Serum transferrin and ferritin in pubertal boys: relations to body growth, pubertal stage, erythropoiesis, and iron deficiency

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Abstract
We studied serum transferrin and ferritin concentrations in relation to individual body growth, stage of puberty, blood hemoglobin, and red blood cell iron (RBCI) in 60 prepubertal or early pubertal boys at 3-mo intervals for 18 mo. One-third of the boys had increased serum transferrin concentrations and almost all had decreased ferritin concentrations during the followup. No change in mean transferrin was observed but the individual 18-mo increments in transferrin correlated positively with the increments in hemoglobin (r = 0.55, P < 0.001) and in estimated RBCI (r = 0.31, P = 0.02). Serum transferrin remained stable at different genital stages, but ferritin was lower in the pubertal than in the prepubertal boys. Transferrin concentrations at 18 mo correlated positively with the preceding weight velocities. The rise in transferrin did not lead to an increase in iron-deficiency anemia. In contrast, transferrin rose in boys whose hemoglobin increased. In pubertal boys with relatively ample iron status, serum transferrin may be an indicator of increased availability of iron for erythropoiesis. The declining ferritin concentration indicates that part of the extra iron is mobilized through redistribution from stores to red blood cell mass and is generally associated with greatly increasing absorption. Thus, the pubertal changes in transferrin and ferritin are not necessarily indications of iron deficiency.