Mat á járnbúskap með mælingu á transferrínviðtökum

Vigfús Þorsteinsson
, Friðrik E. Yngvason

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The purpose of this study was to estimate the value of the transferrin receptor in serum (sTfR) for detecting iron deficiency and compare it with the value of some other blood tests for that purpose. MATERIAL AND METHODS: All patients undergoing bone marrow aspiration in the FSA Hospital, Akureyri, Iceland, in the period 1999 to 2003 were eligible to participate in this prospective study. Included participants were 89. The sensitivity, specificity, efficiency, and Youden index of ferritin, MCV, CHr, sTfR, sTfR-Ferritin-index, the iron saturation of transferrin, and the Thomas-Plot method were calculated. The complete absence of stainable iron in bone marrow was used as the definitive marker of iron depletion. RESULTS: The best method to detect iron deficiency as estimated by the Youden index was the Thomas-Plot method. This method was very specific in cases without evidence of inflammatory processes (CRP <6 mg/L) and very sensitive in cases with elevated CRP (>6 mg/L). The sTfR-Ferritin-index came second and sTfR was the best single blood test to detect iron deficiency according to the Youden index. CONCLUSION: The Thomas-Plot method and the sTfR-Ferritin-index proved to be the most reliable blood tests to diagnose iron deficiency. These parameters can eliminate the need of using bone marrow aspirate to diagnose iron deficiency in some cases.
Inngangur: Tilgangur þessarar könnunar var að bera saman gildi mælinga á transferrínviðtökum í sermi (sTfR) og nokkurra annarra blóðrannsókna við greiningu járnskorts.
 Efniviður og aðferðir: Könnunin var framskyggn og öllum sjúklingum sem fljótandi mergsýni var tekið úr á Fjórðungssjúkrahúsinu á Akureyri á tímabilinu 1999 til 2003 var heimil þátttaka. Fullgildir þátttakendur voru 89. Næmi, sértæki, skilvirkni og mælikvarði Youdens við greiningu járnskorts var reiknað fyrir ferritín, MCV, CHr, sTfR, sTfR-ferritín-vísi, járnmettun transferríns og Tómasartöflu. Járnskortur var skilgreindur sem ekkert sjáanlegt járn við smásjárskoðun á merg.
 Niðurstöður: Samkvæmt mælikvarða Youdens reyndist Tómasartafla best við greiningu járn-skorts. Hjá þátttakendum sem höfðu CRP <6 mg/L og virtust þannig ekki hafa bólgusvörun reyndist hún mjög sértæk en mjög næm hjá þeim sem höfðu CRP ≥6 mg/L. sTfR-ferritín-vísir reyndist næstbest af samsettum mælikvörðum og af einstökum blóðrannsóknum reyndist sTfR best til að greina járnskort samkvæmt mælikvarða Youdens.
 Ályktanir: Í þessari könnun reyndust Tómasartafla og sTfR-ferritín-vísir best við greiningu járnskorts. Notkun þessara mælikvarða getur dregið úr þörf á því að taka mergsýni til að greina járnskort.
 

Original languageIcelandic
JournalLæknablaðið
Publication statusPublished - 1 Jan 2010

Other keywords

  • Járn (næringarefni)
  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Markers
  • Bone Marrow Examination
  • Deficiency Diseases
  • Erythrocyte Indices
  • Female
  • Ferritins
  • Hematologic Tests
  • Humans
  • Iceland
  • Iron
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Receptors, Transferrin
  • Sensitivity and Specificity
  • Young Adult

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