Exploration of iron metabolism: what is new?

Abstract

Many biological analyzes or imaging techniques are currently available to explore iron metabolism and supply. In most cases, the first-line dosage of ferritin is recommended, especially in the diagnosis of martial deficiency, although this marker underestimates iron deficiency in case of inflammation. In patients with comorbidities, the exploration of iron metabolism becomes more complex and requires other tools. For example, the concentration of soluble transferrin receptors is insensitive to inflammation, thus affirming iron deficiency in patients with inflammatory syndrome. In iron pathologies, the transferrin saturation coefficient (TSAT), involving the assay of serum iron and transferrin, may direct the etiology of iron overload. There are also non-invasive nuclear magnetic resonance and computed tomography techniques to assess liver iron overload. Therefore, the exploration of iron metabolism relies on various heterogeneous tools ranging from biomarkers to imaging, including genetics. They must be used in the proper context.