Rusch Jody A, van der Westhuizen Diederick J, Gill Robert S, Louw Vernon J
Division of Chemical Pathology, Department of Pathology, University of Cape Town, Cape Town, South Africa; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
Division of Chemical Pathology, Department of Pathology, University of Cape Town, Cape Town, South Africa; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
Best Pract Res Clin Anaesthesiol. 2023 Dec;37(4):451-467. doi: 10.1016/j.bpa.2023.11.001. Epub 2023 Nov 17.
Iron deficiency, a pervasive global health issue, necessitates precise and reliable diagnostic methods, especially in clinical and surgical settings. This review examines an array of established markers of iron status, encapsulating parameters such as serum iron, ferritin, transferrin, and transferrin saturation alongside novel biomarkers like soluble transferrin receptor, zinc protoporphyrin, and hepcidin. We further scrutinise the potential and limitations of routine and novel diagnostic tools and strategies in distinguishing different anaemic conditions, such as iron deficiency anaemia, iron-restricted erythropoiesis, and anaemia of inflammation. Through a critical lens, we elucidate the current paradigms and pressing questions surrounding the diagnostic criteria and clinical ramifications of iron metabolism. By weaving together the nuances and diverging perspectives within the domain of iron deficiency diagnosis and management, this review aspires to foster a clearer understanding that can steer improved patient care and shape the trajectory of future research in this vital field.
缺铁是一个普遍存在的全球健康问题，需要精确可靠的诊断方法，尤其是在临床和外科环境中。本综述研究了一系列已确立的铁状态标志物，包括血清铁、铁蛋白、转铁蛋白和转铁蛋白饱和度等参数，以及可溶性转铁蛋白受体、锌原卟啉和铁调素等新型生物标志物。我们进一步审视了常规和新型诊断工具及策略在区分不同贫血状况（如缺铁性贫血、铁限制红细胞生成和炎症性贫血）方面的潜力和局限性。通过批判性的视角，我们阐明了围绕铁代谢诊断标准和临床影响的当前范式及紧迫问题。通过梳理缺铁诊断和管理领域内的细微差别和不同观点，本综述旨在促进更清晰的理解，以指导改善患者护理，并塑造这一重要领域未来研究的方向。
