Yao QC, Zhai HL, Wang HC. Ratio of hemoglobin to mean corpuscular volume: A new index for discriminating between iron deficiency anemia and thalassemia trait. World J Clin Cases 2023; 11(35): 8270-8275 [PMID: 38130603 DOI: 10.12998/wjcc.v11.i35.8270]
Corresponding Author of This Article
Hou-Cai Wang, MD, Chief Doctor, Department of Hematology, Shanghai Tenth People’s Hospital, No. 301 Yanchang Road, Shanghai 200072, China. houcaiwang@163.com
Research Domain of This Article
Hematology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2023; 11(35): 8270-8275 Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8270
Ratio of hemoglobin to mean corpuscular volume: A new index for discriminating between iron deficiency anemia and thalassemia trait
Qing-Chun Yao, Hui-Li Zhai, Hou-Cai Wang
Qing-Chun Yao, Department of Oncology, Taizhou Fourth People's Hospital, Taizhou 225300, Jiangsu Province, China
Hui-Li Zhai, Hou-Cai Wang, Department of Hematology, Shanghai Tenth People's Hospital, Shanghai 200072, China
Author contributions: Yao QC performed the study and draft the manuscript; Zhai HL collected the data and drafted the manuscript; Wang HC designed the study and analyzed the data. All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Shanghai Tenth People’s Hospital Institutional Review Board (Approval No. 23K190).
Informed consent statement: All data analyzed in our study were retrospectively collected. No patient consent was necessary.
Conflict-of-interest statement: All the authors declare no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at houcaiwang@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: October 26, 2023 Peer-review started: October 26, 2023 First decision: November 20, 2023 Revised: December 1, 2023 Accepted: December 6, 2023 Article in press: December 6, 2023 Published online: December 16, 2023
Abstract
BACKGROUND
Iron deficiency anemia (IDA) and thalassemia trait (TT) are the most common microcytic and hypochromic anemias. Differentiation between mild TT and early IDA is still a clinical challenge.
AIM
To develop and validate a new index for discriminating between IDA and TT.
METHODS
Blood count data from 126 patients, consisting of 43 TT patients and 83 IDA patients, was retrospectively analyzed to develop a new index formula. This formula was further validated in another 61 patients, consisting of 48 TT patients and 13 IDA patients.
RESULTS
The new index is the ratio of hemoglobin to mean corpuscular volume. Its sensitivity, specificity, accuracy, Youden’s Index, area under the receiver operating characteristic curve, and Kappa coefficient in discriminating between IDA and TT were 93.5%, 78.4%, 83.3%, 0.72, 0.97, and 0.65, respectively.
CONCLUSION
This new index has good diagnostic performance in discriminating between mild TT and early IDA. It requires only two results of complete blood count, which can be a very desirable feature in under-resourced scenarios.
Core Tip: The ratio of hemoglobin to mean corpuscular volume was proposed and validated as a new index for discriminating between iron deficiency anemia and thalassemia trait, with a sensitivity and a specificity of 93.5% and 78.4%, respectively. This new index has good diagnostic performance and is useful in under-resourced scenarios.
