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[Low mean cell hemoglobin is a reliable marker for iron deficiency screening]
Abstract
Introduction:
Screening for iron deficiency, which affects a significant proportion of the population, is a burning issue in the health care system.
Aim:
The aim of the authors was to examine whether low mean cell hemoglobin concentration measured by automated hematology analyzers is a suitable screening parameter for iron deficiency.
Method:
The data for this study included a total of 247,705 complete blood counts and 10,840 tests with different parameters of iron metabolism. Patients were evaluated at Somogy County Kaposi Mór Teaching Hospital during a period of 30 months between January 1, 2013 and June 30, 2015. Low cell hemoglobin values were analyzed with iron metabolism parameters measured simultaneously.
Results:
A total of 830 patients whose iron metabolism parameters were measured simultaneously had low mean cell hemoglobin (<28pg). Of the 830 patients, 679 (82%) had both low mean cell hemoglobin and iron deficiency, while in 126 hemodialysed patients (15%), 8 patients with myelofibrosis, and 5 patients with rheumatic arthritis had low mean cell hemoglobin without iron deficiency. In the remaining 6 patients the cause of low mean cell hemoglobin or iron deficiency was not identified.
Conclusions:
Based on these findings the authors conclude that mean cell hemoglobin may be a reliable screening marker for iron deficiency. Orv. Hetil., 2016, 157(1), 35-38.
... The transferrin saturation, serum ferritin level, reticulocyte haemoglobin content and bone marrow iron content are the most used and suitable parameters to measure the body's iron status nowadays. On the other hand, more reports raised attention that red blood cell hypochromia and decreased red blood cell haemoglobin content indicate the presence of iron deficiency [21][22][23][24][25][26]. The low mean cell haemoglobin content (MCH) is an appropriate parameter which notes iron deficiency [21], and it is more available in retrospective databases in comparison to other iron status parameters. ...
... On the other hand, more reports raised attention that red blood cell hypochromia and decreased red blood cell haemoglobin content indicate the presence of iron deficiency [21][22][23][24][25][26]. The low mean cell haemoglobin content (MCH) is an appropriate parameter which notes iron deficiency [21], and it is more available in retrospective databases in comparison to other iron status parameters. ...
... We consider that the iron deficiency exists in the background of the low MCH level [21][22][23][24][25][26]. The incidence of thromboembolic events was significantly higher in the low MCH group, supporting our hypothesis that low MCH is an independent risk factor for TE morbidity. ...
Objectives: Thrombosis is a leading cause of morbidity and mortality in patients with Philadelphia negative chronic myeloproliferative neoplasms (MPNs). There are many thrombosis risk stratifications used in this patient group taking into consideration the age, thrombosis history and cardiovascular factors (hypertension, hypercholesterinaemia, hyper-trigliceridaemia, thrombocytosis, smoking and diabetes mellitus). In this work we evaluated the possible role of iron deficiency in thrombotic events (TE) of the polycythaemia vera (PV) patients. Methods: We considered the low mean cell haemoglobin (MCH <28 pg) value as a parameter to assess the iron deficiency in the multicentre database (15 Hungarian haematology centres) of our HUMYPRON GROUP (Hungarian MPN Working Group). The MCH values, recorded at the time of diagnosis of 296 patients with polycythemia vera, were retrospectively analysed.Results: The low MCH, at the diagnosis, was found to be a risk factor for thrombotic events occurring after diagnosis (OR: 1.966). It was also shown as an additive and independent parameter in the Tefferi high-risk patient groups, and combining it with Tefferi risk stratification an extremely high thrombotic risk group could be determined (Nagelkerke R square: 0.084). We have supposed that low MCH in PV reveals a disease form featured with a high proliferation activity. Our hypothesis was confirmed with a sub-study (n=52) showing that the high JAK2V617F allele burden was significantly correlated with the low MCH (p=0.005) and the high white blood cell count (WBC) (p<0.001).Conclusions: Iron deficiency, existing at the time of diagnosis of PV, was proven to be a risk factor for imminent thrombotic events. The low MCH was found to be a strong additive factor when it was combined with the known thrombotic risk stratification systems. The low MCH showed significant correlation with the high JAK2V617F allele burden.
... Commonly used laboratory automated analyzers calculate MCV (hematocrit (Htc) / red blood cell (RBC)) and MCH (Hemoglobin (Hgb) / RBC) from the measured parameters (RBC, Hct, Hgb). [4] Previous generations of laboratory analyzers used to measure MCV directly, and IDA was defined as anemia with low MCV or microcytic anemia. ...
... In addition, previous studies have shown that high mean corpuscular volume (MCV) is a prognostic indicator for acute decompensated heart failure 13 and that it is associated with all-cause mortality, cardiovascular disease mortality, and infectionassociated mortality in patients with chronic kidney disease stages 3-5, 14 and that mean corpuscular hemoglobin (MCH) is a predictor of iron deficiency. 15 Although numerous studies have indicated that lifestyle factors such as smoking, alcohol consumption, shift work, and exercise may exert an important effect on WBC count, [16][17][18][19] little is known about the association between hematological parameters and lifestyle factors. To promote primary prevention of CHD and other diseases at the workplace, the evaluation of lifestyle factors related to hematological parameters is considered to be important. ...
Background:
Increasing evidence suggests an association between lifestyle and white blood cell (WBC) count; however, no study has examined the effects of lifestyle associations on hematological parameters. The aim of this study was to examine the association between lifestyle factors and hematological parameters in a large population-based sample of Chinese male steelworkers.
Methods:
This study included 3189 male workers at a steel plant who responded to a cross-sectional questionnaire on basic attributes, lifestyle, and sleep. All workers in the plant underwent periodic health checkups. Hematological parameters were also examined at the checkup.
Results:
Stepwise linear regression analyses showed that smoking, poor sleep, shift work, and obesity were all significant factors associated with WBC count. Obesity was independently associated with RBC count. Furthermore, smoking and obesity were associated with hemoglobin, and smoking, poor sleep, and obesity were independently associated with hematocrit. Moreover, smoking was the main factor associated with MCV and MCH. When the subjects were divided into quartiles according to WBC count, RBC count, hemoglobin, hematocrit, MCV, MCH, and increased WBC count were associated with smoking, poor sleep, shift work, and obesity. Increased hemoglobin was associated with smoking and obesity. Furthermore, an increased RBC count was associated with obesity, and increased hematocrit was associated with smoking, poor sleep, and obesity. Similarly, increased MCV and MCH were also associated with smoking.
Conclusion:
This study indicates that lifestyle factors may exert an important effect on hematological parameters (eg, WBC count, RBC count, hemoglobin, hematocrit, MCV, and MCH).
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