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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.


ABSTRACT:

Background

Standardized practices are needed in the analysis of inflammation biomarker values outside limits of detection (LODs) when used for inflammation correction of nutritional biomarkers.

Objective

We assessed the direction and extent to which serum C-reactive protein (CRP) and α-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

We examined 29 cross-sectional datasets from 7 countries with reproductive-age women (age 15-49 y) (n = 12,944), preschool-age children (age 6-59 mo) (n = 18,208), and school-age children (age 6-14 y) (n = 4625). For each dataset, we compared 6 analytic approaches for addressing CRP ResultsAcross 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

These 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

SUBMITTER: Gosdin L 

PROVIDER: S-EPMC10916364 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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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.

Gosdin Lucas L   Sharma Andrea J AJ   Suchdev Parminder S PS   Jefferds Maria Elena ME   Young Melissa F MF   Addo O Yaw OY  

The Journal of nutrition 20220501 5


<h4>Background</h4>Standardized practices are needed in the analysis of inflammation biomarker values outside limits of detection (LODs) when used for inflammation correction of nutritional biomarkers.<h4>Objective</h4>We assessed the direction and extent to which serum C-reactive protein (CRP) and α-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 wh  ...[more]

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