scholarly journals Predictors of serum ferritin and serum soluble transferrin receptor in newborns and their associations with iron status during the first 2 y of life

2007 ◽  
Vol 86 (1) ◽  
pp. 64-73 ◽  
Author(s):  
Gry Hay ◽  
Helga Refsum ◽  
Andrew Whitelaw ◽  
Elisabeth Lind Melbye ◽  
Egil Haug ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Transferrin Receptor ◽  
Iron Status ◽  
Soluble Transferrin Receptor

scholarly journals Hepcidin, Soluble Transferrin Receptor, and Other Biomarkers of Iron Status Distributions in Healthy 2 Years Old Infants from a National Ambulatory Study in France

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4809-4809
Author(s):  
Anne-Sylvia Sacri ◽  
Thibaud Lefebvre ◽  
Mariane De Montalembert ◽  
Alain Bocquet ◽  
Piotr Gembara ◽  
...  
Keyword(s):  
Young Children ◽  
Serum Ferritin ◽  
Iron Metabolism ◽  
Transferrin Receptor ◽  
Research Funding ◽  
Limit Of Detection ◽  
Iron Status ◽  
Soluble Transferrin Receptor ◽  
Healthy Infants ◽  
Assay Precision

Background: Adequate evaluation of iron status in young children is of paramount importance given the frequency of iron deficiency (ID) and its potential short- and long-term neurocognitive adverse effects when occurs early. Iron metabolism is complex and the correct evaluation of iron status may be difficult, notably when inflammation is present. Soluble transferrin receptor (sTfR) is not modified by inflammation but lacks specificity in ID, and its combination with serum ferritin (SF) by the TfR-F index (TfR/logSF) has been proposed to improve diagnosis performances [Punnonen Blood 1997]. Hepcidin has been identified in the two last decades has the key regulator of iron homeostasis mainly by controlling iron release from macrophages via ferroportin degradation, as well as enterocytes absorption [Ganz Blood 2011]. Scarce studies have been published on hepcidin in healthy children in industrialized countries [Uijterschout Pediatr Res 2014]. The distribution of sTfR and hepcidin in healthy young children is unknown, including according to gender. Aims: Our objective was to describe hepcidin, sTfR and other iron status biomarkers (serum ferritin [SF], hemoglobin (Hb), transferrin saturation, zinc protoporphyrin [ZnPP]) distributions in a population of healthy infants aged 2 years old. Methods: In a cross-sectional observational study conducted in primary care pediatricians' offices throughout France from 2016 to 2017, infants aged 2 years old were consecutively included to undergo a blood sampling in the morning fasting. They were excluded if they were affected by a chronical disease involving iron metabolism, had fever in the last 15 days or biological inflammation defined as a CRP≥10 mg/L, and had no measurement for hepcidin. Hepcidin and ZnPP in erythrocytes were measured after a <24 hours frozen transport at -80°C in the dark by liquid chromatography-tandem mass spectrometry (LC-MS/MS, limit of detection = 0.75 ng/mL, intra- and inter-assay precision ≤ 12.3% and 9.9% [Lefebvre Clin Chem Lab Med 2015]) and by a fluorimetric method, respectively. Hb and mean corpuscular Hb concentration were measured immediately after the sample by spectrophotometric methods. The other iron biomarkers were immediately measured after refrigerated or frozen transport using immuno-turbidimetric method for transferrin (limit of detection = 0.1 g/L, intra- and inter-assay precision ≤1.2 and 2.6%) and sTfR (limit of detection 0.5 mg/L, intra- and inter-assay precision ≤2.1 and 3.6%), and electro‐chemiluminescence immunoassay for SF (limit of detection = 0.5 μg/L, intra- and inter-assay precision ≤1.1% and 5.7%). The distribution of biomarkers were described, including after classical mathematical transformation. Results: Among the 539 included children, the mean age was 24 months (SD 0.6), 49% were girls. Prevalence of ID (SF <10 µg/L) and anemia (Hb <11 g/dL) was 7% (37/539, 95% CI 4.9-9.3) and 3% (19/536, 95% CI 2.1-5.5), respectively. Hepcidin (ng/mL) median was 3.3 (IQR: 1.0-7.1; min-max: 0.75-104.1) and its mean was 6.7 (SD 10.7). Hepcidin was neither normally nor log-normally distributed (Figure 1.A, 1.B). sTfR median was 4.1 (IQR: 3.6-4.8; min-max: 1.2-13.5) and its mean was 4.2 (SD 1.1). TfR-F index median was 1.2 (IQR: 1.0-1.5; min-max: 0.3-8.4) and its mean was 1.4 (SD 0.6). No statistically significant difference was found between girls and boys for hepcidin, sTfR, and TfR-F index distributions (all p t-tests > 0.3). Distributions of other iron biomarkers were closed to those reported in the literature. Conclusion: We described for the first time in a nationwide ambulatory study hepcidin and TfR/logSF distributions in a population of 2 year-old healthy infants with a low ID prevalence. Hepcidin had a right-skewed distribution and its normalisation was not obtained by usual transformations. Low values, partly corresponding to the limit of detection, were over-represented despite the low proportion of ID defined by SF level. High values were also observed despite the exclusion of infants with CRP>10 mg/L. We did not find significant variations according to gender. Our results will help define normal values at this age to better interpret iron status. Disclosures Sacri: Secteur Francais des Aliments de l Enfance: Research Funding; French Ministry of Health DGOS PHRC regional 2014 no. AOR14053: Research Funding. De Montalembert:Bluebird Bio: Membership on an entity's Board of Directors or advisory committees; Addmedica: Consultancy, Honoraria; Novartis: Consultancy, Honoraria. Chalumeau:French Ministry of Health DGOS PHRC regional 2014 no. AOR14053: Research Funding; Secteur Francais des Aliments de l Enfance: Research Funding.

scholarly journals Effect of Fortification with Multiple Micronutrient Powder on the Prevention and Treatment of Iron Deficiency and Anaemia in Brazilian Children: A Randomized Clinical Trial

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2160
Author(s):  
Malaine Morais Alves Machado ◽  
Mirella de Paiva Lopes ◽  
Raquel Machado Schincaglia ◽  
Paulo Sérgio Sucasas da Costa ◽  
Alexandre Siqueira Guedes Coelho ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Transferrin Receptor ◽  
Ferrous Sulfate ◽  
Soluble Transferrin Receptor ◽  
Standard Drug ◽  
Micronutrient Powder ◽  
Prevention And Treatment ◽  
Multiple Micronutrient ◽  
Multiple Micronutrient Powder

Fortification with multiple micronutrient powder has been proposed as a public health intervention able to reduce micronutrient deficiencies in children. Our objective was to compare the effectiveness of fortification with multiple micronutrient powder with drug supplementation in the prevention and treatment of iron deficiency and anaemia. This was a cluster trial with anemic and non-anaemic children between six and 42 months old, in randomization data. Non anaemic children received fortification with multiple micronutrient powder or standard drug supplementation of ferrous sulfate associated with folic acid in a prevention dose. Anaemic children who were randomized to receive multiple micronutrient powder also received the recommended iron complementation for anaemia treatment. A total of 162 children were evaluated. The prevalence of anaemia decreased from 13.58 to 1.85%. Iron deficiency decreased from 21.74% to 7.89% (by serum ferritin) and iron deficiency decreased from 66.81 to 38.27% (by soluble transferrin receptor). No difference was identified between interventions for hemoglobin (p = 0.142), serum ferritin (p = 0.288), and soluble transferrin receptor (p = 0.156). Fortification with multiple micronutrient powder was effective in preventing iron deficiency and anaemia in children aged six to 48 months. In anaemic children; it was necessary to supplement the dose of multiple micronutrient powder with ferrous sulfate.

Value of serum ferritin and soluble transferrin receptor for prediction of coronary artery disease and its clinical presentations

2004 ◽  
Vol 174 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Siegmund Braun ◽  
Gjin Ndrepepa ◽  
Nicolas von Beckerath ◽  
Wolfgang Vogt ◽  
Albert Schömig ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Ferritin ◽  
Transferrin Receptor ◽  
Soluble Transferrin Receptor ◽  
Clinical Presentations ◽  
Artery Disease

scholarly journals Evaluation of new immunoenzymometric assay for measuring soluble transferrin receptor to detect iron deficiency in anemic patients

1997 ◽  
Vol 43 (9) ◽  
pp. 1641-1646 ◽  
Author(s):  
Pauli Suominen ◽  
Kari Punnonen ◽  
Allan Rajamäki ◽  
Kerttu Irjala
Keyword(s):  
Iron Deficiency ◽  
Transferrin Receptor ◽  
Bone Marrow Aspirate ◽  
Clinical Performance ◽  
Iron Status ◽  
Clinical Work ◽  
Analytical Performance ◽  
Soluble Transferrin Receptor ◽  
Commercial Test ◽  
Clinical Applicability

Abstract During the last few years the measurement of serum-soluble transferrin receptor (sTfR) has been introduced as a tool to detect iron deficiency and as an analyte to differentiate between anemia caused by iron deficiency (IDA) and that caused by chronic disease (ACD). Commercially available methods have emerged to make diagnostics by sTfR more readily accessible. We documented the analytical performance of a newly introduced IDeATM sTfR immunoenzymometric assay (IEMA) by Orion Diagnostica. We also evaluated its clinical performance in 98 consecutive anemic patients, with information derived from bone marrow aspirate samples as the reference for iron status. The clinical usefulness of two other commercially available sTfR assays was assessed for comparison. The analytical performance and clinical applicability of the IDeA were sufficient to support reliable clinical work. We conclude that IDA and iron deficiency in the presence of inflammatory states can be differentiated efficiently from ACD with this new commercial test to measure sTfR.

scholarly journals The Iron Status of Sickle Cell Anaemia Patients in Ilorin, North Central Nigeria

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Musa A. Sani ◽  
James O. Adewuyi ◽  
Abiola S. Babatunde ◽  
Hannah O. Olawumi ◽  
Rasaki O. Shittu
Keyword(s):  
Sickle Cell ◽  
Serum Ferritin ◽  
Transferrin Receptor ◽  
Sickle Cell Anaemia ◽  
Iron Status ◽  
Serum Transferrin ◽  
Cross Sectional ◽  
Serum Transferrin Receptor ◽  
Iron Deficient ◽  
The Mean

Objectives. Sickle cell anaemia (SCA) is one of the commonest genetic disorders in the world. It is characterized by anaemia, periodic attacks of thrombotic pain, and chronic systemic organ damage. Recent studies have suggested that individuals with SCA especially from developing countries are more likely to be iron deficient rather than have iron overload. The study aims to determine the iron status of SCA patients in Ilorin, Nigeria.Methods. A cross-sectional study of 45 SCA patients in steady state and 45 non-SCA controls was undertaken. FBC, blood film, sFC, sTfR, and sTfR/log sFC index were done on all subjects.Results. The mean patients’ serum ferritin (589.33 ± 427.61 ng/mL) was significantly higher than the mean serum ferritin of the controls (184.53 ± 119.74 ng/mL). The mean serum transferrin receptor of the patients (4.24 ± 0.17 μg/mL) was higher than that of the controls (3.96 ± 0.17 μg/mL) (p=0.290). The mean serum transferrin receptor (sTfR)/log serum ferritin index of the patients (1.65 ± 0.27 μg/mL) was significantly lower than that of the control (1.82 ± 0.18 μg/mL) (p=0.031).Conclusion. Iron deficiency is uncommon in SCA patients and periodic monitoring of the haematological, biochemical, and clinical features for iron status in SCA patients is advised.

The “Thomas Plot”: Its Usefulness in the Assessment of Iron Status in Anemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3737-3737
Author(s):  
Carmen Canals ◽  
Pilar Sardà ◽  
Jose María Piazuelo ◽  
Ángel F. Remacha
Keyword(s):  
Transferrin Receptor ◽  
Iron Status ◽  
Patient Treatment ◽  
Standard Protocol ◽  
Soluble Transferrin Receptor ◽  
Diagnostic Plot ◽  
Anemia Of Chronic Disorders ◽  
Chronic Disorders ◽  
Very High ◽  
Modified Algorithm

Abstract A diagnostic plot to assess iron status in anemia of chronic disorders (ACD) has recently been developed (Thomas C, Thomas L. Lab Hematol 2005). The plot is based on the relation between the ratio of the soluble transferrin receptor value to the logarithm of the ferritin value (sTfR/log sFt) and the RET-He parameter -reticulocyte hemoglobin equivalent-. A different cut-off point for sTfR/log sFt is proposed for patients with a CRP ≤5mg/L or with a CRP &gt;5mg/L. The main aim of our study was to validate the usefulness of the “Thomas Plot” in assessing iron status. We also ascertained whether a modification on the sTfR/log sFt cut-off point improved the results. CRP was determined in 306 patients, 198 with iron deficiency (ID) and 108 with ACD. All of them were anemia cases studied in accordance with our standard protocol. RET-He, sTfR and sTfR/log sFt were calculated in all samples. The Thomas Plot was applied to all the cases and the results were compared. A discrepancy was considered relevant when it implied a change in patient treatment. Using logistic regression analysis, we investigated the optimum cut-off point of sTfR/log sFt in our series. Overall, the Thomas Plot correctly classified 223/306 patients (73%). There were clinically relevant discrepancies in 29 patients (9.5%), in 5 patients with CRP ≤5mg/L (5%) and in 24 patients with CRP &gt;5mg/L (12%). It failed to identify ID in 12/198 patients (6%) but classified 17 cases with ACD (16%) as latent ID or IDA. The optimum sTfR/log sFt cut-off point in our series was 2.4 for patients with CRP ≤5mg/L and 2.39 for patients with CRP&gt;5mg/L. As a consequence, we investigated a modified “Thomas Plot” using a sTfR/log sFt cut-off point of 2.4 for all the patients. The modified algorithm correctly classified 77% of the patients. There were clinical relevant discrepancies only in 17 patients (5%). It failed to identify ID in 12/198 patients (6%) and only classified 5 cases with ACD as latent ID or IDA (4.6%). The sensitivity of the Thomas Plot to identify ID was very high but the specificity was lower. A cut-off point of 2.4 for sTfR/log sFt is useful for patients with or without inflammatory traits and yields more accurate results.

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.

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