Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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/
Corresponding author: Hou-Cai Wang, MD, Chief Doctor, Department of Hematology, Shanghai Tenth People’s Hospital, No. 301 Yanchang Road, Shanghai 200072, China. houcaiwang@163.com
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
Processing time: 48 Days and 21.9 Hours
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.

Keywords: Iron deficiency anemia; Thalassemia trait; Hemoglobin; Mean corpuscular volume; Thalassemia trait; Gene sequencing

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.