Hostname: page-component-848d4c4894-pjpqr Total loading time: 0 Render date: 2024-07-03T20:51:40.990Z Has data issue: false hasContentIssue false
  • English
  • Français

Severe malnutrition is associated with decreased levels of plasma transferrin receptor

Published online by Cambridge University Press:  09 March 2007

Francis O. T. Akenami ,
Antti Vaheri ,
Marjaleena Koskiniemi ,
Sanna-Maria Kivivuori ,
Emmanuel E. Ekanem ,
Debayo M. Bolarin  and
Martti A. Siimes
Francis O. T. Akenami
Affiliation:
Department of Virology, University of Helsinki, Finland children's Hospital, University of Helsinki, Finland Department of Chemical Pathology, University of Calabar, Nigeria
Antti Vaheri
Affiliation:
Department of Virology, University of Helsinki, Finland
Marjaleena Koskiniemi
Affiliation:
Department of Virology, University of Helsinki, Finland
Sanna-Maria Kivivuori
Affiliation:
children's Hospital, University of Helsinki, Finland
Emmanuel E. Ekanem
Affiliation:
Department of Paediatrics, University of Calabar, Nigeria
Debayo M. Bolarin
Affiliation:
Department of Chemical Pathology, University of Calabar, Nigeria
Martti A. Siimes
Affiliation:
children's Hospital, University of Helsinki, Finland
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Sixty children aged 1-3 years with protein malnutrition were involved in the present study. Measurements were made of plasma transferrin receptor (TfR), haemoglobin (Hb), ferritin, transferrin and Fe in comparison with twenty apparently healthy age- and sex-matched reference children in Nigeria. Plasma TfR was measured by an immunofluorometric assay. The mean plasma concentrations of both albumin (37 g/l) and transferrin (1·88 g/l) were within reference ranges in the ‘healthy’ children. The malnourished children had severe protein deficiency as indicated by their significantly lower mean plasma albumin (24·4-28·2 g/l; P < 0·0001) and transferrin (1·24-1·53 g/l; P < 0·0001) concentrations in comparison with the reference children. In the reference children, the traditional indicators of Fe nutrition (plasma Fe, transferrin Fe saturation and Hb) were within the reference ranges, but ferritin values were raised, indicating acute or chronic infection and/or inflammation. The mean concentrations of plasma TW (4·2-5-2 mg/l) in the malnourished group were significantly lower than the mean (6·1 mgn) of the reference children (P=0·0009). In the children with severe malnutrition, none of the indicators of Fe status except Hb (81·5-86·7 g/l; P<0·0001) showed Fe deficiency, including the serum concentration of TfR and the TfR : ferritin ratio, although the Fe status was lower than in the reference children (for Fe P = 0·009; and ferritin P=0·0004). In the absence of haemodilution, the low Hb values are a clear indication that the malnourished children were Fe deficient; none of the other indices was indicative of Fe deficiency. This is the first report of TfR levels in malnourished and healthy African children.

Keywords

TransferrinFerritinIronMalnutrition
Type
Human and Clinical Nutrition
Information
British Journal of Nutrition , Volume 77 , Issue 3 , March 1997 , pp. 391 - 397
Copyright
Copyright © The Nutrition Society 1997

References

REFERENCES

Anttila, R. & Siimes, M. A. (1996). Serum transferrin and ferritin in pubertal boys: relations to body growth, pubertal stage, erythropoiesis and iron deficiency. American Journal of Clinical Nutrition 63, 179–183.Google Scholar
Beguin, Y., Clemons, G. K., Pootrakul, P. & Fillet, G. (1993). Quantitative assessment of erythropoiesis and functional classification of anaemia based on measurements of serum transfemn receptor and erythropoietin. Blood 81, 1067–1076.Google Scholar
Carriaga, M. T., Skikne, B. S., Finley, B., Cutler, B. & Cook, J. D. (1991). Serum transferrin receptor for the detection of iron deficiency in pregnancy. American Journal of Clinical Nutrition 54, 1077–1081.CrossRefGoogle ScholarPubMed
Editorial (1970). Classification of infantile malnutrition. Lancet 2, 302.Google Scholar
Ferguson, B. J., Skikne, B. S., Simpson, K., Baynes, R. D. & Cook, J. D. (1992). Serum transfemn receptor distinguishes anemia of chronic disease from iron deficiency anemia. Journal of Laboratory and Clinical Medicine 119, 385–390.Google ScholarPubMed
Flowers, C. H., Skikne, B. S., Covell, A. M. & Cook, J. D. (1989). The clinical measurement of serum transferrin receptor. Journal of Laboratory and Clinical Medicine 114, 368–377.Google ScholarPubMed
Hallberg, L., Hulten, L., Lindstedt, G., Lundberg, P. -A., Mark, A., Purens, J., Svanberg, B. & Swolin, B. (1993). Prevalence of iron deficiency in Swedish adolescents. Pediatric Research 34, 680–687.Google Scholar
Hay, R. W., Whitehead, R. G. & Spicer, C. C. (1975). Serum-albumin as a prognostic indicator in oedematous malnutrition. Lancet 2, 427–429.Google Scholar
Huebers, H. A., Beguin, Y., Poottrakul, P., Einspahr, D. & Finch, C. A. (1990). Intact transferrin receptors in human plasma and their relation to erythropoiesis. Blood 75, 102–107.Google Scholar
Kivivuori, S. M., Anttila, R., Viinikka, L., Pesonen, K. & Siimes, M. A. (1993). Serum transfemn receptor for assessment of iron status in healthy prepubertal and early pubertal boys. Pediatric Research 34, 297–299.Google Scholar
Kivivuori, S. M., Heikinheimo, M., Teppo, A. M. & Siimes, M. A. (1994 a). Early rise in serum concentration of transferrin receptor induced by recombinant human erythropoietin in very-low-birth-weight infants. Pediatric Research 36, 85–89.CrossRefGoogle ScholarPubMed
Kivivuori, S. M., Viinikka, L., Teppo, A. M. & Siimes, M. A. (1994 b). Serum transfenin receptor and erythropoiesis in children with newly diagnosed acute lymphoblastic leukaemia. Leukemia Research 18, 823–828.CrossRefGoogle Scholar
Kohgo, Y., Niitsu, Y., Kondo, H., Kato, J., Tsushima, N., Sasaki, K., Hirayama, M., Numata, T., Nishisato, T. & Urushizaki, I. (1987). Serum transfenin receptor as a new index of erythropoiesis. Blood 70, 1955–1958.Google Scholar
Kohgo, Y., Nishisato, T., Kondo, H., Tsushima, N., Niitsu, Y. & Urushizaki, I. (1986). Circulating transferrin receptor in human serum. British Journal of Haematology 64, 277–281.CrossRefGoogle ScholarPubMed
Kuvibidila, S., Yu, L. C., Ode, D. L., Warrier, R. P. & Mbele, V. (1994). Assessment of iron status of Zairean women of childbearing age by serum transferrin receptor. American Journal of Clinical Nutrition 60, 603–609.CrossRefGoogle ScholarPubMed
Nielsen, O. J., Andersen, L. S., Hansen, N. E. & Hansen, T. M. (1994). Serum transferrin receptor levels in anaemic patients with rheumatoid arthritis. Scandinavian Journal of Clinical and Laboratory Investigation 54, 75–82.CrossRefGoogle ScholarPubMed
Petterson, T., Kivivuori, S. M. & Siimes, M. A. (1994). Is serum transferrin receptor useful for detecting iron deficiency in anaemic patients with chronic inflammatory diseases? British Journal of Rheumatology 33, 740–744.Google Scholar
Punnonen, K., Irjala, K. & Rajamäki, A. (1994). Iron-deficiency anaemia is associated with high concentrations of transfemn receptor in serum. Clinical Chemistry 40, 774–776.CrossRefGoogle ScholarPubMed
Saarinen, U. M. & Siimes, M. A. (1979). Iron absorption from breast milk, cow's milk, and iron supplemented formula: an opportunistic use of changes in total body iron determined by haemoglobin, ferritin, and body weight in 132 infants. Pediatric Research 13, 143–147.Google Scholar
Siimes, M. A., Addiego, J. E. & Dallman, P. R. (1974). Femtin in serum: diagnosis of iron deficiency and iron overload in infants and children. Blood 43, 581–590.Google Scholar
Skikne, B. S., Flowers, C. H. & Cook, J. D. (1990). Serum transfemn receptor: a quantitative measure of tissue iron deficiency. Blood 75, 1870–1876.CrossRefGoogle ScholarPubMed
Soini, E. & Kojola, H. (1983). Time-resolved fluorometer for lanthanide chelates: a new generation of nonisotopic immunoassays. Clinical Chemistry 29, 65–68.Google Scholar