Assessment of iron status in cystic fibrosis patients

Abstract

We investigated the use of soluble transferrin receptor (sTfR), together with more traditional measurements such as iron, transferrin and ferritin, to assess iron status in 70 adult cystic fibrosis patients. sTfR concentration was measured using particle-enhanced immunonephelometry. We found that 69% of subjects as determined by transferrin saturation had iron deficiency, but only 29% as determined by sTfR and 11% as determined by ferritin. We found a significant correlation between C-reactive protein (CRP) and both ferritin (r = 0.38, P = 0.0001) and transferrin saturation (r = -0.54, P < 0.0001). In addition, because the CRP concentration was elevated in 64% of subjects, we feel that the transferrin saturation was overestimating, and the ferritin underestimating, iron deficiency in these patients. The sTfR concentration, on the other hand, is unaffected by the acute-phase response and was therefore thought to be the most useful test for detecting iron deficiency in this group of patients.

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

“…Alternatively, this may indicate functional iron deficiency. Indeed, sTfR levels were elevated in cystic fibrosis patients with other signs of functional iron deficiency and were correlated with the degree of inflammation [100]. Therefore, the cutoff point for the diagnosis of depleted iron stores in a patient with inflammation could be higher than the upper limit of normal values [87].…”

Health of boys in secure care

“…It is known that iron deficiency is common in adult patients with CF, 8 but it was surprising that 58% of children had low iron concentrations. Not all of these patients had an associated high total iron binding capacity, so it is probable that the low iron concentrations in most patients merely reflected chronic disease rather than true iron deficiency.…”

Stratégies de prise en charge nutritionnelle de l'enfant et de l'adulte jeune atteint de mucoviscidose

“…Le statut en oligoéléments sera apprécié par le dosage plasmatique du zinc et l'évaluation du statut martial par le dosage du fer plasmatique, du taux d'hémoglobine et de l'hémato-crite [29]. Le statut en acides gras essentiels peut être évalué par chromatographie des acides gras des phospholipides plasmatiques.…”