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Interrelationship between vitamin A, iodine and iron status in schoolchildren in Shoa Region, Central Ethiopia

Published online by Cambridge University Press:  09 March 2007

Zewdie Wolde-Gebriel ,
Clive E. West ,
Haile Gebru ,
Amha-Selassie Tadesse ,
Tezera Fisseha ,
Petros Gabre ,
Chernet Aboye ,
Gonfa Ayana  and
Joseph G. A. J. Hautvast
Zewdie Wolde-Gebriel
Affiliation:
Ethiopian Nutrition Institute, PO Box 5654, Addis Ababa, Ethiopia
Clive E. West
Affiliation:
Department of Human Nutrition, Wageningen Agricultural University, PO Box 8129, 6700 EV Wageningen, The Netherlands
Haile Gebru
Affiliation:
Ethiopian Nutrition Institute, PO Box 5654, Addis Ababa, Ethiopia
Amha-Selassie Tadesse
Affiliation:
Ethiopian Nutrition Institute, PO Box 5654, Addis Ababa, Ethiopia
Tezera Fisseha
Affiliation:
Ethiopian Nutrition Institute, PO Box 5654, Addis Ababa, Ethiopia
Petros Gabre
Affiliation:
Ethiopian Nutrition Institute, PO Box 5654, Addis Ababa, Ethiopia
Chernet Aboye
Affiliation:
Ethiopian Nutrition Institute, PO Box 5654, Addis Ababa, Ethiopia
Gonfa Ayana
Affiliation:
National Health Research Institute, PO Box 1242, Addis Ababa, Ethiopia
Joseph G. A. J. Hautvast
Affiliation:
Department of Human Nutrition, Wageningen Agricultural University, PO Box 8129, 6700 EV Wageningen, The Netherlands
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Abstract

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A total of 14740 schoolchildren in seven provinces of Shoa Administrative Region in Central Ethiopia were surveyed for the prevalence of goitre, xerophthalmia and anaemia. Haemoglobin and packed cell volume were assessed in 966 children in one province while an in-depth study was conducted on 344 children in the same province and two others. Goitre, xerophthalmia (Bitot's spots) and clinical anaemia were observed in 34·2, 0·91 and 18·6% respectively of the children. Most biochemical variables were within the normal range while those of haemoglobin (Hb), mean corpuscular Hb concentration (MCHC) and urinary I excretion were lower, and mean corpuscular volume, mean corpuscular Hb (MCH), and immunoglobulins G and M were higher. Hb was strongly correlated with retinol. ferritin, MCHC, MCH, packed cell volume and erythrocyte count while retinol formed a triad with transthyretin (TTR) and retinol-binding protein (RBP) which were all correlated with one another. Total and free thyroxin and total and free triiodothyronine were positively correlated as were the concentrations of the total and free hormones. Thyrotropin (TSH) was negatively correlated with total and free thyroxin and positively correlated with free triiodothyronine. Thyroxin and triiodothyronine in both free and combined forms were all correlated with thyroxin-binding globulin which in turn was negatively correlated with the triad retinol, RBP and TTR. The triad was also negatively correlated with C-reactive protein. Urinary I excretion was positively associated with total thyroxin and negatively associated with TSH. The anaemia found was not nutritional in origin but due to the effect of infestation with intestinal parasites and malaria.

Keywords

Vitamin AIodineIronChildhood
Type
Interactions between Micronutrient Status
Information
British Journal of Nutrition , Volume 70 , Issue 2 , September 1993 , pp. 593 - 607
Copyright
Copyright © The Nutrition Society 1993

References

REFERENCES

Abdulkadir, J. & Besrat, A. (1981). Thyrotoxicosis due to isolated elevation of triiodothyronine in Ethiopian patients. East African Medical Journal 58, 785–789.Google Scholar
Anonymous (1990). Vitamin A and malnutrition/infection complex in developing countries. Lancet 336, 1349–1351.Google Scholar
Besrat, A., Admasu, A. & Ogbai, M. (1980). Critical study of the iron content of tef (Eragrostis tef). Ethiopian Medical Journal 18, 45–52.Google Scholar
Bloem, M. W., Wedel, M., Egger, R. J., Speek, A. J., Schrijver, J., Saowakontha, S. & Schreurs, W. H. P. (1989). Iron metabolism and vitamin A deficiency in children in Northeast Thailand. American Journal of Clinical Nutrition 50, 332–338.Google Scholar
Bloem, M. W., Wedel, M., van Agtmaal, E. J., Speek, A. J., Saowakontha, S. & Schreurs, W. H. P. (1990). Vitamin A intervention: short-term effects of a single, oral, massive dose on iron metabolism. American Journal of Clinical Nutrition 51, 76–79.Google Scholar
Delange, F., Bastani, S., Benmiloud, M., DeMaeyer, E., Isayama, M. G., Koutras, D., Muzzo, S., Niepomniszcze, H., Pandav, C. S. & Riccabona, G. (1986). Definition of endemic goitre and cretinism, classification of goitre size and severity of endemias, and survey technique. In Towards the Eradication of Endemic Goitre, Cretinism, and Iodine Deficiency. Scientijc Publication no. 502, pp. 373–376 [Dunn, J. T., Pretell, E. A., Daza, C. H. and Viteri, F. E., editors]. Washington, DC: PAHO/WHO.Google Scholar
DeMaeyer, E. & Adiels-Tegman, M. (1985). The prevalence of anaemia in the world. World Health Statistics Quarterly 38, 302–316.Google Scholar
Douer, D. & Koeffler, H. P. (1982). Retinoic acid enhances growth of human early erythroid progenitor cells in vitro. Journal of Clinical Investigation 69, 1039–1041.Google Scholar
Doumas, B. T., Watson, W. & Biggs, H. G. (1971). Albumin standards and the measurement of serum albumin with bromocresol green. Clinica Chimica Acta 31, 87–96.Google Scholar
Erickson, V. J., Cavalieri, R. R. & Rosenberg, L. L. (1982). Thyroxine 5'-deiodinase of rat thyroid, but not that of liver is dependent on TSH. Endocrinology 111, 434–440.Google Scholar
Fink, P. C., Romer, M., Haekel, R., Fateh-Moghadam, A., Delanghe, J., Gressner, A.M. & Dubs, R. (1989). Measurement of protein with the Behring nepbelometer: a multicentre evaluation. Journal of Clinical Chemistry and Clinical Biochemistry 27, 261–276.Google Scholar
Flores, H., Campos, F., Arauja, C. R. C. & Underwood, B. (1984). Assessment of marginal vitamin A deficiency in Brazilian children using the relative dose response procedure. American Journal of Clinical Nutrition 40, 1281–1289.CrossRefGoogle ScholarPubMed
Gebre-Medhin, M., Killander, A., Vahlquist, B. & Wuhib, E. (1976). Rarity of anaemia ofpregnancy in Ethiopia. Scandinavian Journal of Haematology 16, 168–175.CrossRefGoogle Scholar
Grant, J. P. (1991). The State of the World's Children 1991. New York: Oxford University Press on behalf of UNICEF.Google Scholar
Hellemam, P. W., Sixma, J. J., van der Plas, P. M. & Dudoc de Wit, C. (1973). Hematologie. Amsterdam: Elsevier.Google Scholar
Hetzel, B. S. (1987). An overview of the prevention and control of iodine deficiency disorders. In The Prevention and Control of Iodine Deficiency Disorders, pp. 7–31 [Hetzel, B. S., Dunn, J. T. and Stanbury, J. B., editors]. Amsterdam: Elsevier.Google ScholarPubMed
Hodges, R. E., Sauberlich, H. E., Canham, J. E., Wallace, D. L., Rucker, R. B., Mejia, L. A. & Mohanram, M. (1978). Hematopoietic studies in vitamin A deficiency. American Journal of Clinical Nutrition 31, 876–885.Google Scholar
Hofvander, Y. (1968). Hematological investigations in Ethiopia, with special reference to a high iron intake. Acta Medica Scandinavica Suppl. 494, 1–74.Google Scholar
Hollander, C. S., Mitsnma, T., Shenkman, L., Stevenson, C., Pineda, G. & Silva, E. (1972). T3 toxicosis in an iodine deficient area. Lancet ii, 1276–1278.CrossRefGoogle Scholar
Horvat, A. & Maver, H. (1958). The role of vitamin A in the occurrence of goitre on the island of Krk, Yugoslavia. Journal of Nutrition 68, 189–203.Google Scholar
Ingenbleek, Y. & De Visscher, M. (1979). Hormonal and nutritional status: critical conditions for endemic goiter epidemiology? Metabolism 28, 9–19.Google Scholar
Interdepartmental Committee on Nutrition for National Defense (1959). Ethiopia -Nutrition Survey. Washington, DC: US Government Printing Office.Google Scholar
Interdepartmental Committee on Nutrition for National Defense (1963). Manua/fot. Nutrition Surveys, 2nd ed. Bethesda, MD: National Institute of Health.Google Scholar
International Nutritional Anemia Consultative Group (1977). Guidelines for the Eradication of Iron Deficiency Anemia. Washington, DC: INACG.Google Scholar
International Nutritional Anemia Consultative Group (1985). Measurements of Iron Status. Washington, DC: INACG.Google Scholar
James, H. O., West, C. E., Duggan, M. B. & Ngwa, M. (1984). A controlled study on the effect of injected water- miscible retinyl palmitate on plasma concentrations of retinol and retinol-binding protein in children with measles in Northern Nigeria. Acta Paediatrica Scandinavica 73, 22–28.Google Scholar
Jelliffe, D. B. & Jelliffe, E. F. (1989). Community Nutritional Assessment: With Special Reference to Less Technically Developed Countries, pp. 39. New York: Oxford University Press.Google Scholar
Kochupillai, N., Karmarkar, M. G., Weightman, D., Hall, R., Deo, M. G., Mekendrick, M., Everd, D. C. & Ramalingaswami, V. (1973). Pituitary-thyroid axis in Himalayan endemic goitre. Lancet ii, 1021–1024.CrossRefGoogle Scholar
Mejia, L. A. & Arroyave, G. (1982). The effect of vitamin A fortification of sugar on iron metabolism in preschool children in Guatemala. American Journal of Clinical Nutrition 36, 87–93.Google Scholar
Mejia, L. A., Hodges, R. E., Arroyave, G., Viteri, F. & Torun, B. (1977). Vitamin A deficiency and anemia in Central American children. American Journal of Clinical Nutrition 30, 1175–1184.Google Scholar
Meugesha, M. H. (1966). Chemical composition of tef (Eragrostis tej) compared with that of wheat, barley and grain sorghum. Economic Botany 20, 268–273.Google Scholar
Mohanram, M., Kulkarni, K. A. & Reddy, V. (1977). Hematological studies in vitamin A-deficient children. International Journal of Vitamin and Nutrition Research 47, 389–393.Google Scholar
Oba, K. & Kimura, S. (1980). Effect of vitamin A deficiency on thyroid function and serum thyroid levels in the rat. Journal of Nutritional Science and Vitaminology 26, 327–334.Google Scholar
Pharoah, P. O. D., Lawton, N. F., Ellis, S. M., Williams, E. S. & Ekius, R. P. (1973). The role of triiodothyronine (T3) in the maintenance of euthyroidism in endemic goitre. Clinics/ Endocrinology 2, 193–199.Google Scholar
Raz, A., Shiratory, T. & Goodman, D. S. (1969). The interaction of thyroxine with human plasma prealbumin and with the pre-albumin-retinol binding protein complex. Journal of Biological Chemistry 244, 3230–3237.CrossRefGoogle ScholarPubMed
Sandell, E. B. & Kolthoff, I. M. (1937). Micro determination of iodine by a catalytic method. Mikrochemica Acta 1, 9–25.Google Scholar
Schade, A. L., Oyama, J., Reinhardt, R. W. & Miller, J. R. (1954). Bound iron and unsaturated iron-binding capacity of serum: rapid and reliable quantitative determination. Proceedings of the Society for Experimental Biology and Medicine 87, 443–448.Google Scholar
Sijtsma, K. W., van den Berg, G. J., Lemmens, A. G., West, C. E. & Beynen, A. C. (1993). Iron status in rats fed diets containing marginal amounts of vitamin A. British Journal of Nutririon (In the Press).Google Scholar
Solomons, N. W., Morrow, F. D., Vasquez, A., Bulux, J., Guerrero, A. & Russell, R. M. (1990). Test-retest reproducibility of the relative dose response for vitamin A status in Guatemalan adults: issue of diagnostic sensitivity. Journal of Nutrition 120, 738–744.Google Scholar
Staab, D. B., Hodges, R. E., Metcalf, W. K. & Smith, J. L. (1984). Relationship between vitamin A and iron in the liver. Journal of Nutrition 114, 840–844.Google Scholar
Suharno, D., West, C.E., Muhilal, , Logman, M. H. G. M., de Waart, F. G., Karyadi, D. & Hautvast, J. G. A. J. (1992). Cross sectional study on the iron and vitamin A status of pregnant women in West Java, Indonesia. American Journal of Clinical Nutrition 56, 988–993.Google Scholar
van Kampen, E. J. & Zijlstra, W. G. (1961). Standardization of hemoglobinometry. 11. The hemiglobincyanide method. Clinica Chimica Acta 6, 538–544.CrossRefGoogle Scholar
Wassie, E. & Abdulkadir, J. (1990). Normal thyroid function values in Ethiopians. Ethiopian Medical Journal 28, 139–143.Google ScholarPubMed
Wolde-Gebriel, Z., Demeke, T. & West, C. E. (1991). Xerophthalmia in Ethiopia: a nationwide ophthalmological, biochemical and anthropometric survey. European Journal of Clinical Nutrition 45, 469–478.Google Scholar
Wolde-Gebriel, Z., Demeke, T., West, C. E. & van der Haar, F. (1993 a). Goitre in Ethiopia. British Journal of Nutrition 69, 257–268.Google Scholar
Wolde-Gebriel, Z., Gebru, H., Fisseha, T. & West, C. E. (1993 b). Vitamin A, iron and iodine status in children with severe vitamin A deficiency in a rural village in the Hararge Region of Ethiopia. European Journal of Clinical Nutrition 41, 104–114.Google Scholar
World Health Organization (1972). Nutritional Anaemias. Technical Report Series no. 503. Geneva: WHO.Google Scholar
World Health Organization (1982). Control of Vitamin A Deficiency and Xerophthalmia. Technical Report Series no. 672. Geneva: WHO.Google Scholar