IRON DEFICIENCY WITHOUT ANEMIA IN CHILDREN AND ADOLESCENTS: STATE OF THE PROBLEM AND DEVELOPMENT PROSPECTS

. Iron deficiency (ID) without anemia is an early stage of ID, it is a functional disorder characterized by decreased iron stores, sideropenia and normal hemoglobin level (Hb). ID without anemia accounts for 70% of all cases of ID. The results of epidemiological studies show that the prevalence of ID without anemia varies significantly depending on the age of children, conditions of life and nutrition, socio-economic conditions in the country, as well as the applied criteria for diagnosis of ID. According to epidemiological studies, the prevalence of ID without anemia in Russia ranges from 7.9 to 31% and has pronounced gender differences with a predominance of girls. The main causes of ID without anemia in children and adolescents are nutritional disorders, various bleedings, increased iron requirements during periods of intensive growth. Clinical manifestation of ID without anemia is sideropenia, Hb level is normal. Low sensitivity of clinical symptoms of ID without anemia requires diagnosis at the laboratory level. Biochemical criteria for the diagnosis of ID without anemia, developed by WHO experts, require vein blood sample and expensive. It is shown that Hb, hematocrit, color index, MCV and MCH have the highest overall accuracy/effectiveness in detecting ID during screening in adolescents. Treatment of ID without anemia in children and adolescents includes the identification of causes, nutrition recommendations, half of the therapeutic dose of oral iron for a period of 1‒2 months. Iron salt preparations and iron (III) hydroxide polymaltosate are equally effective in the treatment of ID, but the latter causes fewer adverse events, is available in forms that are convenient for use in children of different age (drops, syrup, tablets), which makes the course of treatment more feasible. Primary prevention includes nutrition recommendations and the use of liquid iron (drops, syrup) in young children at risk of developing ID. Secondary prevention consists of early detection of ID during medical check-ups or any examination of the child by a doctor. To improve medical care for children and adolescents it is recommended to create clinical recommendations for the diagnosis and treatment of ID. Unsolved problems should be considered the scientific justification of the dose regime and duration of treatment of ID, the use of dietary supplements containing iron in the prevention of ID.