@article{3143151,
    title = "Serum transferrin receptors: Distribution and diagnostic performance in
pre-school children",
    author = "Chouliaras, Giorgos L. and Premetis, Evangelos and Tsiftis, George and and Drosatou, Panayiota and Papassotiriou, Ioannis and Stamoulakatou, and Alexandra and Lycopoulou, Lilia",
    journal = "BLOOD CELLS MOLECULES AND DISEASES",
    year = "2009",
    volume = "43",
    number = "2",
    pages = "163-168",
    publisher = "ACADEMIC PRESS INC ELSEVIER SCIENCE",
    issn = "1079-9796",
    doi = "10.1016/j.bcmd.2009.03.007",
    keywords = "Transferrin receptors; Reference range; Iron deficiency; Thalassemia
trait",
    abstract = "Soluble transferrin receptors have gained interest in the field of
diagnosing anemias. Reference ranges differ according to the method used
for the quantification of sTfR. We aim to explore the distributional
properties and diagnostic performance of sTfR in pre-school healthy
children as well as in children with beta-thalassemia carriers, iron
deficiency with normal hematological phenotype (ID) and iron deficiency
anemia (IDA). Circulating sTfR as well as biochemical and hematological
indices were determined in 521 pre-school children and four groups
(normal children, beta-thalassemia traits, ID and IDA) were formed.
Diagnostic performance and distribution of sTfR according to age and in
relation to several parameters were evaluated in every group. Three
hundred eighty one children (261 normal, 60 beta-thalassemia traits, 44
ID and 16 IDA) aged 1-6 years were included. We found that distribution
of sTfR differed significantly among the four groups (Kruskal Wallis
p<0.001) with children in the normal group exhibiting lower
concentrations compared to all other. A negative correlation between
sTfR and age occurred in the normal (beta = -0.12, p<0.001) and the ID
groups (beta = -0.13, p = 0.035). In the beta-thal and IDA groups sTfR
is correlated to HbA(2) (beta = 0.34, p = 0.001) and ferritin
(Spearman’s rho = -0.6, p = 0.014) respectively. An area under the curve
equal to 0.63 was achieved by sTfR in distinguishing between normal and
ID children. Sensitivity and specificity were 70.5% and 50%
respectively at a cut-off of 2.5 mg/l. Levels of sTfR are negatively
correlated to age in pre-school children while dyserythropoietic
procedures like beta-thal, ID, and IDA significantly affect them. These
findings indicated that the accuracy of sTfR in diagnosing ID from
normal children is limited. Standardization will allow the use of
formulas that combine sTfR and ferritin which are of greater diagnostic
value than sTfR alone. (C) 2009 Elsevier Inc. All rights reserved."
}