Assessment of iron status of Zairean women of childbearing age by serum transferrin receptor.

Soluble transferrin receptor (sTfR), previously shown to be a sensitive indicator of tissue iron deficiency, was used to assess iron status of 104 Zairean women (69 lactating, 19 pregnant, and 16 nonpregnant, nonlactating women). Thirteen iron-sufficient female laboratory employees were also studied. Mean sTfR concentrations were higher in pregnant women (9.90 mg/L) than in lactating women (8.55 mg/L), nonlactating women (7.74 mg/L), and laboratory employees (5.11 mg/L) (P < 0.005). Mean serum ferritin and transferrin saturation were lower in pregnant than nonpregnant women. sTfR negatively correlated with hemoglobin (P < 0.05) and transferrin saturation (P < 0.05), and nonsignificantly with ferritin and transferrin. With 7.26 mg sTfR/L (the upper limit of laboratory employees) as the cutoff value, sTfR identified 67% of women with tissue iron deficiency compared with 11.5-57% for transferrin saturation, hemoglobin, or ferritin. Despite the moderate sensitivity (68.5%), 90% of women with sTfR > 7.26 mg/L also had another index below normal and 54% had serum ferritin < or = 50 micrograms/L.

Usefulness of serum ferritin levels in the assessment of iron status in non-pregnant Zairean women of childbearing age.

We studied the usefulness of serum ferritin for the assessment of iron deficiency (ID) or ID anaemia (IDA) of 186 lactating and 27 non-lactating Zairean women (15-45 years old). Haemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), and transferrin saturation (TS) were also measured. Participants were recruited in rural Bas-Zaire State in the summers of 1986 and 1989. Serum ferritin ranged from 10 to 360 micrograms l-1 (median 62 micrograms l-1) in lactating women and from 14.2 to 120 micrograms l-1 (median 40 micrograms l-1) in non-lactating women. While mean levels of serum ferritin and TS were within the normal range in both groups of women, those of Hb were below normal (< 12 g dl-1), partly due to inflammation. The prevalence of anaemia was 66% in lactating women and 70% in non-lactating women, and did not change with time. It was higher in women with inflammation than in those without inflammation. Although ID (ferritin < 12 micrograms l-1) was almost absent, after raising the cut-off point of ferritin to 50 micrograms l-1 in women with inflammation, it was present in 28.8% of lactating women and 52% of non-lactating women. While the prevalence of ID assessed by serum ferritin was significantly higher in lactating women studied in 1989 (40.5%) than in those studied in 1986 (13.5%), it was similar in both groups of non-lactating women. ID defined by TS < 16% was present in 41% of lactating women and 21% of non-lactating women. In the presence as well as absence of inflammation, the use of TS identified a higher percentage of lactating women with either ID or IDA than did the use of serum ferritin. We conclude that, in the studied population, unless inflammation is taken into consideration, serum ferritin has a limited value in the diagnosis of ID.

PIP: This cross-sectional study involved 213 healthy Zairian women, 15-45 years old, 186 lactating and 27 nonpregnant, nonlactating women and studied the usefulness of serum ferritin levels for the assessment of iron deficiency (ID) or ID anaemia (IDA). Hemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), and transferrin saturation (TS) were also measured. The median parity of lactating women was three, and that of nonlactating women was two. They were recruited at the Nsundi Lutete Hospital (Bas-Zaire State) during August and September of 1986 and 1989. Serum ferritin ranged from 10 to 360 mcg 1-1 (median 62 mcg 1-1) in lactating women and from 14.2 to 120 mcg 1-l (median 40 mcg 1-l) in nonlactating women. While mean levels of serum ferritin and TS were within the normal range in both groups of women, those of Hb were below normal ( 12 g dl-1), partly owing to inflammation. The prevalence of anemia was 66% in lactating women and 70% in nonlactating women, and did not change with time. It was higher in women with inflammation than in those without inflammation. Although ID (ferritin 12 mcg 1-1 ) was almost absent, after raising the cut-off point of ferritin to 50 mcg 1-1 in women with inflammation, it was present in 28.8% of lactating women and 52% of nonlactating women. While the prevalence of ID assessed by serum ferritin was significantly higher in lactating women studied in 1989 (40.5%) than in those studied in 1986 (13.5%), it was similar in both groups of nonlactating women. ID defined by TS 16% was present in 41% of lactating women and 21% of nonlactating women. In the presence as well as absence of inflammation, the use of TS identified a higher percentage of lactating women with either ID or IDA than did the use of serum ferritin. In the studied population, unless inflammation is taken into consideration, serum ferritin has a limited value in the diagnosis of ID.