Correlations between hemoglobin, serum ferritin, and soluble transferrin receptor levels in children aged 6-59 months

Fajar Diah Tri Kusumastuti; Sutaryo Sutaryo; Sri Mulatsih

doi:10.14238/pi54.2.2014.122-6

Fajar Diah Tri Kusumastuti Department of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta
Sutaryo Sutaryo Department of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta
Sri Mulatsih Department of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta

DOI: https://doi.org/10.14238/pi54.2.2014.122-6

Keywords: hemoglobin, serum ferritin, soluble transferrin receptor, correlation, iron deficiency

Abstract

Background Early detection of iron deficiency is important in young children to prevent iron deficiency anemia, which may cause permanent neurocognitive development disorders. Hemoglobin level is an insensitive tool for detecting iron deficiency without anemia, while serum ferritin levels may be influenced by infection and inflammation. However, soluble transferrin receptor (sTfR) is a sensitive marker for detecting iron deficiency, yet not widely used in daily practice.

Objective To assess for correlations between hemoglobin, serum ferritin, and soluble transferrin receptor levels in children aged 6-59 months.

Methods We performed a cross-sectional study in the Yogyakarta and Bantul Districts involving 85 children aged 6-59 months who visited integrated health posts (posyandu) and who met the inclusion criteria. Subjects were chosen by cluster random sampling. Blood specimens were collected to examine hemoglobin, serum ferritin, and sTfR levels.

Results Spearmanâ€™s correlation test revealed weak negative correlations between hemoglobin and serum ferritin levels, as well as between hemoglobin and sTfR levels, with coefficient correlations of r = -0.220, (P=0.043) and r = -0.317, (P=0.003), respectively. There was no correlation between serum ferritin and sTfR levels (r = -0.033; P=0.767).

Conclusion Hemoglobin levels has weak negative correlations with serum ferritin and sTfR, but serum ferritin does not correlate with sTfR.Â [Paediatr Indones. 2014;54:122-6.]

References

World Health Organization. Assessing the iron status populations. Geneva: WHO; 2007.

Surkesnas. Survei Kesehatan Rumah Tangga (SKRT) 2004 volume 2: status kesehatan masyarakat Indonesia. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan RI; 2005.

Ringoringo HP. Insidensi defisiensi besi dan anemia defisiensi besi pada bayi berusia 0â€“12 bulan di Banjarbaru Kalimantan Selatan: studi kohort prospektif. Sari Pediatri. 2009;11:8-14.

Riskesda. Laporan Hasil Riset Kesehatan Dasar (RISKESDAS) Indonesia tahun 2007. Jakarta: Badan Penelitian dan Pengembangan Departemen Kesehatan RI; 2008.

Sekartini R, Soedjatmiko, Wawolumaya C, Yuniar I, Dewi R. Prevalensi anemia defisiensi besi pada bayi usia 4-12 bulan di Kecamatan Matraman dan sekitarnya Jakarta Timur. Sari Pediatri. 2005;7:2-8.

Lozoff B. Iron deficiency and child development. Food Nutr Bull. 2007;28:560-71.

Kohli-Kumar M. Screening for anemia in children: AAP recommendations--a critique. Pediatrics. 2001;108:E56.

Brugnara C. A hematologic "gold standard" for iron-deficient states? Clin Chem. 2002;48:981-2.

Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: past, present and future. Biochim Biophys Acta. 2010;1800:760-9.

Vendt N, Talvik T, Kool P, Leedo S, Tomberg K, Tillmann V, et al. Reference and cut-off values for serum ferritin, mean cell volume, and hemoglobin to diagnose iron deficiency in infants aged 9 to 12 months. Medicina (Kaunas). 2007;43:698-702.

Skikne BS, Flowers CH, Cook JD. Serum transferrin receptor: a quantitative measure of tissue iron deficiency. Blood. 1990;75:1870-6.

Wiwanitkit V. Molecular structure of human transferrin-transferrin receptor complex. Int J Mol Sci. 2006;7:197-203.

Van den Bosch G, Van den Bossche J, Wagner C, De Schouwer P, Van De Vyvere M, Neels H. Determination of iron metabolism-related reference values in a healthy adult population. Clin Chem. 2001;47:1465-7.

Phiri KS, Calis JC, Siyasiya A, Bates I, Brabin B, van Hensbroek MB. New cut-off values for ferritin and soluble transferrin receptor for the assessment of iron deficiency in children in a high infection pressure area. J Clin Pathol. 2009;62:1103-6.

Schiza V, Giapros V, Pantou K, Theocharis P, Challa A, Andronikou S. Serum transferrin receptor, ferritin, and reticulocyte maturity indices during the first year of life in 'large' preterm infants. Eur J Haematol. 2007;79:439-46.

Raspati H, Reniarti L, Susanah S. Anemia Defisiensi Besi. In: Permono HB, Sutaryo, Ugrasena IDG, Windiastuti E, Abdulsalam M, editors. Buku ajar hematologi onkologi anak. 2nd ed. Jakarta: Badan Penerbit IDAI; 2006. p. 30-43.