Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta , GA.
Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY.
Blood Adv. 2022 Jun 28;6(12):3661-3665. doi: 10.1182/bloodadvances.2022007066.
Our objective is to develop a physiologically based method to determine serum ferritin thresholds for iron deficiency in healthy individuals. The current World Health Organization threshold of <15 µg/L for iron deficiency in women is based on expert opinion. We examined the relationship between serum ferritin and 2 independently measured indicators of iron-deficient erythropoiesis, soluble transferrin receptor (sTfR) and hemoglobin, in baseline data from 286 women, 20 to 49 years, who were first-time or reactivated donors in the Retrovirus Epidemiology Donor Study-II Donor Iron Status Evaluation (REDS-RISE) study. At lower serum ferritin concentrations, median sTfR increased as hemoglobin decreased. Using restricted cubic spline regression analysis to determine thresholds for iron-deficient erythropoiesis, the thresholds identified by sTfR (serum ferritin < 25.4 µg/L) and hemoglobin (serum ferritin < 25.3 µg/L) did not differ significantly. The thresholds found in the REDS-RISE study do not differ from those identified by sTfR (serum ferritin < 25.5 µg/L) and hemoglobin (serum ferritin < 26.6 µg/L) in a previous study of 5442 women, 20 to 49 years, in the US National Health and Nutrition Examination Survey 2003 to 2018 (P = .98 and 0.83, respectively). Although international comparisons are needed, these results with US data provide additional evidence for the potential usefulness of a physiologically based method to identify serum ferritin thresholds for iron deficiency.
我们的目标是开发一种基于生理学的方法，以确定健康个体血清铁蛋白的缺铁阈值。目前，世界卫生组织（WHO）女性缺铁的血清铁蛋白阈值<15μg/L，这是基于专家意见。我们研究了血清铁蛋白与 2 种独立测量的缺铁性红细胞生成指标（可溶性转铁蛋白受体（sTfR）和血红蛋白）之间的关系，纳入了首次或再次献血的 286 名 20 至 49 岁的女性，这些女性来自逆转录病毒流行病学献血者研究-II（REDS-RISE）研究中的铁状态评估（Donor Iron Status Evaluation，DISE）部分。在较低的血清铁蛋白浓度下，sTfR 随着血红蛋白的降低而升高。采用限制性立方样条回归分析来确定缺铁性红细胞生成的阈值，sTfR（血清铁蛋白<25.4μg/L）和血红蛋白（血清铁蛋白<25.3μg/L）确定的阈值没有显著差异。REDS-RISE 研究中发现的阈值与之前在 5442 名 20 至 49 岁的美国女性（National Health and Nutrition Examination Survey，NHANES）中使用 sTfR（血清铁蛋白<25.5μg/L）和血红蛋白（血清铁蛋白<26.6μg/L）确定的阈值没有差异（P=.98 和 0.83）。尽管需要进行国际比较，但这些来自美国的数据结果提供了额外的证据，证明使用基于生理学的方法确定血清铁蛋白缺铁阈值具有潜在的有效性。
