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Limits of detection in acute phase protein biomarkers affect inflammation correction of serum ferritin for quantifying iron status among school-age and preschool-age children and reproductive-age women
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5 05 2022
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Source: J Nutr. 152(5):1370-1377
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Details:
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Alternative Title:J Nutr
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Personal Author:
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Description:Background:
Standardized practices are needed in the analysis of inflammation biomarker values outside limits of detection (LOD) when used for inflammation correction of nutritional biomarkers.
Objective:
We assessed the direction and extent to which serum C-reactive protein (CRP) and alpha-1-acid-glycoprotein (AGP) values outside LODs (<0.05 mg/L and >4.0 g/L, respectively) affect inflammation regression correction of serum ferritin and compared approaches to addressing such values when estimating inflammation-adjusted ferritin and iron deficiency (ID).
Methods:
Examined 29 cross-sectional datasets from 7 countries with reproductive-age women (15–49y) (n=12,944), preschool-age children (6–59m) (n=18,208) and school-age children (6–14y) (n=4,625). For each dataset, we compared 6 analytic approaches for addressing CRP
Results:
Across datasets, observations outside LOD ranged from 0.0 to 35.0% of CRP values and 0.0 to 2.5% of AGP values. Pooled deviance estimates for mean ferritin (μg/L) and ID (percentage points) were: listwise deletion −0.46 (95%CI: −0.76, −0.16) and 0.14 (−0.43, 0.72), lower bound 0.45 (0.14, 0.76) and −0.36 (−0.91, 0.20), middle bound −0.21 (−0.51, 0.09) and 0.22 (−0.34, 0.79), LOD/√(2) −0.26 (−0.57, 0.04) and 0.25 (−0.31, 0.81), upper bound −0.31 (−0.61, −0.01) and 0.30 (−0.27, 0.86), and random number −0.08 (−0.38, 0.22) and 0.11 (−0.46, 0.67). There was moderation by approach in the ferritin model (p<0.001).
Conclusions:
Findings demonstrate the need for standardized analyses of inflammation biomarker values outside LODs and suggest that random number single imputation may be a reliable and feasible alternative to MI for CRP
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Pubmed ID:35179209
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Pubmed Central ID:PMC10916364
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