Differential ferritin interpretation methods that adjust for inflammation yield discrepant iron deficiency prevalence

摘要

We reassessed the iron deficiency ( ) prevalence in a outh frican trial that formed part of the nternational esearch on nfant upplementation study by comparing four methods that account for the high prevalence of acute (28.6%) and chronic (41.8%) inflammation observed in the study. Serum ferritin ( ) was measured as marker of iron status in 192 apparently healthy, 4–13‐month‐old infants. Alpha‐1 glycoprotein and ‐reactive protein concentrations were determined to indicate chronic and acute inflammation, respectively. The prevalence was obtained by four methods that adjust for inflammation: (1) excluding infants with inflammation; (2) using a higher cut‐off (  μg L ); (3) using different cut‐offs for infants with vs. without inflammation (  μg L vs.  μg L ); and (4) adjusting concentrations with correction factors ( s) were compared with a reference method (  μg L ) not accounting for inflammation. Using the higher cut‐off method resulted in the highest prevalence (52.1%), followed by using two different cut‐offs (31.8%), using s (21.9%) and excluding subjects with inflammation (17.6%). The method showed the best agreement with the reference method. Disregarding inflammation resulted in a significantly lower prevalence (17.2%). anaemia ( ) prevalence ranged from 13.2% to 24.5%, with the lowest prevalence (12.0%) for the reference method. Our analysis highlights the challenge of assessing and using only as marker of iron status in the presence of inflammation. We demonstrate the importance of measuring inflammation markers to account for their elevating effect on .