4.7 Review

Classic and emergent indicators for the assessment of human iron status

Journal

CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION
Volume 61, Issue 17, Pages 2827-2840

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/10408398.2020.1787326

Keywords

Anemia; hepcidin; iron deficiency; iron replacement therapy; iron status

Funding

  1. Colombian Ministry of Science, Technology, and Innovation (Minciencias) [567 2012]

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Iron deficiency is the leading cause of anemia, and assessing iron nutritional status requires consideration of various laboratory tests and indicators. Using multiple indicators in combination may be the best practice due to the influence of different factors on these indicators. Constant validation, improvement of assessment methods, and identification of new indicators are key to refining the assessment of iron nutritional status and selecting appropriate treatment for improvement.
Iron deficiency is the leading cause of anemia, a significant global public health problem. Different methods exist for assessing iron nutritional status, including laboratory tests that focus on storage, transportation, and iron functional compartment parameters. Classical markers such as bone marrow, serum iron, ferritin, hemoglobin, erythrocyte parameters, transferrin, transferrin receptors, and zinc protoporphyrin are discussed in this review. Additional parameters calculated from these indicators, including transferrin saturation, ferritin index and Thomas plot, and some emergent parameters such as hepcidin, erythroferrone, and low hemoglobin density are also discussed. There is no a single indicator for assessing iron nutritional status. Therefore, the use of more than one indicator may be the best practice to obtain the correct diagnosis, also considering the influence of inflammation/infection on many of these indicators. The constant validation of the current parameters, the improvement of assessment methods, and the identification of new indicators will be the key to refine the assessment of iron nutritional status and the right choice of treatment for its improvement.

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