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The effects of the acute phase response on biomarkers of iron status differ in the presence of malaria infection
Author(s) -
Wessells Ryan,
Hess Sonja,
Ouedraogo Zinewende,
Rouamba Noel,
Erhardt Juergen,
Ouedraogo JeanBosco,
Brown Kenneth
Publication year - 2013
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.27.1_supplement.107.7
Subject(s) - convalescence , acute phase protein , c reactive protein , malaria , medicine , ferritin , asymptomatic , parasitemia , subclinical infection , confounding , gastroenterology , immunology , inflammation , plasmodium falciparum
Plasma ferritin (pF) is affected by the acute phase (AP) response, independent of iron (Fe) status. To remove the confounding effect of subclinical inflammation in the assessment of Fe deficiency, a correction method has been proposed, based on the ratios of log pF among groups with different stages of infection, as classified by AP proteins (APP): C‐reactive protein (CRP) >;5 mg/L (incubation); α‐1‐acid glycoprotein (AGP) >;1 g/L and CRP >; 5mg/L (early convalescence); AGP >; 1g/L (late convalescence); and non‐elevated CRP and AGP (reference). It is unknown whether malaria affects these relationships, so we compared pF conc in relation to CRP, AGP, and presence of malaria antigenemia among 451 asymptomatic children aged 6–23 mo in Burkina Faso. Correction factors for pF based on aforementioned categories of APP were 0.57, 0.23, 0.49 and 1, respectively. 48.5% of children had current or recent malarial parasitemia (histidine rich protein II (HRP2) >; 0.75 ng/mL); these children had higher geometric mean (± SE) pF conc than children without malaria, even after adjusting for APP (23.5 ± 1.5 vs. 11.1 ± 0.8 μg/L, p<0.001). The estimated prevalence of Fe deficiency after adjusting for APP was 24.1% and 52.0% in those with and without elevated HRP2, respectively. Adjusting pF based only on APP (CRP >;5 mg/L and/or AGP >; 1 g/L) may underestimate the prevalence of Fe deficiency in settings with a high prevalence of malaria and inflammation. Grant Funding Source : Nutsiset, SAS (Malaunay, France); Henry A. Jastro Graduate Research Scholarship Award (UC Davis); Bristol‐Myers Squibb Freedom to Discover Award