@article{fdi:010049034,
  title = {{A}djusting plasma ferritin concentrations to remove the effects of subclinical inflammation in the assessment of iron deficiency : a meta-analysis},
  author = {{T}hurnham, {D}. {I}. and {M}c{C}abe, {L}. {D}. and {H}aldar, {S}. and {W}ieringa, {F}rank and {N}orthrop-{C}lewes, {C}. {A}. and {M}c{C}abe, {G}. {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he {W}orld {H}ealth {O}rganization recommends serum ferritin concentrations as the best indicator of iron deficiency ({ID}). {U}nfortunately, ferritin increases with infections; hence, the prevalence of {ID} is underestimated. {O}bjective: {T}he objective was to estimate the increase in ferritin in 32 studies of apparently healthy persons by using 2 acute-phase proteins ({APP}s). {C}-reactive protein ({CRP}) and alpha(1)-acid glycoprotein ({AGP}), individually and in combination, and to calculate factors to remove the influence of inflammation from ferritin concentrations. {D}esign: {W}e estimated the increase in ferritin associated with inflammation (ie, {CRP} >5 mg/{L} and/or {AGP} >1 g/{L}). {T}he 32 studies comprised infants (5 studies), children (7 studies), men (4 studies), and women (16 studies) (n = 8796 subjects). {I}n 2-group analyses (either {CRP} or {AGP}), we compared the ratios of log ferritin with or without inflammation in 30 studies. {I}n addition, in 22 studies, the data allowed a comparison of ratios of log ferritin between 4 subgroups: reference (no elevated {APP}), incubation (elevated {CRP} only), early convalescence (both {APP} and {CRP} elevated), and late convalescence (elevated {AGP} only). {R}esults: {I}n the 2-group analysis, inflammation increased ferritin by 49.6% ({CRP}) or 38.2% ({AGP}; both {P} <0.001). {E}levated {AGP} was more common than {CRP} in young persons than in adults. {I}n the 4-group analysis, ferritin was 30%, 90%, and 36% (all {P} < 0.001) higher in the incubation, early convalescence, and late convalescence subgroups, respectively, with corresponding correction factors of 0.77, 0.53, and 0.75. {O}verall, inflammation increased ferritin by approximate to 30% and was associated with a 14% ({CI}: 7%, 21%) underestimation of {ID}. {C}onclusions: {M}easures of both {APP} and {CRP} are needed to estimate the full effect of inflammation and can be used to correct ferritin concentrations. {F}ew differences were observed between age and sex subgroups. {A}m {J} {C}lin {N}utr 2010;92:546-55.},
  keywords = {},
  booktitle = {},
  journal = {{A}merican {J}ournal of {C}linical {N}utrition},
  volume = {92},
  numero = {3},
  pages = {546--555},
  ISSN = {0002-9165},
  year = {2010},
  DOI = {10.3945/ajcn.2010.29284},
  URL = {https://www.documentation.ird.fr/hor/fdi:010049034},
}