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Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults.
Nutrients. 2017 May 02; 9(5)N

Abstract

Our aim was to evaluate the cut-off value and efficiency of using reticulocyte hemoglobin content as a marker to diagnose iron deficiency anemia in Chinese adults. 140 adults who needed bone marrow aspiration for diagnosis at the hematology department of the Peking Union Medical College Hospital were enrolled according to the inclusive and exclusive criteria. Venous blood samples were collected to detect complete blood count, including hemoglobin, reticulocyte hemoglobin content, hematocrit, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, free erythrocyte protoporphyrin; iron indexes of serum ferritin, serum transferrin receptor, and unsaturated iron-binding capacity; and inflammation markers of C-reactive protein and α-acid glycoprotein. Bone marrow samples were obtained for the bone marrow iron staining, which was used as the standard for the evaluation of iron status in this study. Subjects were divided into three groups according to hemoglobin levels and bone marrow iron staining results: the IDA (iron deficiency anemia) group, the NIDA (non-iron deficiency anemia) group, and the control group. The differences of the above-mentioned indexes were compared among the three groups and the effect of inflammation was also considered. The cut-off value of reticulocyte hemoglobin content was determined by receiver operation curves. The IDA group (n = 56) had significantly lower reticulocyte hemoglobin content, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, and serum ferritin; and higher free erythrocyte protoporphyrin, unsaturated iron-binding capacity, and serum transferrin receptor (p < 0.05) compared with the NIDA group (n = 38) and control group (n = 46). Hematocrit, serum ferritin, and unsaturated iron-binding capacity were significantly affected by inflammation while reticulocyte hemoglobin content and other parameters were not. The cut-off value of reticulocyte hemoglobin content for diagnosing iron deficiency anemia was 27.2 pg, with a sensitivity of 87.5% and a specificity of 92.9%. The cut-off values for mean cellular volume, serum ferritin, and serum transferrin receptor were 76.6, 12.9, and 4.89 mg/L, respectively. Reticulocyte hemoglobin content had the largest area under the curve of 0.929, while those for mean cellular volume, serum ferritin, serum transferrin receptor were 0.922, 0.887, and 0.900, respectively. Reticulocyte hemoglobin content has a high sensitivity and specificity in the diagnosis of iron deficiency anemia, and its comprehensive diagnostic efficacy is better than other traditional indicators-such as serum ferritin and serum transferrin receptor.

Authors+Show Affiliations

The Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Xicheng District, Beijing 100050, China. caijie1113@126.com.The Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Xicheng District, Beijing 100050, China. wumeng0208@126.com.Health and Family Planning Supervision Institution of Chaoyang, Panjiayuan Huawei 25, Chaoyang District, Beijing 100021, China. jieren0111@163.com.Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. yali_crazy@126.com.Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. longzhangbiao@163.com.Department of General Surgery, Tianjin People's Hospital, 190, Jieyuan Road, Hongqiao District, Tianjin 300121, China. liguoxun@126.com.Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. hanbing_li@sina.com.cn.The Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Xicheng District, Beijing 100050, China. yanglichen28@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28468320

Citation

Cai, Jie, et al. "Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content On Diagnosis for Iron Deficiency Anemia in Chinese Adults." Nutrients, vol. 9, no. 5, 2017.
Cai J, Wu M, Ren J, et al. Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults. Nutrients. 2017;9(5).
Cai, J., Wu, M., Ren, J., Du, Y., Long, Z., Li, G., Han, B., & Yang, L. (2017). Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults. Nutrients, 9(5). https://doi.org/10.3390/nu9050450
Cai J, et al. Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content On Diagnosis for Iron Deficiency Anemia in Chinese Adults. Nutrients. 2017 May 2;9(5) PubMed PMID: 28468320.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults. AU - Cai,Jie, AU - Wu,Meng, AU - Ren,Jie, AU - Du,Yali, AU - Long,Zhangbiao, AU - Li,Guoxun, AU - Han,Bing, AU - Yang,Lichen, Y1 - 2017/05/02/ PY - 2017/03/19/received PY - 2017/04/16/revised PY - 2017/04/26/accepted PY - 2017/5/5/entrez PY - 2017/5/5/pubmed PY - 2018/3/29/medline KW - iron deficiency anemia KW - reticulocyte hemoglobin content JF - Nutrients JO - Nutrients VL - 9 IS - 5 N2 - Our aim was to evaluate the cut-off value and efficiency of using reticulocyte hemoglobin content as a marker to diagnose iron deficiency anemia in Chinese adults. 140 adults who needed bone marrow aspiration for diagnosis at the hematology department of the Peking Union Medical College Hospital were enrolled according to the inclusive and exclusive criteria. Venous blood samples were collected to detect complete blood count, including hemoglobin, reticulocyte hemoglobin content, hematocrit, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, free erythrocyte protoporphyrin; iron indexes of serum ferritin, serum transferrin receptor, and unsaturated iron-binding capacity; and inflammation markers of C-reactive protein and α-acid glycoprotein. Bone marrow samples were obtained for the bone marrow iron staining, which was used as the standard for the evaluation of iron status in this study. Subjects were divided into three groups according to hemoglobin levels and bone marrow iron staining results: the IDA (iron deficiency anemia) group, the NIDA (non-iron deficiency anemia) group, and the control group. The differences of the above-mentioned indexes were compared among the three groups and the effect of inflammation was also considered. The cut-off value of reticulocyte hemoglobin content was determined by receiver operation curves. The IDA group (n = 56) had significantly lower reticulocyte hemoglobin content, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, and serum ferritin; and higher free erythrocyte protoporphyrin, unsaturated iron-binding capacity, and serum transferrin receptor (p < 0.05) compared with the NIDA group (n = 38) and control group (n = 46). Hematocrit, serum ferritin, and unsaturated iron-binding capacity were significantly affected by inflammation while reticulocyte hemoglobin content and other parameters were not. The cut-off value of reticulocyte hemoglobin content for diagnosing iron deficiency anemia was 27.2 pg, with a sensitivity of 87.5% and a specificity of 92.9%. The cut-off values for mean cellular volume, serum ferritin, and serum transferrin receptor were 76.6, 12.9, and 4.89 mg/L, respectively. Reticulocyte hemoglobin content had the largest area under the curve of 0.929, while those for mean cellular volume, serum ferritin, serum transferrin receptor were 0.922, 0.887, and 0.900, respectively. Reticulocyte hemoglobin content has a high sensitivity and specificity in the diagnosis of iron deficiency anemia, and its comprehensive diagnostic efficacy is better than other traditional indicators-such as serum ferritin and serum transferrin receptor. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/28468320/Evaluation_of_the_Efficiency_of_the_Reticulocyte_Hemoglobin_Content_on_Diagnosis_for_Iron_Deficiency_Anemia_in_Chinese_Adults_ L2 - https://www.mdpi.com/resolver?pii=nu9050450 DB - PRIME DP - Unbound Medicine ER -