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Urinary Ferritin as a Noninvasive Means of Assessing Iron Status in Young Children
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 difficul...
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| Published in: | The Journal of nutrition 2024-09, Vol.154 (9), p.2688-2695 |
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| container_issue | 9 |
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| container_title | The Journal of nutrition |
| container_volume | 154 |
| creator | Moumin, Najma A D’Vaz, Nina Kidd, Courtney MacRae, Andrea Zhou, Shao J Richards, Toby Palmer, Debra J Grzeskowiak, Luke E Sullivan, Thomas R Green, Tim J |
| description | 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.
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.
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 |
| doi_str_mv | 10.1016/j.tjnut.2024.04.040 |
| format | article |
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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.
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).
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%).
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.</description><identifier>ISSN: 0022-3166</identifier><identifier>ISSN: 1541-6100</identifier><identifier>EISSN: 1541-6100</identifier><identifier>DOI: 10.1016/j.tjnut.2024.04.040</identifier><identifier>PMID: 38729575</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Australia ; Biomarkers ; Blood levels ; Children ; Childrens health ; Confidence intervals ; Correlation ; Creatinine ; Ferritin ; Iron ; Iron deficiency ; iron status ; noninvasive biomarker ; Nutrient deficiency ; Performance prediction ; serum ferritin ; Specific gravity ; the ORIGINS project ; Urinalysis ; urinary ferritin ; Urine ; young children</subject><ispartof>The Journal of nutrition, 2024-09, Vol.154 (9), p.2688-2695</ispartof><rights>2024 American Society for Nutrition</rights><rights>Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright American Institute of Nutrition Sep 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-92f5e03c24f1178371279e6bd30dc0b11d36e6279f20078eb6714ae77d0608ba3</citedby><cites>FETCH-LOGICAL-c387t-92f5e03c24f1178371279e6bd30dc0b11d36e6279f20078eb6714ae77d0608ba3</cites><orcidid>0000-0002-3336-3153</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022316624002724$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27901,27902,45756</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38729575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moumin, Najma A</creatorcontrib><creatorcontrib>D’Vaz, Nina</creatorcontrib><creatorcontrib>Kidd, Courtney</creatorcontrib><creatorcontrib>MacRae, Andrea</creatorcontrib><creatorcontrib>Zhou, Shao J</creatorcontrib><creatorcontrib>Richards, Toby</creatorcontrib><creatorcontrib>Palmer, Debra J</creatorcontrib><creatorcontrib>Grzeskowiak, Luke E</creatorcontrib><creatorcontrib>Sullivan, Thomas R</creatorcontrib><creatorcontrib>Green, Tim J</creatorcontrib><title>Urinary Ferritin as a Noninvasive Means of Assessing Iron Status in Young Children</title><title>The Journal of nutrition</title><addtitle>J Nutr</addtitle><description>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.
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.
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).
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%).
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.</description><subject>Australia</subject><subject>Biomarkers</subject><subject>Blood levels</subject><subject>Children</subject><subject>Childrens health</subject><subject>Confidence intervals</subject><subject>Correlation</subject><subject>Creatinine</subject><subject>Ferritin</subject><subject>Iron</subject><subject>Iron deficiency</subject><subject>iron status</subject><subject>noninvasive biomarker</subject><subject>Nutrient deficiency</subject><subject>Performance prediction</subject><subject>serum ferritin</subject><subject>Specific gravity</subject><subject>the ORIGINS project</subject><subject>Urinalysis</subject><subject>urinary ferritin</subject><subject>Urine</subject><subject>young children</subject><issn>0022-3166</issn><issn>1541-6100</issn><issn>1541-6100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kMFq3DAQhkVpaLZpn6BQBL3k4s1IsiX70ENYkjSQtpA0h56EbI9bmV0p1dgLefvI3bSHHgoDA8P3zwwfY-8ErAUIfTaupzHM01qCLNewFLxgK1GVotAC4CVbAUhZKKH1MXtNNAKAKJv6FTtWtZFNZaoVu71PPrj0yC8xJT_5wB1xx7_E4MPekd8j_4wuEI8DPydCIh9-8OsUA7-b3DQTz5Hvcc7DzU-_7ROGN-xocFvCt8_9hN1fXnzbfCpuvl5db85vii6fn4pGDhWC6mQ5CGFqZYQ0Deq2V9B30ArRK406zwYJYGpstRGlQ2N60FC3Tp2w08PehxR_zUiT3XnqcLt1AeNMVkGlGlMqozL64R90jHMK-TurhNALImWm1IHqUiRKONiH5HdZjhVgF-V2tL-V20W5haUgp94_757bHfZ_M38cZ-DjAcAsY-8xWeo8hg57n7CbbB_9fw88AdNMkVA</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Moumin, Najma A</creator><creator>D’Vaz, Nina</creator><creator>Kidd, Courtney</creator><creator>MacRae, Andrea</creator><creator>Zhou, Shao J</creator><creator>Richards, Toby</creator><creator>Palmer, Debra J</creator><creator>Grzeskowiak, Luke E</creator><creator>Sullivan, Thomas R</creator><creator>Green, Tim J</creator><general>Elsevier Inc</general><general>American Institute of Nutrition</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3336-3153</orcidid></search><sort><creationdate>20240901</creationdate><title>Urinary Ferritin as a Noninvasive Means of Assessing Iron Status in Young Children</title><author>Moumin, Najma A ; D’Vaz, Nina ; Kidd, Courtney ; MacRae, Andrea ; Zhou, Shao J ; Richards, Toby ; Palmer, Debra J ; Grzeskowiak, Luke E ; Sullivan, Thomas R ; Green, Tim J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-92f5e03c24f1178371279e6bd30dc0b11d36e6279f20078eb6714ae77d0608ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Australia</topic><topic>Biomarkers</topic><topic>Blood levels</topic><topic>Children</topic><topic>Childrens health</topic><topic>Confidence intervals</topic><topic>Correlation</topic><topic>Creatinine</topic><topic>Ferritin</topic><topic>Iron</topic><topic>Iron deficiency</topic><topic>iron status</topic><topic>noninvasive biomarker</topic><topic>Nutrient deficiency</topic><topic>Performance prediction</topic><topic>serum ferritin</topic><topic>Specific gravity</topic><topic>the ORIGINS project</topic><topic>Urinalysis</topic><topic>urinary ferritin</topic><topic>Urine</topic><topic>young children</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moumin, Najma A</creatorcontrib><creatorcontrib>D’Vaz, Nina</creatorcontrib><creatorcontrib>Kidd, Courtney</creatorcontrib><creatorcontrib>MacRae, Andrea</creatorcontrib><creatorcontrib>Zhou, Shao J</creatorcontrib><creatorcontrib>Richards, Toby</creatorcontrib><creatorcontrib>Palmer, Debra J</creatorcontrib><creatorcontrib>Grzeskowiak, Luke E</creatorcontrib><creatorcontrib>Sullivan, Thomas R</creatorcontrib><creatorcontrib>Green, Tim J</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moumin, Najma A</au><au>D’Vaz, Nina</au><au>Kidd, Courtney</au><au>MacRae, Andrea</au><au>Zhou, Shao J</au><au>Richards, Toby</au><au>Palmer, Debra J</au><au>Grzeskowiak, Luke E</au><au>Sullivan, Thomas R</au><au>Green, Tim J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urinary Ferritin as a Noninvasive Means of Assessing Iron Status in Young Children</atitle><jtitle>The Journal of nutrition</jtitle><addtitle>J Nutr</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>154</volume><issue>9</issue><spage>2688</spage><epage>2695</epage><pages>2688-2695</pages><issn>0022-3166</issn><issn>1541-6100</issn><eissn>1541-6100</eissn><abstract>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.
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.
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).
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%).
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38729575</pmid><doi>10.1016/j.tjnut.2024.04.040</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3336-3153</orcidid></addata></record> |
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| ispartof | The Journal of nutrition, 2024-09, Vol.154 (9), p.2688-2695 |
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| source | ScienceDirect Journals |
| subjects | Australia Biomarkers Blood levels Children Childrens health Confidence intervals Correlation Creatinine Ferritin Iron Iron deficiency iron status noninvasive biomarker Nutrient deficiency Performance prediction serum ferritin Specific gravity the ORIGINS project Urinalysis urinary ferritin Urine young children |
| title | Urinary Ferritin as a Noninvasive Means of Assessing Iron Status in Young Children |
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