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Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents

Authors
  • Prenzel, Freerk
  • Kaiser, Thorsten
  • Willenberg, Anja
  • vom Hove, Maike
  • Flemming, Gunter
  • Fischer, Lars
  • Kratzsch, Jürgen
  • Kiess, Wieland
  • Vogel, Mandy
Type
Published Article
Journal
Clinical Chemistry and Laboratory Medicine (CCLM)
Publisher
Walter de Gruyter GmbH
Publication Date
Jul 08, 2024
Volume
63
Issue
1
Pages
184–192
Identifiers
DOI: 10.1515/cclm-2024-0369
PMID: 38965083
Source
De Gruyter
Keywords
License
Yellow

Abstract

Objectives Soluble transferrin receptor (sTfR) is a marker of both erythropoiesis and iron status and is considered useful for detecting iron deficiency, especially in inflammatory conditions, but reference intervals covering the entire pediatric age spectrum are lacking. Methods We studied 1,064 (48.5 % female) healthy children of the entire pediatric age spectrum to determine reference values and percentiles for sTfR and the ratio of sTfR to log-ferritin (sTfR-F index) using a standard immunoturbidimetric assay. Results Soluble TfR levels were highly age-specific, with a peak in infancy and a decline in adulthood, whereas the sTfR-F index was a rather constant parameter. There were positive linear relationships for sTfR with hemoglobin (Hb) (p=0.008) and transferrin (females p<0.001; males p=0.003). A negative association was observed between sTfR and ferritin in females (p<0.0001) and for transferrin saturation and mean corpuscular volume (MCV) in both sexes (both p<0.0001). We found a positive relationship between sTfR and body height, body mass index (BMI) and inflammatory markers (CrP p<0.0001; WBC p=0.0172), while sTfR-F index was not affected by inflammation. Conclusions Soluble TfR values appear to reflect the activity of infant erythropoiesis and to be modulated by inflammation and iron deficiency even in a healthy cohort.

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