Prevalence of Iron Deficiency anemia in Obese Children in Taif Area - Saudi Arabia

Background: The growing global health problem is obesity which has increased dramatically in recent years. The prevalence of obesity continues to rise in developed and developing countries, Poor iron status are affecting millions of people worldwide. Iron deficiency is the first nutrient deficiency all over the world and both obesity and iron deficiency may lead to adverse health issues. In 2013, an estimated 42 million children aged under 5 years (6.3%) were overweight, an increase from around 5% in 2000 to 6% in 2010 and 6.3% in 2013, with the highest rates of increase being observed in Africa and Asia. Rapid changes from traditional to new diets, which contain large amounts of fat, sugar and oil is one of the major causes of obesity. Obesity has been associated with higher rates of death driven by co morbidities. According to the recent researches, the rate of obesity is significantly high in Saudi Arabia, and expected to increase in future.
Aim of the study: To evaluate the association between the obesity and iron deficiency anemia among children in Al-Taif Region, Kingdom of Saudi Arabia and to increase the awareness about the hazards of obesity on the general health. Method: A cross sectional study design. A structured questionnaire was designed to obtain the necessary information from a convenient sample of 200 child aging from (5-12 years) attending the pediatric outpatient clinics of pediatric hospital in Taif region - Saudi Arabia from August till November 2016. Information about weight, height, Body Mass Index (BMI), Hemoglobin levels and the serum iron. The assessment of obesity with BMI index using the CDC2000 reference percentile was divided into four categories5th, 50th, 85th and 95th, namely; underweight, normal, overweight and obese respectively. Iron Deficiency was defined as Transferrin Saturation lower than 16% and Iron deficiency anemia was defined as Transferrin Saturation lower than 16% and hemoglobin (Hb) concentration lower than 12 g/l or 12 mg/dl for children. Results: This study shows negative significant correlation between hemoglobin level with the BMI ( r -0.429 p value 0.017 ) delayed weaning & no iron supplements ( r -0.338p value 0.023), bad food habits (r -0.309  p value 0.012) and warm disease, ( r --0.406  p value 0.028),  suffering  from poor food absorption disease (r 0.266p value 0.033)  and chronic diarrhea ( r -0.311p value 0.011) . The prevalence of anemia among the study group shows 60% of its group are suffering from high BMI 79.2% of them suffering from IDA, while 20.8% are healthy. 40% of study group are with normal BMI 21.25% of them are suffering from anemia while 63% are healthy. Conclusions:Hepcidin plays a central role in the anemia of chronic disease and Hepcidin overproduction even in mild inflammatory disorder as obesity may explain the association of poor iron status with obesity. IL6 and Leptin may be part of the axis that links obesity, inflammation, and Hepcidin with poor iron status. This study suggests that the higher levels of total obesity should be taken into account when assessing the children’s body iron status and should be treated before providing dietary recommendations to correct anemia.