Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Acta Med Indones. 2020 Oct;52(4):334-343.
iron deficiency in pulmonary tuberculosis (TB) patients may weaken their immune system, causing difficulty in overcoming the infection. Accurate diagnosis of iron deficiency anemia (IDA) in pulmonary TB patients is essential. In order to prove the iron deficient state, diagnosis should focus on inflammatory factors, which could highly affect the outcome of iron status, such as measurement of serum ferritin (SF). Soluble Transferrin Receptor (sTfR) is the best parameter to diagnose iron deficiency in the inflammatory condition. This study aimed to understand the role of sTfR to identify IDA in TB patients.
cross-sectional study were applied to 3 study groups: anemic pulmonary TB (68 subjects), IDA (7 subjects), and non-anemic pulmonary TB (15 subjects). The test averages and correlations between sTfR, SF, and other hematological parameters were measured and analyzed.
significant differences of sTfR were found in the anemic TB group compared to the IDA group and also between the IDA and non-anemic TB groups (p<0.0001). However, there was no significant difference (p>0.05) between TB anemic and non-anemic groups. We also found no significant difference between the TB anemic sub-group with normal levels of sTfR compared with the non-anemic group. There was no significant difference of sTfR levels between sub-group of increasing sTfR and group IDA (p>0.05). However, there was strong correlation between sTfR and SF in the IDA group (r=-0.89; p=0.007).
the findings suggest verifying the sTfR amount in anemic patients with pulmonary TB suffering from inflammation, so that the iron deficiency could be more accurately identified and properly treated.
肺结核 (TB) 患者的缺铁会削弱其免疫系统,导致其难以克服感染。准确诊断肺结核患者的缺铁性贫血 (IDA) 至关重要。为了证明缺铁状态,诊断应侧重于炎症因素,这些因素可能高度影响铁状态的结果,如血清铁蛋白 (SF) 的测量。可溶性转铁蛋白受体 (sTfR) 是诊断炎症状态下缺铁的最佳参数。本研究旨在了解 sTfR 在识别 TB 患者 IDA 中的作用。
本研究采用横断面研究,纳入了 3 个研究组:贫血性肺结核 (68 例)、IDA (7 例) 和非贫血性肺结核 (15 例)。测量并分析了 sTfR、SF 和其他血液学参数的测试平均值和相关性。
与 IDA 组和非贫血性 TB 组相比,贫血性 TB 组的 sTfR 差异显著 (p<0.0001)。然而,TB 贫血组与非贫血组之间无显著差异 (p>0.05)。我们还发现,sTfR 水平正常的 TB 贫血亚组与非贫血组之间无显著差异。sTfR 水平在 sTfR 升高的亚组与 IDA 组之间无显著差异 (p>0.05)。然而,IDA 组中 sTfR 与 SF 之间存在很强的相关性 (r=-0.89;p=0.007)。
研究结果表明,对于患有炎症的肺结核贫血患者,应验证 sTfR 量,以便更准确地识别缺铁并进行适当治疗。