Abstract

Iron deficiency is the leading cause of anemia, a significant global public health problem. Different methods exist for assessing iron nutritional status, including laboratory tests that focus on storage, transportation, and iron functional compartment parameters. Classical markers such as bone marrow, serum iron, ferritin, hemoglobin, erythrocyte parameters, transferrin, transferrin receptors, and zinc protoporphyrin are discussed in this review. Additional parameters calculated from these indicators, including transferrin saturation, ferritin index and Thomas plot, and some emergent parameters such as hepcidin, erythroferrone, and low hemoglobin density are also discussed. There is no a single indicator for assessing iron nutritional status. Therefore, the use of more than one indicator may be the best practice to obtain the correct diagnosis, also considering the influence of inflammation/infection on many of these indicators. The constant validation of the current parameters, the improvement of assessment methods, and the identification of new indicators will be the key to refine the assessment of iron nutritional status and the right choice of treatment for its improvement.

摘要

缺铁是导致贫血的主要原因，贫血是一个重要的全球公共卫生问题。存在不同的方法来评估铁营养状况，包括侧重于储存、运输和铁功能隔室参数的实验室测试。本综述讨论了骨髓、血清铁、铁蛋白、血红蛋白、红细胞参数、转铁蛋白、转铁蛋白受体和锌原卟啉等经典标志物。还讨论了根据这些指标计算的其他参数，包括转铁蛋白饱和度、铁蛋白指数和 Thomas 图，以及一些紧急参数，如铁调素、赤铁酮和低血红蛋白密度。没有一个单一的指标来评估铁的营养状况。因此，使用多个指标可能是获得正确诊断的最佳做法，还考虑了炎症/感染对许多这些指标的影响。对现有参数的不断验证、评估方法的改进、新指标的确定，将是完善铁营养状况评估和正确选择治疗方法的关键。