Journal of Diagnostics Concepts & Practice >
Diagnostic efficacy analysis of mean reticulated hemoglobin content for diagnosing iron deficiency anemia and its severity
Received date: 2023-02-04
Accepted date: 2024-04-16
Online published: 2024-06-25
Objective To evaluate the value of mean reticulated hemoglobin content (Mchr) in diagnosing iron deficiency anemia (IDA) and assessing its severity. Methods This study included 302 patients with IDA from January 2021 to December 2021, recruited from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (North), Xinhua Hospital, and Ruijin Hospital. The cohort comprised 118 patients with mild anemia, 159 with moderate anemia, and 25 with severe anemia. In addition, 365 non-IDA patients (encompassing those with thalassemia, megaloblastic anemia, pure red cell aplastic anemia, hemolytic anemia, and aplastic anemia) and 138 healthy controls were included. Venous blood samples were collected from all participants for analysis of hemoglobin (Hb), hematocrit (HCT), Mchr, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron (Fe), transferrin saturation (TS), ferritin, and total iron-binding capacity (TIBC). Mchr levels were compared between the IDA and non-IDA patient groups and between different degrees of IDA severity. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of Mchr in IDA. Results Compared with the non-IDA group, the IDA cohort exhibited significantly reduced levels of Mchr, Hb, MCV, MCH, MCHC, HCT, Fe, TS, and ferritin, while TIBC was markedly elevated, with all differences being statistically significant (P<0.05). Mchr demonstrated positive correlations with Hb, MCV, MCH, MCHC, HCT, Fe, TS, and Ferritin, and a negative correlation with TIBC in the IDA group. Mchr levels decreased sequentially with increasing severity of IDA, with significant differences observed among the three groups (P<0.05). The ROC curve analysis revealed that the cut-off value of Mchr for diagnosing IDA was <26.7 pg, with a sensitivity of 80.00% and specificity of 93.38%, yielding an area under the curve (AUC) of 0.9338(95%CI: 0.9157-0.9518). The sensitivity and the specificity of Mchr+Fe+Ferrit+TIBC in diagnosing IDA (Fe<5.7 μmol/L, Ferritin<7.1 ng/mL, TIBC>65.8 μmol/L) were 90.76% and 94.70% respectively, and the AUC was 0.9839(95%CI: 0.9772-0.9905). Conclusions Mchr can serve as a potential clinical marker for screening IDA and its severity. Its combination with iron metabolism indicators adds diagnostic value for IDA, providing a strong basis for whether further invasive diagnosis is needed.
DING Ning , LIU Lin , JIN Peipei , WANG Fang , WANG Tiankai . Diagnostic efficacy analysis of mean reticulated hemoglobin content for diagnosing iron deficiency anemia and its severity[J]. Journal of Diagnostics Concepts & Practice, 2024 , 23(03) : 318 -323 . DOI: 10.16150/j.1671-2870.2024.03.010
[1] | WAWER A A, JENNINGS A, FAIRWEATHER-TAIT S J. Iron status in the elderly: A review of recent evidence[J]. Mech Ageing Dev, 2018, 175:55-73. |
[2] | MEHTA S, GOYAL L K, KAUSHIK D, et al. Reticulocyte hemoglobin vis-a-vis serum ferritin as a marker of bone marrow iron store in iron deficiency anemia[J]. J Assoc Physicians India, 2016, 64(11):38-42. |
[3] | 李加新, 蔡雁. 经产妇铁营养水平的监测与管理研究进展[J]. 中国临床研究, 2023, 36(2):247-251. |
LI J X, CAI Y. Research progress on monitoring and mana-gement of iron[J]. Chin J Clin Res, 2023, 36(2):247-251. | |
[4] | LIBERTI M E, GAROFALO C, SAGLIOCCA A, et al. Deficit marziale nella Malattia Renale Cronica non diali-tica: dalla diagnosi al trattamento [Iron deficiency in ND-CKD: from diagnosis to treatment][J]. G Ital Nefrol, 2017, 34(5):50-61. |
[5] | URRECHAGA IGARTUA E, HOFFMANN J J M L, IZQUIERDO-áLVAREZ S, et al. Reticulocyte hemoglobin content (MCHr) in the detection of iron deficiency[J]. J Trace Elem Med Biol, 2017, 43:29-32. |
[6] | BAHRAINWALA J, BERNS J S. Diagnosis of iron-deficiency anemia in chronic kidney disease[J]. Semin Nephrol, 2016, 36(2):94-98. |
[7] | REHU M, AHONEN S, PUNNONEN K. The diagnostic accuracy of the percentage of hypochromic red blood cells (%HYPOm) and cellular hemoglobin in reticulocytes (CHr) in differentiating iron deficiency anemia and anemia of chronic diseases[J]. Clin Chim Acta, 2011, 412(19-20):1809-1813. |
[8] | KUJOVICH JL. EVALUATION OF ANEMIA. Obstet Gynecol Clin North Am. 2016; 43(2):247-264. |
[9] | FISHBANE S, GALGANO C, LANGLEY R C JR, et al. Reticulocyte hemoglobin content in the evaluation of iron status of hemodialysis patients[J]. Kidney Int, 1997, 52(1):217-222. |
[10] | PIVA E, BRUGNARA C, SPOLAORE F, et al. Clinical utility of reticulocyte parameters[J]. Clin Lab Med, 2015, 35(1):133-163. |
[11] | TIWARI A K, BHARDWAJ G, ARORA D, et al. Applyi-ng newer parameter Ret-He (reticulocyte haemoglobin equivalent) to assess latent iron deficiency (LID) in blood donors-study at a tertiary care hospital in India[J]. Vox Sang, 2018, 113(7):639-646. |
[12] | TOKI Y, IKUTA K, KAWAHARA Y, et al. Reticulocyte hemoglobin equivalent as a potential marker for diagnosis of iron deficiency[J]. Int J Hematol, 2017, 106(1):116-125. |
[13] | THOMAS C, THOMAS L. Biochemical markers and hematologic indices in the diagnosis of functional iron deficiency[J]. Clin Chem, 2002, 48(7):1066-1076. |
[14] | THOMAS L, FRANCK S, MESSINGER M, et al. Reticulocyte hemoglobin measurement--comparison of two methods in the diagnosis of iron-restricted erythropoiesis[J]. Clin Chem Lab Med, 2005, 43(11):1193-1202. |
[15] | MAST A E, BLINDER M A, LU Q, et al. Clinical utility of the reticulocyte hemoglobin content in the diagnosis of iron deficiency. Blood. 2002; 99(4):1489-1491. |
[16] | BUTTARELLO M, PAJOLA R, NOVELLO E, et al. Evaluation of the hypochromic erythrocyte and reticulocyte hemoglobin content provided by the Sysmex XE-5000 analyzer in diagnosis of iron deficiency erythropoie-sis[J]. Clin Chem Lab Med, 2016, 54(12):1939-1945. |
[17] | DIGNASS A U, GASCHE C, BETTENWORTH D, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel di-seases[J]. J Crohns Colitis, 2015, 9(3):211-222. |
[18] | 崔瑾, 孙晨雨, 程伟, 等. 重庆地区血红蛋白病的患病率及其基因型和血液学表型分析[J]. 重庆医科大学学报, 2023, 48(3):279-285. |
CUI J, SUN C Y, CHENG W, et al. Prevalence, genotype and hematological phenotype analysis ofhemoglobinopathy in Chongqing[J]. J Chongqing Med Univ, 2023, 48(3):279-285. |
/
〈 |
|
〉 |