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Updated: Nov 29, 2025
The Caco-2 Cell Bioassay for Measurement of Food Iron Bioavailability
Published on: April 28, 2022
Soluble Transferrin Receptor during infancy and reference intervals for the Roche Cobas platform
Sara Marie Larsson1,2, Andreas Hillarp1, Pia Karlsland Åkeson3
1Department of Clinical Chemistry, Hospital of Halland, Halmstad, Sweden.
Insights
New reference intervals for soluble transferrin receptor (sTfR) in infants are established. sTfR may improve infant iron status assessment as it is unaffected by inflammation.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical Diagnostics
Background:
- Infant iron status assessment is complicated by infections, necessitating reliable biomarkers.
- The soluble transferrin receptor (sTfR) is a potential biomarker for iron status, minimally affected by acute phase responses.
- Established reference intervals for sTfR during infancy are lacking.
Purpose of the Study:
- To establish reference intervals for sTfR in healthy term infants from birth to 12 months.
- To evaluate the influence of C-reactive protein (CRP) on sTfR measurements in infants.
- To assess the utility of sTfR as a biomarker for infant iron status.
Main Methods:
- Quantified sTfR and CRP concentrations in 451 infants at birth, 48-96 hours, 4 months, and 12 months.
- Established reference intervals using 2.5th and 97.5th percentiles.
- Analyzed the correlation between sTfR and CRP (>1 mg/L) using Kendall correlation.
Main Results:
- Provided reference intervals for sTfR across different infant ages (birth to 12 months).
- Observed no significant sex-based differences in sTfR except at 4 months.
- Found sTfR did not covary with CRP concentrations >1 mg/L, except for samples taken at 48-96 hours.
Conclusions:
- This study provides crucial reference intervals for infant sTfR from birth to 12 months.
- sTfR demonstrates potential as a valuable diagnostic tool for infant iron status.
- The lack of covariation between sTfR and CRP at most time points supports its use in the presence of inflammation.
Introduction:
Infant iron status assessments may be difficult to interpret due to infections. The soluble transferrin receptor (sTfR) has been suggested as a biomarker mainly unaffected by the acute phase response. Reference intervals reflecting dynamics of infant growth first year in life are not well established.
Methods:
The sTfR and CRP concentrations were measured in samples from 451 term infants with the Roche Cobas platform in umbilical cord, at 48-96 hours, 4 and 12 months. Reference values were constructed as the 2.5th and 97.5th percentiles. The relationship between CRP concentrations >1 mg/L and sTfR was tested by Kendall correlation.
Results:
Reference intervals for girls and boys were 2.4-9.5 mg/L at birth, 2.9-8.4 mg/L at 48-96 hours, 2.6-5.7 mg/L at 4 months and 3.0-6.3 mg/L at 12 months. No differences between sexes were observed except for at 4 months. sTfR did not covariate with CRP concentrations >1 mg/L except in 48-96 hours samples.
Conclusion:
This study reports reference intervals for sTfR from birth to 12 months of age in a large group of infants in a low-risk area for iron deficiency. sTfR might add value to infant iron status diagnostics since no covariation with CRP was found at birth, at 4 months or at 12 months.
