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Assessment of iron deficiency in Kenyan children from capillary blood
Author(s) -
Grant Frederick Kobina,
Suchdev Parmi,
Cole Conrad,
Ramakrishnan Usha,
Flores Rafael,
Ruth Laird,
Martorell Reynaldo
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.238.8
Subject(s) - soluble transferrin receptor , iron deficiency , medicine , ferritin , receiver operating characteristic , anemia , gastroenterology , gold standard (test) , area under the curve , fingerstick , serum ferritin , biomarker , hemoglobin , immunology , iron status , endocrinology , chemistry , biochemistry , diabetes mellitus
In absence of a non‐invasive gold standard, iron deficiency anemia (IDA) stages are best characterized by multi‐indices. However, choice of an appropriate single iron biomarker to replace multi‐criteria model for ID screening in resource poor settings is of critical need. We compared ID defined as ¡Ý2 of 3 abnormal values in ferritin (SF), transferrin receptor (sTfR), or zinc protoporphyrin (ZP) concentrations (i.e. multi‐criteria model) to ID defined by abnormal levels in any of iron biomarkers (SF alone, or sTfR alone, or ZP alone). This was a cross‐sectional survey. Capillary blood was obtained from 680 children (aged 6C35 mo) for measurement of iron status using SF, sTfR, and ZP. Based on multi‐criteria model, ID prevalence (¡ÀSE) was 62.1¡À1.9%, whilst those based on abnormal values in SF, sTfR, and ZP, were 40.0¡À1.9%, 57.7¡À1.9%, and 77.3¡À1.6%, respectively. The қ statistics for agreement between multi‐criteria model and other iron indicators were 0.5 to 0.8; with sTfR having the best agreement (қ=0.84). Receiver‐operating characteristic (ROC) curve analysis showed sTfR (area‐under‐the‐curve (AUC) = 0.69) to be superior to both SF (AUC=0.61) and ZP (AUC=0.63) in predicting IDA (p<0.001). sTfR, compared to SF and ZP, accurately estimates the prevalence of ID in children based on multi‐indices and least affected by inflammation. Funded by CDC and Nevin Scrimshaw International Nutrition Foundation. Grant Funding Source : NUTRITION (ASN)