Cook James D, Flowers Carol H, Skikne Barry S
Department of Medicine, Kansas University Medical Center, Kansas City, KS 66160-7233, USA.
Blood. 2003 May 1;101(9):3359-64. doi: 10.1182/blood-2002-10-3071. Epub 2003 Jan 9.
Current initiatives to reduce the high prevalence of nutritional iron deficiency have highlighted the need for reliable epidemiologic methods to assess iron status. The present report describes a method for estimating body iron based on the ratio of the serum transferrin receptor to serum ferritin. Analysis showed a single normal distribution of body iron stores in US men aged 20 to 65 years (mean +/- 1 SD, 9.82 +/- 2.82 mg/kg). A single normal distribution was also observed in pregnant Jamaican women (mean +/- 1 SD, 0.09 +/- 4.48 mg/kg). Distribution analysis in US women aged 20 to 45 years indicated 2 populations; 93% of women had body iron stores averaging 5.5 +/- 3.35 mg/kg (mean +/- 1 SD), whereas the remaining 7% of women had a mean tissue iron deficit of 3.87 +/- 3.23 mg/kg. Calculations of body iron in trials of iron supplementation in Jamaica and iron fortification in Vietnam demonstrated that the method can be used to calculate absorption of the added iron. Quantitative estimates of body iron greatly enhance the evaluation of iron status and the sensitivity of iron intervention trials in populations in which inflammation is uncommon or has been excluded by laboratory screening. The method is useful clinically for monitoring iron status in those who are highly susceptible to iron deficiency.
当前为降低营养性缺铁的高患病率所采取的举措凸显了采用可靠的流行病学方法来评估铁状态的必要性。本报告描述了一种基于血清转铁蛋白受体与血清铁蛋白的比值来估算机体铁含量的方法。分析显示，美国20至65岁男性的机体铁储存呈单一正态分布（均值±1标准差，9.82±2.82毫克/千克）。在牙买加孕妇中也观察到单一正态分布（均值±1标准差，0.09±4.48毫克/千克）。对美国20至45岁女性的分布分析表明存在两个群体；93%的女性机体铁储存平均为5.5±3.35毫克/千克（均值±1标准差），而其余7%的女性平均组织铁缺乏为3.87±3.23毫克/千克。在牙买加的铁补充试验和越南的铁强化试验中对机体铁的计算表明，该方法可用于计算添加铁的吸收情况。对机体铁的定量估算极大地增强了对铁状态的评估以及对炎症不常见或已通过实验室筛查排除炎症的人群中铁干预试验的敏感性。该方法在临床上对于监测极易缺铁人群的铁状态很有用。
