Diagnostic and Etiological Role of Zinc Insufficiency in Children with Iron Deficiency Anemia from Sukkur, Sindh, Pakistan

Abstract

Iron deficiency anemia (IDA) still represents one of the significant public health problems among children living in developing countries. Coexistent zinc deficiency may occur together with iron deficiency and possibly interfere with erythropoiesis, immunity, growth, and recovery of hematological profile. To measure serum zinc status in children with IDA and to explore its correlation with ferritin and hematological parameters. The present cross-sectional comparative study involved 150 children with IDA and 150 healthy controls aged 1–15 years selected from Civil Hospital/Ghulam Muhammad Mahar Medical College Teaching Hospital, Sukkur, Pakistan. Hematological parameters and ferritin were determined on an automated analyzer, whereas serum zinc was analyzed using 5-Br-PAPS method with ADVIA 1800 Chemistry analyzer. Mean serum zinc level was significantly lower in children with IDA than in control children (79.20 ± 0.73 vs. 112.17 ± 0.48 microgram per deciliter; p<0.001). Zinc deficiency was noted in each of the studied age-sex groups. Serum zinc had positive correlations with hemoglobin (r = 0.51), hematocrit (r = 0.42), mean corpuscular volume (r = 0.40), and ferritin (r = 0.41). Multivariate linear regression revealed independent contributions of zinc and ferritin levels as predictors of hemoglobin, accounting for 78% of its variance. There was a clear evidence of severe zinc deficiency among our study subjects suffering from pediatric IDA, which supports the notion of multifactorial nature of IDA. Zinc status evaluation during routine hematological assessment of children with anemia deserves attention as a potential source of valuable information.