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Proxy Indicators for Identifying Iron Deficiency among Anemic Vegetarians in an Area Prevalent for Thalassemia and Hemoglobinopathies

Wongprachum K.a, b · Sanchaisuriya K.b · Sanchaisuriya P.c · Siridamrongvattana S.a, b · Manpeun S.d · Schlep F.P.c
aCenter for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, bMedical Science Program, Graduate School, and cDepartment of Nutrition, Faculty of Public Health, Khon Kaen University, Khon Kaen, and dDepartment of Applied Thai Traditional Medicine, Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand Acta Haematol 2012;127:250–255 (DOI:10.1159/000337032)

Abstract

Background and Aims: The study aimed to determine the proportion of iron deficiency (ID) anemia (IDA) among vegans in northeast Thailand and to explore whether mathematical formulas derived from red blood cell (RBC) indices are applicable for IDA screening in the study population. Methods: Blood samples from 234 individuals (age 6–45 years) living in a vegan community were taken. Complete blood cell count, serum ferritin, hemoglobin profiles and DNA analysis for α-thalassemia were determined. Anemia was defined using the WHO criteria adjusted for age and sex. Serum ferritin <15 ng/ml was considered as ID. A number of mathematical formulas derived from RBC indices were applied to screen ID among anemic individuals. Results: Anemia was found in 41.5% (95% CI = 35.1–48.1%) of the study participants. The overall proportion of thalassemia and hemoglobinopathies was 56.4% (95% CI = 49.8–62.9%). Of the anemic participants, 45.4% had ID. Based on the receiver-operating characteristic curve analysis, 4 formulas were applicable for predicting ID among anemic individuals (highest sensitivity of 86.4%). Conclusions: The proposed formulas might be used as proxy indicators for the identification of ID among anemic children and adult vegans if more sophisticated laboratory determinations are not available due to limited financial resources.

 

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