Mal J Nutr 22(2): 219 - 232, 2016

Underweight as a Risk Factor for Iron Depletion and IronDeficient Erythropoiesis among Young Women in Rural Areas of East Java, Indonesia
Sri Sumarmi1, Nunik Puspitasari2, Retno Handajani3 & Bambang Wirjatmadi1

1Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia
2 Department of Biostatistics and Population Study, Faculty of Public Health, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia
3 Department of Medical Biochemistry Faculty of Medicine, Universitas Airlangga, Jl. Moestopo Surabaya, Indonesia


ABSTRACT

Introduction: Underweight and iron deficiency are serious problems in Indonesia. A good understanding of the association of these problems is required. Methods: A crosssectional study was conducted in Probolinggo Regency, East Java Province, Indonesia on 115 non-pregnant, apparently healthy women, aged 21.7±3.7 years who were recruited after physical examination and pregnancy test at the Public Health Centre. Body weight and height were measured to calculate body mass index. Levels of haemoglobin, serum ferritin and soluble transferrin receptor (sTfR) were determined to assess parameters of iron status (WHO, 2007). Independent t-test was used to compare the mean difference of underweight group (n=27) and non-underweight group (n=88). Binary logistic regression was used to determine the association between underweight and iron status, and odds ratio. Results: The results indicate that 23.5% of women were underweight, and 33% anaemic. Anaemia among underweight women was 48.1%, while in the non-underweight (normal and overweight) women, it was 28.4%. Rates of iron depletion (37%) and iron-deficient erythropoiesis (IDE) (48.1%) among underweight women were higher than among the nonunderweight (9.1% and 17% respectively). After adjusting for nutrient intake, underweight women were seven times more likely to have depleted iron store (OR: 7.05; 95% CI: 1.17-42.41; p=0.03), and approximately four times more likely to be IDE (OR: 3.93; 95% CI: 1.46 -10.54; p=0.007) compared to those who were not underweight. Conclusion: Iron deficiency is more prevalent among underweight young women. Underweight is a risk factor for IDE and iron depletion rather than for anaemia. In addition, the risk for iron depleted iron store is higher than the risk for IDE among underweight young women. Therefore, iron supplementation to prevent iron deficiency among non pregnant women should be simultaneously followed with high energy density supplementary feeding for underweight women in this group.

Keywords: Anaemia, iron deficiency, iron-deficient erythropoiesis, iron depletion

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