title: Using Soluble Transferrin Receptor and Taking Inflammation into Account When Defining Serum Ferritin Cutoffs Improved the Diagnosis of Iron Deficiency in a Group of Canadian Preschool Inuit Children from Nunavik.
abstract: The prevalence of iron depletion, iron deficient erythropoiesis (IDE), and iron deficiency anemia (IDA) was assessed in preschool Inuit children using soluble transferrin receptor (sTfR) and traditional indicators of iron status while disregarding or taking inflammation into account when defining SF cutoffs. Iron depletion was defined as follows: (1) SF < 15 μg/L regardless of the C-reactive protein (CRP) level and (2) SF < 15 or <50 μg/L with CRP ≤ 5 or >5 mg/L, respectively. IDE corresponded to iron depletion combined with total iron binding capacity > 72 μmol/L and/or transferrin saturation < 16%. Iron depletion and IDE affected almost half of the children when accounting for inflammation, compared to one-third when the SF cutoff was defined regardless of CRP level (P < 0.0001). The prevalence of IDE adjusted for inflammation (45.1%) was very similar to the prevalence observed when sTfR was used as a sole marker of IDE (47.4%). The prevalence of anemia was 15%. The prevalence of IDA (IDE + hemoglobin < 110 g/L) was higher when accounting for than when disregarding inflammation (8.0% versus 6.2%, P = 0.083). Using sTfR and different SF cutoffs for children with versus without inflammation improved the diagnosis of iron depletion and IDE. Our results confirm that Inuit children are at particularly high risk for iron deficiency.
authors.affiliation: School of Nutrition, Laval University, 2425 rue de l'Agriculture, Québec City, QC, Canada G1V 0A6.
authors.forename: Huguette
authors.initials: H
authors.lastname: Turgeon O'Brien
authors.affiliation: Interdisciplinary School of Health Sciences, University of Ottawa, 35 University Private THN140, Ottawa, ON, Canada K1N 6N5.
authors.forename: Rosanne
authors.initials: R
authors.lastname: Blanchet
authors.affiliation: Nutrition DG, 1187 rue du Saint-Brieux, Québec City, QC, Canada G1Y 2B9.
authors.forename: Doris
authors.initials: D
authors.lastname: Gagné
authors.affiliation: Department of Family Medicine and Emergency Medicine, University of Sherbrooke, 150 place Charles-Le Moyne, Longueuil, QC, Canada J4K 0A8.
authors.forename: Julie
authors.identifier: 0000-0003-1856-3736
authors.initials: J
authors.lastname: Lauzière
authors.affiliation: Inuulitsivik Health and Social Services Centre, Puvirnituq, QC, Canada J0M 1P0.
authors.forename: Carole
authors.initials: C
authors.lastname: Vézina