Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), INSERM, UPMC Univ Paris 06, Sorbonne Universités, 75013 Paris, France.
Nutrients. 2022 Feb 28;14(5):1039. doi: 10.3390/nu14051039.
Iron deficiency (ID) in patients with chronic inflammatory diseases is frequent. However, under-diagnosis is also frequent due to the heterogeneity between guidelines from different medical societies. We applied a common definition for the diagnosis of ID to a large panel of patients with cancer, heart failure (HF), inflammatory bowel disease (IBD), and chronic kidney disease (CKD), where ID was defined as serum ferritin concentration <100 μg/L and/or a transferrin saturation (TSAT) index <20%. Prevalence estimates using this common definition were compared with that obtained with officially accepted definitions (ESMO 2018, ESC 2016, ECCO 2015, and ERBP 2013). For that purpose, we used data collected during the French CARENFER studies, which included 1232, 1733, 1090, and 1245 patients with cancer, HF, IBD, and CKD, respectively. When applying the common definition, ID prevalence increased to 58.1% (vs. 57.9%), 62.8% (49.6%), and 61.2% (23.7%) in cancer, HF, and IBD patients, respectively. Both prevalence estimates were similar (47.1%) in CKD patients. Based on our results, we recommend combining both ferritin concentration and TSAT index to define ID in patients with chronic inflammatory diseases. In those patients, adopting this common definition of ID should contribute to a better screening for ID, whatever the condition.
缺铁症（ID）在患有慢性炎症性疾病的患者中很常见。然而，由于不同医学协会的指南之间存在异质性，因此也经常出现漏诊的情况。我们将 ID 的常见定义应用于一组患有癌症、心力衰竭（HF）、炎症性肠病（IBD）和慢性肾脏病（CKD）的大型患者中，其中 ID 被定义为血清铁蛋白浓度<100μg/L 和/或转铁蛋白饱和度（TSAT）指数<20%。使用此通用定义得出的患病率估计值与使用官方认可的定义（ESMO 2018、ESC 2016、ECCO 2015 和 ERBP 2013）得出的患病率进行了比较。为此，我们使用了在法国 CARENFER 研究中收集的数据，该研究分别包括 1232、1733、1090 和 1245 例癌症、HF、IBD 和 CKD 患者。当应用通用定义时，癌症、HF 和 IBD 患者的 ID 患病率分别增加至 58.1%（vs. 57.9%）、62.8%（49.6%）和 61.2%（23.7%）。CKD 患者的这两种患病率估计值相似（47.1%）。基于我们的结果，我们建议将铁蛋白浓度和 TSAT 指数结合起来定义慢性炎症性疾病患者的 ID。在这些患者中，采用 ID 的这种通用定义应该有助于更好地筛查 ID，无论病情如何。
