Correlates of iron status, hemoglobin and anemia in Inuit adults
Notice bibliographique
Résumé
Iron deficiency and anemia have been paradoxically observed among circumpolar Inuit populations consuming diets rich in animal-source foods for decades, yet representative data are lacking to clarify the extent and association of both conditions. Little is known about the degree to which iron deficiency anemia can explain anemia for Inuit adults, who are at nutritional risk given the ongoing nutrition transition throughout the Arctic. The objectives of this thesis were: (i) to determine the iron status of Inuit adults (from depleted iron stores to iron overload), the prevalence of anemia, and the extent to which both iron deficiency and anemia occur together for men and women throughout adulthood; (ii) to assess dietary intakes of nutrients required for erythropoiesis and associations between traditional Inuit foods, iron status and anemia; and (iii) controlling for the effect of inflammation, to identify dietary and non-dietary correlates of iron status, hemoglobin, and risk of anemia. Data for this work were from the International Polar Year Inuit Health Survey, 2007-2008. This was a cross-sectional survey, with stratified random sampling of 2550 Inuit adults (60.9 % female) 18-89 years of age with an overall household response rate of 68 %. For objective (i) hemoglobin, serum ferritin, serum high-sensitivity C-reactive protein, and (on a subset n=1039) serum soluble transferrin receptor were measured. For objective (ii), a single 24 hour recall and a 42-item semi-quantitative food frequency questionnaire were utilized. Dietary iron inadequacy was calculated by adjusting the dietary iron intake distribution from the 24 hour recall by within-subject coefficients of variation for iron intake from previous dietary surveys with this population. For objective (iii) multivariate modeling was performed for serum ferritin, iron deficiency, elevated iron stores, hemoglobin, and anemia unexplained by iron deficiency (UA), controlling for potential confounders. Results showed that iron deficiency was pervasive among pre-menopausal women and explained a significant portion of the anemia in this lifestage despite adequate iron intake. For men, body iron stores were lower than expected based on dietary intake but not depleted. Rates of UA increased with age, being highest amongst men >50 years of age (30 %). Traditional food intake was an important correlate of iron status for both men and women, and was associated with reduced risk of iron deficiency among food insecure women. UA prevalence was highest in the most traditional Inuit region and was characterized by factors associated with a more traditional lifestyle including higher red blood cell eicosapentonoic acid (RBC EPA) proportions, elevated blood lead concentrations, low education levels, infections, and inflammation. The relationship between RBC EPA % and UA is a potentially important finding and should be further investigated for impact on RBC stability and hemolysis. Regional differences and correlates of UA across age-groups do not support the hypothesis that physiologically lower hemoglobin concentrations can explain the high rates of anemia observed among Inuit. Without clear evidence for revising the WHO cut-off for Inuit, anemia without evidence of iron deficiency should not be dismissed. Iron deficiency and anemia remain important public health concerns for Canadian Inuit adults.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».