Which of the following is a feature of anemia of chronic disease?

Anemia of chronic disease is characterized by various physiological changes, particularly related to iron metabolism and red blood cell production. One notable feature is decreased transferrin saturation. Transferrin is the primary protein in the blood that binds to iron and transports it; in anemia of chronic disease, the body typically sequesters iron due to ongoing inflammation or chronic illness, leading to lower levels of circulating iron. Consequently, with less iron available for absorption and usage in erythropoiesis (the production of red blood cells), transferrin saturation decreases.

This response reflects the body's attempt to limit iron availability to pathogens in the context of infection or inflammation, which is a key mechanism involved in the anemia of chronic disease. Thus, the decreased transferrin saturation is one of the hallmark findings in laboratory testing for this type of anemia.