SciELO - Scientific Electronic Library Online

vol.34 issue4Biomarkers of metabolism and iron nutritionRecommendations for interventions with iron supplements: lessons learned in a community trial in four regions of Peru author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




  • Have no cited articlesCited by SciELO

Related links

  • Have no similar articlesSimilars in SciELO


Revista Peruana de Medicina Experimental y Salud Publica

Print version ISSN 1726-4634


GONZALES, Gustavo F; FANO, Diego  and  VASQUEZ-VELASQUEZ, Cinthya. Diagnosis of anemia in populations at high altitudes. Rev. perú. med. exp. salud publica [online]. 2017, vol.34, n.4, pp.699-708. ISSN 1726-4634.

Iron deficiency and overload are risk factors for numerous poor health outcomes, and thus the maintenance of iron homeostasis is vital. Considering that hemoglobin contains 70% of the total iron in the body, the World Health Organization (WHO) recommends the measurement of iron levels to calculate the rate of iron deficiency anemia (IDA), although WHO recognizes that IDA is not the only cause of anemia. As hemoglobin increases with altitude, WHO recommends correcting the cut-off point to define anemia at high altitudes. An objection to this correction is that the increase in hemoglobin at high altitudes is not universal and is not linear. In addition, individuals in older age groups have lower hemoglobin levels than those in younger age groups. In infants, children, pregnant women, and adults, the prevalence of anemia using corrected hemoglobin is 3-5 times higher than that using markers of iron status. State programs seek to control anemia by means of iron supplementation. However, these programs are ineffective, particularly for high-altitude populations. Therefore, the occurrence of iron deficiency at high altitudes is controversial. The serum levels of the hormone hepcidin, which regulates iron availability, are similar in individuals at high altitudes to those of individuals at sea level, indicating that iron deficiency does not occur at high altitudes. An additional problem when correcting hemoglobin at high altitudes is that the frequency of erythrocytosis is decreased. In conclusion, the correction of the cut-off point of hemoglobin at high altitudes to determine iron deficiency is inadequate.

Keywords : Anemia; Iron deficiency; Correction factor; Ferritins.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License