Urinary ferritin as a noninvasive means of assessing iron status in young children

Document Type

Journal Article

Publication Title

Journal of Nutrition

Volume

154

Issue

9

First Page

2688

Last Page

2695

PubMed ID

38729575

Publisher

Elsevier

School

School of Medical and Health Sciences

RAS ID

71478

Funders

Telethon Perth Children’s Hospital Research Fund / Joondalup Health Campus / Paul Ramsey Foundation / Commonwealth Government of Australia

Comments

Moumin, N. A., D’Vaz, N., Kidd, C., MacRae, A., Zhou, S. J., Richards, T., ... & Green, T. J. (2024). Urinary ferritin as a noninvasive means of assessing iron status in young children. The Journal of Nutrition, 154(9), 2688-2695. https://doi.org/10.1016/j.tjnut.2024.04.040

Abstract

Background: Iron deficiency (ID) is the most common nutritional deficiency affecting young children. Serum ferritin concentration is the preferred biomarker for measuring iron status because it reflects iron stores; however, blood collection can be distressing for young children and can be logistically difficult. A noninvasive means to measure iron status would be attractive to either diagnose or screen for ID in young children. Objectives: This study aimed to determine the correlation between urinary and serum ferritin concentrations in young children; to determine whether correcting urinary ferritin for creatinine and specific gravity improves the correlation; and to determine a urine ferritin cut point to predict ID. Methods: Validation study was conducted using paired serum and urine collected from 3-y-old children (n = 142) participating in a longitudinal birth cohort study: the ORIGINS project in Perth, Western Australia. We calculated the sensitivity, specificity, positive, and negative predictive values of urinary ferritin amount in identifying those with ID at the clinical cut point used by the World Health Organization (serum ferritin concentration of <12 ng/mL). Results: Urine ferritin, corrected for creatinine, correlated moderately with serum ferritin [r = 0.53 (0.40–0.64)] and performed well in predicting those with ID (area under the curve: 0.85; 95% confidence interval: 0.75, 0.94). Urine ferritin <2.28 ng/mg creatinine was sensitive (86%) and specific (77%) in predicting ID and had a high negative predictive value of 97%; however, the positive predictive value was low (40%) owing to the low prevalence of ID in the sample (16%). Conclusions: Urine ferritin shows good diagnostic performance for ID. This noninvasive biomarker maybe a useful screening tool to exclude ID in healthy young children; however, further research is needed in other populations.

DOI

10.1016/j.tjnut.2024.04.040

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