Diagnostic performance of reticulocyte hemoglobin equivalent in assessing the iron status.
diagnostic performance
exclusion
inflammation
iron deficiency anemia
reticulocyte hemoglobin equivalent (RET-He)
Journal
Journal of clinical laboratory analysis
ISSN: 1098-2825
Titre abrégé: J Clin Lab Anal
Pays: United States
ID NLM: 8801384
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
17
11
2019
revised:
07
01
2020
accepted:
09
01
2020
pubmed:
12
2
2020
medline:
20
5
2021
entrez:
12
2
2020
Statut:
ppublish
Résumé
Measurement of reticulocyte hemoglobin equivalent (RET-He) is rapid, convenient, and cost-effective. Yet, researches on its performance in diagnosing iron deficiency with concurrent inflammation are limited. Hence, this study investigated RET-He value in various states, including inflammation, and evaluated its diagnostic performance in iron status assessment. Retrospectively, 953 clinical data and laboratory results-complete blood count, reticulocyte count, RET-He, and serum ferritin-were reviewed. Patients on iron therapy were excluded. Iron status was defined by serum ferritin as the reference method. RET-He among populations was investigated. Its diagnostic performance and optimal cutoff were determined by ROC analysis. Three population groups were classified: healthy control, iron deficiency anemia (IDA), and non-ID anemia. Significantly, RET-He value in IDA was lower than that of healthy control, anemia of inflammation, and chronic kidney disease (P < .0001). Low RET-He was also observed in IDA with concomitant inflammation despite normal-to-high serum ferritin levels. No significant difference was observed between RET-He values in pure IDA and thalassemia (P = .57). ROC curve analysis revealed AUC of 0.876 (P < .0001) at cutoff 30 pg, by which IDA was discriminated with 74.2% sensitivity and 97.4% specificity. Applying cutoff ≤30 pg, IDA can be diagnosed with 96% sensitivity, 97.4% specificity, 80% PPV, and 99.6% NPV. Hence, RET-He >30 pg signifies a non-IDA state. In addition to convenience and cost-effectiveness, RET-He cutoff >30 pg can be potentially used to exclude IDA due to its excellent diagnostic sensitivity and specificity.
Sections du résumé
BACKGROUND
BACKGROUND
Measurement of reticulocyte hemoglobin equivalent (RET-He) is rapid, convenient, and cost-effective. Yet, researches on its performance in diagnosing iron deficiency with concurrent inflammation are limited. Hence, this study investigated RET-He value in various states, including inflammation, and evaluated its diagnostic performance in iron status assessment.
METHODS
METHODS
Retrospectively, 953 clinical data and laboratory results-complete blood count, reticulocyte count, RET-He, and serum ferritin-were reviewed. Patients on iron therapy were excluded. Iron status was defined by serum ferritin as the reference method. RET-He among populations was investigated. Its diagnostic performance and optimal cutoff were determined by ROC analysis.
RESULTS
RESULTS
Three population groups were classified: healthy control, iron deficiency anemia (IDA), and non-ID anemia. Significantly, RET-He value in IDA was lower than that of healthy control, anemia of inflammation, and chronic kidney disease (P < .0001). Low RET-He was also observed in IDA with concomitant inflammation despite normal-to-high serum ferritin levels. No significant difference was observed between RET-He values in pure IDA and thalassemia (P = .57). ROC curve analysis revealed AUC of 0.876 (P < .0001) at cutoff 30 pg, by which IDA was discriminated with 74.2% sensitivity and 97.4% specificity. Applying cutoff ≤30 pg, IDA can be diagnosed with 96% sensitivity, 97.4% specificity, 80% PPV, and 99.6% NPV. Hence, RET-He >30 pg signifies a non-IDA state.
CONCLUSION
CONCLUSIONS
In addition to convenience and cost-effectiveness, RET-He cutoff >30 pg can be potentially used to exclude IDA due to its excellent diagnostic sensitivity and specificity.
Identifiants
pubmed: 32043622
doi: 10.1002/jcla.23225
pmc: PMC7307362
doi:
Substances chimiques
Hemoglobins
0
Ferritins
9007-73-2
Iron
E1UOL152H7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e23225Informations de copyright
© 2020 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals, Inc.
Références
Clin Lab Haematol. 2006 Oct;28(5):303-8
pubmed: 16999719
Int J Lab Hematol. 2014 Dec;36(6):613-27
pubmed: 24666725
Int J Lab Hematol. 2016 May;38 Suppl 1:123-32
pubmed: 27195903
Rom J Intern Med. 2016 Jan-Mar;54(1):31-6
pubmed: 27141568
Crit Rev Clin Lab Sci. 2010 Dec;47(5-6):213-28
pubmed: 21391831
Anemia. 2016;2016:6430214
pubmed: 27382488
Pediatr Nephrol. 2016 May;31(5):819-26
pubmed: 26667237
Arthritis Rheum. 2011 Dec;63(12):3672-80
pubmed: 22127690
Rev Bras Hematol Hemoter. 2014;36(1):25-8
pubmed: 24624032
Lancet. 2016 Feb 27;387(10021):907-16
pubmed: 26314490
Hematol Oncol Clin North Am. 2014 Aug;28(4):729-45, vi-vii
pubmed: 25064710
Hematol Rep. 2012 Nov 19;4(4):e24
pubmed: 23355942
Int J Lab Hematol. 2010 Apr;32(2):248-55
pubmed: 19624802
Clin Chim Acta. 2014 Apr 20;431:143-7
pubmed: 24525213
Int J Lab Hematol. 2018 Dec;40(6):683-690
pubmed: 30047570
Int J Lab Hematol. 2016 May;38 Suppl 1:100-9
pubmed: 27161194
Scand J Clin Lab Invest. 2015 May;75(3):247-53
pubmed: 25608597
West J Med. 1981 Jun;134(6):496-505
pubmed: 7257364
Eur J Intern Med. 2013 Jan;24(1):63-6
pubmed: 23063249
Am J Clin Pathol. 2014 Oct;142(4):506-12
pubmed: 25239418
JAMA. 1999 Jun 16;281(23):2225-30
pubmed: 10376576
Pediatr Res. 2018 Nov;84(5):765-769
pubmed: 30232412
Rev Bras Hematol Hemoter. 2015 Mar-Apr;37(2):77-81
pubmed: 25818816
Int J Hematol. 2017 Jul;106(1):116-125
pubmed: 28299633
Pediatr Res. 2018 Nov;84(5):657-661
pubmed: 30140071
J Clin Lab Anal. 2020 Jun;34(6):e23225
pubmed: 32043622
Hematol Oncol Clin North Am. 2016 Apr;30(2):247-308
pubmed: 27040955
Gut. 2011 Oct;60(10):1309-16
pubmed: 21561874
Clin Chem. 2004 Jul;50(7):1240-2
pubmed: 15229154
J Assoc Physicians India. 2016 Nov;64(11):38-42
pubmed: 27805332