Diagnostics: Markers of Body Iron Status

Area of Science:

• Biochemistry
• Clinical Medicine
• Nutritional Science

Background:

• Iron is vital for all organisms, impacting metabolism beyond hemoglobin synthesis.
• Both iron deficiency and overload pose health risks, including cell death via ferroptosis.
• Accurate iron status monitoring is clinically essential.

Purpose of the Study:

• To review laboratory tools for assessing iron status.
• To highlight challenges in current iron status diagnostics, especially during inflammation.
• To explore potential future solutions for iron status assessment.

Main Methods:

• Narrative review of existing laboratory methods for iron status evaluation.
• Discussion of limitations of classical biochemical parameters (ferritin, TSAT) in inflammatory conditions.
• Exploration of supplementary indicators like erythrocyte indices, sTfR, hepcidin, and NTBI measurement challenges.

Main Results:

• Classical markers (ferritin, TSAT) are unreliable in inflammatory states, lacking sensitivity and specificity.
• Inflammation necessitates integrating additional markers, but availability and standardization issues exist (e.g., hepcidin).
• Measuring non-transferrin-bound iron (NTBI) remains difficult but is crucial for iron overload.

Conclusions:

• Current iron status assessment tools face significant challenges, particularly in patients with inflammation.
• There is a need for improved, standardized, and widely available diagnostic methods for iron status.
• Future research should focus on overcoming limitations in measuring key iron indicators like NTBI and hepcidin.