Screening for iron deficiency: an analysis based on bone-marrow examinations and serum ferritin determinations in a population sample of women.
Efficacy of different methods in screening for iron deficiency was re-examined in a randomly selected sample of 38-year-old women (n = 203) with known iron status based on absence/presence of stainable iron in bone-marrow smears. The study was made in 1968-69. Serum ferritin (SF) was determined in 1978 in frozen sera using the Ramco IRMA and, in 1992, samples were re-analysed using a RIA calibrated with the International Standard 80/602 for SF determination. The effect of storage on SF was calculated from a previously established relationship (courtesy of Dr Mark Worwood, Cardiff) between the results obtained with the Ramco assay and assays calibrated with IS 80/602. The distributions in iron replete and iron deficient women showed less overlap (diagnostic efficiency 91%) for SF than for other haematological parameters. The best discrimination was obtained at SF < 16 micrograms/l (specificity 98%; sensitivity 75%). Absence of iron stores was associated with signs of an iron deficient erythropoiesis, starting already at SF 25-40 micrograms/l. Use of multiple criteria to diagnose iron deficiency falsely reduces prevalence figures for iron deficiency.
Hallberg
L
L
Department of Internal Medicine, University of Göteborg, Sahlgrenska Hospital, Sweden.
Bengtsson
C
C
Lapidus
L
L
Lindstedt
G
G
Lundberg
P A
PA
Hultén
L
L
D000328:Adult; D001853:Bone Marrow / Q000737:chemistry*; D004920:Erythropoiesis; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D000090463:Iron Deficiencies; D008875:Middle Aged; D015995:Prevalence; D011863:Radioimmunoassay; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology
D005293:Ferritins