American Journal of Clinical Nutrition, Vol 68, 1241-1246, Copyright © 1998 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Serum transferrin receptor: a specific marker of iron deficiency in pregnancy

A Akesson, P Bjellerup, M Berglund, K Bremme and M Vahter
Institute of Environmental Medicine, Division of Metals and Health, Karolinska Institutet, Stockholm, Sweden. Agneta.Akesson@imm.ki.se

BACKGROUND: Current markers of iron deficiency tend to be less reliable in pregnancy. OBJECTIVE: Our aim was to study the usefulness of soluble serum transferrin receptor (sTfR) as a marker for iron deficiency during early and late gestation and to define iron status in 254 pregnant Swedish women. DESIGN: We performed a cross-sectional and longitudinal evaluation of sTfR in comparison with concentrations of serum ferritin and hemoglobin in blood collected around gestational weeks 11 and 36. RESULTS: The specificity of sTfR was 100%. The sensitivity in relation to both anemia and depleted iron stores was approximately 70%, but this figure is less reliable because of few samples. sTfR in early pregnancy was low: 11% of women had a value below the reference interval. sTfR increased significantly from early to late pregnancy even in the group of women with persisting iron stores. In late pregnancy, 14% of women developed tissue iron deficiency and 5% had iron deficiency according to a combination of all 3 markers. CONCLUSIONS: sTfR seems to be a specific and sensitive marker of iron deficiency in pregnancy and may have advantages over serum ferritin and hemoglobin. The low sTfR concentration in early gestation seems to be caused by reduced erythropoiesis, whereas the increase from early to late pregnancy reflects increased erythropoiesis, and in case of iron deficiency, also tissue iron deficiency. Further studies are needed to verify whether decreased erythropoiesis reduces the possibility of detecting iron deficiency during early gestation by sTfR.

This article has been cited by other articles:

				Z. Yang, K. G Dewey, B. Lonnerdal, O. Hernell, C. Chaparro, S. Adu-Afarwuah, E. D McLean, R. J Cohen, M. Domellof, L. H Allen, et al. Comparison of plasma ferritin concentration with the ratio of plasma transferrin receptor to ferritin in estimating body iron stores: results of 4 intervention trials Am. J. Clinical Nutrition, June 1, 2008; 87(6): 1892 - 1898. [Abstract] [Full Text] [PDF]

				J. K. Meinzen-Derr, M. L. Guerrero, M. Altaye, H. Ortega-Gallegos, G. M. Ruiz-Palacios, and A. L. Morrow Risk of Infant Anemia Is Associated with Exclusive Breast-Feeding and Maternal Anemia in a Mexican Cohort J. Nutr., February 1, 2006; 136(2): 452 - 458. [Abstract] [Full Text] [PDF]

				L. L. Iannotti, K. O. O'Brien, S.-C. Chang, J. Mancini, M. Schulman-Nathanson, S. Liu, Z. L. Harris, and F. R. Witter Iron Deficiency Anemia and Depleted Body Iron Reserves Are Prevalent among Pregnant African-American Adolescents J. Nutr., November 1, 2005; 135(11): 2572 - 2577. [Abstract] [Full Text] [PDF]

				J.-I. Lee, J.-A Lee, and H.-S. Lim Effect of time of initiation and dose of prenatal iron and folic acid supplementation on iron and folate nutriture of Korean women during pregnancy Am. J. Clinical Nutrition, October 1, 2005; 82(4): 843 - 849. [Abstract] [Full Text] [PDF]

				D. L. O'Connor, M. E. Latulippe, C. Campos, C. Merlos, S. Villalpando, and M. F. Picciano Folate Deficiency Does Not Alter the Usefulness of the Serum Transferrin Receptor Concentration as an Index for the Detection of Iron Deficiency in Mexican Women during Early Lactation J. Nutr., January 1, 2005; 135(1): 144 - 149. [Abstract] [Full Text] [PDF]

				R. Vikstedt, P. von Lode, T. Takala, K. Irjala, O. Peltola, K. Pettersson, and P. Suominen Rapid One-Step Immunofluorometric Assay for Measuring Soluble Transferrin Receptor in Whole Blood Clin. Chem., October 1, 2004; 50(10): 1831 - 1833. [Full Text] [PDF]

				M. Hambidge Biomarkers of Trace Mineral Intake and Status J. Nutr., March 1, 2003; 133(3): 948S - 955. [Abstract] [Full Text] [PDF]

				A. Akesson, M. Berglund, A. Schutz, P. Bjellerup, K. Bremme, and M. Vahter Cadmium Exposure in Pregnancy and Lactation in Relation to Iron Status Am J Public Health, February 1, 2002; 92(2): 284 - 287. [Abstract] [Full Text] [PDF]

				A. Akesson, P. Bjellerup, M. Berglund, K. Bremme, and M. Vahter Soluble Transferrin Receptor: Longitudinal Assessment From Pregnancy to Postlactation Obstet. Gynecol., February 1, 2002; 99(2): 260 - 266. [Abstract] [Full Text] [PDF]

				S. Muslimatun Weekly Supplementation with Iron and Vitamin A during Pregnancy Increases Hemoglobin Concentration but Decreases Serum Ferritin Concentration in Indonesian Pregnant Women J. Nutr., January 1, 2001; 131(1): 85 - 90. [Abstract] [Full Text]

				M. Olivares, T. Walter, J. D Cook, E. Hertrampf, and F. Pizarro Usefulness of serum transferrin receptor and serum ferritin in diagnosis of iron deficiency in infancy Am. J. Clinical Nutrition, November 1, 2000; 72(5): 1191 - 1195. [Abstract] [Full Text] [PDF]

				J. W. Choi, M. W. Im, and S. H. Pai Serum Transferrin Receptor Concentrations during Normal Pregnancy Clin. Chem., May 1, 2000; 46(5): 725 - 727. [Full Text] [PDF]