Physiologically based serum ferritin thresholds for iron deficiency among women and children from Africa, Asia, Europe, and central America: a multinational comparative study

作者：O. Yaw Addo, Zuguo Mei, Maria Elena Jefferds, Mica Jenkins, Rafael Flores‐Ayala, Anne M Williams, Melissa Young, Hanqi Luo, Yi‐An Ko, Ioannis Papassotiriou, Mireya Palmieri, Karla Mesarina, Zulfiqar A Bhutta, Parminder S. Suchdev, Gary M. Brittenham · 发表于：The Lancet Global Health · 年份：2025 · DOI：10.1016/s2214-109x(25)00009-9 · 被引用次数：11 · 研究领域：Iron Metabolism and Disorders、Erythropoietin and Anemia Treatment、Hemoglobinopathies and Related Disorders

Background Diagnosis of iron deficiency commonly relies on measurement of serum ferritin concentrations. WHO guidelines identify serum ferritin thresholds for iron deficiency among healthy individuals of less than 15 μg/L for women and less than 12 μg/L for children under 5 years, based on expert opinion. We report thresholds for iron deficiency for apparently healthy non-pregnant women and young children based on physiological indicators. Methods We performed secondary analyses of cross-sectional data from women (aged 15–49 years) and children (aged 6–59 months) from 12 countries in Africa, Asia, Europe, and central America from available surveys (2007–19). Using haemoglobin and soluble transferrin receptor concentrations as individual-level indicators of iron deficiency, we identified country-specific serum ferritin thresholds. We conducted multivariate meta-analysis using individual participant data to assess multinational heterogeneity and intercountry consistency. Findings Data were collected from July, 2007 to March, 2019. 18 251 individuals (13 864 women and 4387 children) were included in the final analysis. The thresholds of pooled serum ferritin levels corresponding to the starting point of decline in circulating haemoglobin concentrations were 24·8 μg/L (95% CI 24·4–25·2) for women and 22·1 μg/L (20·8–23·4) for children based on the national survey data from 12 countries. The thresholds were consistent among countries (p heterogeneity : women=0·73, children=0·43) b...