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Utility of Access Soluble Transferrin Receptor (sTfR) and sTfR/log Ferritin Index in Diagnosing Iron Deficiency Anemia.
Ann Clin Lab Sci. 2015 Summer; 45(4):396-402.AC

Abstract

The Access(®) soluble transferrin receptor (sTfR) is considered the world's first automated chemiluminescence immunoassay. In this study, the diagnostic utility of this and other tests for serum iron were evaluated by studying their interrelationships with inflammation. A total of 367 patients with anemia (iron deficiency anemia [IDA], 157; anemia of chronic disease [ACD], 210) and 80 normal controls were subjected to a battery of diagnostic tests, including complete blood cell count, serum iron, total iron-binding capacity (TIBC), C-reactive protein (CRP), ferritin, sTfR, and hepcidin. The accuracy of test parameters was determined by the area under the receiver operating characteristic curve (AUC). Patients falling within the ferritin grey zone (10-100 ng/ml) were evaluated separately, given that such individuals are typically difficult to detect and manage in actual clinical practice. CRP was used to assess the correlation between the aforementioned markers of iron and inflammation. The single most accurate diagnostic test used to differentiate IDA from ACD was serum ferritin (AUC 0.989). However, sTfR assay outperformed other tests in the ferritin grey zone (AUC 0.931), and the sTfR/log ferritin index was the most reliable parameter in both scenarios (AUC 0.994 and 0.962, respectively). Ferritin, TIBC, and hepcidin showed the highest correlation with CRP, whereas sTfR displayed the lowest. The Access sTfR and sTfR/log ferritin index enabled highly accurate diagnosis of IDA in the ferritin grey zone. This is an easy-to-use automated chemiluminescence immunoassay, amenable to routine use in hospitals.

Authors+Show Affiliations

Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, South Korea.Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, South Korea.Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, South Korea.Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea.Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, South Korea sjjajang@hallym.or.kr.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26275690

Citation

Shin, Dong Hoon, et al. "Utility of Access Soluble Transferrin Receptor (sTfR) and sTfR/log Ferritin Index in Diagnosing Iron Deficiency Anemia." Annals of Clinical and Laboratory Science, vol. 45, no. 4, 2015, pp. 396-402.
Shin DH, Kim HS, Park MJ, et al. Utility of Access Soluble Transferrin Receptor (sTfR) and sTfR/log Ferritin Index in Diagnosing Iron Deficiency Anemia. Ann Clin Lab Sci. 2015;45(4):396-402.
Shin, D. H., Kim, H. S., Park, M. J., Suh, I. B., & Shin, K. S. (2015). Utility of Access Soluble Transferrin Receptor (sTfR) and sTfR/log Ferritin Index in Diagnosing Iron Deficiency Anemia. Annals of Clinical and Laboratory Science, 45(4), 396-402.
Shin DH, et al. Utility of Access Soluble Transferrin Receptor (sTfR) and sTfR/log Ferritin Index in Diagnosing Iron Deficiency Anemia. Ann Clin Lab Sci. 2015;45(4):396-402. PubMed PMID: 26275690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of Access Soluble Transferrin Receptor (sTfR) and sTfR/log Ferritin Index in Diagnosing Iron Deficiency Anemia. AU - Shin,Dong Hoon, AU - Kim,Hyun Soo, AU - Park,Min Jeong, AU - Suh,In Bum, AU - Shin,Kyu Sung, PY - 2015/8/16/entrez PY - 2015/8/16/pubmed PY - 2016/5/12/medline KW - anemia KW - ferritin KW - hepcidin KW - iron deficiency KW - soluble transferrin receptor SP - 396 EP - 402 JF - Annals of clinical and laboratory science JO - Ann Clin Lab Sci VL - 45 IS - 4 N2 - The Access(®) soluble transferrin receptor (sTfR) is considered the world's first automated chemiluminescence immunoassay. In this study, the diagnostic utility of this and other tests for serum iron were evaluated by studying their interrelationships with inflammation. A total of 367 patients with anemia (iron deficiency anemia [IDA], 157; anemia of chronic disease [ACD], 210) and 80 normal controls were subjected to a battery of diagnostic tests, including complete blood cell count, serum iron, total iron-binding capacity (TIBC), C-reactive protein (CRP), ferritin, sTfR, and hepcidin. The accuracy of test parameters was determined by the area under the receiver operating characteristic curve (AUC). Patients falling within the ferritin grey zone (10-100 ng/ml) were evaluated separately, given that such individuals are typically difficult to detect and manage in actual clinical practice. CRP was used to assess the correlation between the aforementioned markers of iron and inflammation. The single most accurate diagnostic test used to differentiate IDA from ACD was serum ferritin (AUC 0.989). However, sTfR assay outperformed other tests in the ferritin grey zone (AUC 0.931), and the sTfR/log ferritin index was the most reliable parameter in both scenarios (AUC 0.994 and 0.962, respectively). Ferritin, TIBC, and hepcidin showed the highest correlation with CRP, whereas sTfR displayed the lowest. The Access sTfR and sTfR/log ferritin index enabled highly accurate diagnosis of IDA in the ferritin grey zone. This is an easy-to-use automated chemiluminescence immunoassay, amenable to routine use in hospitals. SN - 1550-8080 UR - https://www.unboundmedicine.com/medline/citation/26275690/Utility_of_Access_Soluble_Transferrin_Receptor__sTfR__and_sTfR/log_Ferritin_Index_in_Diagnosing_Iron_Deficiency_Anemia_ L2 - http://www.annclinlabsci.org/cgi/pmidlookup?view=long&pmid=26275690 DB - PRIME DP - Unbound Medicine ER -