Epidemiology of iron deficiency in Russia: serum ferritin values depending on sex and age

The high prevalence of iron deficiency (ID) in women and its important negative impact on the health care system is beyond doubt. The presence of severe problems of a systemic nature requires the development of special state programs to combat ID. The development of such programs is impossible without conducting epidemiological studies in each specific country. The purpose of this work is to determine the frequency and severity of ID in terms of serum ferritin (SF) in primary outpatients, depending on gender and age. The study was conducted in 15 large cities of Russia, in total, 1737 primary patients were included, of which 97 were males and 1640 were females. When studying the parameters of SF in general groups, its values are significantly lower in females, and average 40 ± 99 μg/l, while 61% of this cohort of patients have SF less than 30 μg/l, and 70% live in conditions of SF below target values, which requires the development of preventive programs to combat ID among female patients. Between the ages of 16 and 49, almost all females live in conditions of absolute ID, and it is probably in this group that the above activities should be carried out. On the contrary, as regards male patients, judging by the data obtained, a mandatory determination of SF is required to make a decision on conducting ferrotherapy.

1. Stevens G.A., Finucane M.M., De-Regil L.M. et al. Nutrition Impact Model Study Group (Anaemia). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16–25.

2. The global prevalence of anaemia in 2011. Geneva: World Health Organization. 2015.

3. World Health Organization. Iron deficiency anaemia: assessment, prevention, and control. A guide for programme managers. Geneva: WHO. 2001. (WHO/NHD/01.3).

4. Huynh B.T., Cottrell, G., Cot M., Briand V. Burden of malaria in early pregnancy: A neglected problem? Clin. Infect. Dis. 2015;60:598–604. DOI: 10.1093/cid/ciu848.

5. Beard J.L. Iron requirements in adolescent females. J. Nutr. 2000;130(2):440S–2S. DOI: 10.1093/jn/130.2.440S.

6. Abbaspour N., Hurrell R., Kelishadi R. Review on iron and its importance for human health. J. Res. Med. Sci. 2014;19(2):164–174.

7. Food and Agriculture Organization of the United Nation, WHO. Human vitamin and mineral requirements. Report of a joint FAO/WHO expert consultation Bangkok, Tailand. Rome, Italy. 2002.

8. World Health Organization. The World Health Report 2002: Reducing risks, promoting healthy life. Geneva: WHO. 2002.

9. See Ling Loy, Li Min Lim, Shiao-Yng Chan et al. Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study. BMC Public Health. 2019:19(1):397. DOI: 10.1186/s12889-019-6736-y.

10. Means R.T. Iron deficiency and iron deficiency anemia: implications and impact in pregnancy, fetal development, and early childhood parameters. Nutrients. 2020;12:447. DOI: 10.3390/nu12020447

11. Stuklov N.I., Sushinskaya T.V., Mitchenkova A.A., Kovalchuk M.S. Anemia of pregnancy in the 21st century. Hematologist’s standpoint. Farmateka. 2020;27(6). (In Russian). DOI: 10.18565/pharmateca.2020.6.00-00.

12. Stuklov N.I., Basiladze I.G., Kisly N.D. Iron deficiency in Russia: main problems and possible solutions. Akusherstvo i Ginekologiya / Obstetrics and Gynecology. 2021;11:237–244 (In Russian). DOI: 10.18565/aig.2021.11

13. Resolution of the expert council on iron deficiency anemia in women. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie. 2020;8(4):28–36. (In Russian). DOI: 10.24411/2303-9698-2020-14004

14. World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: World Health Organization. 2020:82.

15. Camaschella C. Iron-deficiency anemia. N. Engl. J. Med. 2015, 372:1832–1843.

16. Sakhin V.T., Madzhanova E.R., Kryukov E.V. et al. Anemia of chronic disease: features of pathogenesis and possible therapeutic correction (literature review and results of own research). Onkogematologiya / Oncohematology. 2018;13(1):45–53. (In Russian). DOI: 10.17650/1818-8346-2018-13-1-45-53.

17. Clinical guidelines. Iron deficiency anemia. 2021:24. (In Russian).