Low haemoglobin density for detecting iron deficiency across a large population, including pregnancy

Area of Science:

• Hematology
• Clinical Chemistry
• Diagnostic Medicine

Background:

• Low haemoglobin density (LHD%) is a parameter from Coulter counters.
• LHD% has been proposed as a method for detecting iron deficiency.
• The diagnostic performance of LHD% across diverse populations, including pregnant women, remains unevaluated.

Purpose of the Study:

• To assess the effectiveness of LHD% in identifying iron deficiency.
• To evaluate LHD% performance in adult, pediatric, and antenatal patient groups.
• To compare LHD% with existing markers like MCV.

Main Methods:

• Retrospective analysis of patient samples (adults and children <12 years) undergoing blood counts and iron studies.
• Utilized receiver operating characteristic (ROC) curves to determine diagnostic accuracy.
• Analyzed LHD% performance in selected normal, unselected, pediatric, and antenatal cohorts.

Main Results:

• In unselected adults, LHD% showed moderate performance (AUC 0.74) with 74% sensitivity and 60% specificity at 5.9%.
• The pediatric cohort demonstrated better performance (AUC 0.79) with 75% sensitivity and 68% specificity.
• LHD% was ineffective in pregnant women (AUC 0.60) and did not outperform MCV.

Conclusions:

• LHD% can aid in detecting iron deficiency in adult and pediatric populations.
• LHD% is not a reliable indicator for iron deficiency in pregnancy.
• LHD% does not offer a significant advantage over the mean corpuscular volume (MCV) for iron deficiency diagnosis.