补铁对人体血清转铁蛋白受体水平的影响

目的研究补铁过程血清转铁蛋白受体(sTfR)值的时相动态变化趋势,为sTfR是否可作为观察补铁效果的指标提供依据.方法 2002年4～10月,从河北省廊坊市和北京顺义区初筛942名18～45岁育龄妇女,检测其铁生化指标,依现行铁状况评价标准,筛检红细胞生成缺铁(IDE)和缺铁性贫血(IDA)妇女,经知情同意后,共有59名妇女完成了自始至终的补铁效果动态观察.采用L-苏糖酸亚铁胶囊(7 mg元素铁/粒),IDE妇女隔日服4粒,IDA妇女每日服4粒,补铁12周,分别测定补铁过程中0、3、6、9和12周的铁生化指标和sTfR值,观察sTfR时相动态变化.结果 IDE和IDA育龄妇女sTfR含量分别为(26.62±10.57)nmol/L和(41.25±21.96)nmol/L,均显著高于健康者的水平;在补铁过程中,sTfR呈现以下变化特点在IDE期,sTfR在补铁后3周内趋于平稳,3周后渐进性降低,至12周时接近和达到健康者的水平,检测值为(17.86±5.57)nmol/L;在IDA期,补铁后3周内sTfR迅速下降,3周后缓慢下降,至第9周趋于平稳,至12周时接近和达到健康者的水平,检测值为(19.54±5.94)nmol/L;sTfR/血清铁蛋白在补铁过程中的变化趋势与sTfR基本平行;补铁过程中sTfR与血红蛋白、血清铁蛋白呈负相关,与锌卟啉呈正相关.结论在补铁过程,sTfR随机体铁状况的恢复而逐渐下降至正常水平,sTfR可作为观察补铁效果的特异指标.

Effects of iron supplementation on human serum level of transferrin receptor

OBJECTIVE: To study trend of dynamic change in level of serum transferrin receptor (sTfR) in the process of iron supplementation to provide evidence for sTfR in evaluating the efficacy of iron supplementation. METHODS: Totally, 942 child-bearing-age women aged 18 to 45 years were selected from Longfang City, Hebei Province and Shunyi County, Beijing. Biochemical indicators of iron metabolism were measured for all of them, including serum levels of ferritin (SF) and zinc protoporphyrin (ZPP), and hemoglobin (Hb). According to the current criteria for assessing iron status, women were screened for iron deficiency erythropoiesis (IDE) or iron deficiency anemia (IDA). Seventy-two women agreed to participate in the study, and 59 of them finished whole dynamic observations with signed informed consent. Four capsules of ferrous L-threonate (containing 7 mg of iron element per capsule) were administered for women with IDE every other day and for women with IDA every day, respectively, for 12 weeks. Serum biochemical indicators and level of sTfR were measured in 0 wk, 3 wk, 6 wk, 9 wk and 12 wk, respectively, during the process of iron supplementation, and their dynamic changes were observed. RESULTS: Level of sTfR in women with IDE and IDA was (26.62 +/- 10.57) nmol/L and (41.25 +/- 21.96) nmol/L, respectively, significantly higher than normal level. During the process of iron supplementation, level of sTfR changed as the following characteristics. In women with IDE, level of sTfR kept stable within the first 3 weeks of iron supplementation, then dropped gradually and progressively, reached to normal, with (17.86 +/- 5.57) nmol/L, in the 12 wk after iron supplementation. In women with IDA, level of sTfR dropped quickly within the first 3 wk of iron supplementation, then dropped slowly until the 9th wk and kept stable, and reached to normal level in the 12 wk, with (19.54 +/- 5.94) nmol/L and a ratio of sTfR/SF of 12.23 +/- 4.34. Ratio of sTfR/SF changed as level of sTfR during the process of iron supplementation. Level of sTfR correlated reversely with levels of Hb and SF and positively with level of ZPP. CONCLUSION: Serum level of sTfR in child-bearing age women gradually decreased to normal with the restoration of their normal iron status during the process of iron supplementation and could be used as a specific indicator for assessing efficacy of iron supplementation.