Serum or plasma ferritin concentration as an index of iron deficiency and overload

Garcı́a-Casal, Marı́a Nieves; Pasricha, Sant‐Rayn; Martinez, Ricardo X; Lopez-Perez, Lucero; Peña‐Rosas, Juan Pablo

doi:10.1002/14651858.cd011817

Cited by 31 publications

(39 citation statements)

References 44 publications

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“…During liver damage, ferritin leaks from hepatocytes, and plasma concentrations rise. The ferritin measurable in the serum appears to be chiefly derived from macrophages (10) and does not contain storage iron but reflects overall storage iron and ferritin concentrations in the liver and other tissues (11).…”

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confidence: 99%

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Serum ferritin as an indicator of iron status: what do we need to know?

Daru

Colman

Stanworth

et al. 2017

The American Journal of Clinical Nutrition

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Determination of iron status in pregnancy and in young children is essential for both clinical and public health practice. Clinical diagnosis of iron deficiency (ID) through sampling of bone marrow to identify the absence of body iron stores is impractical in most cases. Serum ferritin (SF) concentrations are the most commonly deployed indicator for determining ID, and low SF concentrations reflect a state of iron depletion. However, there is considerable variation in SF cutoffs recommended by different expert groups to diagnose ID. Moreover, the cutoffs used in different clinical laboratories are heterogeneous. There are few studies of diagnostic test accuracy to establish the sensitivity and specificity of SF compared with key gold standards (such as absent bone marrow iron stores, increased intestinal iron absorption, and hemoglobin response to SF) among noninflamed, outpatient populations. The limited data available suggest the commonly recommended SF cutoff of ,15 mg/L is a specific but not sensitive cutoff, although evidence is limited. Data from women during pregnancy or from young children are especially uncommon. Most data are from studies conducted .30 y ago, do not reflect ethnic or geographic diversity, and were performed in an era for which laboratory methods no longer reflect present practice. Future studies to define the appropriate SF cutoffs are urgently needed and would also provide an opportunity to compare this indicator with other established and emerging iron indexes. In addition, future work would benefit from a focus on elucidating cutoffs and indexes relevant to iron adequacy.Am J Clin Nutr 2017;106 (Suppl):1634S-9S.

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“…Several organizations have been evaluating indicators to define iron status over recent years, including the WHO, which has undertaken a multifaceted approach to consider the role of SF to define ID and overload in individuals and populations (11,21). However, there has not yet been a coordinated effort to improve the quality of underlying primary evidence.…”

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confidence: 99%

Serum ferritin as an indicator of iron status: what do we need to know?

Daru

Colman

Stanworth

et al. 2017

The American Journal of Clinical Nutrition

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176

124

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“…The most frequently used commercial methods for the detection of FER and β 2 ‐MG are immunoturbidimetry and chemiluminescence. Immunoturbidimetry needs more sample, and the sensitivity was not high enough; Chemiluminescence needs specific testing instrument . Through the use of lanthanide chelates, the nonspecific background is differentiated from the time‐resolved fluorescence of the specific signal due to different emission wavelengths and kinetics; many researchers had developed the dual‐label TRFIA using Sm 3+ and Eu 3+ chelates, and realized the two substances’ simultaneous detection .…”

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A dual‐label time‐resolved fluorescence immunoassay for the simultaneous determination of ferritin and β₂‐microglobulin

Liu

Huang

et al. 2017

Clinical Laboratory Analysis

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“…Under normal circumstances, the amount of ferritin synthesized and secreted into the serum is proportional to the amount of cellular ferritin produced in the internal iron storage pathway, so that SF concentration is usually related to the quantity of body iron stores. Clinically, SF has been reported to link with iron‐deficiency anemia or a risk of iron overload . For these reasons, SF is widely used as a surrogate marker of iron stores.…”

Section: Introductionmentioning

confidence: 99%

“…Clinically, SF has been reported to link with irondeficiency anemia or a risk of iron overload. 6,7 For these reasons, SF is widely used as a surrogate marker of iron stores. In addition to this, SF has been found to be elevated in patient with inflammation, liver disease, and malignancy.…”

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confidence: 99%

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000_SR analyzer in Chinese adults

Wang

Guo²,

et al. 2019

Clinical Laboratory Analysis

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Background Serum ferritin (SF) test has been widely used in clinical practice. However, its reference intervals (RIs) vary depending on the analytical method and ethnic origin. This study was to establish the RIs using indirect method for SF in Chinese adults. Methods SF was assayed on Abbott i2000SR analyzer. The SF test results of all health examinees (8913 males aged 18‐93 years and 5397 females aged 18‐90 years) between December 2010 and April 2019 were obtained from our laboratory information system. After Box‐Cox transformation of raw data and exclusion of outliers, parametric and non‐parametric approaches were used to calculate 95% RIs. The correlation between SF levels and ages, and the differences in SF levels between subgroups were also analyzed. Results SF levels in females were significantly different from those in males (Z = 88.96, Z* = 23.17; Z > Z*) and showed a weak positive correlation with age (r = .466, P < .0001). The RIs based on parametric approach in males were 66.12‐561.58 µg/L, whereas in all females were 3.59‐269.59 µg/L, females aged <50 years 3.26‐148.02 µg/L and those aged ≥50 years 17.28‐303.27 µg/L. The RIs based on non‐parametric approach in males were 65.00‐571.37 µg/L whereas in all females were 4.00‐254.00 µg/L, females aged <50 years 4.00‐152.00 µg/L and those aged ≥50 years 16.00‐304.05 µg/L. Conclusions Our indirect RIs for SF were markedly different from the manufacturer's recommended RIs and might be more suitable for Chinese adults, which would be helpful in interpreting laboratory data and clinical decision‐making.

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Serum or plasma ferritin concentration as an index of iron deficiency and overload

Cited by 31 publications

References 44 publications

Serum ferritin as an indicator of iron status: what do we need to know?

Serum ferritin as an indicator of iron status: what do we need to know?

A dual‐label time‐resolved fluorescence immunoassay for the simultaneous determination of ferritin and β₂‐microglobulin

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000_SR analyzer in Chinese adults

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Serum or plasma ferritin concentration as an index of iron deficiency and overload

Cited by 31 publications

References 44 publications

Serum ferritin as an indicator of iron status: what do we need to know?

Serum ferritin as an indicator of iron status: what do we need to know?

A dual‐label time‐resolved fluorescence immunoassay for the simultaneous determination of ferritin and β2‐microglobulin

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000SR analyzer in Chinese adults

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A dual‐label time‐resolved fluorescence immunoassay for the simultaneous determination of ferritin and β₂‐microglobulin

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000_SR analyzer in Chinese adults