The effect of the acute phase response (APR) on laboratory biomarkers of iron status is well known, and typically shows increased serum ferritin and decreased serum iron, transferrin, total iron‐binding capacity (TIBC) and transferrin saturation. In contrast, there are limited and conflicting data on the effect of the APR on serum biomarkers of vitamin B12 and folate. Serum total B12 has been reported as unaffected by surgery, but the high total serum B12 seen in malignancies, inflammatory diseases and the critically ill has been attributed by most but not all as being due to inflammation. Similarly, serum folate has been reported as reduced or unaffected by surgery. There are no prospective data on the effect of the APR on serum active B12 or methylmalonic acid (MMA). We, therefore, prospectively evaluated the effect of the APR, as provoked by elective orthopaedic surgery, on laboratory biomarkers of iron, vitamin B12 and folate status to establish their validity in acute illness.Thirty patients (14 male) aged 70.0 (9.4) years gave informed written consent to participate in this study approved by the National Research Ethics Service. Exclusion criteria included patients who received a blood transfusion within 3 months, known to have haematological and liver disorders
International Journal of Laboratory Hematology – Wiley
Published: Jan 1, 2018
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