[Utility of soluble transferrin receptor measurement for early diagnostic of iron deficiency in elderly hospitalized patients].
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.
Blondé-Cynober
Françoise
F
Laboratoire de biologie, Service de gérontologie 1, Hôpital Emile Roux, AP-HP, Limeil-Brévannes. francoise.blonde@erx.aphp.fr
Cassereau
Catherine
C
Morineau
Gilles
G
Etienne
Sandrine
S
Bouillanne
Olivier
O
Lakroun
Samia
S
Vincent
Jean-Pierre
JP
Aussel
Christian
C
D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000172:deficiency; D006400:Hematocrit; D006801:Humans; D008297:Male; D011990:Receptors, Transferrin / Q000097:blood*; D012307:Risk Factors; D014168:Transferrin / Q000378:metabolism
D015415:Biomarkers; D011990:Receptors, Transferrin; D014168:Transferrin; D002097:C-Reactive Protein; D005293:Ferritins