Physiologically based serum ferritin thresholds for iron deficiency in women of reproductive age who are blood donors

Author:

Addo O. Yaw1ORCID,Mei Zuguo1,Hod Eldad A.2ORCID,Jefferds Maria Elena1ORCID,Sharma Andrea J.13,Flores-Ayala Rafael C.1,Spitalnik Steven L.2ORCID,Brittenham Gary M.4

Affiliation:

1. 1Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta , GA;

2. 2Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY;

3. 3US Public Health Service Commissioned Corps, Atlanta, GA; and

4. 4Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY

Abstract

AbstractOur objective is to develop a physiologically based method to determine serum ferritin thresholds for iron deficiency in healthy individuals. The current World Health Organization threshold of <15 µg/L for iron deficiency in women is based on expert opinion. We examined the relationship between serum ferritin and 2 independently measured indicators of iron-deficient erythropoiesis, soluble transferrin receptor (sTfR) and hemoglobin, in baseline data from 286 women, 20 to 49 years, who were first-time or reactivated donors in the Retrovirus Epidemiology Donor Study-II Donor Iron Status Evaluation (REDS-RISE) study. At lower serum ferritin concentrations, median sTfR increased as hemoglobin decreased. Using restricted cubic spline regression analysis to determine thresholds for iron-deficient erythropoiesis, the thresholds identified by sTfR (serum ferritin < 25.4 µg/L) and hemoglobin (serum ferritin < 25.3 µg/L) did not differ significantly. The thresholds found in the REDS-RISE study do not differ from those identified by sTfR (serum ferritin < 25.5 µg/L) and hemoglobin (serum ferritin < 26.6 µg/L) in a previous study of 5442 women, 20 to 49 years, in the US National Health and Nutrition Examination Survey 2003 to 2018 (P = .98 and 0.83, respectively). Although international comparisons are needed, these results with US data provide additional evidence for the potential usefulness of a physiologically based method to identify serum ferritin thresholds for iron deficiency.

Publisher

American Society of Hematology

Subject

Hematology

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