Soluble transferrin receptor/log ferritin ratio distinguishing between iron deficiency anemia and anemia of chronic disease

Background Anemia of chronic disease (ACD) stands as the second most prevalent etiology of anemia, following iron deficiency anemia (IDA). Aim This work was aimed at investigating the potential soluble transferrin receptor (sTfR)/log ferritin index’s impact on the differentiation between IDA and ACD. Patients and methods The case–control work included 80 anemic cases in addition to 40 healthy participants of both sexes, with ages more than or equal to 18 years old. Participants underwent an equal categorization into three groups: group I: 40 ACD patients (serum ferritin ≥300 ng/ml and transferrin saturation≤45%). Group II: 40 IDA patients (serum ferritin<30 ng/ml, transferrin saturation<16%). Group III: 40 medically-free volunteers as a control group. sTfR/log ferritin index was evaluated as a reliable marker for diagnosing IDA. Results At a cut-off value of sTfR as well as sTfR/log ferritin index more than 2.83 and more than 2.45, respectively, the area under the curve (AUC) was 1.0, the sensitivity was 100%, and the specificity was 92.5 and 100%, respectively. For differentiation of ACD from IDA, the STR-F index had a significantly larger AUC than sTfR ( P <0.001). For the diagnosis of IDA, the combination of sTfR and sTfR/log ferritin index had the greatest sensitivity, indicating 100.0%, while specificity reached 92.5% with an accuracy of 96.25%. Conclusions sTfR/log ferritin index had a significantly larger AUC than sTfR alone in distinguishing IDA from ACD. For the diagnosis of IDA, the combination of sTfR and sTfR/log ferritin index had the greatest sensitivity, indicating 100.0%, while specificity reached 92.5%.