Gordeuk VR, et al. - Researchers carried out this study to ascertain the prevalence and predictors of iron deficiency (ID) (serum ferritin [SF] concentration ≤15 μg/L) and elevated iron stores (SF concentration >300 μg/L) in Hemochromatosis and Iron Overload Screening (HEIRS) women of reproductive age (25-44 y). Among women of reproductive age, both ID and elevated iron stores were present and were influenced by ethnicity and hemochromatosis (HFE) C282Y. Efforts to optimize iron status needed to keep these findings in view.

• A cross-sectional study (HEIRS Study) was performed on iron status and HFE mutations in primary care patients at 5 centers in the United States and Canada.
• Data was examined for women of reproductive age according to whether or not they were pregnant or breastfeeding at the time of the study.

• The researchers found ID in 12.5% of 20,080 nonpregnant and nonbreastfeeding women compared with 19.2% of 1,962 pregnant or breastfeeding women (P < 0.001).
• Factors independently associated with a decreased risk of ID in nonpregnant and nonbreastfeeding women and in pregnant or breastfeeding women were Asian American ethnicity (OR ≤0.9; P ≤ 0.049) and HFE C282Y (OR ≤0.84; P ≤ 0.060).
• In nonpregnant and nonbreastfeeding women, Hispanic ethnicity (OR: 1.8; P < 0.001) and African American ethnicity (OR: 1.6; P < 0.001) were associated with an increased risk of ID.
• Compared with 0.7% of pregnant or breastfeeding women (P=0.001), elevated iron stores were shown in 1.7% of nonpregnant and nonbreastfeeding women.
• In nonpregnant and nonbreastfeeding women and in pregnant or breastfeeding women, HFE C282Y homozygosity had the most marked independent association with elevated iron stores (OR >49.0; P < 0.001), however, African American ethnicity was also correlated with increased iron stores in both groups of women (OR >2.0; P < 0.001).
• In nonpregnant and nonbreastfeeding women, Asian American ethnicity (OR: 1.8; P=0.001) and HFE C282Y heterozygosity (OR: 1.9;P=0.003) were correlated with increased iron stores.