Olivares M, Walter T, Cook J D, Hertrampf E, Pizarro F
Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.
Am J Clin Nutr. 2000 Nov;72(5):1191-5. doi: 10.1093/ajcn/72.5.1191.
The serum transferrin receptor (TfR) and the ratio of TfR to serum ferritin (TfR:SF) have been shown to be useful as early indicators of iron deficiency.
The objective of this study was to evaluate the performance of TfR and TfR:SF in the assessment of iron deficiency in infants and to analyze age-related changes in both variables.
A total of 716 blood samples obtained from 515 healthy infants aged 8-15 mo were studied.
In 144 samples in which all other laboratory indicators of iron status were within the reference range, the median and 95% CI for TfR and TfR:SF were 8.5 mg/L (95% CI: 5.9, 13.5) and 497 (95% CI: 134, 975), respectively. TfR and TfR:SF were significantly correlated with the other laboratory indicators of iron status. Furthermore, as the severity of iron deficiency progressed, there was a gradual increase in mean TfR concentration (P: < 0.00001; analysis of variance). The sensitivity of TfR > 13.5 mg/L and TfR:SF > 975 in the diagnosis of iron deficiency was 23.6% and 68.4%, respectively. The specificity was 98.3% and 63.3% for TfR and TfR:SF, respectively. The sensitivity and specificity of SF < 10 microg/L were 63.7% and 60.8%, respectively. Receiver operator characteristic analysis showed that TfR and TfR:SF were more accurate than was SF alone in the diagnosis of iron deficiency.
TfR and TfR:SF showed age-related changes; TfR and TfR:SF appear to be better diagnostic tests for iron deficiency in infants than SF.
血清转铁蛋白受体（TfR）以及TfR与血清铁蛋白的比值（TfR:SF）已被证明可作为缺铁的早期指标。
本研究的目的是评估TfR和TfR:SF在评估婴儿缺铁情况中的表现，并分析这两个变量与年龄相关的变化。
对从515名8至15个月大的健康婴儿采集的716份血样进行了研究。
在144份所有其他铁状态实验室指标均在参考范围内的样本中，TfR和TfR:SF的中位数及95%置信区间分别为8.5 mg/L（95%置信区间：5.9，13.5）和497（95%置信区间：134，975）。TfR和TfR:SF与其他铁状态实验室指标显著相关。此外，随着缺铁严重程度的加重，TfR平均浓度逐渐升高（P < 0.00001；方差分析）。TfR > 13.5 mg/L和TfR:SF > 975诊断缺铁的敏感性分别为23.6%和68.4%。TfR和TfR:SF的特异性分别为98.3%和63.3%。血清铁蛋白（SF）< 10 μg/L的敏感性和特异性分别为63.7%和60.8%。受试者工作特征分析表明，在诊断缺铁方面，TfR和TfR:SF比单独使用SF更准确。
TfR和TfR:SF呈现出与年龄相关的变化；TfR和TfR:SF在诊断婴儿缺铁方面似乎比SF更好。
