SOLUBLE TRANSFERRIN RECEPTOR-FERRITIN INDEX IN THE DIAGNOSIS OF ANEMIA OF CHRONIC DISEASE IN PATIENTS WITH DIABETES

The aim of the present research is to investigate the efficiency of sTfR, ferritin and the ratio sTfR/log ferritin (sTfR-ferritin index) in the diagnosis of anemia of chronic disease (ACD) in patients with diabetes mellitus and healthy controls. The patientsʼ blood samples were taken from the University Hospital of the Medical University – Plovdiv. The serum levels of sTfR and ferritin were determined with commercially available ELISA kits. The measurements of sTfR and ferritin are reliable markers of iron deficiency anemia (IDA) and the calculation of the ratio sTfR/log ferritin can be used also to evaluate ACD. In diabetic patients sTfR is 0.866 (0.694 ÷ 1.201) and in healthy controls is 0.781 (0.585 ÷ 0.914), (p = 0.017) while ferritin is 125.76 (16.2 ÷ 358.85) and 31.21 (17.9 ÷ 54.2), (p = 0.014) respectively. The sTfR-ferritin index in diabetic patients is 0.423 (0.275 ÷ 0.638) and in the healthy controls it is 0.499 (0.378 ÷ 0.602), (p = 0.222). The same parameters are investigated separating the patients according to the CRP level. In the group with increased CRP (>8) the concentration of ferritin is significantly higher (p = 0.03). In this group the sTfR-ferritin index is with 27 % higher than the group with normal CRP (≤8). In contrast to rheumatoid arthritis occuring with acute inflammation where this index can be used for parameter confirming IDA, in diabetes we didn’t find significant difference between the group with normal and increased CRP. Possible explanation of this fact is the low inflammation activity in diabetes where the determination of sTfR is more informative as a parameter for pure iron deficiency.