Transcript
HEMOGLOBIN
LEVELS CHILDREN
OLD W.
By
W.
AMONG SEVEN IN SASKATOON, M.Sc.,
HAWKINS,
AND
NUTRITIONAL
I
N THE as
appraisal
an
globin
index
formation
have
provided
Besides
of
factors,
intake
the
in
case
of
recommendation crease
being
iron
is most
would
be
rats
one
is
mg.
age.
independent
of
it
for
hemoglobin
protein,
some
both
both
daily,
metals
the
at one
and
level
is used
mainly
however,
that
hemo-
and
that
of
certain
are
for
and
and
animal
experiments
of
the
involved
and
findings
of 7 tO may
children as
increased
but
from
comments such
hemoglobin
women,
girls
children
among
by
year
men
boys
figures
part
of age
BA.
KLINE,
remembered,
importance
nutritionally in
month
adequate of
For
These
important
supported
blood be
probable
of iron male.
with
the
should
amounts
adult i
K.
DOROTHY
YEAR
in
vitamins. hemoglobin
but they hardly constitute nutritional problems. Board of the National Research Council’ recommends
mg.
12.
of the
upon the
trace
formation or maintenance, The Food and Nutrition a daily
It
also
evidence
these
status
nutrition.
depends
FOURTEEN CANADA
CONSIDERATIONS
of nutritional
of iron
TO
14
it
is io
reflect
the
with
2.0
the
iron
the
the
i5,
opinion
inthat
This
and
need
of age
to
women.
of Ellis
the
years
tO
and
that
questions
53
opinion
Bessey’
that
intake,
but
for
became
of age.
Widdowson and McCance3 have recently reported that with the onset of sexual development the females of some species possess a greater ability to accumulate iron in the liver than do the males, and they have presented some evidence to indicate a governing role of sex hormones. They found that pregnancy rapidly reduced has
the
liver that
stated
males.
He
ence
up
to the
iron
in
in
the
case
to
that
and
of
age
of
of
the
only
during
human
iron
the
Gm.
to be about
per the
than
amount
of iron
and
is characterized
tional From
its
small
importance factors the
period
Department
since
less
there
slow.
iron
appears
Lapicque4
than
those
to be no
sex
of
differ-
growth. whatever
as calcium
as that
The
for
iron,
The
requirement by upon
but
not
of Biochemistry,
within
by the
be emphasized
level
the body to the
the
in
comparison
order
of
magnesium body
nature and extent
Saskatoon,
Gm.
i
is judged
in much
quantitative
are neglected.
of Saskatchewan, 2.78
in the the
be explained
small of
for
is present between
University
are
requirement
iron
the hemoglobin
is very
which
child’s
difference can
be,
sodium,
conservation should
may
it
and
respectively.
of iron bearing
losses,
of
is magnesium.
which The
time
such
same
was
considerably
Whether or not there is a sex difference in the storage be more factors operating to deplete this reserve Probably the iron intake of the female is of nutritional of the menopause, while in the male it need be con-
requirement,
day
reaccumulation
would
the
of minerals
that
contain
years.
i
female.
to
and
livers
to menstrual
there
up
rats,
female
this
humans,
importance
The
of female
human
attributes
of
sidered
iron
greaten
importance
of its very
metabolism,
low that
The
excretion. other
child’s Canada.
nutri-
greater
W.
need for protein a relationship the
quality and
HAWKINS
AND
dietary
casein
been shown,5 of hemoglobin.6’
protein
oven
as has
gluten
Among
also
the
comparatively
those
importance
ranged to
ards for reference are the averages
and
from 14.5
those
12. to
is questionable up to the year
13
years
because 1933
of
358
Florida Columbia
Saskatchewan
Anderson
i483
,i.8
Pett,
1456
13.3
Pett
-
Britain
500
13.1
Hamilton,
Ont
York,
Saskatoon,
and i
children
Kracke8 of 5,ooo
Children
cc al.24 & Sandstead” Hanley and
Med.
13.3-13.6 I
and
PcrkinsH
Hanley’8
Res.
Council,
MacKay,
Wills
Gt. and
Britain”
Binghan’8
2.00
11.5
Hawkins,
Leeson
and
McHenry”
Ont
i8
11.4
Hawkins,
Leeson
and
McHenry2’
Sask
1669
13.6
Hawkins
Scandinavian year-old
for children, at an altitude
#{182}
Kaucher
Britain
children,
children. within the
These 7
tO
14
which
are
are
in good
year
age
has
formation
Authors
,i.8
Great
in the
of Denver. More useful for American, English,
Hgb
Great
East
among
13.5
I
of egg
animals
per ioo ml. of blood in 6 to 7 yearThe value of these figures as stand-
Values
Gm.
Michigan
values
of the altitude by Wintrobe9
given
Av.
Children
acids
Colorado,
Gm. old.
i-Hemoglobin
No.
Locality
hemoglobin
13.3
superiority
in anemic
CHILDREN
at Denver, of
With regard to is evidence that
The
amino
AMONG
recorded
an average
in
important.
of certain
Andresen
TABLE
British
2.79
KLINE
regeneration
LEVELS
early
of Mugrage
feet. They old children
K.
is particularly in hemoglobin
HEMOGLOBIN
gives
DOROTHY
over that of the adult should always be considered. between hemoglobin and protein nutrition, there
of the
albumin
W.
I2..9
for
6 to io
agreement which
group,
and
Kline
year-old,
and
with more are presented
13.4
for
to
ii
recent figures in table i.
for
The British figures shown in the table have been calculated from the Haldane standard of 14.8 as ioo per cent. This is the figure recently given by King et al.’#{176} in place of the previously accepted 13.8. King et al. calculated the hemoglobin content of blood from its iron content, using H#{252}fner’s (1894) figure of 0.334 for the percentage of iron in hemoglobin. Later and probably more reliable figures are at variance with that of H#{252}fnen:Bernhant and Skeggs” found 0.340, and Drabkin,” 0.33
If the figure 0.340 are thus reduced
8.
figures
bloods gave about than on the basis this
by
cent.
Gibson
calculated culated
its
the
iron
oxygen
the Haldane standard becomes 14.5, and the British extent of about 2. per cent. King et al. found that
higher hemoglobin capacity. Figures
Harrison’3
distinction
from from
used, to the
3 pen cent of oxygen and
A valid
S
between
showed these
content
of blood
capacity
represents
values published
on the basis of iron content about a year previous to
a corresponding two
values
represents functional
difference probably total
of about
is that pigment,
pigment.
2.
pen
hemoglobin and
It illustrates
that
calthat
HEMOGLOBIN
2.80
differences
in methods
ences among The object among
7
when
the
CHILDREN
of standardization
tO
THE
In May and June toon public-school TABLE
AMONG
may
IN
be one
SASKATOON
factor
responsible
hemoglobin values reported by various workers. of the present survey was to establish in this area
healthy
reference
LEVELS
14
year
old
question
of anemia
SASKATOON
of 1948, children.
i-Variation
children,
which
of Hemoglobin
Values
hemoglobin
be used
values
as standards
for
arises.
SURVEY,
hemoglobin This was
could
for differ-
METHODS
AND
determinations about a third with
Age
and
RESULTS
were of the
Sex
among
7
done to Year
7-14
on
1669
age
14 Old
Saskagroup in
Saskatoon
Children Range Age
No.
Av.
of Children
S. D. Gm.
7
98
11.1-14.9
13.1
0.91
8
22.3
11.8-15.4
23.3
0.84
9
89
ii.6-i.8
13.5
0.93
10
101
22.5-15.5
13.6
II
105
11.0-16.7
13.7
,i.o-,6.x
13.9
0.92.
Boys
98
Ii
,,.8-,6.i
14.1
0.91
14
207
11.0-16.4
14.4
1.03
7
115
10915.4
13.0
o.86
8
105
zi.-i.6
13.2.
9
109
I1.515.4
13.4
o.8i 0.83
10
113
,o.o-,6.,
13.5
0.94
ii
,o8
11.1-16.,
13.5
o.8i
ii.-i6.z
23.9
0.95
i,.8-i6.i
14.0
0.97
II.8I6.3
13.9
1.01
13
98 109
24
city.
o.88
105
12.
the
o.86 .
13
Girls
Entire
% Hc-b
8
Boys
7-14
82.7
11.1-16.7
13.7
o.86
Girls
7-14
842.
10.0-16.3
13.5
i.i6
10.0-16.7
13.6
o.8i
the
Saskatoon
Group
In
7-14
1938,
Dr.
Griffith
1669
Binning,’4’
‘
Medical
Officer
of
School Board, had studied the incidence of goiter in these schools, and had concluded that factors of age, sex, race, and social condition were involved. Under Dr. Binning’s direction the schools for our study were chosen so as to provide a sample as representative as possible of the various ponents of this population group. Determination of hemoglobin was done on finger tip into globin method and the figure calculation.
socio-economic capillary
a calibrated pipet, and measurement was made of Collier.16 This was standardized by blood 0.340 as the percentage of iron in hemoglobin
and
blood
taken
racial from
comthe
by the cyanmethemoiron determinations, was utilized in the
W.
At the
foot
of table
the
distribution
is shown TABLE
W.
2.
HAWKiNS
are shown for
3.-Distribution
AND
the
boys
K.
hemoglobin
and
of Hemoglobin
DOROTHY
girls
Values
values
7-14
Boys Class
obtained,
separately, among
2.81
KLINE
Year
and
for
Old
Saskatoon
in table
entire
group.
Children Entire
Group
Number
%
the
Girls
Interval
Gm.
and
%
--
Number
Number
11gb
10.0-10.9
0
11.0-11.9
3
0
4
31
12..0-12..9
163
2.0
13.0-13.9
318
14.0-14.9
2.2.2.
3
0
35
4
0
66
4
197
2.4
360
ii
38
336
40
654
39
2.7
2.21
2.5
433
i6
53
6
15.0-15.9
78
9
16.0-16.9
15
2.
7
8
131
I
2.2.
I
700
39 600
500
26
400 22 U)
0 0
300
U)
2) 04 ‘4
0
200
22
0 C
54
8
U Li 2)
04
100 4 1
9
10
11
12
13
14
Hemoglobin
in
FiG.
Figure
i is
group,
which figures
Our
a graphic
representation
of
the
15 Cm.
16
17
18
%
i.
distribution
of values
indicates the shape of the distribution curve. may be regarded as maximum to the extent that
among total
blood
the
entire
pigment
3
2.82.
HEMOGLOBIN
was
measured.
as is also by Drabkin
LEVELS
AMONG
Standardization
measurement and Austin’7
by
CHILDREN
iron
IN
content
SASKATOON
of blood
of pigment as cyanmethemoglobin, to be an ideal pigment for
is responsible
for
which has determination
the
this,
been said of total
concentration. DISCUSSIoN
Our
average
Wintrobe,
of 13.6
and
for children
as the
ages.
values be made
consideration
of
is not
is of the others
of these
of hemoglobin groups should practiced
worked
of the slightly figures sidered. 3 per
cent,
the
and
dental
greater thinness, 14
a wider
age
province.
and
British
ii.8.
British
group
than
Their
range
comparisons
comparable population can be made only after
by various
did
we,
and
workers,
Columbia,
the
and
range
and
this
survey in included.
about
values,
also
with
serum
where the
children
pen cent
i
10.3
regard
did
tO
and
evidence
consume
16.3,
iS
in the
that this did not necessarily health among Saskatchewan
be
past
much
better rickets,
milk,
and
incidence was said
Saskatchewan
correspond children
conlower,
to of
as
also
both
acid levels. The fat by pinching,
percent
ii
had
were
considered
to
not
they
average
were
ascorbic of subcutaneous
Columbia,
examined
of hemoglobin
in British
of them had low by the estimation British
however,
by
reported
a
of to
group,
to underweight. appears to be quite
estimated the proportion of Saskatoon public-school children below the Baldwin-Wood standard to be between 4.7 and 6 per cent on routine measurings during the school year 1947-48. The high hemoglobin levels which we found may also be a reflection of good general health. Hemoglobin levels reported by Pett and Ogilvie’9 among children examined by 10
per
Dr.
cent
they
the
in
given
of any
average of 13 .3 slightly lower, but the when differences in method are conof anemia among these children to be
but
was pointed out The degree of general
used
average
highest
in methods, workers on comparisons
Saskatchewan
defects;
the
and Hanley’8 carried out a nutrition which the city of Saskatoon was not
children
postural
porportion as judged cent
The
as the
is among
it
standards
Columbia
Columbia
and
per
to 8 pen
In
it
high.
Pett among
1946,
VALUES
of magnitude
but
different Accurate the
among
hematologists.
as compared
15.7,
than
but
order i,
of differences
among
in the
a survey. tO
be
Because
HEMOGLOBIN
narrower than ours, and their are quite comparable, particularly The authors judged the incidence
ducted 10.0
same
in table
differences
with
children
THE
reported by with caution.
In May and June of five areas of Saskatchewan, They
OF
Binning
cent
or
more
them in various parts of Canada average age groups are compared. Two groups 1946’#{176} had among the lowest hemoglobin one of the chief 35 per cent.” Saskatoon laboratory”
is about we have
great
to affect
able
to suppose,
found
defects
the
by Mugrage
was i ,6oo
average and
underweight, feet
expressed
however,
about pen cent lower than ours when the of children studied in Ontario in 1945 and levels of any reported, and among them the
above
the
sea
that Andresen
level.
opinion
hemoglobin
in Denver.
of which
In a previous
that
level
altitude
incidence
this
A recent
is not
group.
determining study
group
was
from
this
publication
altitude
of a population
is a factor
in one
of
It seems the
2.00
sufficiently
normal
high
reasonvalues adults
in
W.
Mexico City’3 for men, and portant The we
has revealed of 15.2. for
factor question
established are
aware
influence
the
TABLE
W.
HAWKINS
values
whether
for limited
areas.
of no
that
women.
here. arises
values Outside
DOROTHY
K,
unusually the altitude
to serve
as standards
of factors
geographic
directly
factors
2.83
KLINE
appear likely
Very
particular
hemoglobin
AND
high: an average of of 7,457 feet is an for
reference
influencing
other
than
4.-Variation
of
Hemoglobin
Values
altitude
with
Boys
No.
that
might
Age
and
Sex
Selected
among
Year
7I4
Old
Av.
of Children
7
91
8 9
114
S. D. 11gb
11.1-14.9
13.1
0.9!
1I.815.4
13.4
0.83
74
ii.6-i.8
13.6
0.95
io
87
11.5-15.2.
13.6
0.85
II
91
11.9-16.7
13.6
0.84
Ii
84
xi.o-x6.i
13.8
1.01
13
92.
11.3-16.2.
14.1
o.88
12.0-16.4
14.4
1.11
14
Girls
103
7
99
10.9-15.0
13.0
0.84
8
98
ix.-x.6
13.2.
0.84
9
99
11.5-15.4
13.4
0.83
io.o-,6.z
13.6
0.92.
o.8i
100
10 II
92.
xi.i-i6.,
13.6
Ii
8i
ii.-i6.z
13.9
0.90
,,.8-,6.i
14.0
0.97
12.1-16.3
13.9
0.97
101
13
77
14
Boys
7-14
736
11.1-16.7
13.7
0.89
Girls
7-14
748
10.0-16.3
13.6
0.87
10.0-16.7
13.6
0.77
Entire
Group
both
boys
in
hemoglobin
cent
Saskatoon
group, of
the
ported similar It has been
1484
7-14
THE
girls
be
health,
children
Gm.
and
should
general
Range Age
Among
im-
level.
Saskatoon
8 per
17.7
EFFECT
and
OF
girls
from
over
and also same age. surveys. previously
AGE,
the
the
shows
These stated
SEX,
age
AND
of 7
seven-year
the
SELECTION
14
there
period.
the similarity findings agree that
tO
OF
in hemoglobin with those
object
of
this
hemoglobin values among provide a range of values
apparently healthy public-school which could be used for reference
anemia
in mind,
arises.
made, and their If an individual
With
this
hemoglobin is ostensibly
a selection
values were healthy,
is an increase
Table
values
(table reasonable
who was
boys
have
healthy
re-
to discover
children, and thus when the question
of obviously
tabulated it seems
in the
between
of others survey
of about this
2. shows
subjects
to of was
4). to conclude
that
the
2.84
HEMOGLOBIN
hemoglobin
level
more
reliable
cause
of
89 per
group,
which
of
such
of the
not
is evident
good
opinion
state
we
differ
general
proportion
hematologic
had
subject the
table
4 are
values
to more
selected
however,
are
compared.
the that
those
for
This
might
be-
found
than
group,
from
any
pigment
regarding
been called
data
of respiratory
knowledge
have
and
2.
SASKATOON
no other
essentially,
if table
IN
adequacy
of
studied
for what
did
CHILDREN
of the
children
Values
cent,
a large
In our evaluation
the unimportance with. On the other
flection
AMONG
unsatisfactory
of illness.
other
dealt
same
individuals. pen cent
degree
generally
is adequate.
in assisting
the
healthy Eleven
LEVELS
in
usual is,
the
the
entire
indicate
of such selection when a large number of subjects is hand, it may be evident particularly in this case as a rehealth among these children, since the selected group was of the
whole. SUMMARY
In May
and June
of
a survey
1948
of hemoglobin
values
was
carried
out
on
842.
girls and 82.7 boys, ages 7 tO 14 inclusive, in Saskatoon public schools, who repnesented about a third of this population group in the city. Values for girls ranged from 10.0 to 16.3 Gm. per ioo ml. of blood, with an average
The
of
ported
The corresponding the whole group
13.5.
average
for
for
children
age groups were parts of Canada. Values from near ity
for
of these slightly
ages.
higher
in hemoglobin
values
7
tO
average those
values
for
reported
.2.
and i even re-
16.7,
tO
the
highest
children
in the
different
groups
in other
for comparable
same age were similar. to near 14 in the 14 year
There was an increase old group. The similar-
for both
boys
ages,
of age,
are
years
14
for boys were i which is among
13.6,
The than
boys and girls of the in the 7 year old group
13
crease from workers.
values was
Eleven per cent of the children illness. No significant differences removing this group.
and in
girls
of these
agreement
with
had been subject to more appear when the above
and
the
small
observations
in-
of other
than the usual degree figures are corrected
of by
ACKNOWLEDGEMENTS We arc survey but
could in the
sincere To and
indebted
not
have
been
preparation
to Dr.
Griffith
carried
out.
of this
paper,
Binning His
were
for
interest very
his
and
much
help
advice,
and not
appreciated,
cop:ration, only
and
during
without
which
course
of the
the
we should
like
this work,
to render
him
our
for their
courtesy
thanks. the
principals
and
staffs
of the
schools
included
in the
survey
extend
we
thanks
help. Dr.
the
greatly
H. B. Collier,
course
Head
of the survey,
of the and
Department
in the
of Biochemistry,
preparation
of this
rendered
paper.
We
valuable
wish
help
and
to acknowledge
advice this
during with
our
thanks. Helpful
suggestions
Saskatchewan, Toronto.
were
and \Ve
extend
received
Dr.
from to
them
E. W.
from
Dr.
McHcnry,
our
L. B. Jaqucs, Professor
Professor of Public
of Physiology
at the
University
of
Nutrition
at the
University
of
Recommended
dietary
Health
thanks. REFERENCES
I NATIONAL
revised
RESEARCH
1948.
COUNCIL
Washington,
Reprint 1948.
and
Circular
Series,
No.
22.9:
allowances,
W.
L. N.,
2 ELLIS,
3
AND
E. M.,
WIDD0w50N,
,J.
Biochem. 4
L. : Une
LAPICQUE,
A. : The
effect
DOROTHY
of diet
on
K.
the
KLINE
hemoglobin
concentration
of the
blood.
R. A. : Sexual
MCCANCE,
differences
in the
storage
and
metabolism
of iron.
i8.
vicille
donn#{233}eperdue
dc l’hommc.
M.,
DAMODARAN,
AND
1935.
AND
577,
42.’
de fer quc cclui 5
58i,
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HAWKINS
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