Bahar Büyükkaragöz1, Necat A Akgun2, Ayse D Bulus3, Sultan Durmus Aydogdu4, Cengiz Bal5. 1. Department of Pediatrics, Osmangazi University, Eskisehir, Turkey. karamanbahar@yahoo.com. 2. Department of Pediatric Hematology, Osmangazi University, Eskisehir, Turkey. 3. Department of Pediatric Endocrinology, Kecioren Research and Training Hospital, Ankara, Turkey. 4. Department of Pediatric Metabolism and Nutrition, Osmangazi University, Eskisehir, Turkey. 5. Department of Biostatistics, Osmangazi University, Eskisehir, Turkey.
Abstract
OBJECTIVE: To evaluate the efficacy of soluble transferrin receptor (sTfR) in diagnosing iron deficiency anemia (IDA) and evaluating iron response in infants with moderate acute malnutrition (MAM). POPULATION AND METHODS: Infants with hemoglobin (Hb) levels lower than threshold values for anemia for their ages and hypochromic/ microcytic anemia on peripheral smear were recruited. MAM was defined as weight/height z score < -2 to -3. Complete blood count (CBC), iron parameters and sTfR were compared among 41 infants with MAM and anemia (MA group), 32 infants with anemia without MAM (group A), and healthy controls (n= 30). Following anemia and malnutrition treatment, tests were repeated. RESULTS: Besides hematological indices compatible with IDA, serum iron (Fe) and transferrin saturation (TS) were significantly lower, while transferrin was significantly higher in MA and A groups compared to controls (p <0.001). Ferritin and C-reactive protein (CRP) were significantly higher in MA group (p <0.05 ferritin, p 0.01 for CRP). Mean sTfR was similar in both MA and A groups (p >0.05) and significantly higher than controls (p <0.001). Following iron treatment, sTfR decreased in both MA and A groups (p <0.001) to similar values as controls. sTfR was negatively correlated to Hb throughout the study (for MA group, r= -0.350, p <0.05; for A group, r= -0.683, p <0.01). CONCLUSIONS: As sTfR values in both MA and A groups decreased following iron treatment, we believe that this parameter was not influenced by MAM or inflammation; and it alone can be used to detect IDA and monitor treatment response in infants with MAM.
OBJECTIVE: To evaluate the efficacy of soluble transferrin receptor (sTfR) in diagnosing iron deficiency anemia (IDA) and evaluating iron response in infants with moderate acute malnutrition (MAM). POPULATION AND METHODS: Infants with hemoglobin (Hb) levels lower than threshold values for anemia for their ages and hypochromic/ microcytic anemia on peripheral smear were recruited. MAM was defined as weight/height z score < -2 to -3. Complete blood count (CBC), iron parameters and sTfR were compared among 41 infants with MAM and anemia (MA group), 32 infants with anemia without MAM (group A), and healthy controls (n= 30). Following anemia and malnutrition treatment, tests were repeated. RESULTS: Besides hematological indices compatible with IDA, serum iron (Fe) and transferrin saturation (TS) were significantly lower, while transferrin was significantly higher in MA and A groups compared to controls (p <0.001). Ferritin and C-reactive protein (CRP) were significantly higher in MA group (p <0.05 ferritin, p 0.01 for CRP). Mean sTfR was similar in both MA and A groups (p >0.05) and significantly higher than controls (p <0.001). Following iron treatment, sTfR decreased in both MA and A groups (p <0.001) to similar values as controls. sTfR was negatively correlated to Hb throughout the study (for MA group, r= -0.350, p <0.05; for A group, r= -0.683, p <0.01). CONCLUSIONS: As sTfR values in both MA and A groups decreased following iron treatment, we believe that this parameter was not influenced by MAM or inflammation; and it alone can be used to detect IDA and monitor treatment response in infants with MAM.
Entities:
Keywords:
infants; iron deficiency anemia; malnutrition; transferrin receptor
Authors: John Muthii Muriuki; Alexander J Mentzer; Emily L Webb; Alireza Morovat; Wandia Kimita; Francis M Ndungu; Alex W Macharia; Rosie J Crane; James A Berkley; Swaib A Lule; Clare Cutland; Sodiomon B Sirima; Amidou Diarra; Alfred B Tiono; Philip Bejon; Shabir A Madhi; Adrian V S Hill; Andrew M Prentice; Parminder S Suchdev; Alison M Elliott; Thomas N Williams; Sarah H Atkinson Journal: BMC Med Date: 2020-02-27 Impact factor: 8.775