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Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children
The detection of iron deficiency anemia is challenged by the paucity of diagnostic tests demonstrating high sensitivity and specificity. Using two biomarkers, zinc-protoporphyrin/heme and hepcidin, we established the diagnostic cut-off values for iron deficiency anemia in preschool children and wome...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ferrata Storti Foundation
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6269316/ https://www.ncbi.nlm.nih.gov/pubmed/30093400 http://dx.doi.org/10.3324/haematol.2018.193243 |
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author | Kanuri, Giridhar Chichula, Deepti Sawhney, Ritica Kuriakose, Kevin De’Souza, Sherwin Pais, Faye Arumugam, Karthika Shet, Arun S. |
author_facet | Kanuri, Giridhar Chichula, Deepti Sawhney, Ritica Kuriakose, Kevin De’Souza, Sherwin Pais, Faye Arumugam, Karthika Shet, Arun S. |
author_sort | Kanuri, Giridhar |
collection | PubMed |
description | The detection of iron deficiency anemia is challenged by the paucity of diagnostic tests demonstrating high sensitivity and specificity. Using two biomarkers, zinc-protoporphyrin/heme and hepcidin, we established the diagnostic cut-off values for iron deficiency anemia in preschool children and women. We randomly selected non-anemic individuals (n=190; women=90, children=100) and individuals with iron deficiency anemia (n=200; women=100, children=100) from a preexisting cohort of healthy preschool children and their mothers. The diagnostic performance of these biomarkers was estimated by analyzing receiver operating characteristic curves. Diagnostic cut-offs with a high predictive value for iron deficiency anemia were selected. Median zinc-protoporphyrin/heme and hepcidin values in non-anemic children were 49 μmol/mol heme and 42 ng/mL, respectively, and in non-anemic women these values were 66 μmol/mol heme and 17.7ng/mL, respectively. Children and women with iron deficiency anemia had higher zinc-protoporphyrin/heme ratios (children=151 μmol/mol heme and women=155 μmol/mol heme) and lower hepcidin levels (children=1.2ng/mL and women=0.6ng/mL). A zinc-protoporphyrin/heme ratio cut-off >90 μmole/mole heme in children and >107 μmole/mole heme in women was associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=20.2: women, likelihood ratio=10.8). Hepcidin cut-off values of ≤6.8ng/mL in children and ≤4.5ng/mL in women were associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=14.3: women, likelihood ratio=16.2). The reference ranges and cut-off values identified in this study provide clinicians with guidance for applying these tests to detect iron deficiency anemia. Erythrocyte zinc-protoporphyrin/heme ratio is a valid point-of-care biomarker to diagnose iron deficiency anemia. |
format | Online Article Text |
id | pubmed-6269316 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Ferrata Storti Foundation |
record_format | MEDLINE/PubMed |
spelling | pubmed-62693162018-12-13 Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children Kanuri, Giridhar Chichula, Deepti Sawhney, Ritica Kuriakose, Kevin De’Souza, Sherwin Pais, Faye Arumugam, Karthika Shet, Arun S. Haematologica Article The detection of iron deficiency anemia is challenged by the paucity of diagnostic tests demonstrating high sensitivity and specificity. Using two biomarkers, zinc-protoporphyrin/heme and hepcidin, we established the diagnostic cut-off values for iron deficiency anemia in preschool children and women. We randomly selected non-anemic individuals (n=190; women=90, children=100) and individuals with iron deficiency anemia (n=200; women=100, children=100) from a preexisting cohort of healthy preschool children and their mothers. The diagnostic performance of these biomarkers was estimated by analyzing receiver operating characteristic curves. Diagnostic cut-offs with a high predictive value for iron deficiency anemia were selected. Median zinc-protoporphyrin/heme and hepcidin values in non-anemic children were 49 μmol/mol heme and 42 ng/mL, respectively, and in non-anemic women these values were 66 μmol/mol heme and 17.7ng/mL, respectively. Children and women with iron deficiency anemia had higher zinc-protoporphyrin/heme ratios (children=151 μmol/mol heme and women=155 μmol/mol heme) and lower hepcidin levels (children=1.2ng/mL and women=0.6ng/mL). A zinc-protoporphyrin/heme ratio cut-off >90 μmole/mole heme in children and >107 μmole/mole heme in women was associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=20.2: women, likelihood ratio=10.8). Hepcidin cut-off values of ≤6.8ng/mL in children and ≤4.5ng/mL in women were associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=14.3: women, likelihood ratio=16.2). The reference ranges and cut-off values identified in this study provide clinicians with guidance for applying these tests to detect iron deficiency anemia. Erythrocyte zinc-protoporphyrin/heme ratio is a valid point-of-care biomarker to diagnose iron deficiency anemia. Ferrata Storti Foundation 2018-12 /pmc/articles/PMC6269316/ /pubmed/30093400 http://dx.doi.org/10.3324/haematol.2018.193243 Text en Copyright© 2018 Ferrata Storti Foundation Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or internal use. Sharing published material for non-commercial purposes is subject to the following conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode, sect. 3. Reproducing and sharing published material for commercial purposes is not allowed without permission in writing from the publisher. |
spellingShingle | Article Kanuri, Giridhar Chichula, Deepti Sawhney, Ritica Kuriakose, Kevin De’Souza, Sherwin Pais, Faye Arumugam, Karthika Shet, Arun S. Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children |
title | Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children |
title_full | Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children |
title_fullStr | Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children |
title_full_unstemmed | Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children |
title_short | Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children |
title_sort | optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling indian women and preschool children |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6269316/ https://www.ncbi.nlm.nih.gov/pubmed/30093400 http://dx.doi.org/10.3324/haematol.2018.193243 |
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