Reference Values of Serum Transferrin Receptor and sTfR/Log Ferritin Index in Healthy Adolescents

Abstract

Adolescence is a period of increased iron requirements, which impact on iron status. The purpose of this research is to determine the reference intervals for serum transferrin receptor (sTfR) and sTfR/log ferritin index (sTfR-F index) in healthy adolescents, and their relation with iron parameters and erythropoiesis. A total of 253 healthy adolescents without overweight, aged 12 to 16 years, were selected in a cross-sectional study. Hemoglobin, red cell indices, reticulocyte hemoglobin content (rHb), reticulocytes, ferritin, transferrin saturation, erythrocyte protoporphirin, erythropoietin, C-reactive protein, sTfR, and sTfR-F index were measured. Changes in erythropoiesis and iron status in the age interval were observed and analyzed, and linear multiple regression was applied to identify the factors that determine the variability of sTfR and sTfR-F index. Mean values for sTfR and sTfR-F index were 1.32 ± 0.3 mg/L (95% CI, 1.3-1.36) and 0.9 ± 0.25 (95% CI, 0.87-0.93). The reference intervals were 0.84 to 1.97 mg/L and 0.51 to 1.44, respectively. sTfR and sTfR-F index values were significantly higher in boys (1.39 ± 0.3 vs. 1.23 ± 0.26 mg/L, P<0.0001 and 0.93 ± 0.37 vs. 0.86 ± 0.22, P<0.04) and decreased with age (P<0.0001 and 0.04, respectively). No changes were recorded in erythropoietin. Age, sex, pubertal status, and ferritin predicted 24.1% of sTfR variability and age, sex, pubertal status, transferrin saturation, rHb, erythrocytes, and reticulocytes predicted 15% of sTfR-F index variability.

Soluble transferrin receptor and soluble transferrin receptor/log ferritin index in diagnosis of iron deficiency anemia in pediatric inflammatory bowel disease

“…Our results are in the accordance with previous findings which suggested that sTfR/log ferritin has a better discriminating power than sTfR in the recognition of iron deficiency anemia in patients with chronic conditions [8,16,[20][21][22]. It could be explained by the fact that a calculation sTfR/log ferritin covers the entire spectrum of body iron status providing information of iron storage and functional iron pool [23]. However, in meta-analysis assessing diagnostic utility of sTfR and sTfR/log ferritin Infusino et al proved that sTfR/log ferritin does not improve diagnostic accuracy of sTfR.…”

Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey

“…Interestingly, serum transferrin receptor levels in our study were statistically significantly higher in males than females despite the markedly worse iron status of females. Similar findings were reported in Spanish adolescents [ 44 ]. The manufacturers of the assay kit recommend adjusting the normal range according to ethnicity ( https://resources.rndsystems.com/pdfs/datasheets/dtfr1.pdf ), and reference ranges for serum transferrin receptor have not been established in the Sri Lankan population.…”

Serum soluble transferrin receptor levels are independently associated with homeostasis model assessment of insulin resistance in adolescent girls

“…Discordant results in previous studies, in addition to the variation in sample size, gender distribution, and ethnic background, might also be attributed to different assays for measurement of sTfR and other iron homeostasis markers (e.g., immunoturbidimetry, immunonephelometry, electrochemiluminescence assays) [ 9 , 10 , 32 ]. Since no assay standardization for sTfR exists and regarding the presence of its different cut-off levels, the interpretation of sTfR in clinical practice is limited [ 33 , 34 ]. Therefore, a better understanding of the factors that modulate sTfR is of great importance in future studies.…”