Anemia diagnosis in populations residing at high altitude (HA) involves an adjustment of hemoglobin (Hb) values owing to the increase in its concentration with altitude. The suitability of the adjustment has been questioned since Hb concentrations depend on how adapted a population is to HA. In Peru, anemia in preschool children (PSC) is a matter of severe public concern for its high rates; in the city of Puno (∼3800 MASL), for example, 67.7% of children under 3 years are diagnosed with anemia. Here, we conducted an observational study in PSC living at different altitudes in Puno to assess Hb, iron status, and the suitability of altitude-adjusted Hb values in defining iron deficiency anemia. After adjusting Hb, 65.66% of the population had anemia, while only 4.8% of PSC had anemia when using unadjusted Hb. Receiver-operating characteristic curves using total body iron (TBI) as a marker of iron status are presented. In the 36- to 59-month age group, unadjusted Hb performed better than altitude-adjusted Hb. In the 6- to 35-month age group, anemia (adjusted or unadjusted) was not associated with TBI. We conclude that Hb adjustment by altitude is not appropriate. Anemia at an early age is not entirely attributable to iron deficiency.

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生活在高海拔地区的儿童贫血患病率是真的吗？秘鲁的一项观察性研究

居住在高海拔 (HA) 人口的贫血诊断涉及血红蛋白 (Hb) 值的调整，因为其浓度随海拔升高而增加。调整的适用性受到质疑，因为 Hb 浓度取决于人群对 HA 的适应程度。在秘鲁，学龄前儿童贫血 (PSC) 的高发生率引起了公众的严重关注；例如，在普诺市（~3800 MASL），67.7% 的 3 岁以下儿童被诊断为贫血。在这里，我们对居住在普诺不同海拔的 PSC 进行了一项观察性研究，以评估 Hb、铁状态以及海拔调整后的 Hb 值在定义缺铁性贫血方面的适用性。调整 Hb 后，65.66% 的人群出现贫血，而使用未调整 Hb 时，只有 4.8% 的 PSC 出现贫血。呈现了使用全身铁 (TBI) 作为铁状态标志物的接受者操作特征曲线。在 36 至 59 个月的年龄组中，未经调整的 Hb 表现优于经海拔调整的 Hb。在 6 至 35 个月的年龄组中，贫血（调整或未调整）与 TBI 无关。我们得出结论，根据海拔高度调整 Hb 是不合适的。早期的贫血并不完全是由于缺铁造成的。