SERUM FERRITIN CONCENTRATION COMPARED TO OTHER IRON‐STORE VARIABLES IN THE DIAGNOSIS OF IRON DEFICIENCY

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Abstract
Serum ferritin concentration was determined in 38‐year‐old women representative of the general female population of the same age resident in Gothenburg, Sweden. The assays were carried out on serum samples which had been frozen (‐22° C to ‐28° C) for ten years. The values were related to haematological variables which had been examined at the time of the initial study. The distribution of serum ferritin values was markedly positively skewed. Woman with a serum ferritin concentration within the lowest three decentiles had the heaviest menstrual blood loss, no or only traces of reticuloendothelial iron in sternal bone marrow and high iron absorption of a tracer dose of labelled iron. High correlation coefficients were obtained when correlations were calculated between serum ferritin and transferrin saturation, sideroblast count in bone marrow and iron absorption. The correlation coefficients were usually higher between serum ferritin concentration and the other haematological variables than the correlations between the individual haematological variables. There was good agreement between the prevalence of reticuloendothelial iron in bone marrow and serum ferritin concentration. We conclude that bone marrow examination may be replaced by determination of serum ferritin concentration when screening for iron deficiency in otherwise healthy subjects. This seems to be relevant also in subjects with a history of recent mild infection or current use of oral contraceptives.