Korean J Hematol 2000; 35(2):
Published online June 30, 2000
© The Korean Society of Hematology
정상 산모에서 제태 기간에 따른 적혈구 조혈과 트란스페린 수용체 농도의 변화
최종원, 임문환, 배수환
인하대학교 의과대학 임상병리학교실,
인하대학교 의과대학 산부인과학교실
Change of Erythropoiesis and Serum Transferrin Receptor Levels with Gestational Age in Healthy Pregnant Women
BACKGROUND: To investigate the change of iron dynamics, erythropoiesis, and serum transferrin receptor (sTfR) concentration during pregnancy, we measured the reticulocyte subpopulations, reticulocyte maturity index (RMI) and sTfR concentration in normal pregnant women. Also we determined which parameter among sTfR, serum iron, or serum ferritin is more representative for clinical features and erythropoiesis on pregnant women.
METHODS: A total of 283 pregnants were examined for reticulocyte subpopulations, sTfR, and a battery of iron parameters. Reticulocytes and their subpopulations were automatically analyzed by flow cytometry (R-3000; Sysmex, Toa, Japan). Serum iron and TIBC were assayed with the automatic chemical analyzer (Hitachi 747; Hitachi, Tokyo, Japan) and serum ferritin was measured by the chemiluminescence method (ACS 180; Chiron, USA). Soluble transferrin receptor was measured by the immunoenzymometric
method (ELISA ; Orion Diagnostica, Finland).
RESULTS: There was no significant difference in sTfR concentration between pregnant women on the 1st trimester (2.29±0.45 mg/L) and non-pregnant women (2.18±0.46mg/L). However, the sTfR concentration gradually increased with gestational age from the 2nd trimester of pregnancy and reached maximal concentration (5.76±1.12 mg/L) in the 3rd trimester. The mean sTfR in postpartum 12 weeks was similar to that in the 1st trimester was three-to four-fold higher than in the 1st trimester. The sTfR
correlated better with RMI (r=0.62, P<0.01), MCH (r=-0.61, P<0.01)and gestational age (r=0.51, P<0.01) than to serum iron and ferritin.
CONCLUSIONS: The sTfR concentration increases with gestational age during pregnancy and returns to normal at 12 weeks after delivery. Elevated sTfR concentration during pregnancy seems to be more influenced by etythroid TfR turnover than by iron depletion. The sTfR is a more reliable predictor of erythropoiesis and iron status during pregnancy than serum iron or ferritin.
Keywords Erythropoiesis; Pregnancy; Reticulocyte maturity index; Transferrin receptor;
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Korean J Hematol 2000; 35(2): 134-142
Published online June 30, 2000
Copyright © The Korean Society of Hematology.
정상 산모에서 제태 기간에 따른 적혈구 조혈과 트란스페린 수용체 농도의 변화
최종원, 임문환, 배수환
인하대학교 의과대학 임상병리학교실,
인하대학교 의과대학 산부인과학교실
Change of Erythropoiesis and Serum Transferrin Receptor Levels with Gestational Age in Healthy Pregnant Women
Jong Weon Choi, Moon Whan Im, Soo Hwan Pai
Department of Clinical Pathology, Obstetrics, College of Medicine, Inha University, Inchon, Korea
Abstract
BACKGROUND: To investigate the change of iron dynamics, erythropoiesis, and serum transferrin receptor (sTfR) concentration during pregnancy, we measured the reticulocyte subpopulations, reticulocyte maturity index (RMI) and sTfR concentration in normal pregnant women. Also we determined which parameter among sTfR, serum iron, or serum ferritin is more representative for clinical features and erythropoiesis on pregnant women.
METHODS: A total of 283 pregnants were examined for reticulocyte subpopulations, sTfR, and a battery of iron parameters. Reticulocytes and their subpopulations were automatically analyzed by flow cytometry (R-3000; Sysmex, Toa, Japan). Serum iron and TIBC were assayed with the automatic chemical analyzer (Hitachi 747; Hitachi, Tokyo, Japan) and serum ferritin was measured by the chemiluminescence method (ACS 180; Chiron, USA). Soluble transferrin receptor was measured by the immunoenzymometric
method (ELISA ; Orion Diagnostica, Finland).
RESULTS: There was no significant difference in sTfR concentration between pregnant women on the 1st trimester (2.29±0.45 mg/L) and non-pregnant women (2.18±0.46mg/L). However, the sTfR concentration gradually increased with gestational age from the 2nd trimester of pregnancy and reached maximal concentration (5.76±1.12 mg/L) in the 3rd trimester. The mean sTfR in postpartum 12 weeks was similar to that in the 1st trimester was three-to four-fold higher than in the 1st trimester. The sTfR
correlated better with RMI (r=0.62, P<0.01), MCH (r=-0.61, P<0.01)and gestational age (r=0.51, P<0.01) than to serum iron and ferritin.
CONCLUSIONS: The sTfR concentration increases with gestational age during pregnancy and returns to normal at 12 weeks after delivery. Elevated sTfR concentration during pregnancy seems to be more influenced by etythroid TfR turnover than by iron depletion. The sTfR is a more reliable predictor of erythropoiesis and iron status during pregnancy than serum iron or ferritin.
Keywords: Erythropoiesis, Pregnancy, Reticulocyte maturity index, Transferrin receptor,
