Association between Consumption of Cow-s Milk and Iron Deficiency Anemia in Children: Are There Roles for Hepcidin-25/Ferroportin? A Case-Control Study
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Systemic iron homeostasis is regulated by the interaction of the peptide hormone, hepcidin and the iron exporter, ferroportin. The objective was to investigate the relationship between the consumption of cow-s milk and iron deficiency anemia in children 2-10 years old and its association with the hepcidin-25 and ferroportin concentrations. The study population consisted of 187 prepubescent children of similar ideal body weight (IBW:90-120%); 82 children with iron deficiency anemia (37girls and 45boys; 4.27 +/- 0.28 years) and 105 (47girls and 58boys; 4.25 +/- 0.34 years) healthy age-sex-matched controls. Serum fasting hepcidin-25/ferroportin concentrations were measured by enzyme immunoassay in all subjects. Mean cow-s milk consumption in the anemic group (373 +/- 248 mL/d) tended to be higher than that in the control group (320 +/- 226 mL/d), but the result was not statistically significant (p = 0.063).The mean hepcidin-25 level was significantly higher in the anemic group (19.5 +/- 18.4 ng/mL) than in the healthy controls (11.0 +/- 10.7, p < 0.001). The mean ferroportin level was lower in the anemic group (21.04 +/- 5.74 ng/mL) than in the healthy controls (22.68 +/- 4.77 ng/ml, p = 0.037). Consuming cow-s milk was not associated with IDA in prepubertal children, provided that it was adequately supplemented with iron-enriched foods. We observed a significant increase in hepcidin-25 levels and a decrease in ferroportin levels in children with iron deficiency anemia compared with healthy controls. Children who consumed more cow-s milk had higher levels of hepcidin-25. Iron deficiency anemia is not a concern when cow-s milk is given to children if the complementary foods are rich in iron.