Interpretation of serum ferritin concentrations as indicators of total-body iron stores in survey populations: the role of biomarkers for the acute phase response
Interpretation of serum ferritin concentrations as indicators of total-body iron stores in survey populations: the role of biomarkers for the acute phase response
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DOI：
10.1093/ajcn/84.6.1498
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发表时间：
2006-12-01
影响因子：
7.1
通讯作者：
Angelilli, Mary Lu
中科院分区：
文献类型：
--
作者：
Beard, John L.;Murray-Kolb, Laura E.;Angelilli, Mary Lu
背景：营养调查使用急性期蛋白（APP）生物标志物，如c反应蛋白（CRP）和α(1)-酸性糖蛋白（AGP）来确定炎症对铁状态生物标志物分布的影响。然而，很少有人研究过哪种生物标志物能更好地识别铁状态标志物虚假升高的人。目的：探讨婴幼儿和学龄儿童APP生物标志物与铁状态生物标志物的关系。设计：在筛选调查中，我们确定了非裔美国婴儿（n = 351）和危地马拉学龄儿童（n = 375）的样本。我们使用一组常见的APP和铁状态生物标志物来检查两组标志物（实验室变量）之间的关联。结果：在两个样本中，炎症或缺铁的总体患病率均< 10%。对数AGP值与CRP值显著相关（r = 0.70），但无法解释的方差仍为bbb50 %。血清铁蛋白（但不包括转铁蛋白受体、转铁蛋白受体指数或血清铁）与APP浓度相关，但阳性预测值较差（< 72%），kappa评分较低。铁蛋白浓度>.1几何SD高于几何平均值，AGP或CRP升高都不能预测。定性CRP分析不能有效识别有其他轻度炎症指征的人。结论：这些分析表明，炎症的低患病率对铁蛋白的分布影响不大，2个常见的炎症指标在识别可能由炎症引起的铁蛋白升高的人群中表现不佳。
Background: Nutritional surveys use acute phase protein (APP) biomarkers such as C-reactive protein (CRP) and a alpha(1)-acid glycoprotein (AGP) to identify the influence of inflammation on the distribution of iron status biomarkers. Few, however, have examined which biomarker better identifies persons with spurious elevations in iron status markers.Objective: We explored the relations of APP biomarkers to iron-status biomarkers in infants and school-age children.Design: In screening surveys, we identified a sample of African American infants (n = 351) and Guatemalan school-age children (n = 375). We used a common set of APP and iron-status biomarkers to examine the association between the 2 sets of markers (laboratory variables).Results: The overall prevalence of either inflammation or iron deficiency was < 10% in both samples. The log AGP and CRP values were significantly correlated (r = 0.70), but the unexplained variance still was > 50%. Serum ferritin-but not transferrin receptor, transferrin receptor index, or serum iron-was related to APP concentrations, but poor positive predictive value (< 72%) and low kappa scores were found. Ferritin concentrations > 1 geometric SD above the geometric mean were poorly predicted by either elevated AGP or CRP. Qualitative CRP analysis was not effective in identifying persons who had other indications of mild inflammation.Conclusions: These analyses show that a low prevalence of inflammation has little influence on the distribution of ferritin, and 2 common indicators of inflammation do not perform equally well in identifying persons who may have elevations in ferritin due to inflammation.