferritin Q2-4 was 1.64 (CI: 0.90-2.99), 2.23 (CI: 1.26-3.96) and 2.31 (CI: 1.30-4.10), compared with Q1, respectively. This association persisted after adjusting for potential confounders factors. In addition, in Q4, pregnant women with a pre-pregnancy body mass index ≥24 kg/m2, maternal age ≤35 years old or haemoglobin≥ 110 g/L did have an increased risk of developing GDM. CONCLUSIONS Elevated serum ferritin concentrations in early gestation are associated with an increased risk of GDM, especially in pregnant women who have a high baseline iron storage status with no anaemia or who are overweight/obese. Individual iron supplementation should be considered to minimize the risk of GDM.
2.
The Effect of Iron Fortification on Iron (Fe) Status and Inflammation: A Randomized Controlled Trial.
Ma, J, Sun, Q, Liu, J, Hu, Y, Liu, S, Zhang, J, Sheng, X, Hambidge, KM
PloS one. 2016;(12):e0167458
Abstract
BACKGROUND Iron deficiency (ID) is common in toddlers in developing countries. Iron fortified or meat-based complementary foods may be effective to prevent ID. OBJECTIVE Our objective was to compare iron status at 18 months and growth from 6 to 18 months in rural poor toddlers fed 3 different complementary foods. METHODS The study was nested within a larger trial in which 6-month-old infants were randomized to receive 50g/d meat (MG), an equi-caloric fortified cereal supplement (FG) or local cereal supplement (LG) for 1 year. Hb, sTfR, HsCRP, ferritin and AGP were measured in 410 blood samples collected by a random sampling (MG, 137; FG, 140; LG, 133); calprotectin was measured in feces. Body iron = -[log (sTfR ×1000/ferritin)-2.8229] /0.1207. ID = ferritin<12ug/L. RESULTS The toddlers in FG had the significantly highest levels in serum ferritin and body iron (P = 0.043, 0.004), and the rates of both ID and iron deficiency anemia (IDA) were the lowest in FG (P = 0.010, 0.021). The rate of systemic inflammation in FG was 30.71%, which was the highest among three groups (P = 0.042). No intervention effects on either the rates of ID and IDA or iron stores (serum ferritin and body iron) were shown in MG. The change in length-for-age z scores (LAZ) from 6 to 18 months among three groups was significantly different (P = 0.021) and a smaller decrease of LAZ in MG and a larger decrease of LAZ in FG were observed. CONCLUSION Iron fortified cereal improved iron status of poor rural toddlers but was also associated with systemic inflammation which was likely to impair their growth.