Percentage of hypochromic erythrocytes as a potential marker of iron availability

Clin Chem Lab Med. 2011 Dec 17;50(4):685-7. doi: 10.1515/cclm.2011.837.

Abstract

Background: The percentage of hypochromic red cells (% Hypo-He) is now available on the Sysmex analyzer XE 5000 (Sysmex Corporation, Kobe, Japan). In this study the reliability of % Hypo-He in the assessment of iron status in the presence of inflammation is investigated.

Methods: Ninety healthy subjects, 91 patients with iron deficiency anemia (IDA) previous to therapy, 65 patients with chronic kidney disease (CKD), 57 patients with anemia of chronic diseases (ACD) and 28 patients with storage iron deficiency (ACD/IDA) receiving therapy were analyzed. Pearson's correlation, Independent samples t-test, receiver operating characteristic (ROC) curve analysis and Cohen's k index were applied.

Results: % Hypo-He values inversely correlated with the blood hemoglobin (Hb) (r=-0.78) and Hb content (MHC, r=-0.75). In patients with IDA and ACD/IDA the values obtained for % Hypo-He showed no statistical difference (p=0.5037). ROC analysis results for % Hypo-He in the detection of iron deficiency defined by a serum transferrin receptor (sTfR) >21 nmol/L. The area under the curve is 0.929; cut-off 3.6%, sensitivity 91.5% and specificity 80.9%. Using the threshold 3.6% the k index obtained in comparison to sTfR was 0.64.

Conclusions: % Hypo-He is a reliable parameter for the detection of iron deficiency in patients with anemia in the presence of inflammation.

MeSH terms

  • Adult
  • Anemia, Iron-Deficiency / blood
  • Biomarkers / blood
  • Erythrocytes / metabolism*
  • Female
  • Hemoglobins / metabolism*
  • Humans
  • Iron / metabolism*
  • Male
  • Middle Aged
  • Pigmentation*

Substances

  • Biomarkers
  • Hemoglobins
  • Iron