The association between serum trace elements and iron deficiency anemia in children and adolescents: a systematic review and meta-analysis.
Maryam Mobasheri-Shiri, Sepehr Ramezanipour, Zahra Azizi et al.
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In 30 seconds
This systematic review and meta-analysis examined serum iron, zinc, copper, and magnesium in children and adolescents with iron deficiency anemia (IDA), using observational studies identified through January 2025. Eight articles contributed twelve datasets and 1105 participants. Compared with controls, participants with IDA had lower serum iron (weighted mean difference [WMD] −13.07 μmol/L, 95% CI −16.09 to −10.05), zinc and magnesium, and higher copper. The findings indicate that pediatric IDA is associated with differences in several trace elements, although heterogeneity was high for iron, zinc, and copper.
Key findings
- Serum iron was lower in IDA than in controls (WMD: -13.07 μmol/L, 95% CI: -16.09 to -10.05).
- Serum zinc and magnesium were lower, while copper was higher, in children and adolescents with IDA than in controls.
- High heterogeneity (I² >95%) was reported for iron, zinc, and copper.
Why it matters
The results suggest that pediatric IDA is associated with changes beyond iron alone, including differences in zinc, copper, and magnesium. These findings may help frame research into nutritional factors and anemia pathophysiology. Because the evidence comes from observational studies, the associations do not establish that trace-element changes cause IDA or that correcting them improves outcomes.
What to keep in mind
The review included observational studies, and heterogeneity was high for iron, zinc, and copper, limiting the certainty and consistency of pooled estimates.