Solubilni transferenski receptori u dijagnostici anemije zbog deficita gvožđa

Abstract

Introduction In recent years, determination of soluble transferrin receptor levels has been emerging as a test that can reliably indicate iron deficiency in various states, and that is non-invasive and easy to use. Objective To determine reference values of sTfR concentrations in serums in our population, to examine the reliability of the method in the diagnosis of anemia due to iron deficiency and associated iron deficiency in anemia accompanying chronic illnesses, to identify possible limitations of the test in certain conditions, to examine the value of combinations with other tests in the diagnosis of mentioned anemia types. Methods The prospective research included 86 patients with anemia: 46 patients with iron-deficiency anemia, and 40 patients with anemia of a chronic disease. The control group consisted of 40 healthy persons aging over 18. It was performed at the Clinic of Hematology, while laboratory tests were conducted in the Immunology and Biochemistry Laboratory of the Clinical Center Niš. Values of complete blood count, iron and iron-binding capacity in serum, ferritin and soluble transferrin receptors were determined. Results Ferritin values were reduced in 76.1% of patients, while higher levels of soluble transferrin receptors appeared in 100% of patients with anemia due to iron deficiency. In patients with reduced serum ferritin levels, sTfR/log ferritin index was statistically significantly higher than in patients in whom ferritin concentration was in the normal range (p <0.001). ROC analysis of patients with anemia due to iron deficiency showed that sTfR/log ferritin index (AUC 0.992) and levels of soluble transferrin receptors (AUC 0.986) occupied the largest area under the curve, thus representing the best diagnostic markers for these patients. The best diagnostic parameter for detecting iron deficiency in patients with anemia of a chronic disease by ROC analysis is the sTfR/log ferritin index (AUC 0.770). Conclusion Soluble transferrin receptors are useful in the diagnosis of anemia due to iron deficiency, especially when ferritin values are not reduced. The calculation of sTfR/log ferritin index is even more reliable. In patients with anemia of a chronic disease, the associated iron deficiency could be best indicated by sTfR/log ferritin index