Kılıç Merve, Özpınar Aysel, Serteser Mustafa, Kilercik Meltem, Serdar Muhittin
Acıbadem Mehmet Ali Aydinlar University, School of Medicine, Dept. Medical Biochemistry, Istanbul, Turkey.
J Med Biochem. 2022 Feb 2;41(1):1-13. doi: 10.5937/jomb0-31435.
Iron deficiency anemia (IDA) is the most common type of anemia worldwide and has many adverse effects on life quality. This meta-analysis study aims to show that reticulocyte hemoglobin content (CHr) is more effective than routinely used parameters in the diagnosis of IDA.
Comprehensive and systematic research was done using international databases including PubMed, Web of Science, Cochrane Library, Science Direct, and Google Scholar, which contain all articles published on IDA until December 29, 2020. Seventeen articles were included in the meta-analysis.
The analyses found the Cohen's deffect size (Standardized Mean Difference) values of the parameters. Accordingly, CHr is 2.84 (95% CI 2.36 to 3.31), mean corpus volume (MCV) is 2.46 (95% CI 1.97 to 2.95), ferritin is 2.37 (95% CI 1.63 to 3.11), and transferrin saturation (TSAT) is 3.76 (95% CI 2.14 to 5.38). To diagnose IDA, the sensitivity value of the CHr concentration was found as 83.5% (95% CI 76.1 to 89.8), specificity value to be 91.8% (95% CI 85.5 to 96.4), and mean cut-off value as 28.2 pg.
The results of our study reveal the findings that CHr is a better biomarker than MCV and ferritin used in determining IDA, and its efficacy is lower than TSAT. It is very important to use it routinely for the pre-diagnosis of IDA, which is very important for public health. The groups in the study are heterogeneous but contain bias. Therefore, meta-analyses of studies with less heterogeneity of CHr are needed.
缺铁性贫血（IDA）是全球最常见的贫血类型，对生活质量有诸多不利影响。本荟萃分析研究旨在表明，网织红细胞血红蛋白含量（CHr）在IDA诊断中比常规使用的参数更有效。
利用包括PubMed、科学网、考克兰图书馆、科学Direct和谷歌学术在内的国际数据库进行全面系统的研究，这些数据库包含截至2020年12月29日发表的所有关于IDA的文章。17篇文章被纳入荟萃分析。
分析得出了各参数的科恩效应量（标准化均值差）值。据此，CHr为2.84（95%置信区间2.36至3.31），平均红细胞体积（MCV）为2.46（95%置信区间1.97至2.95），铁蛋白为2.37（95%置信区间1.63至3.11），转铁蛋白饱和度（TSAT）为3.76（95%置信区间2.14至5.38）。为诊断IDA，发现CHr浓度的敏感性值为83.5%（95%置信区间76.1至89.8），特异性值为91.8%（95%置信区间85.5至96.4），平均截断值为28.2 pg。
我们的研究结果表明，CHr是比用于确定IDA的MCV和铁蛋白更好的生物标志物，其有效性低于TSAT。对IDA进行常规预诊断非常重要，这对公众健康意义重大，而CHr在其中作用显著。本研究中的组具有异质性但存在偏差。因此，需要对CHr异质性较小的研究进行荟萃分析。
