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 Processing time: 48 Days and 21.9 Hours
ARTICLE HIGHLIGHTS
Research background
Iron deficiency anemia (IDA) and thalassemia trait (TT) are common causes of microcytic anemia that are challenging to differentiate, especially in resource-limited settings. A simple screening index using basic complete blood count parameters could facilitate diagnosis.
Research motivation
To develop and validate a new index for discriminating between IDA and TT which only requires two routine complete blood count results.
Research objectives
To determine the optimal formula for a new screening index to differentiate between IDA and TT and validate its performance against gold standard tests.
Research methods
Retrospective analysis of complete blood counts from 126 patients to develop the index formula based on receiver operating characteristic curves. Prospective validation in 61 additional patients using sensitivity, specificity, and other metrics.
Research results
The hemoglobin to mean corpuscular volume ratio (Hb/MCV) showed the best discrimination. An index cut-off of 1.512 differentiated IDA from TT with 93.5% sensitivity and 78.4% specificity.
Research conclusions
The Hb/MCV index successfully differentiated between IDA and TT. As it only requires hemoglobin and MCV, which is convenient for use in resource-limited settings.
Research perspectives
The Hb/MCV index could facilitate screening and early diagnosis of TT in areas without access to genetic testing. Future studies should evaluate it prospectively across diverse populations.
