Virtanen M A, Viinikka L U, Virtanen M K, Svahn J C, Anttila R M, Krusius T, Cook J D, Axelsson I E, Räihä N C, Siimes M A
Department of Clinical Chemistry and Hospital for Children and Adolescents, University of Helsinki, Finland.
Am J Clin Nutr. 1999 Feb;69(2):256-60. doi: 10.1093/ajcn/69.2.256.
The serum transferrin receptor (TfR) concentration in adults is suggested to provide a sensitive measure of iron depletion and together with the serum ferritin concentration to indicate the entire range of iron status, from iron deficiency to iron overload. However, little is known about TfR concentrations in children.
Our objective was to compare serum TfR and ferritin concentrations and their ratios in children and adults and look for correlations between TfR concentrations and other measures of iron status.
Our study groups were healthy 1-y-old infants (n = 36), 11-12-y-old prepubertal boys (n = 35), and 20-39-y-old men (n = 40).
TfR concentrations were higher in infants (x; 95% reference interval: 7.8 mg/L; 4.5, 11.1) than in prepubertal boys (7.0 mg/L; 4.7, 9.2) and higher in prepubertal boys than in men (5.8 mg/L; 3.1, 8.5). Geometric mean TfR-ferritin ratios were higher in infants (316; 95% reference interval: 94, 1059) than in prepubertal boys (219; 78, 614) and higher in prepubertal boys than in men (72; 23, 223). By multiple linear regression analysis, the best predictors of TfR concentration were serum iron (P = 0.004) and log serum ferritin (P < 0.0001), both being inverse correlations (R2 = 0.32). Mean corpuscular volume, blood hemoglobin, transferrin iron saturation, transferrin, and even age seemed to not have an influence on the TfR concentration and erythropoiesis was not a determinant of TfR concentration.
Low serum ferritin and iron concentrations, even within the normal physiologic range, result in high TfR concentrations. The lower the iron stores, the stronger the influence of ferritin on TfR. A high TfR concentration in children, especially in infants, is a response to physiologically low iron stores. Age-specific reference concentrations for TfR are needed.
有研究表明，成人血清转铁蛋白受体（TfR）浓度可作为铁缺乏的敏感指标，与血清铁蛋白浓度一起可反映从缺铁到铁过载的整个铁状态范围。然而，关于儿童TfR浓度的情况却知之甚少。
我们的目的是比较儿童和成人血清TfR和铁蛋白浓度及其比值，并寻找TfR浓度与其他铁状态指标之间的相关性。
我们的研究组包括健康的1岁婴儿（n = 36）、11 - 12岁青春期前男孩（n = 35）和20 - 39岁男性（n = 40）。
婴儿的TfR浓度（x；95%参考区间：7.8 mg/L；4.5，11.1）高于青春期前男孩（7.0 mg/L；4.7，9.2），青春期前男孩的TfR浓度高于男性（5.8 mg/L；3.1，8.5）。婴儿的TfR - 铁蛋白几何平均比值（316；95%参考区间：94，1059）高于青春期前男孩（219；78，614），青春期前男孩的该比值高于男性（72；23，223）。通过多元线性回归分析，TfR浓度的最佳预测指标是血清铁（P = 0.004）和血清铁蛋白对数（P < 0.0001），两者均呈负相关（R2 = 0.32）。平均红细胞体积、血红蛋白、转铁蛋白铁饱和度、转铁蛋白，甚至年龄似乎对TfR浓度均无影响，且红细胞生成不是TfR浓度的决定因素。
即使在正常生理范围内，低血清铁蛋白和铁浓度也会导致高TfR浓度。铁储备越低，铁蛋白对TfR的影响越强。儿童尤其是婴儿的高TfR浓度是对生理上低铁储备的一种反应。需要针对不同年龄的TfR参考浓度。
