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. 2011;24(2):108-114.

Soluble transferrin receptor-ferritin index in the evaluation of anemia in inflammatory bowel disease: a case-control study

Pantelis Oustamanolakis  1 , Ioannis E Koutroubakis  1 , Ippokratis Messaritakis  2 , Maria Niniraki  3 , Elias A Kouroumalis  1
Affiliations

Soluble transferrin receptor-ferritin index in the evaluation of anemia in inflammatory bowel disease: a case-control study

Pantelis Oustamanolakis et al. Ann Gastroenterol. 2011.

Abstract

Background: No reliable biochemical markers exist for the differentiation between iron deficiency anemia (IDA) and anemia of chronic disease (ACD) in the setting of inflammatory bowel disease (IBD). The aim of this study was to investigate the use of soluble transferrin receptor (sTfR) and sTfR-ferritin (sTfR-F) index in the evaluation of anemia in patients with IBD.

Methods: One hundred IBD patients [49 ulcerative colitis (UC), 51 Crohn's disease (CD)] and 102 healthy controls were enrolled. Serum levels of ferritin, transferrin saturation and sTfR were analyzed in all patients and controls. sTfR-F index was calculated based on the ratio: sTfR/ log ferritin. The value of sTfR and sTfR-F for diagnosis of IDA was assessed.

Results: Forty two IBD patients (41% of UC and 42.9 % of CD) fulfilled the WHO criteria for the diagnosis of anemia. Among them thirty (30 %) had IDA, four (4%) had ACD and eight (8%) had mixed IDA/ACD. Patients with IDA had significantly higher sTfR and sTfR-F index levels compared with those without IDA (P<0.0001). Both sTfR and sTfR-F index were not correlated with CRP levels or disease activity. High sTfR levels (>1.8 mg/L) had sensitivity 81% and specificity 80%, whereas high sTfR-F index (>1.4) had sensitivity 91% and specificity 92% for the diagnosis of IDA.

Conclusion: These results suggest that the sTfR-F index seems to be very efficient in the detection and diagnosis of IDA, among patients with IBD.

Keywords: Crohn’s disease; anemia; ferritin; iron deficiency; ulcerative colitis.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Distribution of soluble transferrin receptor (sTfR) levels in patients with inflammatory bowel disease (IBD) and iron deficiency anemia (IDA, n=30) and IBD patients without IDA (Non IDA, n=70). Boxes indicate the interquartile range with median value. Bars show the 5th and 95th percentiles.
Figure 2
Figure 2
Distribution of soluble transferrin receptor –ferritin (sTfR-F) index in patients with inflammatory bowel disease (IBD) and iron deficiency anemia (IDA, n=30) and IBD patients without IDA (Non IDA, n=70). Boxes indicate the interquartile range with median value. Bars show the 5th and 95th percentiles.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curves for soluble transferrin receptor (sTfR) and sTfR –ferritin (sTfRF) index, in the diagnosis of iron deficiency anemia in patients with inflammatory bowel disease
See this image and copyright information in PMC

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