Department of Pediatrics and Gastroenterology, Medical University of Lublin, Al. Racławickie 1, 20-059 Lublin, Poland.
Nutrients. 2020 May 9;12(5):1358. doi: 10.3390/nu12051358.
Inflammation may affect many routinely available parameters of iron homeostasis. Thus, the recognition of iron deficiency in inflammatory bowel disease (IBD) remains a diagnostic challenge in a clinical routine. The aim of the study was to detect the most efficient marker of iron deficiency in IBD children. In a group of 75 IBD children, we evaluated the sensitivity, specificity, accuracy, and positive and negative predictive values of erythrocytes' indices, including MCV, MCH, MCHC and RDW, and biochemical markers, including iron, transferrin, sTfR and sTfR/log ferritin, for identifying iron deficiency. Receiver operating characteristic (ROC) analysis was used to compare the ability of these parameters to detect iron deficiency. The best predictors of iron deficiency were sTfR/log ferritin, with accuracy 0.86, sensitivity 0.98, specificity 0.63, positive predictive value 0.83 and negative predictive value 0.94, and sTfR, with accuracy 0.77, sensitivity 0.82, specificity 0.67, positive predictive value 0.82 and negative predictive value 0.67. Moreover, sTfR/log ferritin exhibited the largest area under ROC (0.922), followed by sTfR (0.755) and MCH (0.720). The sTfR/log ferritin index appears to be the most efficient marker of iron depletion in pediatric IBD, and it may give an added value in the management of IBD patients.
炎症可能会影响铁稳态的许多常规参数。因此，在临床常规中，识别炎症性肠病 (IBD) 中的缺铁仍然是一个诊断挑战。本研究的目的是检测 IBD 儿童缺铁的最有效标志物。在 75 名 IBD 儿童的组中，我们评估了红细胞指数（包括 MCV、MCH、MCHC 和 RDW）和生化标志物（包括铁、转铁蛋白、sTfR 和 sTfR/铁蛋白）的灵敏度、特异性、准确性、阳性和阴性预测值，用于识别缺铁。使用受试者工作特征 (ROC) 分析比较这些参数识别缺铁的能力。sTfR/log 铁蛋白是缺铁的最佳预测指标，准确性为 0.86，灵敏度为 0.98，特异性为 0.63，阳性预测值为 0.83，阴性预测值为 0.94，sTfR 的准确性为 0.77，灵敏度为 0.82，特异性为 0.67，阳性预测值为 0.82，阴性预测值为 0.67。此外，sTfR/log 铁蛋白的 ROC 曲线下面积最大（0.922），其次是 sTfR（0.755）和 MCH（0.720）。sTfR/log 铁蛋白指数似乎是小儿 IBD 缺铁的最有效标志物，它可能为 IBD 患者的管理提供附加价值。
