Ferritin and transferrin levels of the elderly population at Lagos State university teaching hospital, Ikeja, Lagos, Nigeria
DOI:
https://doi.org/10.18203/issn.2454-2156.IntJSciRep20214492Keywords:
Ferritin, Transferrin, ElderlyAbstract
Background: The elderly have limited regenerative abilities thus predisposing them to various diseases. Measuring both serum ferritin and transferrin serve as biomarkers of iron deficiency. This study, using enzyme-linked immunosorbent assay (ELISA) determined the serum levels of ferritin and transferrin in the elderly. Full blood count was also done and correlated with serum ferritin and transferrin levels of every participant.
Methods: This was a cross-sectional study at the Geriatric Clinic of Lagos State University Teaching Hospital (LASUTH). Following receipt of written consents from ninety (90) elderly participants, venous samples were drawn for full blood count (FBC) and samples for serum ferritin and transferrin ELISA assay collected and stored at -40oC until the required sample size was obtained. Data were analyzed using SPSS version 23.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). The Pearson chi-square test was used for statistical analysis. P value was considered to be statistically significant when <0.05.
Results: Participants consisted of 50 (55.6%) females and 40 (44.4%) males. The mean age of all participants was 71.31±7.38 years. The Majority, 90% (36 of 40) of the males had haemoglobin values lower than 13 gm/dl, while 66% (33 of 50) of females had haemoglobin values lower than 12 gm/dl. The mean ferritin concentration of all participants was 196.19 ±121.21ng/ml. The overall mean serum transferrin was 0.187±0.157 ng/ml with a minimum of 0.03 ng/ml and a maximum of 1.18 ng/ml.
Conclusions: Anaemia in the elderly is very common using the World Health Organization (WHO) haemoglobin cut-off values, however, iron deficiency anaemia prevalence is low.
Metrics
References
WHO, Geneva: Switzerland; 2010. World Health Organization. Definition of an older or elderly. Available at: http://www.who.int/healthinfo/survey/ ageingdefnolder/en/index.html. Accessed on 12 March 2021.
Jacobs JM, Maaravi Y, Cohen A, Bursztyn M, Ein-Mor E, Stessman J. Changing profile of health and function from age 70 to 85 years. Gerontology. 2012;58(4):313–21.
Goggins WB, Woo J, Sham A, Ho SC. Frailty Index as a Measure of Biological Age in a Chinese Population. J Gerontol A Biol Sci Med Sci. 2005;60(8):1046–51.
Mitnitski AB, Graham JE, Mogilner AJ, Rockwood K. Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr. 2002;2:1.
Washington, DC: National Academy Press; 2001. IOM. Institute of Medicine. iron. In: Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc; pp. 290–393.
Allen L, de Benoist B, Dary O, Hurrel R (eds). Geneva: WHO and FAO; 2006. WHO Guidelines on food fortification with micronutrients; p.236.
Jacobs A, Miller F, Worwood M, Beamish MR, Wardrop CA, Ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. Br Med J. 1972;1:206–8.
WHO, CDC. Assessing the iron status of populations: including literature reviews. Report of a Joint World Health Organization/Centers for Disease Control and Prevention Technical Consultation on the assessment of iron status at the population level, Geneva, Switzerland, 6–8 April 2004. 2nd ed. Geneva (Switzerland): WHO/CDC; 2007.
Wally J, Buchanan SK. A structural comparison of human serum transferrin and human lactoferrin. Biometals. 2007;20(3-4):249-62.
Giansanti F, Panella G, Leboffe L, Antonini G. Lactoferrin from Milk: Nutraceutical and Pharmacological Properties. Pharmaceuticals (Basel). 2016;9(4):1.
Bermejo F, García-López S. A guide to diagnosis of iron deficiency and iron deficiency anemia in digestive diseases. World J Gastroenterol. 2009;15(37):4638-43.
Bothwell TH. Iron metabolism in man. Oxford, Blackwell Scientific Publications, 1979.
Dautry-Varsat A. Receptor-mediated endocytosis: the intracellular journey of transferrin and its receptor. Biochimie. 1986;68(3):375-81.
Pupim LB, Martin CJ, Ikizler TA; Assessment of Protein and Energy Nutritional Status. Nut Manage Ren Dis. (2013);1:137-58.
Neyra NR, Hakim RM, Shyr Y, Ikizler TA. Serum transferrin and serum prealbumin are early predictors of serum albumin in chronic hemodialysis patients. J Ren Nutr. 2000;10:184e90.
Taylor SJ, Fettes SB, Jewkes C, Nelson RJ. A prospective, randomized, controlled trial to determine the effect of early enhanced enteral nutrition on clinical outcome in mechanically ventilated patients suffering a head injury. Crit Care Med. 1999;27:2525e31.
Daniel WW. Biostatics: A foundation for analysis in the health sciences. 7th edition. New York: John Wiley and sons: 1999.
Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R. Prevalence and possible causes of anaemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Dove Press Journal, 2014;9:1187-96.
Beutler E, Waalen J. The definition of anaemia: what is the lower limit of normal the blood haemoglobin concentration? Blood. 2006;107:1747-50.
Beutler E, West C. Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on haemoglobin levels and mean corpuscular volume. Blood. 2005;106:740-5.
Lipschitz DA, Mitchel CO, Thompson C, The anaemia of senescence. Am.J.Hematol. 1981;11:47-54.
Thomas DR. Anemia and quality of life: unrecognized and undertreated. The journals of gerontology Series A, Biological sciences and medical sciences. 2004;59:238-41.
Chaves PH, Semba RD, Leng SX, Woodman RC, Ferrucci L, Guralnik JM, et al. Impact of anaemia and cardiovascular disease on frailty status of community-dwelling older women: the Women's Health and Aging Studies I and II. The journals of gerontology Series A, Biological Sciences and Medical Sciences. 2005;60:729-35.
Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. Journal of the American Geriatrics Society. 2004;52:719-24.
Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anaemia on mortality, cognition, and function in community-dwelling elderly. The American journal of medicine. 2006;119:327-34.
Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR. Impact of anaemia on hospitalization and mortality in older adults. Blood. 2006;107:3841-6.
Nathavitharana RL, Murray JA, D'Sousa N, Sheehan T, Frampton CM, Baker BW. Anaemia is highly prevalent among unselected internal medicine inpatients and is associated with increased mortality, earlier readmission and more prolonged hospital stay: an observational retrospective cohort study. Internal medicine journal. 2012;42:683-91.
World Health Organization. Nutritional Anaemias: Report of a WHO Scientific group. WHO Technical Report Series 405.Geneva, Switzerland. World Health Organaization.1968.
Izaks GJ, Westendrop RGJ, Knook DL. The definition of anaemia in the older person. J Am Med Assoc. 1999;281:1714-7.
Andrès E, Serraj K, Federici L, Vogel T, Kaltenbach G. Anemia in elderly patients: new insight into an old disorder. Geriatr Gerontol Int. 2013;13(3):519-27.
McLennan WJ, Andrews GR, Macleod C, Caird FI. Anaemia in the Elderly, QJM: An Int J Med. 1973;42(1):1–13.
Assessment of iron nutriture in DHHS publication No 89-1255 pp 129-151. Maryland MD.USA. Department of Health and Human Services, 1989.
Calvey HD, Castleden CM. Gastrointestinal investigations for anaemia in the elderly. A prospective study. Age Aging. 1987;16:399-404.
Guyatt GH, Oxmann AD, Ali M. Laboratory diagnosis of iron deficiency anaemia.an overview. J Gen Intern Med.1992;7:145-53.
Casale G, Bonora C, Migliavacca A. Serum ferritin and aging. Age Aging 1981;10;119-22.
Goddard AF, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. Gut. 2000:46;(iv):1-5.
Holyoake TL, Stott DJ, McKay PJ. Use of plasma ferritin concentrations to diagnose iron-deficiency anaemia in the elderly. J Clin Pathol. 1993;46:857-60.
Milman N, Ingerslev J, Gradual N. Serum ferritin and Iron Status in a population of ‘healthy’ 85-year-old individuals. Scan J Clin Lab Inves. 1990;50:77-83.
Bachman E, Feng R, Travison T, Li M, Olbina G, Ostland V, et al. Testosterone suppresses hepcidin in men: a potential mechanism for testosterone-induced erythrocytosis. J Clin Endocrinol Metab. 2010;95:4743-57.
Yang Q, Jian J, Katz S, Abramson SB, Huang X. 17β-Estradiol inhibits iron hormone hepcidin through an estrogen-responsive element half-site. Endocrinology. 2012;153:3170-8.
Tandara L, Salamunic I. Iron metabolism: current facts and future directions. Biochem Med (Zagreb). 2012;22(3):311-28.
Macedo MF, de Sousa M. Transferrin and the transferrin receptor: of magic bullets and other concerns. Inflammation & Allergy Drug Targets. 2008;7(1):41-52.