(serum ferritin to detect iron deficiency in children below five years of age)

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Paediatrica IndonesianaVOLUME 53 NUMBER 3May

Original Article

150Paediatr Indones, Vol. 53, No. 3, May 2013

Serum ferritin to detect iron deficiency in children

below five years of age

Windy Saufia Apriyanti, Sutaryo, Sri Mulatsih

AbstractBackground ,URQGHILFLHQF\,'DQHPLDLPSDFWVWKHcognitive and motor development of children until the age of

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is recommended and serum ferritin has been proposed as an

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Objective To assess the diagnostic accuracy of serum ferritin forGHWHFWLQJ,'LQFKLOGUHQEHORZILYH\HDUVRIDJH

MethodsThis cross-sectional, diagnostic study was conducted inSULPDU\KHDOWKFDUHFHQWHUVLQ


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Windy Saufia Apriyanti et al: Serum ferritin to detect iron deficiency in children below five years of age

Paediatr Indones, Vol. 53, No. 3, May 2013151

World Health Organization recommends

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in children aged 6 months to 5 years.However, this

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levels of serum ferritin to detect iron deficiency

in children below five years of age has not been

determined. The aim of the study was to assess serum

ferritin diagnostic levels and the best cutoff point to

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Methods

We conducted a cross-sectional, diagnostic study

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the Ethics Committee of the Gadjah Mada University

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Paediatr Indones, Vol. 53, No. 3, May 2013153

Cross-tabulation between serum ferritin and

sTfR values are shown in Table 3. According to ROC,

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Discussion

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life, due to decreased iron intake and rapid growth in

the first year of life. Normal infants need to absorb

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the end of the second year of life, this swift rate of

growth begins to slow, so routine diets should includesufficient iron-rich foods to meet demands.

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poor recalled diet, and low socioeconomic status.

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age. No history of cows milk consumption was found

in either group. Low socioeconomic status led to

parents being unable to provide appropriate diets,

as well as appropriate developmental stimulation fortheir children.

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females. Gender differences reportedly only affect

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loss due to parasitic infections.A limitation of our

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to detect parasitic infections.

We found that the mean Hb level in the

iron deficient group was lower than that of theQRUPDOJURXS3(YHQLIWKH+EOHYHOZDV

still within normal limits in iron deficient patients,

iron supplementation must be given to prevent

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recommendations.

Mean sTfR level in the iron deficient group was

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Levels of serum ferritin in both groups were within

normal ranges. This shows that sTfR is a more

sensitive indicator for iron deficiency than serum

ferritin. Normal values of serum ferritin for children

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closely. Ferritin is an acute-phase reactant that can

become elevated in settings of inflammation, chronic

infection, and malignancy.

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and inflammation under field conditions. The WHO

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the onset of inflammation and remains elevated for

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suffered from infection and inflammation based on

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in our study.

Both cut off and diagnostic values of serum

ferritin to detect iron deficiency in children below five

years of age have not yet been identified. The WHO

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diagnosis in children aged 6 months to 5 years.

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as an initial cut off point. However, this level resulted

in poor diagnostic values, with sensitivity, specificity

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ferritin was not a useful differentiator. The poor

diagnostic values may have been influenced by the

small sample size.

Several studies had similar results. Serum ferritin

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values.However, an Estonian study found serum

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We constructed a ROC in order to choose the

best cut off point of serum ferritin concentration,

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level was still not sensitive enough to make a confident

diagnosis. A good screening tool is defined as having

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specificity.

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in children below five years of age. However, further

study should be performed with a larger sample size

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iron status.

Acknowledgment

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comments during manuscript preparation, Hendro Dwi Wicaksonoas our assistant in the study. We also thank the laboratory staffRIWKH 3DUDKLWD/DERUDWRU\ LQFLWHG0D\@

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5. Wu AC, Lesperance L, Bernstein H. Screening for iron

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et al. The reference limits and cut-off value for serum soluble

transferrin receptors for diagnosing iron deficiency in infants.

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transferrin receptors and iron deficiency, a step beyond

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anemia penyakit kronis menggunakan peran indeks

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of iron deficiency and iron deficiency anemia in infants and

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Combined measurement of ferritin, soluble transferrin

receptor, retinol binding protein, and C-reactive protein by an

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iron parameters in the prediction of iron deficiency in an

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MG. Clinical utility of the soluble transferrin receptor and

comparison with serum ferritin in several populations. Clin

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et al. Reference and cut-off values for serum ferritin, mean

cell volume, and hemoglobin to diagnose iron deficiency in

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(serum ferritin to detect iron deficiency in children below five years of age)

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