不飽和鉄結合能 unsaturated iron bindingcapacity
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/01/17 22:41:19」(JST)
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Total iron-binding capacity |
Diagnostics |
transferrin
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MedlinePlus |
003489 |
LOINC |
14800-7, 35215-3, 2501-5 |
Total iron-binding capacity (TIBC) is a medical laboratory test that measures the blood's capacity to bind iron with transferrin.[1] It is performed by drawing blood and measuring the maximum amount of iron that it can carry, which indirectly measures transferrin[2] since transferrin is the most dynamic carrier. TIBC is less expensive than a direct measurement of transferrin.[3][4]
The TIBC should not be confused with the UIBC, or "unsaturated iron binding capacity" (22753-8 and 35216-1). The UIBC is calculated by subtracting the serum iron from the TIBC.[5]
Interpretation[edit]
Taken together with serum iron and percent transferrin saturation clinicians usually perform this test when they are concerned about anemia, iron deficiency or iron deficiency anemia. However, because the liver produces transferrin, alterations in function (such as cirrhosis, hepatitis, or liver failure) must be considered when performing this test. It can also be an indirect test of liver function, but is rarely used for this purpose.
The percent transferrin saturation (i.e., the result of the formula of serum iron/TIBC x 100) can also be a useful indicator.
Condition |
Serum iron (highly variable) |
Transferrin and TIBC |
Percent transferrin saturation |
iron deficiency anemia |
Low |
High. The liver produces more transferrin, presumably attempting to maximize use of the little iron that is available. |
Low, as there is insufficient iron. |
anemia of chronic disease |
Low, as the body holds iron intracellularly with ferritin. |
Low. The body produces less transferrin (but more ferritin), presumably to keep iron away from pathogens that require it for their metabolism. This is mainly regulated by increased hepcidin production. |
Normal |
pregnancy or use of hormonal contraception, but without iron deficiency |
Normal |
High. The liver increases the production of transferrin, thus raising TIBC. |
Low, as there is excess transferrin with normal serum iron levels. |
These examples demonstrate that to properly understand a value for TIBC, one also must know the serum iron, the percent transferrin saturation, and the individual clinical situation.
Usual values[edit]
Reference ranges for blood tests, comparing blood content of iron and related compounds (shown in brown and orange) with other constituents.
Normal reference ranges are:
- Serum iron: Male 65–177 μg/dL (11.6–31.7 μmol/L); Female 50–170 μg/dL (9.0–30.4 μmol/L)
- TIBC: 250–370 μg/dL (45-66 μmol/L)[6]
- Transferrin saturation: Male 20–50%; Female 15–50%
- Serum ferritin: Male 20-250 μg/L, Female 15-150 μg/L[6]
μg/dL = micrograms per deciliter; μmol/L = micromoles per litre.
Laboratories often use different units and "normal" may vary by population and the lab techniques used. Look at the individual laboratory reference values to interpret a specific test (for instance, your own).
References[edit]
- ^ "MedlinePlus Medical Encyclopedia: Total iron binding capacity". Retrieved 2008-12-31.
- ^ Yamanishi H, Iyama S, Yamaguchi Y, Kanakura Y, Iwatani Y (January 2003). "Total iron-binding capacity calculated from serum transferrin concentration or serum iron concentration and unsaturated iron-binding capacity". Clin. Chem. 49 (1): 175–8. doi:10.1373/49.1.175. PMID 12507977.
- ^ Kasvosve I, Delanghe J (October 2002). "Total iron binding capacity and transferrin concentration in the assessment of iron status". Clin. Chem. Lab. Med. 40 (10): 1014–8. doi:10.1515/CCLM.2002.176. PMID 12476940.
- ^ Gambino R, Desvarieux E, Orth M, et al. (December 1997). "The relation between chemically measured total iron-binding capacity concentrations and immunologically measured transferrin concentrations in human serum". Clin. Chem. 43 (12): 2408–12. PMID 9439462.
- ^ "Iron Transport". Retrieved 2008-12-31.
- ^ a b Harrison's Principles of Internal Medicine. 17th Edition (2008). Pg. 2432 (Table 351-2)
Medical test: Serology, reference range: Clinical biochemistry blood tests (including BMP, CMP) (CPT 82000–84999)
|
|
Fluid/electrolytes |
- electrolytes
- renal function, BUN-to-creatinine ratio
- Ca
- derived values: Plasma osmolality
- Serum osmolal gap
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Acid-base |
- Arterial blood gas
- Base excess
- Anion gap
- CO2 content
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Nutrition |
- Iron tests: Transferrin saturation = Serum iron / Total iron-binding capacity; Ferritin
- Transferrin
- Transferrin receptor
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Endocrine |
- ACTH stimulation test
- Thyroid function tests
- Blood sugar: Glucose test
- C-peptide
- Fructosamine
- Glycated hemoglobin
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Metabolic |
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Cardiovascular |
- Cardiac marker: Troponin test
- CPK-MB test
- LDH
- Myoglobin
- Glycogen phosphorylase isoenzyme BB
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Digestive |
- Liver function tests: protein tests
- Human serum albumin
- Serum total protein
- ALP
- transaminases
- Bilirubin
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noco/acba/cong/tumr, sysi/epon, urte
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proc/itvp, drug (G4B), blte, urte
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noco (d)/cong/tumr, sysi/epon
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proc, drug (A10/H1/H2/H3/H5)
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noco/cong/tumr, sysi/epon, injr
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proc, drug (C1A/1B/1C/1D), blte
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anat (t, g, p)/phys/devp/enzy
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noco/cong/tumr, sysi/epon
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proc, drug (A2A/2B/3/4/5/6/7/14/16), blte
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UpToDate Contents
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Japanese Journal
- 鉄キレート剤が血清鉄・UIBCに及ぼす影響 (鉄代謝のバイオマーカー) -- (疾患と鉄代謝)
- 血清鉄と鉄結合能 (鉄代謝のバイオマーカー) -- (検査指標)
Related Links
- 貧血検査(血清鉄・フェリチン・トランスフェリン・TIBC・UIBC)をわかりやすく解説し ております。
Related Pictures
★リンクテーブル★
[★]
- 健康成人が徐々に鉄欠乏状態となるときに、初めに起こる検査値変化はどれか
[★]
- 英
- transferrin, Tf
- 同
- シデロフィリン siderophilin
- 関
- 鉄、TIBC、UIBC
概念
*糖タンパク質
- 80kDa
- Fe3+を2分子結合できる
- 通常、トランスフェリンの鉄の飽和度は1/3程度 (SP.499)
- 基準値:190-320 mg/dl (臨床検査法提要第32版)
- 生体防御機構の一つとして機能する。ラクトフェリンと同様に鉄を結合して外来生物の増殖を妨げる。
基準値
判定
- 鉄欠乏性貧血、妊娠、避妊薬投与、タンパク同化ホルモン投与
- 鉄欠乏性貧血:代償性
-
- 肝臓でのトランスフェリン合成が低下する病態で産生低下。
国試
- 慢性炎症が持続している病態では血清のFe, UIBC, TIBCがいずれも低下する
- 慢性炎症下では網内系に鉄が取り込まれて血清鉄が減少する。またTIBCの減少によりUIBCも減少。
[★]
- 英
- ineffective erythropoiesis
- 関
- [[]]
まとめ
- 骨髄内で造血が亢進しているものの、末梢に出現する前に細胞死が生じている病態であり、サラセミア、巨赤芽球性貧血、鉄芽球性貧血、骨髄異形成症候群などでみられる。検査上、細胞死に至った細胞からの鉄の漏出による血清鉄の上昇、これにともない不飽和鉄結合能の低下がみられる。
定義
- 血球前駆細胞が成熟血球に分化する過程で細胞死が生じている病態を指す。
- 骨髄所見と末梢血所見に乖離がみられ、骨髄中の細胞は十分に存在するが、末梢血では血球減少を示す
検査
無効造血を呈する疾患
- サラセミア:赤芽球系の細胞の内に異常ヘモグロビンが沈殿することによる?
- 巨赤芽球性貧血:全ての血球において、核酸合成が十分に行われず細胞質分裂が起こりにくくなっているため核が巨大化?
- 鉄芽球性貧血:ヘムの合成異常。原因は多様
[★]
- 英
- unsaturated iron binding capacity, UIBC
- 関
- 総鉄結合能 TIBC
- 鉄結合していないトランスフェリンの量を結合可能な鉄量で表した値
- 検体の血清の「予備的な鉄結合能」
- 鉄を結合していないトランスフェリンの量に比例し、これらに鉄結合を飽和させたとき、結合しうる鉄の量を示す。(厳密には一致しない)
定義
- 減少:鉄を結合しているトランスフェリンが増加 or トランスフェリンが減少
- 増加:鉄を結合しているトランスフェリンが減少 or トランスフェリンが増加
基準値
- M:170-250 ug/dl (LAB)
- F:180-270 ug/dl (LAB)
[★]
- 英
- total iron binding capacity, TIBC
- 関
- 鉄結合能、鉄、貧血, UIBC
概念
- 血液中で鉄はトランスフェリンと結合して運搬されるが、そのトランスフェリンが結合可能な鉄の総量。
- 血液中に存在するトランスフェリンが鉄を結合しうる能力を示している。
- TIBC = UIBC + Fe の関係がある。
基準値
- 臨床検査法提要第32版
- HIM.A-6
[★]
- 関
- 慢性疾患による貧血