scholarly journals Using Soluble Transferrin Receptor and Taking Inflammation into Account When Defining Serum Ferritin Cutoffs Improved the Diagnosis of Iron Deficiency in a Group of Canadian Preschool Inuit Children from Nunavik

Anemia ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Huguette Turgeon O’Brien ◽  
Rosanne Blanchet ◽  
Doris Gagné ◽  
Julie Lauzière ◽  
Carole Vézina
Keyword(s):  
Iron Deficiency ◽  
Transferrin Receptor ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor ◽  
Iron Depletion ◽  
Reactive Protein ◽  
Iron Deficient

The prevalence of iron depletion, iron deficient erythropoiesis (IDE), and iron deficiency anemia (IDA) was assessed in preschool Inuit children using soluble transferrin receptor (sTfR) and traditional indicators of iron status while disregarding or taking inflammation into account when defining SF cutoffs. Iron depletion was defined as follows: (1) SF < 15 μg/L regardless of the C-reactive protein (CRP) level and (2) SF < 15 or <50 μg/L with CRP ≤ 5 or >5 mg/L, respectively. IDE corresponded to iron depletion combined with total iron binding capacity > 72 μmol/L and/or transferrin saturation < 16%. Iron depletion and IDE affected almost half of the children when accounting for inflammation, compared to one-third when the SF cutoff was defined regardless of CRP level (P<0.0001). The prevalence of IDE adjusted for inflammation (45.1%) was very similar to the prevalence observed when sTfR was used as a sole marker of IDE (47.4%). The prevalence of anemia was 15%. The prevalence of IDA (IDE + hemoglobin < 110 g/L) was higher when accounting for than when disregarding inflammation (8.0% versus 6.2%,P=0.083). Using sTfR and different SF cutoffs for children with versus without inflammation improved the diagnosis of iron depletion and IDE. Our results confirm that Inuit children are at particularly high risk for iron deficiency.

Serum Soluble Transferrin Receptor in Heterozygous β-Thalassaemia: Application in the Diagnosis of Iron Deficiency and as Hematologic Marker of Erythroid Activity According to Thalassaemic Genotypes (β0 vs β+).

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3828-3828
Author(s):  
Jose Manuel Calvo-Villas ◽  
María Francisca Zapata ◽  
Ivan Alvarez ◽  
Silvia de la Iglesia ◽  
Jorge Cuesta ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Transferrin Receptor ◽  
Biochemical Parameters ◽  
Iron Status ◽  
Direct Sequencing ◽  
Saturation Index ◽  
Transferrin Saturation ◽  
Soluble Transferrin Receptor ◽  
Iron Deficient ◽  
Significant Difference

Abstract Although an increased level of serum soluble transferrin receptor (sTfR) have been found in both heterozygous β-thalassaemia patients with iron deficiency and in those with more severe genotype (β0), it is not a useful marker of iron deficiency status associated to β-thalassaemia. The aim of this study was to analyse the use of two biochemical parameters (sTfR and sTfR/log of ferritin ratio) to determine the iron status and to evaluate the degree of erythropoietic activity in a group of 221 β-thalassaemic heterozigotes patients (155 β0 and 66 β+). Serum ferritin and transferrin saturation index were measured in order to establish the iron status. Of the whole group, 51 patients were iron defficient (βthal-ID) while the remaining 170 were iron sufficient (βthal-IS). Based on the combination of β-thalassaemia genotype and iron status, patients were classified into four subgroups: β0thalassaemia and iron-sufficient (β0thal-IS) (n=124); β0thalassaemia and iron-deficient (β0thal-ID) (n=31); β+thalassaemia and iron-sufficient (β+thal-IS) (n=46); β+thalassaemia and iron-deficient (β+thal-ID) (n=20). 258 healthy and 56 iron-deficient individuals were used as controls. All the haematological parameters were measured by using analyzer Coulter® GEN-S™. Haemoglobins A2 (Hb A2) and F (HbF) were analysed by high performance liquid chromatography and molecular analysis was performed by real-time PCR and direct sequencing techniques. Chemical, inmunoturbidimetrical and nephelometric methods were used to measure iron status as well as sTfR. Comparison of haemalogical and biochemical parameters between subgroups was performed by using the t-student test and correlation analysis was calculated by using least-squares regression model. Mean sTfR level obtained was 2.63 ± 0.8 mg/dL and 2.57 ± 1.1 mg/dL in βthal-ID and βthal-IS patients respectively (p=0.783). Soluble transferrin receptor showed a positive correlation with HbA2, HbF and reticulocyte count values in βthal-IS patients (r=0.208 [p<0.05], r=0.440 [p<0.0001] and r=0.393 [p<0.00001] respectively) while it did not reach a significant correlation in βthal-ID patients. Mean sTfR/log sFt ratio was 2.75 ± 1.6 and 1.34 ± 0.5 in βthal-ID and βthal-IS patients (p<0.001). Interestingly, sTfR level was significantly higher in β0thal-IS patients when compared with β+thal-IS patients (2.76 ± 0.9 vs 1.42 ± 0.4) (p<0.001) as a result of an increased globin chains imbalance related to the β0 genotype. In the other hand, in the comparison between β0thal-ID and β+thal-ID subgroups neither sTfr level (2.71 ± 0.7 vs 2.40 ± 1.1) (p=0.417) nor sTfR/log sFt ratio (2.93 ± 1.7 vs 2.24 ± 1.3) (p=0.371) showed significant difference. In summary, sTfR/log sFt ratio is a valid parameter for diagnosis of iron deficiency associated to heterozygous β-thalassaemia. Unlike the findings observed in β-thalassaemic heterozigotes with normal iron status, sTfR level is not useful to evaluate the genotype severity in those with iron deficiency. Consequently, iron status should be determined before using sTfR as a parameter to provide a reliable estimation of the ineffective erythropoiesis related to the severity of β-thalassaemia genotypes.

scholarly journals Increased Serum Transferrin Saturation Is Associated with Lower Serum Transferrin Receptor Concentration

1999 ◽  
Vol 45 (12) ◽  
pp. 2191-2199 ◽  
Author(s):  
Anne C Looker ◽  
Mark Loyevsky ◽  
Victor R Gordeuk
Keyword(s):  
Iron Deficiency ◽  
Iron Overload ◽  
Transferrin Receptor ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Reference Interval ◽  
Serum Transferrin ◽  
Reactive Protein ◽  
Serum Transferrin Receptor ◽  
Health And Nutrition

Abstract Background: Serum transferrin receptor (sTfR) concentrations are increased in iron deficiency. We wished to examine whether they are decreased in the presence of potential iron-loading conditions, as reflected by increased transferrin saturation (TS) on a single occasion. Methods: We compared sTfR concentrations between 570 controls with normal iron status and 189 cases with increased serum TS on a single occasion; these latter individuals may be potential cases of iron overload. Cases and controls were selected from adults who had been examined in the third National Health and Nutrition Examination Survey (1988–1994) and for whom excess sera were available to perform sTfR measurements after the survey’s completion. Increased TS was defined as &gt;60% for men and &gt;55% for women; normal iron status was defined as having no evidence of iron deficiency, iron overload, or inflammation indicated by serum ferritin, TS, erythrocyte protoporphyrin, and C-reactive protein. Results: Mean sTfR and mean log sTfR:ferritin were ∼10% and 24% lower, respectively, in cases than in controls (P &lt;0.002). Cases were significantly more likely to have an sTfR value &lt;2.9 mg/L, the lower limit of the reference interval, than were controls (odds ratio = 1.8; 95% confidence interval, 1.04–2.37). Conclusion: Our results support previous studies that suggested that sTfR may be useful for assessing high iron status in populations.

scholarly journals Co-existence of Iron Deficiency in Beta Thalassaemia Trait

2017 ◽  
Vol 19 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Nur Mohammad ◽  
MA Jalil Chowdhury ◽  
Md Rafiqul Alam ◽  
Amin Lutful Kabir ◽  
Mohammad Ferdous Ur Rahaman ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Binding Capacity ◽  
Venous Blood ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Iron Level ◽  
Nutritional Disorder ◽  
Beta Thalassaemia ◽  
Iron Deficient ◽  
Thalassaemia Trait

Background: Beta-Thalassaemia Trait (β-TT) is common in this subcontinent as well as Bangladesh. 3% of our total population is documented to have β-TT. Iron deficiency anemia (IDA), remains one of the most severe and important nutritional disorder in the world especially in Bangladesh. Microcytic hypochromic blood picture is common manifestation of both disorders. Purpose of the present study was to see whether both can co-exist.Methods: This was a cross sectional study carried out in Department of Internal Medicine, Bangabandu Sheikh Mujib Medical University (BSMMU), Dhaka from January-2014 to August-2015. Total 54 participants were selected from Haematology outpatient department (OPD), BSMMU. All of them had β-TT confirmed by Capillary Haemoglobin Electrophoresis. Proper counseling was done and informed consent was taken. Relevant history was taken and examination was done. Five ml of venous blood was collected and sent to Biochemistry department to measure serum iron, ferritin and tissue iron binding capacity (TIBC). Transferrin saturation (T.Sat) was calculated by formula (iron/TIBC) X100.Results: Total 54 patients who fulfilled the recruitment criteria were finally analyzed. Among them 85% (46) patients were females and 15% (8) were males. Median age was 30 years (range11-80 yrs). Most of the patients 78 % (42) belong to the age group between 15 to 44 years. Mean (±SD) HbA2 (%) was 5.35 (±1.39), Hb (%) 9.04± (1.39), MCV (fl)- 67.02 (±10.39), MCH (pg)- 21.06 (±3.99), RDW (%)- 17.77 (±3.85). Among them 44.4% (24) had low iron (<40μg/dl), 29.6 % (16) had low ferritin (15μgm/L), 33.3% (18) had high TIBC (>407μg/dl), and 50% (27) had low transferrin saturation (<16%). 13% (7) patients were found to be iron deficiency considering all parameters and 63% (34) patients were iron deficient in at least one parameter.Conclusions: The present study shows the frequent occurrence of iron deficiency (29.6%) in subjects with β-TT which is a potentially correctable clinical condition. Proper assessment of iron level among the β-TT should be done and those who are iron deficient, should be treated promptly which may improve their general wellbeing.J MEDICINE Jan 2018; 19 (1) : 44-48

SOLUBLE TRANSFERRIN RECEPTOR IS A PROMISING MARKER of IRON DEFICIENCY ANEMIA IN PREVALENT HEMODIALYSIS PATIENTS

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Abou seif ◽  
Hussien Sayed Hussien ◽  
Shaimaa Abdelmegied ◽  
Marwa Abdulhady
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Iron Status ◽  
Hemodialysis Patients ◽  
Deficiency Anemia ◽  
P Value ◽  
Soluble Transferrin Receptor ◽  
Significant Difference ◽  
And Control

Abstract: Background Diagnosis of iron deficiency is traditionally based on ferritin and other iron parameters becomes difficult in end stage renal disease patients due to the inflammatory condition which affects these markers and masks the iron deficiency. Serum soluble transferrin receptor (sTfR) is able to be a reliable indicator for assessing iron status, as it is not affected by inflammatory procedures. Aim To evaluate the usefulness of serum soluble transferrin receptors in iron deficiency anemia detection in comparison to the classic markers of iron status in prevalent hemodialysis patients. Methods This case-control study assessed sTfR in 80 prevalent ESRD patients on regular hemodialysis in 2 groups. Group A (N = 40): CRP &gt;10 and group B (N = 40):CRP &lt;10 and apparently healthy 8 control subjects. Results The cut of value of STFRs in hemodialysis patients was 12.5 mg\l. The prevalence of STFRs in patients with CRP&lt;10 was 85%, while in patients with CRP&gt;10 was 92.5% (P-value 0.288). STFRs have high sensitivity 88.75, specificity 100, PPV100% and NPV 47.1%. The hemodialysis patients who have elevated STFRs have risk 1.22 times to have iron deficiency anemia if CRP &lt;10 (odds ratio: 1.22) and 3.14 times if CRP&gt;10 (odds ratio: 3.14). There was significant difference on comparing patients with CRP&lt;10, CRP&gt;10 and control as regard Hb and STFR with P-value 0.0001 and 0.0001 respectively. Post Hoc analysis showed significant difference in both between the patients with CRP&lt;10 and control also in patients with CRP&gt;10 and control (p value &lt;0.0001). while on comparing patients with CRP&lt;10 with patients with CRP&gt;10 there was significant difference in STFRs p value 0.0001 despite no significant difference in hemoglobin (p value 0.642) and classic marker of iron deficiency (s.iron, TIBC, TSAT) with p value 0.701,0.192,0.382 respectively. Serum STFRs was negatively correlated with s.iron and Kt\v (r -0.372, P-value 0.018) and (r-0.416, p value 0.008) respectively in patients with CRP &lt;10. Conclusion Serum soluble transferrin receptor is highly sensitive and specific marker for iron deficiency in hemodialysis patients especially in patients with high CRP level.

scholarly journals Iron deficiency in preschool non-anemic Egyptian children

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Osama M. El-Asheer ◽  
Mary S. Naeem ◽  
Fardos A. Abdel-Hafez ◽  
Madleen A. A. Abdou ◽  
Khalil A. Mohamed
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Complete Blood Count ◽  
Binding Capacity ◽  
Iron Status ◽  
Ferritin Level ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Healthy Children ◽  
Egyptian Children

Abstract Background Iron deficiency anemia remains a common cause of anemia in young children. The term iron deficiency without anemia, or the so-called latent iron deficiency, has become increasingly significant as it is not only difficult to identify this condition in non-anemic children, but it also adversely affects neurocognitive development, and unfortunately, some of these effects may be irreversible and not respond to treatment. This cross-sectional study was conducted to evaluate iron status in 68 apparently healthy, non-anemic Egyptian children aged 1–6 years. They were subjected to detailed history-taking, physical examination, complete blood count, and tests for serum iron, total iron binding capacity, serum ferritin, and transferrin saturation. Results Low serum ferritin level and low transferrin saturation were detected in 41.2% and 47% of the children, respectively. Iron deficiency parameters were significantly affected among toddlers aged “1” to “3” years compared with preschool children, and boys were found to be more affected than girls of the same age group. Conclusions A normal hemoglobin level does not exclude iron deficiency, which should be screened in healthy children to prevent the possible long-term effects of iron deficiency on their cognition and mental development.

scholarly journals Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Abidullah Khan ◽  
Wazir Muhammad Khan ◽  
Maimoona Ayub ◽  
Mohammad Humayun ◽  
Mohammad Haroon
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Strong Positive Correlation ◽  
Obese People ◽  
Strong Negative Correlation ◽  
Reactive Protein ◽  
Group A

Background. In clinical practice, serum ferritin is used as a screening tool to detect iron deficiency. However, its reliability in obesity has been questioned. Objectives. To investigate the role of ferritin in overweight and obese people, either as a marker of inflammation or iron deficiency. Methods. On the basis of body mass index (BMI), 150 participants were divided into three equal groups: A: BMI 18.5–25 kg/m2, B: BMI 25–30 kg/m2, and C: BMI>30 kg/m2. Serum iron, total iron binding capacity (TIBC), transferrin saturation, ferritin, C-reactive protein, and hemoglobin (Hb) were measured for each participant and analyzed through SPSS version 16. One-way ANOVA and Pearson’s correlation tests were applied. Results. Ferritin was the highest in group C (M=163.48±2.23, P<0.001) and the lowest in group A, (M=152.78±1.81, P<0.001). Contrarily to ferritin, transferrin was the lowest in group C, (M=30.65±1.39, P<0.001) and the highest in group A, (M=38.66±2.14, P<0.001). Ferritin had a strong positive correlation with both BMI (r=0.86, P<0.001) and CRP (r=0.87, P<0.001) and strong negative correlation with Hb, iron, TIBC, and transferrin saturation (P<0.001). Conclusion. Ferritin is a marker of inflammation rather than iron status in overweight and obese people. Complete iron profile including transferrin, rather than serum ferritin alone, can truly predict iron deficiency in such people.

Prevalence of Iron Depletion and Anemia in Top-level Basketball Players

2004 ◽  
Vol 14 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Gal Dubnov ◽  
Naama W. Constantini
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Blood Count ◽  
Complete Blood Count ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Iron Store ◽  
Basketball Players ◽  
Iron Depletion

Iron depletion, with or without anemia, may have a negative effect on physical and mental performance. Even with current recognition of the problem, its incidence among athletes remains high. Most studies describe iron status in endurance athletes. This study examined the prevalence of iron depletion and anemia among male and female top-level basketball players. Adolescents and adults (N = 103) from 8 national basketball teams were screened for anemia and iron stores status, which included a complete blood count and levels of plasma ferritin, transferrin, and serum iron. Iron depletion, defined by a ferritin level below 20 μg/L, was found among 22% of study participants (15% in males vs. 35% in females, p = .019). Anemia was found among 25% of athletes (18% in males vs. 38% in females, p = .028). Iron deficiency anemia, defined by the presence of anemia, ferritin levels below 12 μg/L, and transferrin saturation below 16%, was found among 7% of players (3% in males vs. 14% in females, p = .043). In summary, a high prevalence of iron depletion, anemia, and iron deficiency anemia was found among basketball players of both genders. We recommend screening ballgame players for blood count and iron store status, and providing nutritional counseling and iron supplementation when necessary.

Prevalence of Iron Deficiency in Infants of Diabetic Mothers at the Age of 6 to 12 Months

2020 ◽  
Vol 103 (12) ◽  
pp. 1262-1268
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Iron Depletion ◽  
Iron Storage ◽  
Infants Of Diabetic Mothers ◽  
History Of ◽  
Diabetic Mothers

Background: Iron deficiency (ID) and iron deficiency anemia (IDA) are worldwide problems in infants. The infants of diabetic mothers (IDMs) usually have low iron storage at birth. Therefore, they are at risk for developing ID and IDA during late infancy. Objective: To determine the prevalence of ID and IDA in IDMs aged 6 to 12 months and to identify the risk factors associated with abnormal iron status. Materials and Methods: The present study was a prospective descriptive study conducted in healthy, full-term, IDMs between the ages of 6 to 12 months. Growth and dietary history of IDMs as well as maternal history of diabetes were evaluated. Anemia and iron status were determined by hemoglobin, serum ferritin, and transferrin saturation. Results: Of the 50 IDMs, the prevalence of ID was 46%, and iron depletion was 14%. IDA was found in 11 IDMs. Although the gender, gestational age, birthweight, and the age of complementary food introduction were not found to be associated with abnormal iron status, infants with ID and iron depletion were more likely to be breastfed, or breastfed longer than six months, when compared to iron sufficient infants (p<0.001). No exclusively breastfed infants had iron sufficiency in the study. Conclusion: There was a high prevalence of ID and IDA in IDMs. Therefore, screening for iron status along with anemia is crucial in IDMs at an earlier age. Moreover, iron supplementation starting at four months should be considered in IDMs who were exclusively or mainly breastfed. Keywords: Anemia, Iron deficiency, Iron deficiency anemia, Infants of diabetes mothers

scholarly journals Comparative Evaluation of the Reticulocyte Hemoglobin Content Assay When Screening for Iron Deficiency in Elderly Anemic Patients

Anemia ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Torbjörn Karlsson
Keyword(s):  
Iron Deficiency ◽  
Sensitivity And Specificity ◽  
Transferrin Receptor ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Soluble Transferrin Receptor ◽  
Hemoglobin Content ◽  
Iron Parameters ◽  
Reticulocyte Hemoglobin Content

The aim of this study was to evaluate sensitivity and specificity for reticulocyte hemoglobin content (CHr) compared to other hematimetric and biochemical iron parameters, in particular, mean corpuscular hemoglobin (MCH), when screening for iron deficiency in elderly anemic patients. Bone marrow staining negative for iron was used as the gold standard criterion for iron deficiency anemia (IDA). Sensitivity and specificity for CHr, soluble transferrin receptor (sTfR), soluble transferrin receptor/log ferritin (TfR-F index), ferritin, MCH, and transferrin saturation were determined. The best cut-off point for CHr was 30.5 pg corresponding to a sensitivity and specificity of 93% and 69% for IDA, respectively. For MCH, a sensitivity of 93% and a specificity of 86%, respectively, correspond to an optimal cut-off of 28.5 pg. Analysis of CHr was not superior to MCH with respect to sensitivity and specificity when screening for IDA in elderly anemic patients.

scholarly journals Laboratory tests of iron status: correlation or common sense?

1996 ◽  
Vol 42 (5) ◽  
pp. 718-724 ◽  
Author(s):  
J Hastka ◽  
J J Lasserre ◽  
A Schwarzbeck ◽  
A Reiter ◽  
R Hehlmann
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Hemoglobin Concentration ◽  
Deficiency Anemia ◽  
Zinc Protoporphyrin ◽  
Iron Supply ◽  
Iron Deficient ◽  
Red Cell Indices ◽  
Total Body

Abstract We demonstrate that simple correlation between the various tests of iron status is not sufficient for examining their value in diagnosing iron deficiency (ID). Three degrees of ID are recognized: Iron depletion (ID grade I) is defined by decreased total body iron and normal iron support to erythropoiesis, as diagnosed by decreased storage iron, decreased ferritin, normal sideroblast count, normal zinc protoporphyrin (ZPP), and transferrin saturation &gt;15%. When the iron supply to erythropoiesis becomes insufficient, as diagnosed by transferrin saturation &lt; or = 15%, increased ZPP, and decreased sideroblast count, iron-deficient erythropoiesis (ID grade II) occurs. When finally hemoglobin is below its normal range, iron-deficiency anemia (ID grade III) results. The various tests for ID cannot be compared without taking into account the severity of the deficiency. Depending on the grade of ID examined, the correlation of markers seen in our patients' data varied considerably. We conclude that a "best" marker of ID does not exist. However, the different tests efficiently complement each other by detecting different stages and individually show the clinical extent of ID. Ferritin reflects the iron stores. ZPP indicates whether the ID in a given patient is clinically relevant or not. Finally, the extent of a clinically relevant ID can be assessed by the measured ZPP, hemoglobin concentration, and red cell indices.

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