Iron Deficiency Anemia Prevalence at First Stroke or Transient Ischemic Attack

• Published in: Canadian journal of neurological sciences 2012-03, Vol.39 (2), p.189-195
• Main Authors: Dubyk, Melanie D., Card, Robert T., Whiting, Susan J., Boyle, Carol A. J., Zlotkin, Stanley H., Paterson, Phyllis G.
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Algorithms; Anemia; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - complications; Anemia, Iron-Deficiency - diagnosis; Anemia, Iron-Deficiency - epidemiology; Biological and medical sciences; Brain Ischemia - complications; Dietary intake; Female; Ferritin; Ferritins - blood; Food; Geriatrics; Heme; Hemoglobin; Hemoglobins - metabolism; Hospitals; Humans; Iron; Ischemia; Ischemic Attack, Transient - complications; Male; Medical sciences; Neurology; Nutrient deficiency; Nutrition; Prevalence; Prospective Studies; Receptors, Transferrin - blood; Regression analysis; Risk Factors; Statistical analysis; Stroke; Stroke - complications; Transferrin receptors; Transient ischemic attack; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0317-1671; 2057-0155
• DOI: 10.1017/S0317167100013214

Iron deficiency anemia (IDA) has been implicated in the etiology of transient ischemic attack and ischemic stroke. This study aimed to: 1) document IDA prevalence in patients ≥ 65 years of age admitted to hospital with transient ischemic attack or first ischemic stroke, and 2) investigate dietary intake as a predictor of iron status. Ninety-four patients were enrolled. An algorithm containing values for hemoglobin, ferritin, total iron binding capacity, transferrin saturation, and serum transferrin receptor measured at admission was used to identify IDA. Usual dietary intake was assessed with the Clue II food frequency questionnaire. Prevalence estimates were 6.4% for IDA, 2.1% for iron deficiency without anemia, and 6.4% for anemia from other causes. IDA prevalence was significantly higher than published National Health and Nutrition Examination Survey III (NHANES III) estimates for gender-specific age groups ≥ 70 years (One-Sample Proportion Test; males p = 0.038 [n= 37]; females p = 0.002 [n=44]). A comparison of IDA prevalence against selected controls from the NHANES III database yielded an odds ratio (OR) of 6.3, 95% confidence interval (CI) 0.8 to 53.7, which was not statistically significant (Fisher's Exact Test; n=94; p = 0.118). Multivariate linear regression analysis of dietary intake with indicators of iron status (n=58) revealed only iron supplements (p = 0.013) and heme iron intake (p = 0.038) as negative predictors of total iron binding capacity (p