Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project
Background: Total body iron (TBI) that is calculated from ferritin and soluble transferrin receptor (sTfR) allows for the evaluation of the full range of iron status from deficiency to excess. However, both ferritin and sTfR are affected by inflammation and malaria, which may require a statistical a...
| Autores principales: | , , , , , , , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Elsevier
2017
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/146246 |
| _version_ | 1855523495673331712 |
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| author | Namaste, Sorrel M. L. Rohner, Fabian Huang, Jin Bhushan, Nivedita L. Flores-Ayala, Rafael Kupka, Roland Mei, Zuguo Rawat, Rahul Williams, Anne M. Raiten, Daniel J. Northrop-Clewes, Christine A. Suchdev, Parminder S. |
| author_browse | Bhushan, Nivedita L. Flores-Ayala, Rafael Huang, Jin Kupka, Roland Mei, Zuguo Namaste, Sorrel M. L. Northrop-Clewes, Christine A. Raiten, Daniel J. Rawat, Rahul Rohner, Fabian Suchdev, Parminder S. Williams, Anne M. |
| author_facet | Namaste, Sorrel M. L. Rohner, Fabian Huang, Jin Bhushan, Nivedita L. Flores-Ayala, Rafael Kupka, Roland Mei, Zuguo Rawat, Rahul Williams, Anne M. Raiten, Daniel J. Northrop-Clewes, Christine A. Suchdev, Parminder S. |
| author_sort | Namaste, Sorrel M. L. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: Total body iron (TBI) that is calculated from ferritin and soluble transferrin receptor (sTfR) allows for the evaluation of the full range of iron status from deficiency to excess. However, both ferritin and sTfR are affected by inflammation and malaria, which may require a statistical adjustment. TBI has been used to assess iron status in the United States, but its use worldwide and in settings with inflammation has been limited.
Objective: We examine whether inflammation-adjusted ferritin and sTfR concentrations affect TBI values and the prevalence of low TBI (<0 mg/kg) in preschool children (PSC) (age range: 6–59 mo) and women of reproductive age (WRA) (age range: 15–49 y).
Design: Cross-sectional data for PSC (8 surveys; n = 8413) and WRA (4 surveys; n = 4258) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed individually and combined. TBI and the prevalence of low TBI were compared following 3 adjustment approaches for ferritin and sTfR: 1) the exclusion of individuals with inflammation (C-reactive protein concentration >5 mg/L or α-1-acid glycoprotein concentration >1 g/L), 2) the application of arithmetic correction factors, and 3) the use of regression correction.
Results: Regardless of the method that was used to adjust ferritin and sTfR for inflammation, the adjusted mean TBI decreased in both PSC and WRA compared with unadjusted values. Subsequently, inflammation-adjusted TBI increased the prevalence of low TBI by a median of 4–14 percentage points (pps) in PSC and 1–3 pps in WRA compared with unadjusted TBI. The regression approach resulted in a greater median increase than was achieved with the exclusion or correction-factor approaches, and accounting for malaria in addition to inflammation did not have an added effect on the prevalence estimates.
Conclusions: The prevalence of low TBI is underestimated if it is not adjusted by inflammation, particularly in children living in areas with a high prevalence of inflammation. |
| format | Journal Article |
| id | CGSpace146246 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| record_format | dspace |
| spelling | CGSpace1462462024-10-25T07:57:08Z Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project Namaste, Sorrel M. L. Rohner, Fabian Huang, Jin Bhushan, Nivedita L. Flores-Ayala, Rafael Kupka, Roland Mei, Zuguo Rawat, Rahul Williams, Anne M. Raiten, Daniel J. Northrop-Clewes, Christine A. Suchdev, Parminder S. iron deficiency chlorosis ferritin anaemia nutrition assessment analysis inflammation Background: Total body iron (TBI) that is calculated from ferritin and soluble transferrin receptor (sTfR) allows for the evaluation of the full range of iron status from deficiency to excess. However, both ferritin and sTfR are affected by inflammation and malaria, which may require a statistical adjustment. TBI has been used to assess iron status in the United States, but its use worldwide and in settings with inflammation has been limited. Objective: We examine whether inflammation-adjusted ferritin and sTfR concentrations affect TBI values and the prevalence of low TBI (<0 mg/kg) in preschool children (PSC) (age range: 6–59 mo) and women of reproductive age (WRA) (age range: 15–49 y). Design: Cross-sectional data for PSC (8 surveys; n = 8413) and WRA (4 surveys; n = 4258) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed individually and combined. TBI and the prevalence of low TBI were compared following 3 adjustment approaches for ferritin and sTfR: 1) the exclusion of individuals with inflammation (C-reactive protein concentration >5 mg/L or α-1-acid glycoprotein concentration >1 g/L), 2) the application of arithmetic correction factors, and 3) the use of regression correction. Results: Regardless of the method that was used to adjust ferritin and sTfR for inflammation, the adjusted mean TBI decreased in both PSC and WRA compared with unadjusted values. Subsequently, inflammation-adjusted TBI increased the prevalence of low TBI by a median of 4–14 percentage points (pps) in PSC and 1–3 pps in WRA compared with unadjusted TBI. The regression approach resulted in a greater median increase than was achieved with the exclusion or correction-factor approaches, and accounting for malaria in addition to inflammation did not have an added effect on the prevalence estimates. Conclusions: The prevalence of low TBI is underestimated if it is not adjusted by inflammation, particularly in children living in areas with a high prevalence of inflammation. 2017-07 2024-06-21T09:06:20Z 2024-06-21T09:06:20Z Journal Article https://hdl.handle.net/10568/146246 en Open Access Elsevier Namaste, Sorrel ML; Rohner, Fabian; Huang, Jin; Bhushan, Nivedita L.; Flores-Ayala, Rafael; Kupka, Roland; Mei, Zuguo; Rawat, Rahul; Williams, Anne M.; Raiten, Daniel J.; Northrop-Clewes, Christine A.; and Suchdev, Parminder S. 2017. Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. American Journal of Clinical Nutrition 106(Supplement 1): 359S-371S. https://doi.org/10.3945/ajcn.116.141762 |
| spellingShingle | iron deficiency chlorosis ferritin anaemia nutrition assessment analysis inflammation Namaste, Sorrel M. L. Rohner, Fabian Huang, Jin Bhushan, Nivedita L. Flores-Ayala, Rafael Kupka, Roland Mei, Zuguo Rawat, Rahul Williams, Anne M. Raiten, Daniel J. Northrop-Clewes, Christine A. Suchdev, Parminder S. Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project |
| title | Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project |
| title_full | Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project |
| title_fullStr | Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project |
| title_full_unstemmed | Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project |
| title_short | Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project |
| title_sort | adjusting ferritin concentrations for inflammation biomarkers reflecting inflammation and nutritional determinants of anemia brinda project |
| topic | iron deficiency chlorosis ferritin anaemia nutrition assessment analysis inflammation |
| url | https://hdl.handle.net/10568/146246 |
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