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Serum iron, serum transferrin and transferrin saturation in healthy children without iron deficiency
Insights
Transferrin saturation is not a reliable standalone indicator for diagnosing iron deficiency in children. Further tests are needed to accurately assess iron status in pediatric populations.
Area of Science:
- Pediatric Hematology
- Nutritional Biochemistry
- Clinical Diagnostics
Background:
- Assessing iron status in children is crucial for development.
- Iron deficiency can impact cognitive and physical health.
- Existing diagnostic markers require careful interpretation in pediatric populations.
Purpose of the Study:
- To evaluate the utility of transferrin saturation as a diagnostic marker for iron status in children.
- To compare iron status indicators between children and adults.
- To determine the effectiveness of transferrin saturation in identifying depleted iron stores in children.
Main Methods:
- Studied serum iron, transferrin, and transferrin saturation in 253 healthy children (aged 4, 8, 13) and 60 healthy adults.
- Categorized children into iron replete, intermediate, and depleted iron stores based on serum ferritin levels.
- Analyzed age-related trends and compared values between children and adults.
Main Results:
- Iron replete children showed increasing serum iron and transferrin saturation with age.
- Children had lower serum iron and transferrin saturation, but higher transferrin levels compared to adults.
- Transferrin saturation below 7% showed high diagnostic efficiency for exhausted iron stores in depleted children, but with low positive predictive value.
Conclusions:
- Transferrin saturation alone is insufficient for diagnosing iron deficiency in children.
- Combined assessment with other iron status indicators is essential for accurate diagnosis.
- Age-related differences in iron metabolism markers exist between children and adults.
Abstract:
Serum iron, serum transferrin and transferrin saturation were studied in 253 healthy, non-anaemic children 4, 8 and 13 years old, and in 60 healthy, non-anaemic adults having serum ferritin values greater than or equal to 15 micrograms/l. One hundred and ninety-six children had serum ferritin values greater than or equal to 15 micrograms/l (i.e. replete iron stores), 35 had intermediate ferritin values from 10-14 micrograms/l and 22 had ferritin values less than 10 micrograms/l (i.e. depleted iron stores). Iron replete children showed a gradual rise in serum iron and transferrin saturation values with age. Serum iron and transferrin saturation values were lower (P less than 0.001, P less than 0.0001) and transferrin values higher (P less than 0.0001) in iron replete children compared to adults. Iron replete children had a 2.5 centile transferrin saturation value of 5%; 19.9% of these children had saturation values less than 15% and 8.2% had values less than 10%. In iron depleted children a transferrin saturation value less than 7% yielded the highest diagnostic efficiency as regards exhausted iron stores, although with a low predictive value of a positive test. The transferrin saturation is unsuitable as a single diagnostic criterion in the evaluation of iron deficiency in children and should always be combined with other indicators of iron status.