Transferrin—A Poor Measure of Nutritional Status

Abstract

The present study evaluated the sensitivity and specificity of the serum transferrin concentration as a measure of the nutritional state. Serum transferrin was derived from total iron-binding capacity measurements in 74 patients on 114 occasions and correlated with body composition as measured by multiple isotope dilution. Highly significant correlations (p less than 0.001) existed between serum transferrin and both the body cell mass and the nutritional state as measured by the Nae/Ke ratio. However, the 95% confidence limits about both regressions were wide. The false-positive rate was 60% while the false-negative rate was 31%. Body composition and transferrin were measured before and after 2 wk of total parenteral nutrition in 34 malnourished patients. Eighteen patients restored body cell mass toward normal after 2 wk of total parenteral nutrition while in 16 patients the body cell mass continued to decrease in size, despite 2 wk of total parenteral nutrition. The changes in serum transferrin were not significant over this period of time in either group, despite significant changes in the nutritional state in both groups. The presence of a statistically significant relationship between the serum transferrin concentration and the nutritional state indicates that the serum transferrin concentration accurately reflects a population's nutritional status, and is therefore useful in epidemiologic surveys. However, because of the large variance of the data, as demonstrated by the wide 95% confidence limits, and because of the poor sensitivity and specificity, in an individual patient it is of little value as a measure of the nutritional status.

Triiodothyronine Is an Indicator of Nutritional Status in Adolescent Girls with Eating Disorders

“…The present data confirm that in EDs with weight loss, and in the absence of thyroid disease, serum concentrations of T3 are low, those of T4 low-normal but that serum concentrations of TSH do not increase [3,4,5,6,7,8,9,10]. This configuration of hormones is that of the ‘euthyroid sick syndrome’, observed in a number of disease and stress states including starvation [23].…”

“…Such observations suggest that serum T3 concentrations could be used to monitor nutritional status. There would be an advantage in that T3 is not influenced by fluid shifts and inflammatory responses as are other putative nutritional indicators [5,6,7] but rather correlate with energy balance [8, 9]. …”

Nutritional Assessment of Bariatric Surgery Patients Presenting for Plastic Surgery: A Prospective Analysis

“…Transferrin levels were not considered as accurate markers of malnutrition as they can be affected by the presence of iron deficiency, which is more common in the postbariatric population. 19,20 Vitamin and mineral deficiencies were assessed through laboratory measures of vitamin B 12 (Ͻ200 pg/ml), folate (Ͻ2.5 ng/ml), and iron studies. Current use of vitamin supplementation was recorded.…”

Assessment of Protein and Energy Nutritional Status

“…The normal range for serum transferrin is between 250e300 mg/dL. In addition, routine iron loading in ESRD patients, losses due to the nephrotic syndrome and gastrointestinal diseases, and, as with all the visceral proteins, any condition associated with inflammatory response or liver failure will affect serum transferrin concentrations [75,76]. Increases in serum transferrin levels have also been observed with nutritional supplementation [73].…”