Iron Status of Preadolescents Without Clinical Pallor Attending a Tertiary Care Hospital in South India- A...

Area of Science:

• Pediatric Nutrition
• Hematology
• Biochemistry

Background:

• Iron deficiency (ID) is a global health concern, particularly in children.
• Clinical signs like pallor are not always present in children with ID.
• WHO recommends novel biomarkers such as soluble transferrin receptor (sTfR) and the sTfR/serum ferritin ratio (sTfR-F index) for ID assessment.

Purpose of the Study:

• To determine the prevalence of iron deficiency in children without clinical pallor.
• To evaluate the utility of serum ferritin, sTfR, and the sTfR-F index in identifying ID.
• To assess the predictive accuracy of sTfR and sTfR-F index as individual predictors of ID.

Main Methods:

• A cross-sectional study involving 230 healthy children aged 9-11 years without clinical pallor.
• Measurements included hemoglobin (Hb), C-reactive protein (CRP), serum ferritin, sTfR, and sTfR-F index.
• Receiver-operating characteristic (ROC) curve analysis was used to determine the predictive abilities of sTfR and sTfR-F index.

Main Results:

• The prevalence of ID was 25.9% (57 out of 220 children).
• Among children with low CRP, 45 had ID based on serum ferritin.
• The positive predictive values for sTfR and sTfR-F index were low (32.9% and 35.9%), while negative predictive values were high (85.6% and 95.3%).

Conclusions:

• Iron deficiency affects a significant proportion of children even without visible pallor.
• sTfR and sTfR-F index are not reliable individual predictors for diagnosing iron deficiency in this population.
• Further research may be needed to refine the use of these novel biomarkers in pediatric populations.