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Transferrin saturation, plasma iron turnover, and transferrin uptake in
normal humans
M Cazzola, HA Huebers, MH Sayers, AP MacPhail, M Eng and CA Finch
The relationship between plasma iron, transferrin saturation, and plasma
iron turnover was studied in 53 normal subjects whose transferrin
saturation varied between 17% and 57%, in 25 normal subjects whose
transferrin saturation was increased by iron infusion to between 67% and
100%, and in five subjects with early untreated idiopathic hemochromatosis
whose transferrin saturation was continually elevated to between 61% and
86%. The plasma iron turnover of all of these subjects ranged from 0.45 to
1.22 mg/dL whole blood/d. The mean values for the above-mentioned three
groups were 0.71 +/- 0.17, 1.01 +/- 0.11, and 1.01 +/- 0.13 mg/dL whole
blood/d, respectively. Most of this variation, estimated at 72% by
regression analysis, was due to a direct relationship between transferrin
saturation and plasma iron turnover. This effect was attributed to a
competitive advantage of diferric over monoferric transferrin in delivering
iron to tissues. This was confirmed by the demonstration of a more rapid
clearance of diferric as compared to monoferric transferrin in an
additional group of eight normal subjects. Calculations were made of the
amount of transferrin reacting with membrane receptors per unit time.
Allowance was made for the noncellular (extravascular) exchange and for the
4.2:1 preference of diferric over monoferric transferrin demonstrated in
vitro. The amount of iron-bearing transferrin leaving the plasma to bind to
tissue receptors for 53 subjects with a transferrin saturation between 17%
and 57% was 71 +/- 13; for 25 subjects with a saturation from 67% to 100%,
72 +/- 12; and for five subjects with early idiopathic hemochromatosis, 82
+/- 11 mumol/L whole blood/d. There were no significant differences among
these groups. These studies indicate that while the number of iron atoms
delivered to the tissues increases with increasing plasma iron and
transferrin saturation, the number of iron-bearing transferrin molecules
that leave the plasma per unit time to bind to tissue receptors is
relatively constant and within the limits studied, independent of
transferrin saturation.
Volume 66,
Issue 4,
pp. 935-939,
10/01/1985
Copyright © 1985 by The American Society of Hematology
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