Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Abstract

Abstract:Purpose -We performed a meta-analysis of all eligible case-control studies published to date, to assess the association of salivary ferritin and iron with hematological disorders. Methods -We conducted Medline/PubMed and Scopus searches for papers published from January 1, 1980, through January 1, 2013. Data were merged the summary mean difference were estimated using either a random-effects model or a fixed-effects model. Results -There were 3 studies including 196 cases and 70 controls. There was a statistically significant difference in the salivary ferritin and iron between hematological diseases and control groups, and the summary estimate of mean difference was 1.37 (95%CI: 0.01-2.74) and 2.23 (0.92-3.54) in salivary ferritin and iron, respectively. The stratification showed the same statistically significant differences in the salivary ferritin between Iron deficiency anemia (IDA) with thalassemia intermedia (TI), and IDA with thalassemia major (TM) groups. Besides, the stratification showed that there were statistically significant differences in the salivary iron between IDA with TM groups, while no statistically significant difference was observed between IDA with TI. Conclusion -Saliva ferritin iron and ferritin increase significantly in patients with thalassemia compared to IDA. Salivary ferritin and iron can be used as a diagnostic marker and new discriminating indices routinely to differentiate IDA from thalassemia, especially thalassemia trait; furthermore, their easy applicability, safe, relatively simple, and noninvasive procedure may be an important advantage compared to blood sample collection. Consequently, it could be promising to develop a simplified testing and differentiating procedure, which could reach many clinical decision-makers as a diagnostic potential.

Salivary and Serum Ferritin Levels: Is There a Correlation?

“…A study by Kodati [13] reported lower levels of ferritin in serum and saliva of patients with iron deficiency anemia. Rahim [14] reported that salivary ferritin levels significantly increased in patients with thalassemia. The discrepancy between the two studies may be explained by the differences in sample size and, age of patients.…”

“…Thus, the use of saliva has come to be regarded as a reliable alternative method of ferritin assessment, one that is less invasive and offers a similar degree of sensitivity as serum [9,13]. In addition, it appears that changes in the salivary ferritin levels occur even before changes in the serum, meaning that saliva can be used as a valuable tool to assess the iron status [3,9,14]. The present study aimed to explore the correlation between the salivary and serum ferritin levels.…”