الفهرس 
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Abstract
Background: Anemia of chronic disease (ACD) is the second most prevalent cause of anemia, after iron deficiency anemia (IDA). The aim of this study was to study the possible role of the Soluble Transferrin Receptor (sTfR)/Log Ferritin Ratio in distinguishing IDA from ACD. Methods: This case-control study was carried out on 80 patients with microcytic hypochromic or normocytic normochromic anemia (IDA and ACD) and 40 normal subjects, aged ≥18 years old, both sexes. Patients were divided into three equal groups: group 1: ACD (Serum Ferritin ≥ 300 ng/ml and transferrin saturation (TSAT) ≤ 20-50%). group 2: IDA (hemoglobin < 12 in females and < 13gm/dL in males, serum ferritin < 15 ng/ml, TSAT < 16%). group 3: normal subjects as a control group. Results: At a cut-off value of sTfR and sTfR/log ferritin index was ≤1.85 and >0.50 respectively; the area under the curve (AUC) was 1.0, the sensitivity was 100% and the specificity was (92.5% and 97.5% respectively). For differentiation of ACD from IDA, the STR-F index had a significantly Larger AUC than STFR (P- value <0.001). For the diagnosis of IDA, the combination of sTfR & sTfR/log ferritin index had the highest sensitivity of 100.0% and specificity of 92.5% while the combination of ferritin & sTfR/log ferritin index had a specificity of 92.5% and sensitivity of 97.5%. Conclusion: sTfR/log ferritin index had a significantly larger AUC than sTfR alone. The combination of sTfR and sTfR/log ferritin index showed excellent sensitivity and specificity for diagnosing IDA, while the combination of ferritin and sTfR/log ferritin index exhibited high specificity and sensitivity.