Iron Absorption and Malnutrition

Iron Absorption during Recovery from Malnutrition

Edgar Vasquez Garibay, MD, Irene Santos Torres, MD, Steven E. Nelson, BA, Ekhard E. Ziegler, MD, FACN, Ronald R. Rogers, BS, Morteza Janghorbani, PhD, and Samuel J. Fomon, MD

Instituto de Nutricion Humana, Hospital Civil “Dr. Juan I. Menchaca,” Universidad de Guadalajara, Guadalajara, Jalisco, MEXICO (E.V.G., I.S.T.), Department of Pediatrics, University of Iowa, Iowa City, Iowa (S.E.N., E.E.Z., R.R.R., S.J.F.), BioChemAnalysis Corporation, Chicago, Illinois (M.J.) []

Objective: In infants and children recovering from severe malnutrition, iron deficiency is common, and the ability to absorb iron during such recovery is uncertain. The objective of this study was to determine iron absorption during recovery from malnutrition.

Methods: During the later stages of recovery from malnutrition, erythrocyte incorporation of orally administered 58Fe was determined as a surrogate for iron absorption. Based on four indices, subjects were classified as iron-sufficient, iron-deficient or indeterminate.

Results: Of the 25 subjects, 9 were classified as iron sufficient, 5 as indeterminate and 11 as iron deficient; all but 5 had evidence of inflammation or infection. Geometric mean erythrocyte incorporation of 58Fe was 32.0% of the dose in the iron-deficient subjects, which was not significantly different (p = 0.073) than the 13.1% in the iron-sufficient subjects. Incorporation of 58Fe by the iron-sufficient subjects did not differ significantly from that by normal subjects in the same age range. Surprisingly, we found no correlation of erythrocyte incorporation of 58Fe and reticulocyte count.

Conclusions: Even in the presence of infection or inflammation, iron absorption by children during a late stage of recovery from malnutrition is not impaired.

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