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The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated with High Serum Ferritin and Soluble Transferrin Receptor Concentrations among Women in Rural Cambodia.
J Nutr. 2015 Dec; 145(12):2765-73.JN

Abstract

BACKGROUND

Ferritin and soluble transferrin receptor (sTfR) concentrations are commonly used to assess iron deficiency (ID); however, they are influenced by multiple factors.

OBJECTIVES

We assessed associations between numerous variables and both ferritin and sTfR concentrations in Cambodian women and compared ID prevalence through the use of study-generated correction factors (CFs) for ferritin with those from a published meta-analysis.

METHODS

Venous blood from 450 women (aged 18-45 y) was assessed for hemoglobin (Hb), ferritin, sTfR, retinol binding protein, folate, vitamin B-12, C-reactive protein, α-1 acid glycoprotein (AGP), and genetic Hb disorders. Linear regression was used to calculate geometric mean ratios (95% CIs) for ferritin and sTfR concentrations.

RESULTS

The variant Hb EE genotype was associated with 50% (14%, 96%) and 51% (37%, 66%) higher geometric mean ferritin and sTfR concentrations, respectively, than was the normal Hb AA genotype; a 1-g/L increase in AGP was associated with 99% (50%, 162%) and 48% (33%, 64%) higher concentrations in the same variables, respectively. ID prevalence in nonpregnant women (n = 420) was 2% (n = 9) with the use of ferritin <15 μg/L and 18% (n = 79) with the use of sTfR >8.3 mg/L as criteria. ID prevalence with the use of sTfR was higher in women with the Hb EE genotype (n = 17; 55%) than in those with the Hb AA genotype (n = 20; 10%); and in women with the Hb AA genotype and chronic inflammation (n = 10; 18%) than in that group of women without chronic inflammation (n = 10; 7%) (P < 0.05). No differences in ID prevalence were found with the use of ferritin between women with Hb EE and AA genotypes (P = 1.0) or by chronic inflammation status (P = 0.32). There were no differences in mean ferritin concentrations among all 450 women when study-generated CFs were compared with those from the meta-analysis (P = 0.87).

CONCLUSIONS

Compared with sTfR, ferritin concentrations appear to reflect more accurately true ID in rural Cambodian women. The CFs from a published meta-analysis were appropriate for use in this population with a high prevalence of Hb disorders and inflammation.

Authors+Show Affiliations

Food, Nutrition and Health and The Child and Family Research Institute, Vancouver, Canada;Food, Nutrition and Health and The Child and Family Research Institute, Vancouver, Canada;Food, Nutrition and Health and The Child and Family Research Institute, Vancouver, Canada;Food, Nutrition and Health and.Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, Canada; The Child and Family Research Institute, Vancouver, Canada; Division of Hematopathology, Children and Women's Health Centre of British Columbia, Vancouver, Canada;Food, Nutrition and Health and.National Maternal and Child Health Center, Ministry of Health, Phnom Penh, Cambodia;Helen Keller International, Cambodia Country Office, Phnom Penh, Cambodia; and.Helen Keller International, Cambodia Country Office, Phnom Penh, Cambodia; and.Laboratory Department, National Pediatric Hospital, Phnom Penh, Cambodia.Food, Nutrition and Health and The Child and Family Research Institute, Vancouver, Canada; tim.green@ubc.ca.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26491125

Citation

Karakochuk, Crystal D., et al. "The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated With High Serum Ferritin and Soluble Transferrin Receptor Concentrations Among Women in Rural Cambodia." The Journal of Nutrition, vol. 145, no. 12, 2015, pp. 2765-73.
Karakochuk CD, Whitfield KC, Rappaport AI, et al. The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated with High Serum Ferritin and Soluble Transferrin Receptor Concentrations among Women in Rural Cambodia. J Nutr. 2015;145(12):2765-73.
Karakochuk, C. D., Whitfield, K. C., Rappaport, A. I., Barr, S. I., Vercauteren, S. M., McLean, J., Prak, S., Hou, K., Talukder, A., Devenish, R., & Green, T. J. (2015). The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated with High Serum Ferritin and Soluble Transferrin Receptor Concentrations among Women in Rural Cambodia. The Journal of Nutrition, 145(12), 2765-73. https://doi.org/10.3945/jn.115.218636
Karakochuk CD, et al. The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated With High Serum Ferritin and Soluble Transferrin Receptor Concentrations Among Women in Rural Cambodia. J Nutr. 2015;145(12):2765-73. PubMed PMID: 26491125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated with High Serum Ferritin and Soluble Transferrin Receptor Concentrations among Women in Rural Cambodia. AU - Karakochuk,Crystal D, AU - Whitfield,Kyly C, AU - Rappaport,Aviva I, AU - Barr,Susan I, AU - Vercauteren,Suzanne M, AU - McLean,Judy, AU - Prak,Sophonneary, AU - Hou,Kroeun, AU - Talukder,Aminuzzaman, AU - Devenish,Robyn, AU - Green,Timothy J, Y1 - 2015/10/21/ PY - 2015/07/14/received PY - 2015/10/02/accepted PY - 2015/10/23/entrez PY - 2015/10/23/pubmed PY - 2016/3/29/medline KW - Cambodia KW - anemia KW - correction factor KW - ferritin KW - hemoglobin KW - inflammation KW - iron deficiency KW - soluble transferrin receptor KW - thalassemia KW - women SP - 2765 EP - 73 JF - The Journal of nutrition JO - J Nutr VL - 145 IS - 12 N2 - BACKGROUND: Ferritin and soluble transferrin receptor (sTfR) concentrations are commonly used to assess iron deficiency (ID); however, they are influenced by multiple factors. OBJECTIVES: We assessed associations between numerous variables and both ferritin and sTfR concentrations in Cambodian women and compared ID prevalence through the use of study-generated correction factors (CFs) for ferritin with those from a published meta-analysis. METHODS: Venous blood from 450 women (aged 18-45 y) was assessed for hemoglobin (Hb), ferritin, sTfR, retinol binding protein, folate, vitamin B-12, C-reactive protein, α-1 acid glycoprotein (AGP), and genetic Hb disorders. Linear regression was used to calculate geometric mean ratios (95% CIs) for ferritin and sTfR concentrations. RESULTS: The variant Hb EE genotype was associated with 50% (14%, 96%) and 51% (37%, 66%) higher geometric mean ferritin and sTfR concentrations, respectively, than was the normal Hb AA genotype; a 1-g/L increase in AGP was associated with 99% (50%, 162%) and 48% (33%, 64%) higher concentrations in the same variables, respectively. ID prevalence in nonpregnant women (n = 420) was 2% (n = 9) with the use of ferritin <15 μg/L and 18% (n = 79) with the use of sTfR >8.3 mg/L as criteria. ID prevalence with the use of sTfR was higher in women with the Hb EE genotype (n = 17; 55%) than in those with the Hb AA genotype (n = 20; 10%); and in women with the Hb AA genotype and chronic inflammation (n = 10; 18%) than in that group of women without chronic inflammation (n = 10; 7%) (P < 0.05). No differences in ID prevalence were found with the use of ferritin between women with Hb EE and AA genotypes (P = 1.0) or by chronic inflammation status (P = 0.32). There were no differences in mean ferritin concentrations among all 450 women when study-generated CFs were compared with those from the meta-analysis (P = 0.87). CONCLUSIONS: Compared with sTfR, ferritin concentrations appear to reflect more accurately true ID in rural Cambodian women. The CFs from a published meta-analysis were appropriate for use in this population with a high prevalence of Hb disorders and inflammation. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/26491125/The_Homozygous_Hemoglobin_EE_Genotype_and_Chronic_Inflammation_Are_Associated_with_High_Serum_Ferritin_and_Soluble_Transferrin_Receptor_Concentrations_among_Women_in_Rural_Cambodia_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.115.218636 DB - PRIME DP - Unbound Medicine ER -