Low hemoglobin density potential marker of iron availability.

Area of Science:

• Hematology
• Clinical Chemistry

Background:

• Low hemoglobin density (LHD%) is a novel parameter derived from mean cell hemoglobin concentration.
• It is calculated using a specific mathematical sigmoid transformation: LHD% = 100×√(1-(1/(1 + e(1.8(30-MCHC))))).

Purpose of the Study:

• To evaluate the reliability of LHD% for assessing iron status.
• To investigate its utility in the presence of inflammation.

Main Methods:

• Analysis of healthy subjects (n=90) and patients with iron deficiency anemia (IDA, n=110), chronic kidney disease (CKD, n=65), and anemia of chronic disease (ACD, n=85).
• Utilized a LH 780 analyzer for measurements.
• Employed independent samples U test, receiver operating characteristic (ROC) curve analysis, and Cohen's κ index for statistical analysis and concordance determination with soluble transferrin receptor (sTrR).

Main Results:

• LHD% values did not differ significantly between IDA and iron-deficient ACD groups (P = 0.6427).
• LHD% values were significantly lower in iron-deficient patients compared to iron-sufficient ACD patients (P < 0.0001).
• ROC analysis for iron deficiency detection showed an area under the curve of 0.903, with a cutoff of 5.5%, sensitivity of 88.6%, and specificity of 76.9% (κ index = 0.65).

Conclusions:

• LHD% is a dependable parameter for identifying iron deficiency in anemic individuals, even when inflammation is present.
• The study supports the clinical utility of LHD% in diagnosing iron deficiency anemia in complex patient populations.