ABSTRACT
This cross-sectional comparative study was aimed at investigating the iron status of a group of post-menopausal women with and without diabetes. Thirty-five post-menopausal women in each group were selected purposively from among patients attending the out-patient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), a specialist hospital, and two of its satellite clinics, all in Dhaka. Patients were enrolled based on their existing records. The subjects were matched on age, menstrual status and fasting status at blood draw. Ferritin, serum soluble transferrin receptors (sTfR) and fasting plasma glucose were measured by standard methods. Dietary information was collected by a specific food frequency questionnaire. No significant difference in plasma ferritin [62.02 ng/ml, (range:4.68-288.89) vs 54.25 ng/ml (range: 4.58-137.17); p=0.28] was observed between the groups. But a higher level of plasma sTfR was found in diabetic women [(21.12 nmol/l (range: 7.91-39.79) vs 17.63 nmol/l (range: 10.30-110.00); p<0.01]. TFR-F index showed no difference between diabetic and control (p=0.25). Significantly a lower hemoglobin level [10.58±0.67 g/dl vs11.76±1.5 g/dl; p<0.01] was detected in diabetic women. Plasma sTfR (log) did not show any significant association with the dietary parameters and iron indices. No significant association between fasting glucose, ferritin and sTfR was seen except for haemoglobin (r=0.39, p=0.05). Total iron intake recorded was more than the requirement, and was significantly higher in control group [38.11mg/day (range: 19.83-105.63) vs 56.65 mg/day (range: 29.75-109.54); p<0.01)]. More than 97 % of total iron was of plant origin. No differences in heme iron [0.85 mg/day (range:0.09-4.07) vs. 0.96 mg/day (range: 0.04-4.34), p= 0.17] and vitamin C intake was observed between the groups. Iron indices of non-diabetic women were within the normal range. A higher level of sTfR and a lower level of hemoglobin in diabetic cases is suggestive of iron deficiency anaemia rather than iron overload.
ABSTRACT
Objective:To study the critical value of soluble transferring receptor (sTfR) for assessing iron overload in Chinese adult men. Method:226 normal iron status and 331 iron overload men were drawn from National Nutrition and Health Survey 2002 as control group and case group respectively. To compare the sTfR concentration and distribution between two groups and ascertain the sTfR critical value to assess iron overload by ROC curve. Results:The concentrations of sTfR were 1 325.46?484.92 ng/ml, 1 788.56? 457.02 ng/ml in case group and control group respectively, the former lower than the latter (P
ABSTRACT
BACKGROUND: The transferrin receptor (TfR) is expressed on almost all cellular surfaces and is shedded into the blood to form the soluble transferrin receptor (sTfR). The sTfR has been known to be a good marker to reflect cellular iron status and to differentiate between iron deficiency anemia (IDA) and anemia of chronic disease (ACD) without the need for a bone marrow aspiration in rheumatoid arthritis (RA) patients. So we aimed to evaluate the diagnostic availability of sTfR in patients with RA and degenerative joint disease (DJD). METHODS: Eighty-seven outpatients visiting the Department of Rheumatology at HYUH were studied and divided into anemic and non-anemic groups according to their Hb levels (female< 12 g/dL, male< 14 g/dL). The sTfR was measured by ELISA method (Quantikine IVDTM, R&D system). To differentiate whether the anemia was due to iron deficiency or other causes, we used the RBC parameters and a discriminant index which was calculated from serum iron, ferritin and TIBC instead of a bone marrow aspiration, an invasive procedure of which interpretation can be subjective. RESULTS: The median was higher (31.09 nM) than the normal reference values (9-28 nM) only in the anemic group of RA. The medians were within normal limit in all the other groups. sTfR levels were high in 15 of the 28 RA anemic patients which were composed of 10 patients with IDA, 4 with non-anemic RA and 1 with non-anemic RA & DJD. CONCLUSIONS: In the present study, sTfR was increased not only in IDA but also in ACD of RA patients and also in non-anemic patients, which showed that sTfR cannot be used to differentiate these two types of anemia by itself and the further tests are needed. We conclude that the expression of TfR in RA patients was dependent not only on iron deficiency but also on the disease itself.