Sensitivity, specificity, and predictive value of serum soluble transferrin receptor at different stages of iron deficiency

This study investigated the efficiency of serum soluble transferrin receptor (sTfR) for assessing body iron status at different stages of iron deficiency. Among 72 patients with advanced iron-deficiency anemia (IDA), the sensitivity and specificity of sTfR (at a diagnostic cutoff of 3.24 mg/L) were 70.8% and 90.6%, respectively, with a positive predictive value of 85.0%. Sensitivities of sTfR in patients at the earliest stage of iron deficiency (n=41) and the intermediate stage of iron-deficient erythropoiesis (n=15) were 21.9% and 26.7%, respectively, at the same cutoff value of sTfR. Serum ferritin concentrations averaged 6.7+/-1.9 microg/L in IDA patients with sTfR <3.24 mg/L, which were significantly above the values in IDA patients with sTfR >or=3.24 mg/L (4.8+/-1.2 microg/L, p<0.05). In healthy controls, blood reticulocyte counts were significantly higher in subjects with sTfR >or=3.24 mg/L than in those with sTfR <3.24 mg/L (0.045+/- 0.013 (10(12)/L) vs 0.034+/- 0.011 (10(12)/L), p<0.05]. In conclusion, sTfR level is not a sensitive indicator for the early or intermediate stages of iron deficiency, although sTfR assay can be a useful aid in the diagnosis of advanced IDA. Serum sTfR concentration has significant relationships with blood reticulocyte counts in healthy subjects and with serum ferritin levels in IDA patients.     

检测血液参数在常见小细胞性贫血患者中诊断鉴别的意义

目的明确不同检测血液参数在常见小细胞性贫血患者鉴别诊断中的意义。方法获取2017年10月至2018年9月在北京协和医院就诊的铁代谢相关疾病患者的血液标本,进行常规化验检查,同时检测网织红细胞血红蛋白含量(CHr)、铁蛋白(SF)、可溶性转铁蛋白受体(sTfR)、铁调素(hepcidin)等铁代谢相关指标,并比较其在不同疾病中表达的异同。结果缺铁性贫血(IDA)26例,慢性病性贫血(ACD)12例,地中海贫血(TA)12例,伴环形铁粒幼细胞增多的难治性贫血(RARS)12例。另有17名健康对照(NC)。平均红细胞体积(MCV):IDA和TA明显低于对照(P<0.01),且TA更低。平均红细胞血红蛋白浓度(MCHC):ACD、IDA、TA、RARS均显著低于NC(P<0.01),其中IDA最低。网织红细胞计数:除RARS外,其他3者均显著高于NC(P<0.01),TA相较于ACD、IDA升高更为明显。CHr:ACD、IDA、TA较NC显著下降(P<0.01)。SF在IDA患者中较NC显著下降(P<0.01)且低于其他3种贫血,而ACD、RARS较NC显著升高(P<0.01)。转铁蛋白饱和度(TS)中:ACD、IDA、TA相对NC降低(P<0.01),而RARS相对NC显著升高(P<0.01),且高于其他3种贫血。sTfR和sTfR指数(sTfR/log SF)在IDA患者中相较于NC显著升高(P<0.01),且相对ACD、TA、RARS更高。ROC曲线分析显示:SF、sTfR指数对鉴别诊断IDA和ACD、TA、RARS具有较高的诊断准确性。结论综合利用外周血检测的常规指标及铁代谢参数指标可以初步区分不同类型的小细胞贫血并辅助鉴别诊断。     

Serum transferrin receptor-ferritin index shows concomitant iron deficiency anemia and anemia of chronic disease is common in patients with rheumatoid arthritis in north India

Anemia is a frequent cause of morbidity in patients with rheumatoid arthritis (RA). We studied the prevalence of anemia of chronic disorders (ACD) and ACD with coexistent iron deficiency anemia (IDA) in patients with RA using sTfR/log ferritin ratio (sTfR - F index). Complete blood counts, percent transferrin saturation, serum ferritin, sTfR, sTfR-F index measurements were carried out in 100 anemic RA patients. Twenty-five IDA subjects without any other illness and 25 age- and sex-matched normal controls were studied. Prevalence of anemia in RA patients was 50.5%. Patients with sTfR-F index value < 1.5 were classified as pure ACD and patients with sTfR-F index value> 1.5 were classified as ACD with coexistent IDA. Using these criteria, 20% patients were found to have pure ACD and 80% patients had coexistent ACD and IDA. In the normal control group, sTfR-F index was found to be 0.16-1.8. We found that sTfR-F index can clearly distinguish IDA control cases and normal subjects with no overlap in the range of sTfR-F index.     

Diagnostic significance of serum soluble transferrin receptors in various anemic diseases: the first multi-institutional joint study in Japan

Serum soluble transferrin receptor (sTfR) has been reported to be higher in patients with iron deficiency or with elevated erythropoiesis. In the present study, serum sTfR was measured in various anemic diseases and their clinical significance was examined in a multi-institutional joint study. Serum sTfRs in patients with the following anemic diseases were markedly higher than those in normal healthy adults: non-treated iron deficiency anemia (IDA) (9.13 +/- 7.04 mg/l, n = 52, p < 0.0001), anemia of chronic disorders (ACD) (3.45 +/- 1.38 mg/l, n = 20, p < 0.0001), hemolytic anemia (HA) (5.57 +/- 3.26 mg/l, n = 17, p < 0.0001), and myelodysplastic syndrome (MDS) (4.03 +/- 2.83 mg/l, n = 20, p < 0.0001). There were significant differences between IDA and ACD (p < 0.0001), between aplastic anemia (AA) (1.58 +/- 1.26 mg/l, n = 16) and MDS (p < 0.001), and between AA and MDS with refractory anemia (MDS-RA) (4.16 +/- 3.40 mg/l, n = 9) (p < 0.02). In patients with chronic renal failure (CRF), serum sTfR levels and serum sTfR/log serum ferritin ratios (sTfR/F index) were compared in the two classified groups according to Muirhead's criteria, as IDA and non-IDA groups with or without recombinant human erythropoietin (rHuEPO) treatment. Significantly high levels of both serum sTfR (p < 0.0001) and the sTfR/F index (p < 0.0001) were observed in IDA without rHuEPO treatment. Especially in CRF with rHuEPO treatment, the sTfR/F index showed marked elevation in the IDA group (p < 0.0001) compared with serum sTfR (p < 0.001), indicating more diagnostic efficacy of the sTfR/F index for CRF with IDA. In conclusion, the serum sTfR concentration is a useful diagnostic tool for discrimination between IDA and ACD, and between AA and MDS-RA, and for the detection of iron deficiency in CRF patients in the Japanese population.     

Reticulocyte maturity as an indicator for estimating qualitative abnormality of erythropoiesis.

AIMS--To determine the maturity of reticulocytes in patients with anaemia as a result of various haematological disorders including those with qualitative abnormalities such as ineffective erythropoiesis or dyserythropoiesis. METHODS--The number of mature reticulocytes was measured with flow cytometry in venous blood samples from 122 patients with haematological disorders and 100 healthy controls. Reticulocytes were classified into three categories by the fluorescence intensity of auramin O staining: low fluorescence ratio (LFR), medium fluorescence ratio (MFR), and high fluorescence ratio (HFR). Immature reticulocytes were determined as the aggregate of MFR and HFR (%). RESULTS--The mean (2SD) number of immature reticulocytes in 100 normal subjects was 9.0 (7.0)%. Significantly high mean values of immature reticulocytes with a normal or reduced reticulocyte count were shown in 90 patients with dyserythropoietic or ineffective erythropoietic conditions, such as acute myeloid leukaemia (AML) (n = 37), myelodysplastic syndrome (MDS) (n = 35), aplastic anaemia (AA) (n = 8), or megaloblastic anaemia (MA), (n = 6). Reticulocyte ratios returned to normal after successful treatment of patients with AML (n = 10) and MA (n = 3). However, high percentages of immature reticulocytes with increased reticulocyte counts were consistently observed in patients with enhanced erythropoiesis such as those with acquired autoimmune haemolytic anaemias (AIHA) (n = 4) or acute blood loss (ABL) (n = 4). Reticulocyte maturity was within the normal range in patients with reduced erythropoiesis such as occurs in chronic renal failure (CRF) (n = 11), or in iron deficiency anaemia (IDA) (n = 13). CONCLUSIONS--The evaluation of reticulocyte maturity with total reticulocyte count seems to be clinically useful for estimating the qualitative impairment of erythropoiesis, and so could help differentiate haematological disorders.     

Anemia and iron status in young fertile non-professional female athletes

We evaluated the effects of regular physical exercise on anemia and iron status in young non-professional female athletes. A total of 191 healthy white Italian women (23.5 ± 4.68 years) were analyzed; 70 were non-professional athletes performing 11.1 ± 2.63 h week⁻¹ exercise and 121 were sedentary controls. Blood markers of anemia and iron status—hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), serum ferritin, iron, transferrin (Tf), transferrin saturation (TfS), soluble transferrin receptor (sTfR), and the sTfR/log ferritin ratio (sTfR-F index)—were evaluated. Anemia threshold was Hb < 120 g l^–1. Ferritin concentrations < 12 μg l^–1 were considered as iron deficiency (ID). Frequency of anemia (15.7 versus 10.7%, P = 0.32), ID (27.1 versus 29.8%, P = 0.70), and ID anemia (8.6 versus 5.8%, P = 0.46) was not different in athletes and controls. However, athletes were threefold more likely than controls (17.1 versus 5.8%) to have serum iron < 50 μg dl^–1 [odds ratio (OR) 3.37, P = 0.012]. Low-TfS (<15%) was found in 25.7% of athletes and in 13.2% of controls, OR 2.27, P = 0.030. Elevated-sTfR (>1.76 mg l^–1) was found in 24.3% of athletes and in 12.4% of controls, OR 2.27, P = 0.034. Regular non-professional sport activity does not cause an increased rate of anemia or of iron deficiency in fertile women. However, physical exercise has an impact on iron status as it reduces serum iron and transferrin saturation, and elevates sTfR. Nearly one fifth of recreational athletes have anemia and a third have iron deficit, these conditions can decrease their physical performance.     

Changes in serum lipid concentrations during iron depletion and after iron supplementation

To investigate the effects of body iron depletion and iron supplementation on serum lipid concentrations, hematologic indices, iron markers, and serum lipid profiles were measured in 427 girls, age 14-19 yr. There were no significant differences in serum lipid concentrations between subjects with moderate iron deficiency anemia (blood Hb < 12.0 g/dL) and healthy controls. However, serum total cholesterol concentration (mean +/- SD, 148 +/- 16 mg/dL) in severely anemic subjects with blood Hb < 8.0 g/dL was significantly lower than in subjects with blood Hb > or = 14.0 g/dL (170 +/- 17 mg/dL) (p < 0.01). Moreover, serum triglyceride concentration in subjects with blood Hb > 14.0 g/dL was 2-fold higher than in the severely anemic subjects. Mean values of serum total cholesterol and triglyceride (149 +/- 17 mg/dL and 58 +/- 22 mg/dL) in girls with severe anemia were significantly elevated after iron supplementation (164 +/- 17 mg/dL and 98 +/- 26 mg/dL) (p < 0.01, respectively). In the severely anemic subjects, blood Hb concentration was correlated with serum total cholesterol (r = 0.49, p < 0.01) and triglyceride concentrations (r = 0.51, p < 0.01). These findings indicate that severe iron deficiency anemia in girls is attended by decreased concentrations of serum total cholesterol and triglyceride, and that these reduced serum lipid levels return to normal following iron supplementation.     

益气补血法联合小剂量铁剂治疗对缺铁性贫血患儿的疗效分析

目的 分析益气补血法联合小剂量铁剂治疗对缺铁性贫血患儿的临床疗效。方法 选择本院2016年4月~2017年4月122例缺铁性贫血患儿的临床资料,随机分为对照组与研究组,每组61例,对照组实施小剂量的铁剂治疗,研究组实施益气补血法与小剂量铁剂联合治疗,分析两组铁代谢有关指标变化情况及治疗效果。结果 研究组SI（血清铁）及SF(铁蛋白)水平比对照组高,TIBC（总铁结合力）比对照组更低,研究组治疗效果高于对照组,存在统计学差异(P＜0.05)。结论 益气补血法联合小剂量铁剂治疗对缺铁性贫血患儿的临床疗效显著,值得推广。     

Elliptocytes and tailed poikilocytes correlate with severity of iron-deficiency anemia

This study examines the relationships between abnormal RBC morphology, RBC indices measured with an automated hematology analyzer, serum iron studies, and severity of anemia in patients with findings indicative of iron-deficiency anemia. Counts and morphologic classification of 1,000 RBCs from each of 22 patients were performed, and correlations were determined between parameters. The Student t test was used to determine the level of significance for correlations between parameters. Several significant relationships were found. As the percentage of elliptocytes increased, hemoglobin concentration, hematocrit, RBC concentration, and mean corpuscular hemoglobin level decreased (r = .48, .44, .40, and .49, respectively; P < .05). As the percentage of tailed poikilocytes increased, hemoglobin concentration, hematocrit, and RBC concentration decreased (r = .70, .77, and .71, respectively; P < .01) and RBC distribution width increased (r = .73; P < .01). Of significance, serum ferritin levels, long considered the best single indicator of iron deficiency, showed no correlation with the morphologic abnormalities assessed, severity of anemia, or any of the analyzer-generated indices. Our results indicate that microscopic evaluation of RBC morphology remains an important tool for the pathologist to evaluate the severity of anemia in patients with iron deficiency.     

Effect of iron status on reticulocyte mean channel fluorescence.

Flow cytometric reticulocyte enumeration measures the fluorescence intensity of the reticulocyte population, the reticulocyte mean channel fluorescence. Reticulocyte mean channel fluorescence, used as an indicator of reticulocyte maturation, is directly proportional to the amount of intracellular RNA. Other factors, such as iron stores, may affect reticulocyte mean channel fluorescence. Iron status in normal controls, patients with anemia of chronic disease, and pregnant women was evaluated by hemoglobin, hematocrit, red blood cell indices, iron, total iron-binding capacity, and ferritin. Reticulocyte mean channel fluorescence was significantly elevated (P less than 0.0001) to 85.6 +/- 4.6 (mean +/- 1 standard deviation) in iron-deficient anemic patients and to 81.1 +/- 8.4 in iron-depleted patients compared to healthy individuals (69.7 +/- 2.6). The reticulocyte mean channel fluorescence in anemia of chronic disease was 71.3 +/- 5.8 and was not significantly different from that of normal controls. Reticulocyte mean channel fluorescence showed significant correlations with total iron-binding capacity (P less than 0.0001, r = 0.62) and ferritin (P less than 0.0001, r = 0.40). A possible explanation for these findings, describing differences in cytoplasmic levels of transferrin receptor mRNA, is discussed.     

The assessment of serum soluble transferrin receptor in alcoholics

The consumption of large amounts of alcohol disturbs body iron metabolism and leads to increase of body iron stores and may cause various hematologic changes. Both, iron overload and iron depletion could have effect on the metabolic, transit and storage pools. These pools and its indicators were evaluated previously in abusers, but there is no information concerning the serum soluble transferrin receptor (sTfR) as a new marker of transit compartment. Therefore, the aim of this study was to assess the sTfR and compare it to the other indicators of transit pool in alcoholics. sTfR was measured immunoturbidimetrically. The markers of alcohol abuse, metabolic, transport and storage pools and the other hematologic assays were determined by routine laboratory methods. The tested group consisted of 148 alcoholics. The abusers were not affected by anemia. Every second patient had increased iron storage pool. Serum iron level only tended to increase. The mean serum sTfR did not show any significant difference and the mean transferrin–ferritin index (sTfR/log ferritin ratio) was significantly decreased compared with the controls. None of the transit pool markers presented significant differences between subgroups classified according to liver enzyme activities. We suggest that the iron excess in alcoholics did not limit the cellular iron uptake by transferrin receptor-mediated endocytosis which was confirmed by the unchanged level of serum soluble transferrin receptor. Additionally, the serum sTfR in alcohol abusers is independent of the weekly alcohol intake, age of the patients, duration of dependence, time of abstinence, time of last drinking and the liver function tests.     

Serum transferrin receptor status of healthy adult Arabs

Several studies have provided reference ranges for the concentration of serum transferrin receptor (sTfR) in various white populations, but there is a dearth of relevant reference sTfR data in non-whites. The aim of this investigation was to establish sTfR reference ranges and mean values for a healthy non-white Arab population that could be used also for Arabs worldwide. sTfR and serum ferritin concentrations were estimated by immunoassays and blood counts were determined by conventional methods. Analysis of the data of 114 volunteer Arab blood donors (91 male, 23 female) revealed a higher mean sTfR concentration in males of 22.6+/-8.1 nmol/L (range 10.9-38.7 nmol/L) compared to that in females of 18.7+/-4.4 nmol/L (range 10.7-25.8 nmol/L, p=0.001). There was no significant correlation of sTfR concentration with age, serum ferritin level, or blood haemoglobin level, but a strong inverse correlation was demonstrated with mean cell volume and mean cell haemoglobin of red cells. Iron-replete volunteer subjects with alpha-thalassaemia trait appear to have relatively high mean sTfR concentration. We recommend the use of gender-dependent sTfR reference values for Arabs.     

Elevated iron status strongly predicts mortality in West African adults with HIV infection

OBJECTIVE: To comprehensively assess iron status and determine whether elevated iron status, like anemia, predicts mortality. METHODS: We followed 1362 Gambian adults (53% female) in an HIV-seroprevalent clinic-based cohort over 11.5 years to ascertain all-cause mortality. Baseline iron status (iron, soluble transferrin receptor [sTfR], transferrin, ferritin, transferrin saturation, log [transferrin receptor: ferritin]), age, gender, ethnicity, hemoglobin, body mass index, HIV type, absolute CD4 count, malaria status, and [alpha]-(1)-antichymotrypsin were measured. RESULTS: The mortality rate was 25.9/100 person-years. Elevated iron universally predicted greater mortality compared to normal iron status for all iron status indices, with the exception of sTfR in unadjusted models. In fully adjusted models, transferrin (elevated vs. normal, hazard ratio [HR]: 1.77; 95% confidence interval [CI]: 1.30 to 2.42; P < 0.001), ferritin (elevated vs. normal, HR: 1.40; 95% CI: 1.07 to 1.83; P = 0.014), and the combined iron status index (highly elevated vs. normal, HR: 2.20; 95% CI: 1.16 to 4.18; P = 0.016) remained significant predictors. As expected, hemoglobin (Hb) concentration and absolute CD4 counts were each inversely associated with mortality. CONCLUSIONS: Elevated iron status predicts mortality in HIV infection, even after adjustment for immunosuppression and other confounders. This finding has implications in the clinical monitoring of disease progression and for iron-supplementation practices in areas of high HIV prevalence.     

Variation of soluble transferrin receptor and ferritin concentrations in human serum during recovery from exercise

Serum soluble transferrin receptor (sTfR) has been proposed as a more stable index of iron status than serum ferritin in athletes. However, the variation in sTfR concentration during recovery from acute exercise is unknown. The aim of the present study was to examine the effect of prolonged moderate exercise on ferritin and sTfR concentrations, as well as on several hematologic variables up to 24 h post-exercise. Fifteen young, untrained men exercised on a cycle ergometer for 45 min at a heart rate of 150–155 beats min⁻¹ and provided blood samples before as well as immediately, 6 h, and 24 h after exercise. Ferritin and sTfR values did not change significantly with time. sTfR levels exhibited lower variation during the observation period, the median intra-individual coefficient of variation being 5.2%, as opposed to 10.9% for ferritin. In conclusion, serum ferritin concentration is not affected by prolonged moderate exercise and can be used as a reliable index of iron status, at least for athletes not involved in extreme physical activities. Serum sTfR concentration seems to be more stable and could replace ferritin as the preferred index of iron stores if problems associated with the novelty of the assay were overcome. Electronic Publication     

Reticulocyte as indication of the erythroid hematopoiesis: reticulocyte fractions in peripheral blood and bone marrow

Reticulocyte fractions of peripheral blood and bone marrow were measured for hematological disease in 235 patients using automated fluorescent reticulocyte analysis of Sysmex R-3000. The comparison with R-3000 and the manual method of bone marrow measurement showed an excellent agreement with a correlation coefficient of r = 0.933. In the ratio of reticulocyte fractions of marrow blood and peripheral blood, the marrow blood rate of reticulocytes, HFR, MFR, and LFR was 3.3, 6.2, 1.6, and 0.9 times higher than the peripheral blood rate, respectively. Cases in which the marrow reticulocyte rate was over ten times higher than the peripheral blood rate were observed in MDS and megaloblastic anemia at ratio of 55% and 100%, respectively. These findings suggest ineffective hematopoiesis in bone marrow. Immature reticulocyte fraction(10% or more) showed an excellent agreement with granulocyte(500/microliter or more) as an indication of the engraftment of allotransplantation of bone marrow, in which the analysis of reticulocyte fractions showed a useful indication of engraftment. In cases of death after bone marrow transplantation unlike in survivors, reticulocyte fractions decreased after engraftment.     

Intérêt du dosage des récepteurs solubles de la transferrine dans le dépistage de la carence martiale en fin de grossesse

Aim of the study is to compare serum transferrin receptor (sTfR) with ferritin in the diagnosis of iron deficiency at the end of pregnancy. Proteins were determinated by immunonephelometry in 60 patients on serum taken during labor. None of them presented serious inflammatory syndrome or malnutrition on the basis of PINI index. sTfR are >1.50 mg/l, the reference value for young women, by 72% of patients and ferritin < 20 μg/l among 50%. The two parameters are negatively correlated (r: 0.62). In patients with ferriprive anemia (hemoglobin < 10 g/dl), sTfR are highly enhanced (2.1–4.05). In non-anemic patients (hemoglobin > 12 g/dl) with ferritin level within reference value of non-menopaused women (7.17–52.6) sTfR are frequently >1.5 mg/l (0.7–3.09). Indeed, sTfR increase with physiological erythropoïesis activation observed at the end of pregnancy. It is essential to determine references values adapted at the end of pregnancy for an optimal interpretation of sTfR.     

Association of serum insulin-like growth factor-I and erythropoiesis in relation to body iron status

This study investigated the associations between serum insulin-like growth factor-I (IGF-I) concentrations and erythropoietic activities in relation to body iron status. Serum IGF-I concentrations, free erythrocyte protoporphyrin (FEP), hemograms, and serum iron markers were measured in 71 female adolescents, age 14 to 17 yr. No significant differences were observed in hemograms, iron parameters, or FEP between the subjects with IGF-I <681.2 ng/ml and IGF-I 681.2 ng/ml. However, blood hemoglobin and serum iron concentrations averaged 13.4 +/- 0.8 g/dl and 93.7 +/- 41.2 microg/dl in the subjects with IGF-I >809 ng/ml, which were above the values in those with IGF-I <523 ng/ml (12.3 +/- 0.9 g/dl and 50.5 +/- 30.8 microg/dl, p < 0.05, respectively). On the other hand, FEP was significantly lower in the adolescents with IGF-I >809 ng/ml than in those with IGF-I <523 ng/ml (38.9 +/- 16.2 microg/dl vs 63.4 +/- 23.1 microg/dl, p <0.05). Prevalences of iron deficiency or iron deficiency anemia were 3- or 5-fold higher in the subjects with IGF-I <523 ng/ml, compared to those with IGF-I >809 ng/ml. Serum IGF-I correlated significantly with FEP (r = -0.45, p <0.05) and serum iron concentrations (r = 0.40, p <0.05) in iron deficient subjects. In summary, IGF-I seems to have an important relationship to iron metabolism and protoporphyrin synthesis in adolescents.     

Hematologic and iron-related measurements in rheumatoid arthritis

The hematologic status of 265 patients with rheumatoid arthritis was assessed. In the group as a whole, a mild depression in the hemoglobin concentration and mean cell volume (MCV) was associated with an increase in the red blood cell distribution width (RDW), erythrocyte sedimentation rate (ESR), and platelet count. Bone marrow trephine biopsies and further measurements of iron status and disease activity were done in [a further] 38 more anemic patients, and the findings in those with absent marrow iron (iron deficiency) were compared with those having stainable stores (anemia of chronic disorders). The RDW was raised in both, and there was no significant difference between the two groups. The concentrations of nonheme iron in the marrow and of serum ferritin were significantly lower in the iron-deficient group, but the geometric mean serum ferritin of 34 micrograms/L was still a good deal higher than that associated with uncomplicated iron deficiency. This was presumably because of the fact that the serum ferritin, which was significantly correlated with the ESR (r 0.55; P less than 0.0004) and C-reactive protein (CRP) r 0.41; P less than 0.01), was also functioning as an acute phase protein. While there was a weak correlation (r 0.37; P less than 0.04) between the marrow nonheme iron and the serum ferritin concentrations, it disappeared when nonactive patients with normal CRP concentrations were excluded. The absence of a correlation is unlike the findings that have previously been noted in other chronic inflammatory conditions and in neoplasia. This raises the possibility that serum ferritin concentrations in rheumatoid arthritis may reflect, in part at least, another store of iron located in affected joints.     

Relationship between maternal and infant iron stores: 1. Full term infants

Serum ferritin, serum iron and total iron binding capacity were determined in 218 pregnant women at term and in the cord blood of their normal term infants. Both the mean weight (3210 g) and serum ferritin level (geometric mean 81 micrograms/l) of the neonates of iron deficient mothers were significantly lower than those of mothers with "normal" iron stores (weight 3390 g; cord ferritin level 115 micrograms/l). A weakly significant correlation was found between the logarithm of the maternal and neonatal serum ferritin concentration (r = 0.15, p less than 0.05) and the maternal log serum ferritin and the newborn's weight (r = 0.15, p less than 0.05). The weak correlations were supported by the differences between the values of cord samples from babies of iron deficient mothers and those whose mothers had "normal" iron values. Adequate iron supplementation during the early period of pregnancy is suggested.     

早期检测及干预铁缺乏对妊娠期缺铁性贫血影响的研究

目的 探讨检测孕妇血清铁蛋白,及早发现并干预铁缺乏对妊娠期缺铁性贫血的影响.方法 选择我院产科门诊就诊的血红蛋白(Hb)值正常,但血清铁蛋白(SF)＜ 30μg/L的妊娠早期孕妇共68人,分成试验组和对照组,试验组孕妇即日起口服多糖铁复合物胶囊150mg/d,对照组孕妇未服任何药物.两组研究对象于妊娠20、28w时复查Hb、SF值了解指标变化.结果 试验组妊娠20、28w时SF值均明显高于对照组,差异有统计学意义(P＜0.05);妊娠28w时试验组Hb值明显高于对照组(P＜0.05),试验组无贫血孕妇出现,对照组有6例孕妇出现缺铁性贫血.结论 妊娠早期检测血清铁蛋白能及早发现铁缺乏孕妇,及时口服多糖铁复合物补充缺乏铁可显著减低妊娠期贫血的发生几率.