Title
Diagnosis of anemia in populations at high altitudes
Other title
[Necesidades de investigación para el diagnóstico de anemia en poblaciones de altura]
Date Issued
01 October 2017
Access level
open access
Resource Type
journal article
Publisher(s)
Instituto Nacional de Salud
Abstract
Iron deficiency and overload are risk factors for numerous poor health outcomes, and thus the maintenance of iron homeostasis is vital. Considering that hemoglobin contains 70% of the total iron in the body, the World Health Organization (WHO) recommends the measurement of iron levels to calculate the rate of iron deficiency anemia (IDA), although WHO recognizes that IDA is not the only cause of anemia. As hemoglobin increases with altitude, WHO recommends correcting the cut-off point to define anemia at high altitudes. An objection to this correction is that the increase in hemoglobin at high altitudes is not universal and is not linear. In addition, individuals in older age groups have lower hemoglobin levels than those in younger age groups. In infants, children, pregnant women, and adults, the prevalence of anemia using corrected hemoglobin is 3–5 times higher than that using markers of iron status. State programs seek to control anemia by means of iron supplementation. However, these programs are ineffective, particularly for high-altitude populations. Therefore, the occurrence of iron deficiency at high altitudes is controversial. The serum levels of the hormone hepcidin, which regulates iron availability, are similar in individuals at high altitudes to those of individuals at sea level, indicating that iron deficiency does not occur at high altitudes. An additional problem when correcting hemoglobin at high altitudes is that the frequency of erythrocytosis is decreased. In conclusion, the correction of the cut-off point of hemoglobin at high altitudes to determine iron deficiency is inadequate.
Start page
699
End page
708
Volume
34
Issue
4
Language
Spanish
OCDE Knowledge area
Nutrición, Dietética
Ciencias del medio ambiente
Subjects
Scopus EID
2-s2.0-85040231997
PubMed ID
Source
Revista Peruana de Medicina Experimental y Salud Publica
ISSN of the container
17264634
Sources of information:
Directorio de Producción Científica
Scopus