Publication:

Serum transferrin receptor-ferritin index as a marker of iron deficiency anemia in active inflammatory bowel disease patients in Indian population

Background Anemia is most common complication in IBD (inflammatory bowel disease). The aim of the study was to assess the sTfR-F (soluble transferrin receptor-ferritin) index as early marker of IDA (iron deficiency anaemia) in IBD.

Methods Retrospective cross sectional study has 480 cases of IBD (group I ) with controls 220 (group II), CBP, serum hsCRP, serum iron, TIBC (total iron binding capacity), sTfR, ferritin, fecal calprotectin, vitamin B12, folic acid were assessed.

Results In study I, group I was compared with group II showed (66.5%) patients had active disease and in that 65.0% of UC, 32.1% of CD and 2.9% others colitis had anemia. In study II, subgroup I 56.4% had IDA subgroup II 7.3% had ferritin between 30-100 ng/ml combi subgroup III 23.3% had ferritin>100 ng/ml (ACD, anaemia of chronic disease) subgroup IV 5.6% had vitamin B12 and folic acid deficiency excluding sTfR-F analysis. In study III, subdivided to identify IDA with sTfR-F index as group A 60.8% had sTfR-F index>2, group B 32.6% had sTfR-F index=1-2 and group C 3 (6.2%) had sTfR-F index<1. Intially diagnosed IDA was 56.4%, in addition with group A, IDA has increased by 66.5%. In study IV, in IDA, sensitivity of sTfR-F index was100%, sTfR 89% and SF 85%. Specificity of sTfR and sTfR-F index were 80.60% and SF has low specificity 73.90%. In study V, a statistical significance was seen more in female than male and in children than in adults with sTfR-F index in IDA.

Conclusions sTfR-F index as an early diagnostic marker, in differentiating IDA, ACD and combi in IBD patients.