Serum transferrin in newborns, healthy children and with iron deficiency anemia

ABSTRACT

Serum transferrin receptor [STfR] is a reliable tool for assessing functional iron status and erythropoietic activity in adults, but little is known about its role in children. The aim of this study was to evaluate STfR concentrations in healthy newborns, infants, and children and to show age and sex-related variations. A further aim was to investigate the value of STfR in children with iron deficiency anemia [IDA], and its response to oral iron therapy. We studied 3 groups. Group I included 26 healthy newborns, they were 70 preterm and 16 term babies. Group II included 22 healthy infants and children. Group III included 27 children with IDA. Complete blood count, serum iron, total iron binding capacity [TIBC], serum ferritin [SF], and STfR levels were measured. STfR/log ferritin index [STfR-F index] was calculated. Cord blood samples were obtained from the studied newborns just after delivery. Children with IDA were treated for 3 months with oral iron to evaluate its effects on parameters reflecting iron status. The results showed that in group I, serum iron, SF, and TIBC were highest at term, whereas reticulocytes were highest in the preterm babies. STfR levels were not influenced by gestation. STfR in healthy newborns correlated negatively with hemoglobin [r = -0.779; P 0.005], with iron[r -0.25; P = 0.03] and with SF [r = -0.273; P= 0.071, and positively with reticulocytes [r = 0.838; P = 0.007]. In-group II, a negative correlation was found between STfR and age among healthy infants and children [r = -0.595; P = 0.001]. There was no significant difference in STfR between male and female subjects in-group I and II [P = 0.113, and P = 0.456]. STfR concentration was significantly higher in children with IDA compared to healthy children [P = 0.001]. After oral iron therapy, STfR level was significantly decreased compared to that before iron therapy [P 0.006]. STfR-F index was significantly decreased in children with IDA after oral iron therapy compared to that before iron therapy [P = 0.0001]. In children with IDA before treatment, STfR correlated negatively with hemoglobin [r = -0.798; P 0.001], with serum iron [r = -0.485; P =0.02], and with SF [r = -0.447; P = 0.03], and positively with TIBC [r = 0.503; P=0.02]