Ferroportin and soluble transferrin receptor in women with first-trimester missed abortion.
Laboratory diagnostics of iron homeostasis during pregnancy typically rely on routine parameters, which often inadequately reflect the actual maternal iron status. This study aimed to evaluate the investigative and diagnostic utility of soluble transferrin receptor (sTfR) and ferroportin (Fpn) concentrations as key indicators of iron dysregulation in women with normal early pregnancy and those experiencing missed abortion. These primary biomarkers were assessed in conjunction with standard laboratory parameters of iron status across the study groups. Notably, Fpn concentration had not previously been determined in women with either normal or abnormal pregnancies. The study enrolled 45 women with missed abortion and 45 women with normal first-trimester pregnancies. Peripheral blood concentrations of iron (Fe), unsaturated iron-binding capacity (UIBC), ferritin, hemoglobin (Hb), transferrin, and sTfR were measured using automated analyzers, while hepcidin and Fpn were quantified using ELISA kits. Transferrin saturation (TSAT), the sTfR/log ferritin index (sTfR-F index), and the ferroportin to soluble transferrin receptor ratio (Fpn/sTfR) were calculated. In the missed abortion group, Fpn (p < 0.001), Fe (p = 0.008), TSAT (p = 0.018), and Fpn/sTfR (p < 0.001) were significantly decreased, whereas sTfR (p = 0.001) and the sTfR-F index (p = 0.003) were significantly increased compared to women with normal pregnancies. Proposed multiparameter models incorporating sTfR and Fpn, or sTfR, hepcidin, and Fpn, accurately classified over 80% of cases and demonstrated excellent area under the curve (AUC) values of approximately 0.9. These findings indicate that Fpn and sTfR may serve as valuable investigative biomarkers for identifying dysregulation of iron homeostasis in early pregnancy.