Discriminating between iron deficiency anemia and anemia of chronic disease using traditional indices of iron status vs transferrin receptor concentration

We compared the ability of soluble serum transferrin receptor (TfR) concent ration, quantified using the R&D Systems (Minneapolis, MN) enzyme-linked im munosorbent TfR assay, with other more traditional indicators of iron statu s (total iron binding capacity [TIBC], mean corpuscular volume [MCV] percen t transferrin saturation [%TS] RBC distribution width (RDW] and serum iron concentration [SIC])for discriminating between patients with iron deficienc y anemia (IDA) or anemia of chronic disease (ACD). The TfR concentration wa s determined in 72 serum samples selected from men and nonpregnant women cl assified biochemically on the basis of ferritin concentration as having IDA (n = 41) or ACD (n = 31). By using receiver operating characteristic curve analysis, the diagnostic accuracy of the various indicators of iron status that we evaluated for discriminating between IDA and ACD decreased in the following order TIBC > TfR > MCV > (%TS = RDW) > SIG. There was no signific ant difference between the diagnostic accuracy of TIBC and TfR. Thus, the r outine measurement of TfR offers no advantage over TIBC for discriminating between people with biochemically defined IDA or ACD.