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Abstracts/Presentation Description
Kay Weng Choy
Department of Pathology, Northern Health, Epping, Australia
Introduction: Serum ferritin <30 µg/L is used to diagnose iron deficiency in adults based on the RCPA iron studies standardised reporting protocol (2021). Functional reference limits for iron deficiency have been derived using erythrocyte indices like haemoglobin. Soluble transferrin receptor (sTfR) and sTfR index (sTfR/log ferritin ratio) may be useful as alternative markers.
Department of Pathology, Northern Health, Epping, Australia
Introduction: Serum ferritin <30 µg/L is used to diagnose iron deficiency in adults based on the RCPA iron studies standardised reporting protocol (2021). Functional reference limits for iron deficiency have been derived using erythrocyte indices like haemoglobin. Soluble transferrin receptor (sTfR) and sTfR index (sTfR/log ferritin ratio) may be useful as alternative markers.
Methods: NHANES data (2017-March 2020; August 2021-August 2023) for non-pregnant women aged 15-49 years were used to derive ferritin thresholds for iron-deficient erythropoiesis. Those with missing data, signs of infection (WBC >10.0×10⁹/L) and/or inflammation (CRP >5.0 mg/L) were excluded. Functional reference limits were identified using restricted cubic spline regression. Ferritin was tested on Cobas e601, STFR on Cobas c501 and haemoglobin on Beckman Coulter DxH 800.
Results: Among 1681 women, ferritin thresholds for iron-deficient erythropoiesis were 25.0 µg/L (haemoglobin), 22.3 µg/L (sTfR) and 20.9 µg/L (sTfR index). Using the sTfR index threshold, 26% of subjects were iron-deficient, compared to 39% using the <30 µg/L cut-off.
Discussion: Functional reference limits for serum ferritin are lower than the RCPA cut-off. Validation across diverse populations is required, along with method-specific threshold derivation. Alternative models for determining functional serum ferritin reference limits should also be explored to find the best approach.
Speaker/Presenting Authors
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Submitting/Presenting Authors
Dr Kay Weng Choy - Northern Health (Victoria, Australia)