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Vol. 55. Núm. 2.
Páginas 113-120 (agosto 2001)
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Vol. 55. Núm. 2.
Páginas 113-120 (agosto 2001)
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Receptor sérico de la transferrina en niños sanos
Serum transferrin receptor in healthy children
Visitas
9177
M.aA. Vázquez Lópeza,
Autor para correspondencia
mavazquezl@terra.es

Correspondencia: Plaza del Castillo, 10. Carboneras. 04140 Almería.
, A. Carracedo Moralesa, J. Muñoz Vicob, R. Morcillo Llorensa, M.D. Calvo Bonacheraa, J. López Muñoza, J. Muñoz Vicob, A. Muñoz Hoyosc
a Servicios de Pediatría Hospital Torrecárdenas. Almería.
b Análisis Clínicos. Hospital Torrecárdenas. Almería.
c Servicio de Pediatría. Hospital San Cecilio. Granada.
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Antecedentes

El receptor sérico de la transferrina (RsTf) es un parámetro fiable en la valoración del estado del hierro tisular y la actividad eritropoyética en adultos, pero los conocimientos sobre su papel en la infancia son escasos.

Objetivo

Evaluar la concentración de RsTf en niños sanos, su variación con la edad y sexo y su relación con otros parámetros del hierro y con la eritropoyetina.

Pacientes y métodos

Se obtuvieron muestras de sangre de 155 niños sanos entre 1-10 años de edad para determinar el RsTf, índices del estado del hierro y eritropoyetina. Se calculó el cociente RsTf/ferritina y el índice RsTf-F (RsTf/Log-ferritina). Se descartó la deficiencia de hierro y el aumento de actividad eritropoyética.

Resultados

Los valores de RsTf, RsTf/ferritina e índice RsTf-F fueron: 1,94 ± 0,41 mg/l (IC 95%; 1,14-2,74 mg/l), 83 ± 40,3 (IC 95%; 4-162) y 1,4 ± 0,36 (IC 95%; 0,69-2,1), respectivamente. No hubo diferencias significativas relacionadas con el sexo. Los valores más altos de RsTf fueron obtenidos en niños de 1a 2 años. Se observó una correlación positiva entre el RsTf y el número de hematíes (r: 0,17; p < 0,03), hemoglobina (r: 0,16; p < 0,05) y capacidad de saturación de hierro (CFH) (r: 0,258; p < 0,001). En el análisis de regresión lineal múltiple, sólo la CFH (0,0001) y log eritropoyetina (p < 0,016) predijeron de forma significativa los valores de RsTf.

Conclusiones

Los valores de RsTf son elevados en la infancia en relación con el aumento de los requerimientos de hierro necesarios para el crecimiento. En niños normales, el valor de RsTf depende de la actividad eritropoyética y la necesidad de hierro intracelular. Los datos obtenidos son útiles como referencia estándar en niños normales.

Palabras clave:
Receptor sérico de la transferrina
Hierro
Ferritina
Protoporfirina eritrocitaria
Eritropoyetina
Niños
Background

Serum transferrin receptor (sTfR) is a reliable tool for assessing functional iron status and erythropoietic activity in adults, but little is known about its role in children.

Objective

To evaluate sTfR concentrations in healthy children and age and sex-related variations. A further aim was to determine the relationship of these concentrations with other iron parameters and with erythropoietin.

Patients and methods

Blood samples from 155 healthy children aged 1-10 years old were obtained to determine sTfR, iron status indices and erythropoietin. The sTfR/ferritin ratio and the sTfR-ferritin index (sTfR/log ferritin) were calculated. Iron deficiency and increased erythropoiesis were eliminated.

Results

Values of sTfR, the sTfR/ferritin ratio and the sTfR-F index were 1.94 ± 0.41mg/L (95% CI: 1.14-2.74 mg/L), 83 ± 40.3 (95% CI: 4-162) and 1.4 ± 0.36 (95% CI: 0.69-2.1) respectively. No significant sex-related differences were found. Children aged 1-2 years old showed the highest sTfR levels. sTfR was directly related to erythrocyte count (r: 0.17; p < 0,03), hemoglobin level (r: 0.16; p < 0.05) and total iron binding capacity (r: 0.258; p < 0,001). In the multiple linear regression analysis, the best predictors of sTfR concentrations were log erythropoietin (p < 0.016) and total iron binding capacity (p < 0.0001).

Conclusions

sTfR concentrations are elevated in children due to increased iron requirements for growth. In healthy children sTfR concentrations are related to erythropoietic activity and intracellular iron requirements. The current data are useful as a standard reference for healthy children.

Key words:
Serum transferrin receptor
Iron
Ferritin
Free erythrocyte porphyrin
Erythropoietin
Children
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BibliografÍa
[1.]
Y. Kohgo, T. Nishisato, H. Kondo, N. Tsushima, Y. Niitsu, I. Urushizaki.
Circulating transferrin receptor in human serum.
Br J Haematol, 64 (1986), pp. 77-281
[2.]
Y. Beguin.
The soluble transferrin receptor: biological aspects and clinical usefulness as quantitative measure of erythropoiesis.
Haematologica, 77 (1992), pp. 1-10
[3.]
H.A. Huebers, C.A. Finch.
The physiology of transferrin and transferring receptors.
Physiol Rev, 67 (1987), pp. 520-582
[4.]
C.H. Flowers, B.S. Skikne, A.M. Covell, J.D. Cook.
The clinical measurement of serum transferrin receptor.
J Lab Clin Med, 114 (1989), pp. 368-377
[5.]
Y. Kohgo, Y. Niitsu, H. Kondo, I. Kato, N. Tsushima, K. Sasaki, et al.
Serum transferrin receptor as a new index of erythropoiesis.
Blood, 70 (1987), pp. 1955-1958
[6.]
Y.J. Shih, R.D. Baynes, B.G. Hudson, C.H. Flowers, B.S. Skikne, J.D. Cook.
Serum transferrin is a truncated form of tissue receptor.
J Biol Chem, 265 (1990), pp. 19077-19081
[7.]
J.D. Cook, B.S. Skikne, R.D. Baynes.
Serum Transferrin Receptor.
[8.]
K. Rao, D. Shapiro, E. Mattia, K. Bridges, R.D. Klausner.
Effects of alterations in cellular iron on biosynthesis of the transferring receptor in K562 cells.
Mol Cell Biol, 5 (1985), pp. 595-600
[9.]
M. Cazzola, Y. Beguin.
Annotation. New tools for clinical evaluation of erythron function in man.
Br J Haematol, 80 (1992), pp. 278-284
[10.]
M. Cazzola, P. Pootrakul, H. Huebers, M. Eng, J. Eschbach, C. Finch.
Erythroid Marrow Function in Anemic Patients.
Blood, 69 (1987), pp. 296-301
[11.]
Y. Beguin, G.K. Clemons, P. Pootrakul, G. Fillet.
Quantitative assessment of erythropoiesis and functional classification of anemia based on measurements of serum transferrin receptor and erythropoietin.
Blood, 81 (1993), pp. 1067-1076
[12.]
H.A. Huebers, Y. Beguin, P. Pootrakul, D. Inspahr, C.A. Finch.
Intact transferrin receptors in human plasma and their relation to erythropoiesis.
Blood, 75 (1990), pp. 102-107
[13.]
H. Khumalo, Z. Gomo, V. Moyo, V. Gordel, T. Saungweme, T. Rouault.
Serum transferrin receptors are decreased in the presence of iron overload.
Clin Chem, 44 (1998), pp. 40-44
[14.]
J. Allen, K. Backstrom, J. Cooper.
Measurement of soluble transferring receptor in healthy adults.
Clin Chem, 44 (1998), pp. 35-39
[15.]
J.W. Choi, M.W. Im, S.H. Pai.
Serum transferrin receptor concentrationsduring normal pregnancy.
Clin Chem, 46 (2000), pp. 725-727
[16.]
M. Carriaga, B. Skikne, B. Finley, B. Cutler, J. Cook.
Serum transferring receptor for the detection of iron deficiency in pregnancy.
Am J Clin Nutr, 54 (1991), pp. 1077-1081
[17.]
B. Skikne, C. Flowers, J. Cook.
Serum transferrin receptor: A quantitative measure of tissue iron deficiency.
Blood, 75 (1990), pp. 1870-1876
[18.]
K. Punnonen, K. Irjala, A. Rajamaki.
Iron-Deficiency Anemia is Associated with High Concentrations of Transferrin Receptor in Serum.
Clin Chem, 40 (1994), pp. 774-776
[19.]
K. Punnonen, K. Irjala, A. Rajamaki.
Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency.
Blood, 89 (1997), pp. 1052-1057
[20.]
P. Suominen, K. Punnonen, A. Rajamaki, K. Irjala.
Serum transferring receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits.
Blood, 92 (1998), pp. 2934-2939
[21.]
P. Suominen, K. Punnonen, A. Rajamaki, K. Irjala.
Evaluation of new immunoenzymometric assay for measuring soluble transferring receptor to detect iron deficiency in anemic patients.
Clin Chem, 45 (1997), pp. 1641-1646
[22.]
A. Remacha, M. Sarda, M. Parellada, J. Ubeda, R. Manteiga.
The role of serum transferrin receptor in the diagnosis of iron deficiency.
Haematologica, 83 (1998), pp. 963-966
[23.]
U. Rusia, C. Flowers, N. Madan, N. Agarwal, S.K. Sood, M. Sikka.
Serum transferrin receptor in detection of iron deficiency in pregnancy.
Ann Haematol, 78 (1999), pp. 358-363
[24.]
B.J. Ferguson, B.S. Skikne, K.M. Simpson, R.D. Baynes, J.D. Cook.
Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia.
J Lab Clin Med, 119 (1992), pp. 385-390
[25.]
R.T. Means, J. Allen, D.A. Sears, S.J. Schuster.
Serum soluble transferring receptor and the prediction of marrow aspirate iron results in a heterogeneous group of patients.
Clin Lab Haem, 21 (1999), pp. 161-167
[26.]
P. Suominen, T. Mottonen, A. Rajamaki, K. Irjala.
Single values of serum transferrin receptor and transferrin receptor ferritin index can be used to detect true and functional iron deficiency in rheumatoid arthritis patients with anemia.
[27.]
H. Schrezenmeier, G. Noe, A. Raghavachar, I.N. Rich, H. Heimpel, B. Kubanek.
Serum erythropoietin and serum transferrin receptor levels in aplastic anaemia.
Br J Haematol, 88 (1994), pp. 286-294
[28.]
P. Suominen, K. Punnonen, A. Rajamaki, R. Majuri, V. Aninen, K. Irjala.
Automated immunoturbidometric metod for measuring serum transferrin receptor.
Clin Chem, 45 (1999), pp. 1302-1305
[29.]
J.W. Choi, S.H. Pai, M.W. Im, S.K. Kim.
Change in transferrin receptor concentrations with age.
Clin Chem, 45 (1999), pp. 1562-1563
[30.]
U. Rusia, C. Flowers, N. Madan, N. Agarwal, S.K. Sood, M. Sikka.
Serum transferrin receptor levels in the evaluation of iron deficiency in the neonate.
Acta Paediatr Jpn, 38 (1995), pp. 455-459
[31.]
G. Carpani, M. Buscaglia, L. Ghisoni, D. Pizzotti, N. Bozo, M. Bellotti.
Soluble transferrin receptor in the study of fetal erythropoietic activity.
[32.]
E. Kiuper-Kramer, W. Baerts, R. Baker, J. Van Eyjk, J. Van Raan, H. Van Eijk.
Evaluation of the iron status of the newborn by soluble transferrin receptor in serum.
Clin Chem Lab Med, 36 (1998), pp. 17-21
[33.]
P. Kling, R. Roberts, J. Widness.
Plasma transferrin receptor levels and índices of erythropoiesis and iron status in healthy term infants.
J Pediatr Hematol Oncol, 20 (1998), pp. 309-314
[34.]
B. Lonnerdal, O. Hernell.
Iron, zinc, copper and selenium status of breast-fed infants and infants fed trace element fortified milk-based infant formula.
Acta Paediatr, 83 (1994), pp. 367-373
[35.]
G. Yeung, S. Zlotkin.
Percentile estimates for transferrin receptor in normal infants 9-15 mo of age.
Am J Clin Nutr, 66 (1997), pp. 342-346
[36.]
M. Virtanen, L. Viinikka, M. Virtanen, J. Svahn, R. Anttila, T. Krusius.
Higher Concentrations of serum transferrin receptor in children than in adults.
Am J Clin Nutr, 69 (1999), pp. 256-260
[37.]
R. Anttila, J. Cook, M. Siimes.
Body iron stores decrease in boys during pubertal development: the transferrin receptor-ferritin ratio as an indicator of Iron Status.
Pediatr Res, 41 (1997), pp. 224-228
[38.]
S.M. Kivivuori, R. Anttila, L. Viinikka, M.A. Siimes.
Serum transferring receptor for the assessment of iron status in healthy prepubertal and early pubertal boys.
Pediatr Res, 34 (1993), pp. 297-299
[39.]
J. Chisolm, D. Brown.
Micro-scale photofluorometric determination of “free erythrocyte porphyrin” (Protoporphyrin IX).
Clin Chem, 21 (1975), pp. 1669-1682
[40.]
P.R. Dallman, M.A. Siimes.
Percentile curves for hemoglobin and red cell volume in infancy and childhood.
J. Pediatr, 94 (1979), pp. 26-31
[41.]
F. Osky.
Iron deficiency in infancy and childhood.
N Engl J Med, 329 (1993), pp. 190-193
[42.]
B.H. Lubin.
Reference values in infancy and childhood.
Hematology of infancy and childhood, 3.ª ed, pp. 1977-1997
[43.]
A.C. Looker, P.R. Dallman, M.D. Carroll, E.W. Gunter, C.L. Johnson.
Prevalence of iron deficiency in the United States.
Jama, 277 (1997), pp. 973-976
[44.]
M. Hellebostad, P. Haga, M. Cotes.
Serum immunoreactive erythropoietin in healthy normal children.
Br J Haematol, 70 (1988), pp. 247-250
[45.]
R. Baynes.
Assessment of Iron Status.
Clin Chem, 29 (1996), pp. 209-215
[46.]
N. Ahluwalia.
Diagnostic utility of serum transferrin receptors measurement in assessing iron status.
Nutr Rev, 56 (1998), pp. 133-141
[47.]
M. Vernet.
Le recepteur de la transferrine: röle dans le métabolisme du fer et intérët en biologie clinique.
Ann Biol Clin, 57 (1999), pp. 9-17
[48.]
B.S. Skikne.
Circulating transferrin receptor assay-coming of age.
Clin Chem, 44 (1998), pp. 7-9
[49.]
M. Cooper, S. Zlotkin.
Day-to-day variation of transferrin receptor and ferritin in healthy men and women.
Am J Clin Nutr, 64 (1996), pp. 738-742
[50.]
M. Maes, E. Bosmans, S. Scharpe, D. Hendriks, W. Cooremans, H. Neels, et al.
Components of biological variation in serum soluble transferrin receptor: relationships to serum iron, transferri and ferritin concentrations, and immune and haematological variables.
Scand J Clin Lab Invest, 57 (1997), pp. 31-41
[51.]
E. Kuiper-Kramer, J. Van Raan, H.G. Van Eijk.
A new assay for soluble transferrin receptors in serum: time for standarisation.
Eur J Clin Chem Clin Biochem, 35 (1997), pp. 793
[52.]
G.S. Yeung, J.C. Kjarsgaard, S.H. Zlotkin.
Disparity of serum transferring receptor measurements among different assay methods.
Eur J Clin Nutr, 52 (1998), pp. 801-804
[53.]
A. Akesson, P. Bjellerup, M. Vahter.
Evaluation of kits for measurement of the soluble transferrin receptor.
Scand J Clin Lab Invest, 59 (1999), pp. 77-82
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