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Utility of soluble transferrin receptor measurement for early diagnostic of iron deficiency in elderly hospitalized patients |
Annales de Biologie Clinique. Volume 68, Number 5, 569-75, septembre-octobre 2010, article original
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Author(s) : Françoise Blondé-Cynober, Catherine Cassereau, Gilles Morineau, Sandrine Etienne, Olivier Bouillanne, Samia Lakroun, Jean-Pierre Vincent, Christian Aussel |
Summary : Diagnosis of iron deficiency is not easily performed in inflammatory situation as usually encountered in elderly hospitalized patients (> 70 years old). At first, we determined serum soluble receptor transferrin (RsTf), RsTf/serum ferritin ratio (RsTf-F index) and biochemical and haematological values used to evaluate iron status, in iron-depleted subjects (ferritinemia ≤ 50 μg/L) (group 2) (n \= 22, 82 ± 7 years) or not (group 1, reference group) (n \= 18, 82 ± 6 years), without inflammatory diseases. Relevance of the biological parameters to diagnose iron deficiency was evaluated (ROC curve) and a cut-off value of RsTf-F (> 1.85) was established. Then, we selected 60 patients (group 3) suspect of iron deficiency as previously validated with an inflammatory syndrome (CRP > 12 mg/L). Almost all patients (95%) presented at least one risk factor of iron deficiency (anticoagulant drugs, nutritional or gastrointestinal diseases). In group 3, index RsTf-F values were increased (RsTf-F: 2.69 ± 0.82 versus group 1: 1.25 ± 0.34, p <\; 0.05), in anemic patients (women Hb <\; 120 g/L, men Hb <\; 130 g/L) (n \= 42) and in non-anemic patients (n \= 18) (respectively RsTf-F: 2.84 ± 0.87 versus 2.35 ± 0.58, p <\; 0.05). Thus, in elderly patients with inflammatory disorders, RsTf-F index could suspect iron deficiency before appearance of biological anemia. |
Keywords : elderly, iron deficiency, inflammation, soluble transferrin receptor |
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