Laboratory Reference Intervals for Routinely Analyzed Transferrin and Unsaturated Iron-Binding Capacity Parameters in the Adult Population of Uasin Gishu County, Kenya

Willington Kasimu; Gitonga Godfrey; Ezra Osoro; Anne Wanjiku; James Mbithi Mulinge

doi:10.51867/ajernet.6.1.58

Authors

Willington Kasimu
tonnykasimu@gmail.com
Department of Medical Laboratory Sciences, School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, P.O. Box 190-50100 Kakamega, Kenya https://orcid.org/0009-0009-5809-1922
Dr. Gitonga Godfrey Department of Medical Laboratory Sciences, School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, P.O. Box 190-50100 Kakamega, Kenya https://orcid.org/0000-0003-1891-1817
Dr. Ezra Osoro Department of Medical Biochemistry, Masinde Muliro University of Science and Technology, P.O. Box 190-50100 Kakamega, Kenya https://orcid.org/0000-0001-6565-5911
Anne Wanjiku Directorate of Laboratory and Pathology Services, Moi Teaching and Referral Hospital, P.O. Box 3 - 30100 Eldoret, Kenya
James Mbithi Mulinge Department of Medical Biochemistry, Masinde Muliro University of Science and Technology, P.O. Box 190-50100 Kakamega, Kenya https://orcid.org/0000-0002-2987-3724

Keywords:

Healthy Population, Reference Intervals, Transferrin, Unsaturated Iron Binding Capacity, Uasin Gishu, Kenya

Abstract

Reference intervals (RIs) are used in the interpretation of clinical laboratory data to help doctors reach a medical decision point. However, due to a variety of reasons, RIs varies significantly between various populations. This study aimed at establishing transferrin, and IUBC reference intervals that can be used locally for the interpretation of iron indices at MTRH. A cross sectional study was conducted at Moi Teaching and Referral Hospital, 290 healthy volunteers were enrolled in the study where their transferrin and IUBC were examined. The non-parametric approach was used to determine reference values with a 95% confidence interval. The Sigma diagnostics approach was used to verify the established Ris. IBM SPSS version 23.0 was used to conduct the statistical analysis. Mann-Whitney U tests were used to compare genders for significant differences. The established reference intervals for Transferrin: males: 2.13–4.01 g/L, females, 2.08–4.04 g/L; UIBC: males, 20.50–64.08 umol/L, females: 20.07–64.21 umol/L. Comparisons between genders for significant differences were done using Mann-Whitney U tests, revealing no significant gender-based differences between transferrin and UIBC exhibited. The established reference intervals in this study are age and sex-specific for routinely used transferrin and IUBC catering for the adult population of Uasin Gishu County aged 18–64 years. The result will assist the clinicians in reaching an informed medical decision.

Dimensions

REFERENCES

Pagani, A., Nai, A., Silvestri, L., & Camaschella, C. (2019). Hepcidin and Anemia: A Tight Relationship. Frontiers in Physiology, 10. https://www.frontiersin.org/articles/10.3389/fphys.2019.01294 DOI: https://doi.org/10.3389/fphys.2019.01294

Pfeiffer, C. M., & Looker, A. C. (2017). Laboratory methodologies for indicators of iron status: Strengths, limitations, and analytical challenges. The American Journal of Clinical Nutrition, 106(suppl_6), 1606S-1614S. https://doi.org/10.3945/ajcn.117.155887 DOI: https://doi.org/10.3945/ajcn.117.155887

Katayev, A., Balciza, C., & Seccombe, D. W. (2010). Establishing Reference Intervals for Clinical Laboratory Test Results: Is There a Better Way? American Journal of Clinical Pathology, 133(2), 180-186.

https://doi.org/10.1309/AJCPN5BMTSF1CDYP DOI: https://doi.org/10.1309/AJCPN5BMTSF1CDYP

Jones, G., & Barker, A. (2008). Reference Intervals. The Clinical Biochemist Reviews, 29(Suppl 1), S93-S97.

Xia, L., Chen, M., Liu, M., Tao, Z., Li, S., Wang, L., Cheng, X., Qin, X., Han, J., Li, P., Yu, S., Ichihara, K., & Qiu, L. (2016). Nationwide Multicenter Reference Interval Study for 28 Common Biochemical Analytes in China. Medicine, 95(9). https://doi.org/10.1097/MD.0000000000002915 DOI: https://doi.org/10.1097/MD.0000000000002915

Ozarda, Y. (2020). Establishing and using reference intervals. Turkish Journal of Biochemistry, 45(1), 1-10. https://doi.org/10.1515/tjb-2017-0299 DOI: https://doi.org/10.1515/tjb-2017-0299

Miller, W., Horowitz, G., Ceriotti, F., Fleming, J., Greenberg, N., Katayev, A., Jones, G., Rosner, W., & Young, I. (2016). Reference Intervals: Strengths, Weaknesses, and Challenges. Clinical Chemistry, 62. https://doi.org/10.1373/clinchem.2016.256511 DOI: https://doi.org/10.1373/clinchem.2016.256511

Higgins C. (2009). Reference intervals (2) - some practical considerations. https://acutecaretesting.org/-/media/acutecaretesting/files/pdf/reference-intervals-2--some-practical-considerations.pdf

Sikaris, K. A. (2014). Physiology and its Importance for Reference Intervals. The Clinical Biochemist Reviews, 35(1), 3-14.

Rappoport, N., Paik, H., Oskotsky, B., Tor, R., Ziv, E., Zaitlen, N., & Butte, A. J. (2018). Comparing Ethnicity-Specific Reference Intervals for Clinical Laboratory Tests from EHR Data. The Journal of Applied Laboratory Medicine, 3(3), 366-377. https://doi.org/10.1373/jalm.2018.026492 DOI: https://doi.org/10.1373/jalm.2018.026492

Ozarda, Y., Higgins, V., & Adeli, K. (2018). Verification of reference intervals in routine clinical laboratories: Practical challenges and recommendations. Clinical Chemistry and Laboratory Medicine (CCLM), 57(1), 30-37. https://doi.org/10.1515/cclm-2018-0059 DOI: https://doi.org/10.1515/cclm-2018-0059

Ozarda, Y. (2016). Reference intervals: Current status, recent developments, and future considerations. Biochemia Medica, 26(1), 5-11. https://doi.org/10.11613/BM.2016.001 DOI: https://doi.org/10.11613/BM.2016.001

Solberg, H. E., & Stamm, D. (1991). IFCC recommendation: The theory of reference values. Part 4. Control of analytical variation in the production, transfer, and application of reference values. The Journal of Automatic Chemistry, 13(5), 231-234. https://doi.org/10.1155/S146392469100038X DOI: https://doi.org/10.1155/S146392469100038X

Juma, A. A., Ngeranwa, J. J. N., & Njagi, E. N. M. (2012). Reference Values for Some Renal Function Parameters for Adult Population in North-Rift Valley, Kenya. Indian Journal of Clinical Biochemistry, 27(1), 40-45. https://doi.org/10.1007/s12291-011-0177-4 DOI: https://doi.org/10.1007/s12291-011-0177-4

Gitimu, R. M. (2015). Laboratory Reference Values for Some Routinely Analyzed Biochemical Parameters for Children and Young Adults in Taita Taveta, Kenya. Undefined. https://www.semanticscholar.org/paper/Laboratory-Reference-Values-for-Some-Routinely-for-Gitimu/6982b7f44e4835b3b00d8bdf6ecd5c35e6edc32f

Rutayisire, R. (2017). Establishment of Adult Reference Intervals for Selected Biochemical Analytes in Adult Rwandan Population [Thesis, COHES, JKUAT]. http://localhost/xmlui/handle/123456789/2826

Sing'oei, V., Ochola, J., Owuoth, J., Otieno, J., Rono, E., Andagalu, B., Otieno, L., Nwoga, C., Copeland, N. K., Lawlor, J., Yates, A., Imbach, M., Crowell, T. A., Eller, L. A., Kamau, E., Modjarrad, K., Cowden, J., Ake, J., Robb, M. L., & Polyak, C. S. (2021). Clinical laboratory reference values in adults in Kisumu County, Western Kenya; hematology, chemistry, and CD4. PLOS ONE, 16(3), e0249259. https://doi.org/10.1371/journal.pone.0249259 DOI: https://doi.org/10.1371/journal.pone.0249259

Horowitz, G. L., Clinical, & Institute, L. S. (2008). Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory: Approved Guideline. Clinical and Laboratory Standards Institute. https://books.google.co.ke/books?id=GG7FtgAACAAJ

Borai A, Ichihara K, Al Masaud A, Tamimi W, Bahijri S, Armbuster D, Bawazeer A., Nawajha M., Otaibi N., Khalil H., Kawano R., Kaddam I., Abdelaal M. (2016). Establishment of reference intervals of clinical chemistry analytes for the adult population in Saudi Arabia: a study conducted as a part of the IFCC global study on reference values. PMID: 26527074, https://doi.org/10.1515/cclm-2015-0490 DOI: https://doi.org/10.1515/cclm-2015-0490

Bawua, Abigail S. A. Ichihara, Kiyoshi Keatley, Rosemary, Arko-Mensah, John, Dei-Adomakoh, Yvonne, Ayeh-Kumi, Patrick F., Erasmus, Rajiv, Fobil, Julius (2020).Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation. International journal of laboratory hematology, 42(6):705-717. doi:10.1111/ijlh.13296 DOI: https://doi.org/10.1111/ijlh.13296

Omuse G, Ichihara K, Maina D, Hoffman, M, Kagotho E, Kanyua A, et al. (2020). Determination of reference intervals for common chemistry and immunoassay tests for Kenyan adults based on an internationally harmonized protocol and up-to-date statistical methods. PLoS ONE 15(7): e0235234. https://doi.org/10.1371/journal.pone.0235234 DOI: https://doi.org/10.1371/journal.pone.0235234

Kristin Rieger, Mandy Vogel, Christoph Engel, Uta Ceglarek, Joachim Thiery, Jürgen Kratzsch, Kristian Harms, Fabian Glock, Andreas Hiemisch and Wieland Kies (2016). Reference intervals for iron-related blood parameters: results from a population-based cohort study (LIFE Child). https://doi.org/10.1515/labmed-2016-0019 DOI: https://doi.org/10.1515/labmed-2016-0019