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[Changes of serum transferrin receptor in children with iron deficiency and its response to iron supplementation]
1Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100083, China.
Insights
Serum transferrin receptor (sTfR) levels effectively identify iron deficiency erythropoiesis (IDE) and iron deficiency anemia (IDA) in children. The sTfR/serum ferritin ratio is a sensitive indicator for monitoring iron supplementation effectiveness.
Area of Science:
- Pediatric Nutrition
- Hematology
- Biochemistry
Background:
- Iron deficiency is a prevalent nutritional disorder in children, affecting growth and development.
- Accurate assessment of iron status and treatment efficacy is crucial for public health interventions.
- Serum transferrin receptor (sTfR) has emerged as a potential biomarker for iron status.
Purpose of the Study:
- To evaluate serum transferrin receptor (sTfR) levels in children across different stages of iron deficiency.
- To assess the response of sTfR to iron supplementation.
- To explore the utility of sTfR in monitoring iron status and evaluating iron supplementation efficacy.
Main Methods:
- A cohort of 1,006 children aged 6-14 years were categorized into control, iron depletion (ID), iron deficiency erythropoiesis (IDE), and iron deficiency anemia (IDA) groups.
- Serum transferrin receptor (sTfR) and sTfR/log serum ferritin (SF) were measured using enzyme immunoassay.
- Children with ID and IDE received weekly iron supplementation, while those with IDA received thrice-weekly supplementation for nine weeks.
Main Results:
- Elevated sTfR and sTfR/log SF levels were observed in children with ID, IDE, and IDA compared to controls.
- sTfR levels significantly decreased in the ID group after iron supplementation, but remained unchanged in IDE and IDA groups.
- sTfR/log SF showed significant decreases in all iron-deficient groups post-supplementation, indicating improved iron status.
Conclusions:
- sTfR serves as a specific biomarker for identifying IDE and IDA in pediatric populations.
- The sTfR/log SF ratio is a sensitive index for assessing the effectiveness of iron supplementation programs.
- These findings support the use of sTfR and sTfR/log SF in the surveillance of iron status and management of iron deficiency in children.
Objectives:
To study the level of serum transferrin receptor (sTfR) in children with different stages of iron deficiency, as well as in the normal children, to observe its response to iron supplementation, and to explore the role of sTfR in surveillance of iron status and assessment of iron supplementation in population.
Methods:
By determining iron status index, 1,006 children aged 6-14 years in Fangshan District, Beijing were divided into four groups, control group, iron depletion (ID) group, iron deficiency erythropoiesis (IDE) group and iron deficiency anemia (IDA) group, and 239 of them were measured for sTfR with Quintikine enzyme immunoassay (R&D system, Minneapolis, MN) and sTfR/logserum ferratin (SF) was estimated. Iron supplementation (NaFeEDTA capsules, containing 60 mg iron element per capsule) was administered for the children with ID and IDE per capsule once weekly and for the children with IDA per capsule thrice weekly for nine weeks. Iron status index and sTfR were measured before and after iron supplementation.
Results:
The levels of sTfR and sTfR/log SF in children with ID, IDE and IDA were (20.03 +/- 2.33) nmol/L, (24.52 +/- 1.07) nmol/L, (33.28 +/- 6.09) nmol/L and (18.15 +/- 5.31), (20.98 +/- 8.88), (29.08 +/- 8.57), respectively, significantly higher than those in the control group [sTfR(18.74 +/- 3.06) nmol/L and sTfR/log SF(9.89 +/- 1.74)]. Statistical analysis showed that sTfR correlated to free erythrocyte protoporphyrin and hemoglobin. sTfR levels in normal children was (12.5-23.5) nmol/L. After iron supplementation, sTfR levels in children with ID was (16.37 +/- 3.10) nmol/L, significantly decreased than those before iron supplementation, but no change in sTfR was observed in children with IDE and IDA. sTfR/log SF were decreased significantly in all children with ID group(11.42 +/- 3.12), IDE (16.54 +/- 4.70) and IDA (23.59 +/- 9.93).
Conclusion:
sTfR is a specific indicator for identifying IDE and IDA, and sTfR/log SF is a sensitive index for assessing the effects of iron supplementation.
