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Disturbed homeostasis of iron metabolism in children from marginalised Roma communities

European Journal of Clinical Nutrition (2025)Cite this article

Subjects

Abstract

Objectives

The purpose of this study was to compare selected iron markers (serum iron, total iron-binding capacity (TIBC), transferrin and ferritin concentration, transferrin saturation, and free haemoglobin) in children from marginalised Roma communities (MRCs) with children from the majority population and explore their associations with diet composition.

Methods

We obtained cross-sectional data (questionnaires, blood samples from children) from 119 mother-child dyads from MRCs and the majority population. Group differences were tested using Chi-square and Mann–Whitney U tests. Associations of belonging to MRCs and diet with iron markers (transferrin, ferritin, TIBC, serum iron, transferrin saturation) were examined using bootstrapped linear regression models, and mediation analyses assessed whether eating habits mediated group differences.

Results

Statistically significant differences between children from MRCs, and the majority were found in serum transferrin, ferritin, and TIBC levels. The more frequent consumption of sweetened drinks, sweets, and salty snacks is associated with lower levels of transferrin, and more frequent consumption of dairy products is associated with higher levels of total iron-binding capacity. Current breastfeeding was found to be negatively associated with ferritin. Consumption of sweets and salty snacks partially mediates the differences in transferrin between children from MRCs and the majority.

Conclusions

Our findings suggest that the observed low ferritin levels, elevated TIBC, and reduced transferrin saturation in Roma children are likely indicative of early-stage iron deficiency, potentially driven by underlying malnutrition. This study underscores the significant disparities in iron metabolism between children from MRCs and those from the majority population, primarily driven by social determinants of health, including diet composition.

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Data availability

Data described in the manuscript will be made available upon request to the corresponding author.

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Funding

This research was funded by the Slovak Research and Development Agency under Contract No. APVV-19-0493 and from ERDF/ESF project DigiWELL (No. CZ.02.01.01/00/22_008/0004583).

Author information

Authors and Affiliations

  1. Department of Medical and Clinical Biochemistry, Faculty of Medicine, PJ Safarik University, 041 11, Kosice, Slovakia

    Beáta Hubková, Jana Mašlanková, Ivana Večurkovská, Anna Birková & Beáta Čižmárová

  2. Clinic of Vascular Surgery, Faculty of Medicine, PJ Safarik University and East Slovak Institute of Cardiovascular Diseases, Kosice, 040 11, Slovakia

    Martina Zavacká

  3. Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, 041 11, Kosice, Slovakia

    Daniela Fiľakovská Bobáková

  4. Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11, Olomouc, Czech Republic

    Daniela Fiľakovská Bobáková

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  1. Beáta Hubková
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  2. Jana Mašlanková
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  3. Ivana Večurkovská
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Contributions

DFB and BH conceptualised the study and developed the methodology. BH and JM conducted the formal analysis. The investigation was carried out by DFB, BH, JM, IV, BČ, and AB. BH and JM were responsible for data curation. BH and JM prepared the original draft. DFB, MZ, and IV contributed to review and editing of the manuscript. Visualisation and supervision were provided by DFB. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Daniela Fiľakovská Bobáková.

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Ethics approval

This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving research study participants were approved by the Ethics Committees in both the Presov (No. 03682/2022/OZ-20) and the Kosice (“RomaREACH”) regions and by the Ethics Committee of the Medical Faculty at P.J. Safarik University in Kosice (16 N/2021). Written informed consent was obtained from all participants (or their legal guardians) involved in the study.

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The authors declare no competing interests.

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Hubková, B., Mašlanková, J., Večurkovská, I. et al. Disturbed homeostasis of iron metabolism in children from marginalised Roma communities. Eur J Clin Nutr (2025). https://doi.org/10.1038/s41430-025-01686-y

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