Related Experiment Video
Updated: Jul 6, 2026
Quantitating Iron Transport Across the Mouse Placenta In Vivo Using Nonradioactive Iron Isotopes
Published on: May 10, 2022
The reference limits and cut-off value for serum soluble transferrin receptors for diagnosing iron deficiency in
1Department of Paediatrics, University of Tartu, Tartu, Estonia. neve.vendt@kliinikum.ee
Insights
Serum soluble transferrin receptors (sTfR) effectively diagnose childhood iron deficiency (ID). This study established reference limits and optimal cut-off values for sTfR testing in infants, showing method-specific values are crucial for accurate ID diagnosis.
Area of Science:
- Pediatric Hematology
- Nutritional Biochemistry
- Clinical Diagnostics
Background:
- Childhood iron deficiency (ID) is a significant global health concern.
- Serum soluble transferrin receptors (sTfR) are recognized biomarkers for diagnosing ID.
- Establishing reliable reference ranges and diagnostic cut-offs for sTfR is essential for clinical practice.
Purpose of the Study:
- To determine reference limits for serum sTfR concentrations in healthy Estonian infants aged 9-12 months.
- To evaluate the diagnostic accuracy of sTfR for identifying iron deficiency in this population.
- To compare the performance of two different assay methods (IDeA and Tina-quant) for sTfR measurement.
Main Methods:
- sTfR concentration was measured in 179 infants using IDeA and Tina-quant assays.
- Iron deficiency was defined by serum ferritin levels <10 microg/l.
- Reference limits (5th-95th percentile) and receiver operating characteristic (ROC) curves were used to determine optimal cut-off values.
Main Results:
- Reference limits for sTfR were 1.5-2.7 mg/l (IDeA) and 4.1-7.8 mg/l (Tina-quant).
- The two methods showed poor agreement.
- Optimal cut-off values for ID diagnosis were >2.4 mg/l (IDeA; sensitivity 84%, specificity 94%) and >7.4 mg/l (Tina-quant; sensitivity 80%, specificity 92%).
Conclusions:
- Serum sTfR is an efficient diagnostic tool for childhood iron deficiency in infants.
- Method-specific cut-off values are necessary for accurate interpretation of sTfR results.
- Further research may be needed to harmonize results between different sTfR assay methods.
Abstract:
Serum soluble transferrin receptors (sTfR) concentration is a useful test in the diagnosis of childhood iron deficiency (ID). The aims of this study were to establish reference limits and to evaluate the diagnostic characteristics of sTfR in the diagnosis of ID in infants aged 9-12 months. In addition to mean erythrocyte cell volume, haemoglobin and ferritin measurements, sTfR concentration was measured in 179 healthy children in Estonia using the IDeA and Tina-quant methods. Using the ID criteria of ferritin <10 microg/l, subjects were divided into healthy (n = 146) and ID (n = 33) groups. The reference limits (5th and 95th percentile) were calculated in the study group. We used receiver operating characteristic curves to find out the cut-off values for the best diagnostic characteristics. The reference limits for sTfR were 1.5-2.7 mg/l in the IDeA method and 4.1-7.8 mg/l in the Tina-quant) method. The methods had poor agreement, the mean ratio with 95% limits of agreement was 2.9 (2.4-3.6). The best cut-off value in order to identify ID by hypoferritinaemia in this population is an sTfR level > 2.4 mg/l in the IDeA (sensitivity 84%, specificity 94%) and an sTfR level > 7.4 mg/l in the Tina-quant (sensitivity 80%, specificity 92%). We conclude that sTfR concentration is an efficient tool in the diagnosis of ID, but that every method needs its own cut-off value.
Related Concept Videos
01:28The Early Endosome: Endocytosis of Transferrin
01:24Serum Studies: Renal Function Tests