Cited by 859Iron Metabolism and DisordersHematological disorders and diagnosticsErythropoietin and Anemia Treatment

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Serum Transferrin Receptor and Its Ratio to Serum Ferritin in the Diagnosis of Iron Deficiency

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Punnonen, Kari, Irjala, Kerttu, Rajamäki, Allan·1997·Blood

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Abstract

The objective of the study was to evaluate the diagnostic efficiency of laboratory tests, including serum transferrin receptor (TfR) measurements, in the diagnosis of iron depletion. The patient population consisted of 129 consecutive anemic patients at the University Hospital of Turku who were given a bone marrow examination. Of these patients, 48 had iron deficiency anemia (IDA), 64 anemia of chronic disease (ACD), and 17 patients had depleted iron stores and an infectious or an inflammatory condition (COMBI). Depletion of iron stores was defined as a complete absence of stainable iron in the bone marrow examination. Serum TfR concentrations were elevated in the vast majority of the IDA and COMBI patients, while in the ACD patients, the levels were within the reference limits reported earlier for healthy subjects. TfR measurement thus provided a reliable diagnosis of iron deficiency anemia (AUCROC 0.98). Serum ferritin measurement also distinguished between IDA patients and ACD patients. However, the optimal decision limit for evaluation of ferritin measurements was considerably above the conventional lower reference limits, complicating the interpretation of this parameter. Calculation of the ratio TfR/log ferritin (TfR-F Index) is a way of combining TfR and ferritin results. This ratio provided an outstanding parameter for the identification of patients with depleted iron stores (AUCROC 1.00). In anemic patients, TfR measurement is a valuable noninvasive tool for the diagnosis of iron depletion, and offers an attractive alternative to more conventional laboratory tests in the detection of depleted iron stores.

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The meaning and use of the area under a receiver operating characteristic (ROC) curve.
Hanley, J. A., & McNeil, B. J. (1982) · Radiology · doi:10.1148/radiology.143.1.7063747 · Cited by 21,856
Serum transferrin receptor: a quantitative measure of tissue iron deficiency
SKIKNE, B. S., Flowers, C., & Cook, J. (1990) · Blood · doi:10.1182/blood.v75.9.1870.1870 · Cited by 723
The use of relative operating characteristic (ROC) curves in test performance evaluation.
Beck, & Shultz, E. K. (1986) · PubMed · Cited by 621
The physiology of transferrin and transferrin receptors.
Huebers, H. A., & Finch, C. A. (1987) · Physiological Reviews · doi:10.1152/physrev.1987.67.2.520 · Cited by 586
Laboratory diagnosis of iron-deficiency anemia: An overview
Guyatt, G. H., Oxman, A. D., Ali, M., Willan, A., McIlroy, W., & Patterson, C. (1992) · Journal of General Internal Medicine · doi:10.1007/bf02598003 · Cited by 564
Evaluation of the Gastrointestinal Tract in Patients with Iron-Deficiency Anemia
Rockey, D. C., & Cello, J. P. (1993) · New England Journal of Medicine · doi:10.1056/nejm199312023292303 · Cited by 500
Serum Transferrin Receptor
Cook, J. D., SKIKNE, B. S., & Baynes, R. D. (1993) · Annual Review of Medicine · doi:10.1146/annurev.me.44.020193.000431 · Cited by 381
Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia.
Ferguson, B. J., SKIKNE, B. S., Simpson, K. M., Baynes, R. D., & Cook, J. D. (1992) · PubMed · Cited by 374
Intact transferrin receptors in human plasma and their relation to erythropoiesis
Huebers, H., Beguin, Y., Pootrakul, P., Einspahr, D., & Finch, C. (1990) · Blood · doi:10.1182/blood.v75.1.102.102 · Cited by 364
Serum transferrin receptor as a new index of erythropoiesis
KOHGO, Y., Niitsu, Y., Kondo, H., Kato, J., Tsushima, N., Sasaki, K., Hirayama, M., Numata, T., Nishisato, T., & Urushizaki, I. (1987) · Blood · doi:10.1182/blood.v70.6.1955.1955 · Cited by 267

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Torino, A. B. B., Gilberti, M. D. F. P., da Costa, E., de Lima, G. A. F. M., & Grotto, H. Z. W. (2014) · Revista Brasileira de Hematologia e Hemoterapia · doi:10.1016/j.bjhh.2014.09.004 · Cited by 35
Serum transferrin receptor assay in iron deficiency anaemia and anaemia of chronic disease in the elderly
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John, S., Baltodano, J. D., Mehta, N., Mark, K., & Murthy, U. K. (2018) · Gastroenterology report · doi:10.1093/gastro/goy001 · Cited by 34
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Prevalence and causes of iron deficiency anemias in infants aged 9 to 12 months in Estonia
Vendt, N., Grünberg, H., Leedo, S., Tillmann, V., & Talvik, T. (2007) · Medicina · doi:10.3390/medicina43120123 · Cited by 35
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A ferritin level >50 μg/L is frequently consistent with iron deficiency
Koulaouzidis, A., Cottier, R., Bhat, S. K., Said, E., Linaker, B. D., & Saeed, A. A. (2008) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2007.09.024 · Cited by 34
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Background
Laboratory diagnosis of iron deficiency
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Comparative accuracy of ferritin, transferrin saturation and soluble transferrin receptor for the diagnosis of iron deficiency in inflammatory bowel disease
Daude, S., Rémen, T., Chateau, T., Danese, S., Aimone‐Gastin, I., Baumann, C., Guéant, J., & Peyrin‐Biroulet, L. (2020) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.15739 · Cited by 33
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“Several clinical markers have been used to differentiate between AI and AI/IDA, including the soluble transferrin receptor (sTfR) reflecting the needs of iron for erythropoiesis [14-16].”
BackgroundInfluential
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Elemraid, M. A., Mackenzie, I. J., Fraser, W. D., Harper, G., Faragher, B. E., Atef, Z., Al-Aghbari, N., & Brabin, B. J. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.58 · Cited by 33
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Background
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Method
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The association between subjective assessment of menstrual bleeding and measures of iron deficiency anemia in premenopausal African-American women: a cross-sectional study
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“6 g/dL and iron deficient if serum ferritin was less than 41 ng/mL [18, 19].”
Background
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“Similar studies have reported sensitivities of 92% (27) and even 94% (12), the classification of the patients in these studies having been made on the basis of medullary Perls test data.”
Result
Guidelines for the management of iron deficiency anaemia
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Lapointe, M. (2004) · Critical Care · doi:10.1186/cc2825 · Cited by 32
“Values derived from Rodriguez and coworkers [3], Hudson and Comstock [22], Miller and coworkers [49], and Punnonen and coworkers [50].”
Method
Total Hemoglobin Mass, Iron Status, and Endurance Capacity in Elite Field Hockey Players
Hinrichs, T., Franke, J., Voss, S. C., Bloch, W., Schänzer, W., & Platen, P. (2010) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0b013e3181a5bc59 · Cited by 31
“(30) even calculated a cut-off limit for ferritin of 41 ng/mL to provide the optimal diagnostic efficiency in patients with anemia who do not have an accompanying infection or inflammatory disease.”
Background
The usefulness of soluble transferrin receptor in the diagnosis and treatment of iron deficiency anemia in children
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Celkan, T. T., Çelik, M., Kasapçopur, Ö., Özkan, A., Apak, H., Ocak, S., Arısoy, N., & Yıldız, İ. (2005) · Pediatric Hematology and Oncology · doi:10.1080/08880010500278681 · Cited by 31
“[20] found TS 12% in IDA and 23% in CDA, while we have found 11% in IDA and 16.”
Background
Anemia in Pediatric Inflammatory Bowel Disease
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Jonker, F. A. M., van Hensbroek, M. B., Leenstra, T., Vet, R. J. W. M., Brabin, B. J., Maseko, N., Gushu, M. B., Emana, M., Kraaijenhagen, R. J., Tjalsma, H., et al. (2014) · Journal of Clinical Pathology · doi:10.1136/jclinpath-2014-202291 · Cited by 33
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“Additionally, soluble transferrin receptor (sTfR) is a good indicator of absolute iron deficiency and/or iron restricted erythropoiesis in patients with inflammation [28–30].”
Background
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Arora, N. P., & Ghali, J. K. (2014) · Heart Failure Clinics · doi:10.1016/j.hfc.2013.11.002 · Cited by 30
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Ritchie, B. K., McNeil, Y., & Brewster, D. (2004) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.2003.01158.x · Cited by 30
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“To overcome this limitation, some studies have incorporated the measurement of sTfR as an indicator of iron deficiency together with serum ferritin measurement.(20,31) A log[sTfR/ ferritin] ratio of more than 2.”
BackgroundMethod
Soluble transferrin receptor as a diagnostic laboratory test for detection of iron deficiency anemia in acute illness of hospitalized patients.
Berlin, T., Meyer, A., Rotman‐Pikielny, P., Natur, A., & Levy, Y. M. (2011) · PubMed · Cited by 29
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(2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511545238 · Cited by 29
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“Particularly in latent iron deficiency when the iron deposits of the body are lower, but Hb level is still not under the reference limit, sTfR/log ferritine is the first and foremost parameter to show iron deficiency [12, 13].”
Background
Iron Status in Highly Active and Sedentary Young Women
Woolf, K., Thomas, M. M. S., Hahn, N. L., Vaughan, L. A., Carlson, A. G., & Hinton, P. S. (2009) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.19.5.519 · Cited by 28
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“TSAT is low in IDA, typically less than 10%, and in this case, the sensitivity is 48%, and the specificity is 88% (43, 44).”
Background
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“This allowed the model to optimize the model fit using power and log functions to approximate the shape of the relationship of the parameter with hepcidin (Royston and Altman, 1994).”
Method
Sensitivity, specificity, and predictive value of serum soluble transferrin receptor at different stages of iron deficiency.
Choi, J. W. (2005) · PubMed · Cited by 28
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Pérez, M. O., López, M. Á. V., Ibáñez-Alcalde, M., Martínez, R. G., González, M. M., Lendínez, F., & Perales, A. B. (2020) · Childhood Obesity · doi:10.1089/chi.2019.0276 · Cited by 26
“13,15,16,42 Yanoff et al., 18 in a study of adults, and other studies focusing on children and adolescents, 21,22,25,53 have observed increased sTfR values in obese persons, associating this response to the ID provoked by obesity.”
Effects of alcohol consumption on iron metabolism
Lieb, M., Palm, U., Hock, B., Schwarz, M., Domke, I., & Soyka, M. (2010) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2010.535584 · Cited by 27
“performance in estimating body iron stores (15,18,19).”
The usefulness of reticulocyte haemoglobin content, serum transferrin receptor and the sTfR-ferritin index to identify iron deficiency in healthy children aged 1–16 years
Vázquez-López, M. Á., López‐Ruzafa, E., Ibáñez-Alcalde, M., Martín-González, M., Bonillo-Perales, A., & Lendínez, F. (2018) · European Journal of Pediatrics · doi:10.1007/s00431-018-3257-0 · Cited by 27
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“…information about functional iron and its stores It shows high sensitivity and specificity As ferritin, it is an APP and affected by inflammation Yes (Punnonen, Irjala, and Rajam€aki 1997; Drakesmith 2016; Enko et al. 2015; V azquezL opez et al. 2016; Infusino et al. 2012) Zinc Protoporphyrin…”
BackgroundInfluential
The Impact of Iron Dyshomeostasis and Anaemia on Long-Term Pulmonary Recovery and Persisting Symptom Burden after COVID-19: A Prospective Observational Cohort Study
Sonnweber, T., Grubwieser, P., Sahanic, S., Boehm, A., Pizzini, A., Luger, A. K., Schwabl, C., Koppelstätter, S., Kurz, K., Puchner, B., et al. (2022) · Metabolites · doi:10.3390/metabo12060546 · Cited by 29
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Huang, J. J., Sun, J., Li, W., Wang, L., Huo, J., Chen, J., Chun-Ming, C. H. E. N., & An-Xu, W. A. N. G. (2009) · Biomedical and Environmental Sciences · doi:10.1016/s0895-3988(09)60033-7 · Cited by 26
Low hemoglobin density potential marker of iron availability
Urrechaga, E., UNCETA, M., Borque, L., & Escanero, J. F. (2011) · International Journal of Laboratory Hematology · doi:10.1111/j.1751-553x.2011.01355.x · Cited by 26
Iron deficiency and hair loss: The jury is still out
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Hepcidin detects iron deficiency in S ri L ankan adolescents with a high burden of hemoglobinopathy: A diagnostic test accuracy study
Wray, K., Allen, A., Evans, E., Fisher, C. A., Premawardhena, A., Perera, L., Rodrigo, R., Goonathilaka, G., Ramees, L., Webster, C., et al. (2016) · American Journal of Hematology · doi:10.1002/ajh.24617 · Cited by 26
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“These two parameters, that is, serum ferritin and sTfR, may be combined by calculating the ferritin index, that is, the ratio of serum sTfR to the logarithm of serum ferritin level [41].”
Background
The cutoff value of serum ferritin for the diagnosis of iron deficiency in community-residing older persons
Choi, C. W., Cho, W. R., Park, K. H., Choi, I. K., Seo, J. H., Kim, B., Shin, S. W., Kim, Y. H., Kim, J. S., & Lee, J. (2005) · Annals of Hematology · doi:10.1007/s00277-005-1033-5 · Cited by 25
“5 was diagnosed as iron deficiency [5, 19, 20, 22].”
Background
The prevalence and etiology of anemia among HIV-infected children in India
Shet, A., Arumugam, K., Rajagopalan, N., Dinakar, C., Krishnamurthy, S., Mehta, S., & Shet, A. S. (2011) · European Journal of Pediatrics · doi:10.1007/s00431-011-1599-y · Cited by 27
“(sTfR) is a biomarker that is increased in iron deficiency [33], and is normal or low during anemia of inflammation [50].”
Background
Dried Plasma Spot Measurements of Ferritin and Transferrin Receptor for Assessing Iron Status
Flowers, C. H., & Cook, J. D. (1999) · Clinical Chemistry · doi:10.1093/clinchem/45.10.1826 · Cited by 25
“In a recent clinical study, 129 patients with anemia underwent a diagnostic bone marrow examination to determine the cause ( 18 ). There were 48 patients with IDA, 64 with ACD, and 17 with both.”
Background
Measurement of soluble transferrin receptor by immunoturbidimetry and immunonephelometry
COTTON, F. J., Thiry, P., & Boeynaems, J. (2000) · Clinical Biochemistry · doi:10.1016/s0009-9120(00)00071-0 · Cited by 25
Response of Soluble Transferrin Receptor and Iron-Related Parameters to Iron Supplementation in Elite, Iron-Depleted, Nonanemic Female Athletes
Pitsis, G., Fallon, K. E., Fallon, S. K., & Fazakerley, R. (2004) · Clinical Journal of Sport Medicine · doi:10.1097/00042752-200409000-00009 · Cited by 25
“has previously been found to be useful in the identification of healthy subjects with subclinical iron deficits.(10,11) Souminen et al(11) suggest that an index of >1.”
Background
Identification, diagnosis, and management of anemia in adult ambulatory patients treated by primary care physicians: evidence-based and consensus recommendations
Dubois, R. W., Goodnough, L. T., Ershler, W. B., Winkle, L. V., & Nissenson, A. R. (2006) · Current Medical Research and Opinion · doi:10.1185/030079906x89720 · Cited by 25
The diagnostic accuracy of the percentage of hypochromic red blood cells (%HYPOm) and cellular hemoglobin in reticulocytes (CHr) in differentiating iron deficiency anemia and anemia of chronic diseases
Rehu, M., Ahonen, S., & Punnonen, K. R. A. (2011) · Clinica Chimica Acta · doi:10.1016/j.cca.2011.06.004 · Cited by 24
Self-citation
Interpreting tests for iron deficiency among adults in a high HIV prevalence African setting: routine tests may lead to misdiagnosis
Lewis, D. K., Whitty, C. W. M., Epino, H. M., Letsky, E. A., Mukiibi, J. M., & van den Broek, N. R. (2007) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/j.trstmh.2006.11.004 · Cited by 24
Influence of maternal diabetes mellitus on fetal iron status
Verner, A., Manderson, J. G., Lappin, T. R. J., McCance, D. R., Halliday, H. L., & Sweet, D. G. (2006) · Archives of Disease in Childhood Fetal & Neonatal · doi:10.1136/adc.2006.097279 · Cited by 24
Concurrent Anemia and Elevated C-Reactive Protein Predicts HIV Clinical Treatment Failure, Including Tuberculosis, After Antiretroviral Therapy Initiation
Shivakoti, R., Yang, W.-T., Gupte, N., Berendes, S., Rosa, A. L., Cardoso, S. W., Mwelase, N., Kanyama, C., Pillay, S., Samaneka, W. P., et al. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ265 · Cited by 26
“Although there are no established criteria to define ACD, previous studies have suggested using TfR-F index values 1 [18, 29].”
MethodInfluential
Using Soluble Transferrin Receptor and Taking Inflammation into Account When Defining Serum Ferritin Cutoffs Improved the Diagnosis of Iron Deficiency in a Group of Canadian Preschool Inuit Children from Nunavik
O’Brien, H. T., Blanchet, R., Gagné, D., Lauzière, J., & Vézina, C. (2016) · Anemia · doi:10.1155/2016/6430214 · Cited by 26
“When using traditional indicators of iron status, we raised the cutoff value for SF from 15 to 50 μg/L with an elevated CRP level, whereas sTfR has been shown to be unaffected by concomitant infectious or inflammatory conditions [18, 45].”
Method
Managing anemia in lymphoma and multiple myeloma
Birgegård, G. (2008) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s1351 · Cited by 23
“A combination of serum ferritin and sTfR, the so called sTfR-F index, is a very reliable indicator of depleted iron stores (Punnonen et al 1997).”
Pediatric reference intervals for soluble transferrin receptor and transferrin receptor-ferritin index
Ooi, C. L., Lepage, N., Nieuwenhuys, E. J., Sharma, A. P., & Filler, G. (2009) · World Journal of Pediatrics · doi:10.1007/s12519-009-0024-3 · Cited by 23
Is soluble transferrin receptor a good marker of iron deficiency anemia in chronic kidney disease patients?
Gupta, S., Uppal, B., & Pawar, B. (2009) · Indian Journal of Nephrology · doi:10.4103/0971-4065.57105 · Cited by 23
CLINICOLABORATORY FINDINGS AND TREATMENT OF IRON-DEFICIENCY ANEMIA IN CHILDHOOD
Panagiotou, J. P., & Douros, K. (2004) · Pediatric Hematology and Oncology · doi:10.1080/08880010490477310 · Cited by 23
“These two indices can be combined in the sTfR/log ferritin ratio (TfR-F index), which is very useful for the estimation of the entire range of body iron stores [51].”
Background
Iron deficiency anaemia in hospitalised patients: value of various laboratory parameters Differentiation between IDA and ACD
van Tellingen, A. T. (2001) · The Netherlands Journal of Medicine · doi:10.1016/s0300-2977(01)00169-3 · Cited by 23
The role of iron supplementation during epoietin treatment for cancer-related anemia
Hedenus, M., & Birgegård, G. (2008) · Medical Oncology · doi:10.1007/s12032-008-9072-0 · Cited by 23
“A combination of s-ferritin and sTfR, the socalled sTfR-F index, seems to be a reliable indicator of depleted iron stores [ 12 ].”
Background
Iron deficiency anaemia in Jamaican children, aged 1-5 years, with sickle cell disease
King, L., Reid, M. E., & Forrester, T. E. (2005) · West Indian Medical Journal · doi:10.1590/s0043-31442005000500004 · Cited by 21
“Alternatively, serum ferritin concentrations and/or ratios based on transferrin receptor concentration to ferritin concentration, have been proposed as the best noninvasive measure of iron status in individuals (14, 22, 23).”
Background
Eisenmangelanämie und Anämie der chronischen Erkrankungen
Metzgeroth, G., & Hastka, J. (2015) · Der Internist · doi:10.1007/s00108-015-3711-2 · Cited by 22
Prevalence and Risk Factors for Iron Deficiency in Adults With Cystic Fibrosis
Gettle, L. S., Harden, A., Bridges, M., & Albon, D. P. (2020) · Nutrition in Clinical Practice · doi:10.1002/ncp.10454 · Cited by 22
Bacterial Lipopolysaccharides Suppress Erythroblastic Islands and Erythropoiesis in the Bone Marrow in an Extrinsic and G- CSF-, IL-1-, and TNF-Independent Manner
Bisht, K., Tay, J., Wellburn, R. N., McGirr, C., Fleming, W., Nowlan, B., Barbier, V., Winkler, I. G., & Lévesque, J.-P. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.583550 · Cited by 24
“Iron-deficient anemia is characterized by microcytic hypochromatic erythrocytes, low plasma ferritin: soluble transferrin receptor (sTrfR) ratio whereas true AI is normocytic, normochromatic (11) with high plasma ferritin: sTrf ratio (12, 13).”
Background
Impact of inflammation on the biomarkers of iron status in a cross-sectional survey of Lao women and children
Knowles, J., Thurnham, D. I., Phengdy, B., Houamboun, K., Philavong, K., Keomoungkhone, I., & Keovilay, K. (2013) · British Journal Of Nutrition · doi:10.1017/s000711451300158x · Cited by 22
“ment of Fe status in groups with a high prevalence of infection((19,20)).”
Background
Screening for iron deficiency in surgical patients based on noninvasive zinc protoporphyrin measurements
Füllenbach, C., Stein, P., Glaser, P., Triphaus, C., Lindau, S., Choorapoikayil, S., Schmitt, E., Zacharowski, K. D., Hintereder, G., Hennig, G., et al. (2019) · Transfusion · doi:10.1111/trf.15577 · Cited by 22
“A potential candidate to track erythropoietic iron demand independent from inflammation is sTfR.(23,34,35) This is supported by a good analytical performance even in the presence of inflammation observed here (AUC = 0.”
BackgroundResult
The relationship between red blood cell and reticulocyte indices and serum markers of iron status in the cord blood of newborns
Ervasti, M., Kotisaari, S., Sankilampi, U., Heinonen, S. T., & Punnonen, K. R. A. (2007) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2007.187 · Cited by 22
Self-citation
Review article: the diagnosis and treatment of haematinic deficiency in gastrointestinal disease
Pawson, & Mehta (1998) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.1998.00368.x · Cited by 22
Baseline Iron Indices as Predictors of Hemoglobin Improvement in Anemic Vietnamese Women Receiving Weekly Iron-Folic Acid Supplementation and Deworming
Pasricha, S., Casey, G. J., Phuc, T. Q., Mihrshahi, S., MacGregor, L., Montresor, A., Tien, N. T., & Biggs, B. (2009) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2009.09-0162 · Cited by 22
Research outcomes in British gastroenterology: an audit of the subsequent full publication of abstracts presented at the British Society of Gastroenterology
Sanders, D. S., CARTER, M. J., HURLSTONE, D. P., LOBO, A. J., & HOGGARD, N. (2001) · Gut · doi:10.1136/gut.49.1.154a · Cited by 22
Utility of plasma transferrin receptor, ferritin and inflammatory markers in children with sickle cell disease
Al-Saqladi, A.-W. M., Bin-Gadeem, H. A., & Brabin, B. J. (2012) · Paediatrics and International Child Health · doi:10.1179/2046905511y.0000000009 · Cited by 21
Assessment of human iron status: A cross-sectional study comparing the clinical utility of different laboratory biomarkers and definitions of iron deficiency in daily practice
Enko, D., Wagner, H., Kriegshäuser, G., Kimbacher, C., Stolba, R., & Halwachs‐Baumann, G. (2015) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2015.05.008 · Cited by 21
Early signs of maternal iron deficiency do not influence the iron status of the newborn, but are associated with higher infant birthweight
ERVASTI, M., Sankilampi, U., Heinonen, S. T., & Punnonen, K. R. A. (2009) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340802595993 · Cited by 21
“The main outcome measures of this study were serum iron status measurements (serum iron, transferrin, TfR and ferritin) and complete blood count.”
BackgroundInfluentialSelf-citation
The value of the Thomas‐plot in the diagnostic work up of anemic patients referred by general practitioners
Leers, M. P. G., Keuren, J. F. W., & Oosterhuis, W. P. (2010) · International Journal of Laboratory Hematology · doi:10.1111/j.1751-553x.2010.01221.x · Cited by 21
“The ROC analyses produced on the basis of the present patient population (Table 3) are in good agreement with those generated earlier on the basis of metaanalysis for ferritin and iron saturation of transferrin (Guyatt et al., 1992; Punnonen et al., 1997).”
Result
Serum iron and iron stores in non-anemic patients with fibromyalgia
Mader, R., Koton, Y., Buskila, D., Herer, P., & Elias, M. S. (2011) · Clinical Rheumatology · doi:10.1007/s10067-011-1888-x · Cited by 23
“Although none of the patients had an additional chronic disease, a cutoff level of serum ferritin levels ≤30 ng/mL and sTfR/ferritin ratio was also calculated, in order to further define iron depletion [11, 12].”
Background
Iron deficiency anaemia
(2001) · Practice Nursing · doi:10.12968/pnur.2001.12.1.4459 · Cited by 21
Hematologic Aspects of Kidney Disease
Brugnara, C., & Eckardt, K. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4160-6193-9.10056-9 · Cited by 21
Serum soluble transferrin receptor in hypochromic microcytic anaemia.
Jayaranee, S., & Sthaneshwar, P. (2006) · PubMed · Cited by 21
Transferrin receptor‐ferritin index: a useful parameter in differential diagnosis of iron deficiency and hyperplastic erythropoiesis
Čermák, J., & Brabec, V. (1998) · European Journal Of Haematology · doi:10.1111/j.1600-0609.1998.tb01086.x · Cited by 21
Development of Iron Status Measures during Youth: Associations with Sex, Neighborhood Socioeconomic Status, Cognitive Performance, and Brain Structure
Larsen, B., Baller, E. B., Boucher, A. A., Calkins, M. E., Laney, N. C., Moore, T. M., Roalf, D. R., Ruparel, K., Gur, R. C., Gur, R. E., et al. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.05.005 · Cited by 20
Delayed awakening and its associated factor following general anesthesia service, 2022: a cross-sectional study
Bayable, S. D., Amberbir, W. D., & Fetene, M. B. (2023) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000001103 · Cited by 20
“Preoperative anemia – preoperative levels of Hgb <12 g/dl in both sexes([13]).”
Background

Authors: Punnonen, K., Irjala, K., & Rajamäki, A.
Affiliations: Turku University Hospital (FI)
From the Central Laboratory, Departments of Clinical Chemistry and Hematology, University Hospital of Turku, Turku, Finland.
Venue: Blood
Publisher: American Society of Hematology
Published: 1997-02-01
Volume: 89
Issue: 3
Pages: 1052-1057
ISSN: 0006-4971 (ISSN-L)
1528-0020
DOI: 10.1182/blood.v89.3.1052
OpenAlex: W1924847619
Cited by: 859
References: 28
Citations by year: 2026: 11 · 2025: 10 · 2024: 19 · 2023: 20 · 2022: 10 · 2021: 26 · 2020: 29 · 2019: 25 · 2018: 37 · 2017: 22 · 2016: 28 · 2015: 44 · 2014: 35 · 2013: 30 · 2012: 45
FWCI: 13.83
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Blood (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
Health Sciences › Medicine › Hematology › Hematological disorders and diagnostics
Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
Keywords: serum transferrin receptor, serum ferritin, iron deficiency anemia, anemia of chronic disease, iron depletion, diagnostic accuracy, inflammatory diseases
MeSH terms: Adult, Anemia, Blood Cell Count, Bone Marrow, Chronic Disease, Female, Ferritins, Humans, Iron, Male, Receptors, Transferrin, Staining and Labeling, Anemia, Iron-Deficiency

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Serum Transferrin Receptor and Its Ratio to Serum Ferritin in the Diagnosis of Iron Deficiency

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