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Serum ferritin in evaluation of iron status in children
Insights
Serum ferritin alone is unreliable for assessing iron status in young children. Multiple diagnostic markers are needed for accurate iron deficiency and iron deficiency anemia detection.
Area of Science:
- Pediatric Nutrition
- Hematology
Background:
- Iron deficiency is a significant global health concern in preschool-aged children.
- Accurate assessment of iron status is crucial for early intervention and prevention of complications.
Purpose of the Study:
- To evaluate the diagnostic value of serum ferritin in determining iron status among preschool children.
- To compare serum ferritin levels in children with and without iron deficiency and iron deficiency anemia.
Main Methods:
- A study involving 192 children aged 3-60 months.
- Iron deficiency defined by transferrin saturation (<16%) and microcytosis/hypochromia.
- Iron deficiency anemia defined by hemoglobin (<10.5 g/dl) alongside iron deficiency criteria.
Main Results:
- 46% of children exhibited iron deficiency (11.5%) or iron deficiency anemia (34.4%).
- Mean serum ferritin levels were lower in iron deficiency groups (39.1-41.7 ng/ml) compared to normal (84.7 ng/ml), but not statistically significant.
- Only 30% of children with iron deficiency/anemia had serum ferritin <12 ng/ml.
Conclusions:
- Serum ferritin alone is not a sufficient marker for diagnosing iron status in preschool children.
- Combining multiple parameters, including hemoglobin and transferrin saturation, enhances the reliability of iron status assessment.
Abstract:
The value of serum ferritin in assessing iron status was studied in 192 preschool age children between the ages of 3 and 60 months. Children were considered to have iron deficiency if the transferrin saturation was less than 16% and the peripheral smear revealed microcytosis and hypochromia. Anemia was present when hemoglobin level was 10.5 g/dl. According to this criteria, 46% of children screened had either iron deficiency (11.5%) or iron deficiency anemia (34.4%). Mean serum ferritin for the iron deficiency anemia group was 39.1 ng/mg as compared to 41.7 ng/ml for the iron deficiency group and 84.7 ng/ml for the normal group. Even though the serum ferritin level was lower in the iron deficiency group, the difference in the means did not reach statistical significance. Furthermore, only 30% of children who had either iron deficiency or iron deficiency anemia had serum ferritin level of less than 12 ng/ml, the level considered diagnostic for iron deficiency. It can be concluded that serum ferritin cannot be used alone for iron status determination. Multiple parameters will make the assessment more reliable.