Health-related quality of life in iron deficient young women

Abstract

BACKGROUND: The most important cause of anemia in the world is iron deficiency. Young women are more susceptible to the formation of latent iron deficiency and iron deficiency anemia in comparison with other population groups. Iron deficiency conditions can lead to a deterioration in exercise tolerance and adaptation to them, however, the effect of latent iron deficiency and iron deficiency anemia on cognitive functions, emotional status and quality of life is still a subject of discussion, which may be due to the small number of studies in which iron deficiency conditions are studied in the absence of concomitant chronic diseases.

AIM: Evaluate the effect of latent iron deficiency and iron deficiency anemia on the quality of life in young women.

MATERIALS AND METHODS: a cross-sectional simultaneous study was conducted in women aged 18–21 years. The occurrence of iron deficiency conditions was assessed, a study of the quality of life was conducted using the SF-36 questionnaire. In the statistical processing of the results obtained, the assessment of normality within each group was carried out using Shapiro-Wilk test. For an intergroup comparison of the results obtained between two independent groups, Mann–Whitney test was used, and Wilcoxon test was used when comparing the results of two dependent groups. The intergroup comparison between the three groups was carried out using Kruskal–Wallis test. When detecting deviations from the null hypothesis, a posteriori analysis was carried out using Mann–Whitney test with Bonferroni correction.

RESULTS: 68 subjects aged 18–21 took part in the study. The median age was 18 years [18; 21]. 25 (36.7%) women were diagnosed with ID, 16 (23.5%) with IDA. The level of C-reactive protein in all subjects was <5 mg/l, median 2.4 [1.2; 3.1] mg/l. During a posteriori analysis, comparable indicators of the total blood count between the groups of healthy women and those with ID were revealed. At the same time, there were no differences in ferritin levels between the ID and IDA groups. In the study of quality of life, statistically significant intergroup differences between the study groups were obtained in the scales of general health, vital activity, role functioning due to emotional state, mental health and general mental well-being. When conducting a posteriori analysis, the number of points in the questionnaire scales turned out to be comparable between groups of healthy women and those with ID.

CONCLUSIONS: data on the high incidence of latent iron deficiency and iron deficiency anemia in young women have been obtained. The presence of latent iron deficiency does not independently affect the quality of life associated with health. Mild iron deficiency anemia moderately reduces the quality of life due to the emotional component.

Keywords

anemia / ferritin / iron deficiency / iron deficiency anemia / latent iron deficiency / quality of life / SF-36

References

[1] WHO. The global prevalence of anemia in 2011. World Health Organization: Geneva; 2015.

[2] WHO. The global prevalence of anemia in 2011. World Health Organization: Geneva, 2015.

[3] Drapkina OM, Martynov AI, Balda AP, et al. Resolution of the expert council “Relevant issues of iron deficiency in the Russian Federation”. Cardiovascular Therapy and Prevention. 2020;19(5): 236–241 (In Russ.) DOI: 10.15829/1728-8800-2020-2700

[4] Драпкина О.М., Мартынов А.И., Байда А.П., и др. Резолюция экспертного совета «Актуальные вопросы железодефицита в Российской Федерации» // Кардиоваскулярная терапия и профилактика. 2020. Т. 19, № 5. С. 236–241. DOI: 10.15829/1728-8800-2020-2700

[5] Pal S, Rishi P, Pawaria S, et al. Prevalence of iron deficiency with or without anemia in female athletes — a review. European Journal of Molecular & Clinical Medicine 2020;7(11):2586–2595.

[6] Pal S., Rishi P., Pawaria S., et al. Prevalence of iron deficiency with or without anemia in female athletes — a review // European Journal of Molecular & Clinical Medicine. 2020. Vol. 7, No. 11. P. 2586–2595.

[7] Sakhin VТ, Madzhanova ЕR, Kryukov EV, et al. Anemia of chronic disease: features of pathogenesis and possible therapeutic correction (literature review and results of own research). Oncohematology. 2018;13(1):45–53. (In Russ.) DOI: 10.17650/1818-8346-2018-13-1-45-53

[8] Сахин В.Т., Маджанова Е.Р., Крюков Е.В., и др. Анемия хронических заболеваний: особенности патогенеза и возможности терапевтической коррекции (обзор литературы и результаты собственных исследований) // Онкогематология. 2018. Т. 13, № 1. С. 45–53. DOI: 10.17650/1818-8346-2018-13-1-45-53

[9] Sakhin VT, Kryukov EV, Rukavitsyn OA. Anemia of chronic diseases — the key mechanisms of pathogenesis and the attempt of the classification. Pacific Medical Journal. 2019;(1):33–37. (In Russ.) DOI: 10.17238/PmJ1609-1175.2019.1.33-37

[10] Сахин В.Т., Крюков Е.В., Рукавицын О.А. Анемия хронических заболеваний — особенности патогенеза и попытка классификации // Тихоокеанский медицинский журнал. 2019. № 1. С. 33–37. DOI: 10.17238/PmJ1609-1175.2019.1.33-37

[11] Bondarchuk SV, Golovko KP, Ovchinnikov DV. Anemia of chronic diseases as an interdisciplinary problem. Russian Military Medical Academy Reports. 2021;40(2):55–61. (In Russ.) DOI: 10.17816/rmmar81177

[12] Бондарчук С.В., Головко К.П., Овчинников Д.В. Анемия хронических заболеваний как междисциплинарная проблема // Известия Российской Военно-медицинской академии. 2021. Т. 40, № 2. С. 55–61. DOI: 10.17816/rmmar81177

[13] Volkov KYu, Tyrenko VV, Buryak IS, et al. Anemia of chronic diseases in the practice of rheumatologist: features of pathogenesis, diagnosis and differential diagnosis. Clinical Pathophysiologocal Research. 2018;24(6):37–41. (In Russ.)

[14] Волков К.Ю., Тыренко В.В., Буряк И.С., и др. Анемия хронических заболеваний в практике ревматолога: особенности патогенеза, диагностики и дифференциальной диагностики // Клиническая патофизиология. 2018. T. 24, № 6. С. 37–41.

[15] Badenhorst CE, Goto K, O’Brien W, et al. Iron status in athletic females, a shift in perspective on an old paradigm. Journal of Sports Sciences. 2021;39:1565–1575. DOI: 10.1080/02640414.2021.1885782

[16] Badenhorst C.E., Goto K., O’Brien W., et al. Iron status in athletic females, a shift in perspective on an old paradigm // Journal of Sports Sciences. 2021. Vol. 39. P. 1565–1575. DOI: 10.1080/02640414.2021.1885782

[17] Grondin M, Ruivard M, Perre’ve A, et al. Prevalence of Iron Deficiency and Health-related Quality of Life among Female Students. Journal of the American College of Nutrition. 2008;27(2):337–341. DOI: 10.1080/07315724.2008.10719709

[18] Grondin M., Ruivard M., Perre’ve A., et al. Prevalence of Iron Deficiency and Health-related Quality of Life among Female Students // Journal of the American College of Nutrition. 2008. Vol. 27, No. 2. P. 337–341. DOI: 10.1080/07315724.2008.10719709

[19] Dziembowska I, Kwapisz J, Izdebski P, et al. Mild iron deficiency may affect female endurance and behavior. Physiology & Behavior Nutrition. 2019;205:44–50. DOI: 10.1016/j.physbeh.2018.09.012

[20] Dziembowska I., Kwapisz J., Izdebski P., et al. Mild iron deficiency may affect female endurance and behavior // Physiology & Behavior Nutrition. 2019. Vol. 205. P. 44–50. DOI: 10.1016/j.physbeh.2018.09.012

[21] Lukina EA, Tsvetaeva NV, Dvirnyk VN, et al. Zhelezodeficitnaya anemiya. Federalnye klinicheskie recomendacii. Moscow; 2021. 45 p. (In Russ.)

[22] Лукина Е.А., Цветаева Н.В., Двирнык В.Н., и др. Железодефицитная анемия. Федеральные клинические рекомендации. М., 2021. 45 с.

[23] Ko CW, Siddique SM, Patel A, et al. AGA clinical practice guidelines on the gastrointestinal evaluation of iron deficiency anemia. Gastroenterology. 2020;159(3):1085–1094. DOI: 10.1053/j.gastro.2020.06.046

[24] Ko C.W., Siddique S.M., Patel A., et al. AGA clinical practice guidelines on the gastrointestinal evaluation of iron deficiency anemia // Gastroenterology. 2020. Vol. 159, No. 3. P. 1085–1094. DOI: 10.1053/j.gastro.2020.06.046

[25] Cappellini MD, Musallam KM, Taher AT. Iron deficiency anemia revisited. Journal of Internal Medicine. 2020;287(2):153–170. DOI: 10.1111/joim.13004

[26] Cappellini M.D., Musallam K.M., Taher A.T. Iron deficiency anemia revisited // Journal of Internal Medicine. 2020. Vol. 287, No. 2. P. 153–170. DOI: 10.1111/joim.13004

RIGHTS & PERMISSIONS

Kovalev A.V., Polyakov A.S.