IRON DEFICIENCY ANEMIA IN ACUTE STROKE AND TRANSIENT ISCHEMIC ATTACK PATIENTS
Date
2002
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
Type
Degree Level
Masters
Abstract
Iron deficiency anemia (IDA) has been implicated as a possible risk factor for stroke and transient ischemic attack (TIA) on the basis of epidemiological findings and numerous case reports. The study objectives were to document the prevalence of IDA in a series of patients ≥ 65 years of age admitted with TIA or stroke, and to investigate whether previous dietary intake was a predictor of iron status. Blood samples were collected within 24 hours of admission for 94 patients, and IDA was identified using an algorithm containing values for hemoglobin, ferritin, total iron binding capacity, transferrin saturation, and serum transferrin receptor (sTfR). The Clue II food frequency questionnaire was administered to obtain information about usual dietary intake. The prevalence of IDA in this study was 6.4%. Two methods were used to compare this prevalence figure with findings from the Third National Health and Nutrition Examination Survey (NHANES III). The first comparison was with published prevalence figures for males and females ≥ 70 years of age, and revealed a significantly higher IDA prevalence in the current study for both genders. The second analysis, a case-control comparison, compared prevalence figures with data for 94 age and gender-matched, non-Hispanic white controls with no previous history of stroke from the NHANES III database; this difference approached statistical significance. These findings suggest that IDA should be further investigated as an independent risk factor using a prospective case-control design, using age and gender-matched controls. An unexpected finding from this study was the high percentage of subjects (30%) with sTfR values below the reference range; problematic reference ranges for the elderly or a stroke response might be implicated. Multivariate regression analysis was used to identify significant predictors of iron status, but few significant associations were apparent. Gender emerged as a significant predictor of hemoglobin, and supplemental iron and heme iron were found to be significant predictors of total iron binding capacity. Limited study power or underreporting of intake may have contributed to the
lack of association between iron status and previous dietary intake.
Description
Keywords
IRON DEFICIENCY ANEMIA
Citation
Degree
Master of Science (M.Sc.)
Department
Pharmacy and Nutrition