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In recent years both the concept and diagnosis of iron deficiency (ID) have evolved considerably. The introduction of new laboratory tests, especially soluble transferrin receptor (sTfR), has enabled the identification of storage iron depletion, iron-deficient erythropoiesis, iron deficiency anemia (IDA), and functional ID as readily distinguishable clinical conditions (1)(2)(3)(4)(5). Efficient use of the new tests, however, requires that the respective reference populations be appropriately characterized. A problem of conventionally derived reference intervals (RIs) is that the reference groups may contain individuals with subclinical ID (6). Especially in populations with an increased risk of ID, this may widen RIs and impair the sensitivity of these laboratory tests (7).Efforts have been aimed at modeling the development of subclinical ID and, subsequently, toward establishing truly health-related RIs for adults, children, and adolescents (2)(7)(8)(9)(10)(11). Studies performed in the elderly have used highly variable criteria for the selection of reference populations (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Therefore, despite the particular clinical interests regarding iron status in the elderly, no comprehensive studies covering the issue of subclinical ID are available.This study was undertaken to investigate how subclinical ID influences the RIs of hematologic indices, sTfR, and other laboratory tests defining iron status in the elderly. To achieve this, we selected a general reference group of individuals ≥65 years of age and produced RIs for hematologic indices, sTfR, and other laboratory tests. We also formed an iron-replete subgroup by excluding individuals with storage iron depletion. The differences between values from the general reference group and the iron-replete subgroup were used to investigate the extent of storage iron depletion …

Iron-Replete Reference Intervals to Increase Sensitivity of Hematologic and Iron Status Laboratory Tests in the Elderly