The value of Ret-Hb and sTfR in the diagnosis of iron depletion in healthy, young children

Uijterschout, Lieke; Domellöf, Magnus; Vloemans, J.; Vos, Rimke C.; Hudig, Cisca; Bubbers, S.; Verbruggen, S. C. A. T.; Veldhorst, Margriet A. B.; Leeuw, Tom de; Teunisse, Peter-Paul; Goudoever, Johannes B. van; Brus, F

doi:10.1038/ejcn.2014.70

Cited by 18 publications

(12 citation statements)

References 33 publications

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“…Reference intervals have been reported for newborns within 24 h, in a population of children between 6 months and 5 years, with a median of 4 years, and for infants during their fist 90 days (18)(19)(20)(21). A recent study compared Ret-He and soluble transferrin receptors (sTfR) for the diagnosis of iron depletion in young children aged 0.5-3 years, comparing these biomarkers with ferritin levels (22). The study showed that Ret-He was decreased at low levels of ferritin, and also that Ret-He level was significantly correlated with ferritin, MCV and Hb.…”

Section: Introductionmentioning

confidence: 99%

Reference intervals for reticulocyte hemoglobin content in healthy infants

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Reference intervals for reticulocyte hemoglobin content in healthy infants

et al. 2018

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“…Diagnosis requires various biomarkers to be examined, some of which lack clearly defined cutoff values [2,37]. In recent years, the diagnostic usefulness of sTfR and sTfR-F index has been recognized, and currently both parameters are included in diagnostic algorithms and clinical guidelines for ID, especially for the differential diagnosis of chronic anemia [32,38,39].…”

Section: Discussionmentioning

confidence: 99%

“…Infancy and childhood are periods of high prevalence of iron deficiency (ID) because of increased iron requirements for rapid growth [1][2][3][4][5]. Early detection of ID is essential in order to avoid adverse effects on development [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Reference values of serum transferrin receptor (sTfR) and sTfR/log ferritin index in healthy children

Vázquez-López

López-Ruzafa

Lendínez-Molinos

et al. 2016

Pediatric Hematology and Oncology

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ABSTARCT The aims of this study were to determine appropriate reference ranges for serum transferrin receptor (sTfR) and sTfR/log ferritin (sTfR-F index) in healthy children and their relationship with iron parameters, erythropoiesis, and other conditions presented by the subject. A total of 902 children with normal iron status, aged 1-11 years, were included in a cross-sectional study. A physical examination was conducted and z-score of body mass index (zBMI) obtained. Complete blood count, iron biomarkers, erythropoietin, C-reactive protein, sTfR, and sTfR/log ferritin were determined. Linear multiple regression was applied to identify the factors that determined sTfR and sTfR-F index variability. Mean values for sTfR and sTfR-F index were 1.22 ± 0.28 mg/L (95% confidence interval [CI]: 1.2-1.23) and 0.87 ± 0.25 (95% CI: 0.85-0.88). The reference intervals (2.5th to 97.5th percentiles [P2.5-P97.5]) were 0.78-1.9 mg/L and 0.49-1.46, respectively. sTfR and sTfR-F values decreased with age (P <.03 and P <.0001, respectively). No changes were observed with sex. Changes in sTfR and sTfR-F index were consistent with ferritin and erythropoietin variations. Iron biomarkers, erythropoietin, and zBMI predicted 19% and 18.1% of the sTfR and sTfR-F index variability. The results provide reference ranges for sTfR and sTfR-F index in healthy children for clinical use in the assessment of body iron status. Both biomarkers are predicted by iron parameters, erythropoietin, and zBMI.

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“…In the first method, a SF cutoff < 15 μ g/L was used irrespective of the CRP level. In the second method, two different cutoffs were used for SF to take into account the absence (SF < 15 μ g/L) [ 30 ] or presence of inflammation (SF < 50 μ g/L) [ 6 ], which were defined as a CRP ≤ 5 mg/L or >5 mg/L, respectively [ 7 , 31 – 33 ].…”

Section: Methodsmentioning

confidence: 99%

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

O’Brien

Blanchet

Gagné³

et al. 2016

Anemia

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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.

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The value of Ret-Hb and sTfR in the diagnosis of iron depletion in healthy, young children

Cited by 18 publications

References 33 publications

Reference intervals for reticulocyte hemoglobin content in healthy infants

Reference intervals for reticulocyte hemoglobin content in healthy infants

Reference values of serum transferrin receptor (sTfR) and sTfR/log ferritin index in healthy children

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

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