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

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.

Factors associated with anaemia and iron deficiency among women of reproductive age in Northeast Thailand: a cross-sectional study

“…Nonetheless, food consumption behaviour, which differs from region to region, may also account for the difference in anemia prevalence. Of note, the high prevalence and complexity of thalassemia Including homozygous α + -thalassemia, homozygous Hb CS, α 0 -thalassemia trait, and β-thalassemia trait *For anaemia, adjusted for length of menstruation and blood donation in recent 3 months; For ID, adjusted for BMI and length of menstruation observed in our study, which was very similar to that were reported in previous studies on adolescent, pregnant women, and vegetarians community in northeast Thailand [14,16,31], thus indicating the presence of heterogeneity of thalassemia and hemoglobinopathies in the region.…”

Red Cell Indices and Formulas Used in Differentiation ofβ-Thalassemia Trait from Iron Deficiency in Thai Adults

“…In addition, the reference ranges of Hb and RBC counts between male and female are nearly similar, moreover, those of MCV, MCH, MCHC and RDW are the same (24). Both b-thal and iron deficiency are the major causes of anemia in all age groups of the Thai population (25)(26)(27)(28)(29)(30). Although, the b-thal Table 2.…”

Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis

“…Some investigators included also subjects with other types of hemoglobinopathy, like HbE [116,117,125], HbOArab [126] and HbS, both sickle cell thalassemia and sickle cell disease [48,94]. Unfortunately the numbers reported are too small for making a solid conclusion as to the utility of the discriminant indices in these conditions.…”