Small-dose oral iron absorption test in anaemic and non-anaemic elderly hospitalized patients
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E Joosten1, B Vander Elst, J Billen
1Department of Physiopathology, University Hospitals K.U. Leuven, Belgium.
Insights
The small-dose oral iron absorption test (OIAT) effectively identifies iron deficiency in elderly patients. A Cmax level above 80 micrograms/dL indicates adequate iron stores, differentiating deficiency from anemia of chronic disorders.
Area of Science:
- Clinical Chemistry
- Hematology
- Geriatric Medicine
Background:
- Iron deficiency anemia is common in hospitalized elderly patients.
- Accurate assessment of iron status and absorption is crucial for effective treatment.
- Distinguishing iron deficiency from anemia of chronic disorders can be challenging.
Purpose of the Study:
- To evaluate the utility of a small-dose oral iron absorption test (OIAT) in hospitalized elderly patients.
- To assess the correlation between serum ferritin levels and iron absorption.
- To determine if OIAT can differentiate iron deficiency from other causes of anemia.
Main Methods:
- A 20 mg oral iron absorption test (OIAT) was administered to 76 elderly patients and 30 healthy adults.
- Serum ferritin levels were measured to assess iron stores.
- Maximum increase in serum iron (Cmax) was measured over 3 hours post-ingestion.
Main Results:
- A significant inverse correlation was observed between serum ferritin and Cmax in both elderly and healthy groups.
- A Cmax decision limit of 80 micrograms/dL effectively discriminated between absent and adequate iron stores.
- 68% of iron-deficient patients had Cmax > 80 micrograms/dL, unlike ACD or healthy controls.
Conclusions:
- The small-dose OIAT shows promise as a simple, safe test for evaluating iron absorption.
- OIAT may help predict mild iron deficiency and differentiate anemia categories in the elderly.
- Further validation is recommended before widespread clinical adoption of OIAT.
Abstract:
The small-dose (20 mg) oral iron absorption test (OIAT) was performed in 76 hospitalized elderly patients and 30 healthy adults. Of the elderly patients, 34 were considered as iron deficient (serum ferritin level < 20 micrograms/L) of whom 23 were anaemic and 11 not anaemic, 21 had the anaemia of chronic disorders (ACD) and another 21 were non-anaemic patients with a normal serum ferritin level. There was a significant inverse correlation between the serum ferritin level as a measure of iron store and the maximum increase in serum iron during a 3-h test (Cmax), in the elderly as well as in the healthy adult group. A decision limit of 80 micrograms/dL for Cmax is a good discriminant between absent (serum ferritin < 20 micrograms/L) and adequate body iron stores. Sixty-eight per cent of the patients with a serum ferritin level < 20 micrograms/L but virtually none of the ACD patients, non-anaemic elderly inpatients with normal serum ferritin levels and healthy adults had a Cmax level > 80 micrograms/L. Although further investigation is needed before the OIAT can be recommended as a valuable test for evaluating iron absorption, predicting mild iron deficiency and differentiating between different categories of anaemia, it seems worthwhile that more effort should be done to validate this simple and safe test.