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Associations Between Serum Transferrin Receptor Concentrations and Erythropoietic Activities According to Body Iron Status

Address correspondence to Jong Weon Choi, MD, PhD, Dept. of Laboratory Medicine, Inha University Hospital, 7-206, 3-ga, Shinheung-dong, Jung-gu, Inchon, 400-711, South Korea; tel 82 32 890 2503; fax 82 32 890 2529; e-mail jwchoi{at}inha.ac.kr.

This study investigated the associations between serum transferrin receptor (sTfR) concentrations and erythropoietic activities during 3 stages of iron deficiency in humans. Serum iron markers, fluorescent intensity of reticulocytes, and sTfR concentrations were measured in 227 prepubescent children, age 9 to 12 yr. Reticulocyte subpopulations were analyzed by flow cytometry and sTfR concentrations were measured by enzyme immunoassay. Mean values of middle-fluorescence reticulocytes (MFR), reticulocyte maturity index (RMI), and sTfR concentrations were significantly higher in iron-deficiency anemia subjects than in healthy controls. Reticulocyte subpopulations increased gradually, as body iron status diminished; the mean values of MFR and RMI in subjects with serum ferritin concentrations <4.0 µg/L were 3-fold higher than those in healthy controls (p <0.01). Correlation coefficients of MFR and RMI vs log ferritin values (r = 0.43 and r = 0.42) were higher than those of MFR and RMI vs sTfR concentrations (r = 0.24 and r = 0.27) in iron-deficiency anemia subjects. In summary, iron deficiency leads to increased production of immature reticulocytes. Erythropoietic activity is more closely associated with log ferritin values than with sTfR concentrations in iron-deficiency anemia.

Keywords: serum transferrin receptor, erythropoietic activity, ferritin, reticulocyte subpopulations

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