Related Experiment Video
Updated: Jun 14, 2025
Simultaneous Quantification of T-Cell Receptor Excision Circles TRECs and K-Deleting Recombination Excision Circles KRECs by Real-time PCR
Published on: December 6, 2014
Reference values for reticulocyte haemoglobin equivalent in healthy Chinese children under 5 years and its
Keith Tsz Suen Tung1, Chen Chen1, Yung Tuen Chiu2
1Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.
Insights
Reticulocyte haemoglobin equivalent (RET-He) reference ranges were established for Hong Kong children under five. Lower RET-He levels in infants suggest age-specific iron deficiency screening is crucial.
Area of Science:
- Hematology
- Pediatric Medicine
- Clinical Chemistry
Background:
- Reticulocyte haemoglobin equivalent (RET-He) is a key indicator of recent iron utilization, independent of inflammation.
- Establishing age-specific reference ranges for RET-He in children is essential for accurate assessment.
Purpose of the Study:
- To determine the reference range for RET-He in healthy Hong Kong children under 5 years old.
- To investigate the correlation between RET-He and other hematological parameters in this population.
Main Methods:
- A cross-sectional study involving 946 children aged 2-48 months.
- Hematological parameters, including RET-He and ferritin, were measured using automated analyzers and immunoassay.
- Statistical analyses included regression and ROC curve analysis to establish normal ranges and identify iron deficiency thresholds.
Main Results:
- RET-He levels showed an approximate normal distribution, with age-specific lower limits ranging from 25.81 pg to 27.15 pg.
- Lower mean RET-He levels were observed in infants aged 2-12 months.
- RET-He was significantly influenced by age, red blood cell parameters, and reticulocyte counts (p<0.05).
- A RET-He cut-off value of ≤27.8 pg was identified for detecting iron deficiency.
Conclusions:
- RET-He levels in children vary with age, being lower in infants.
- Age-specific lower limits of RET-He serve as a valuable tool for preliminary iron deficiency screening in pediatric populations.
Background:
Reticulocyte haemoglobin equivalent (RET-He) is a useful tool for evaluating recent iron usage irrespective of inflammatory status. This study aims to establish a reference for RET-He among Hong Kong healthy children under the age of 5 years and to investigate the association between RET-He and various blood parameters.
Methods:
A total of 946 children aged 2-48 months from July 2019 to December 2022 were recruited in this cross-sectional study. The RET-He and other haematological parameters were measured by the haematology analyser from Sysmex XN-9100/XN-1500. The ferritin test was performed with the electrochemiluminescence immunoassay. Interval 2.5th percentile to 97.5th percentile represented the normal RET-He ranges. Linear multiple regression analysis was performed to examine the relation between RET-He and various blood parameters. Receiver-operating characteristic curve analysis revealed the sensitivity and specificity of RET-He in identifying iron deficiency.
Results:
The RET-He in the study population was approximately normally distributed. The age-specific lower limit of RET-He ranges from 25.81 pg (25-36 months) to 27.15 pg (13-24 months). RET-He was found to be lower in the age group 2-6 months (mean=29.47 pg) and 7-12 months (mean=29.41 pg). Changes in RET-He and haemoglobin in relation to age were observed in both sexes (both p<0.001). RET-He was influenced by age, some red blood cell parameters and reticulocyte concentrations (all p<0.05). A cut-off value of RET-He ≤27.8 pg was determined for identifying iron deficiency.
Conclusions:
RET-He levels varied with age, with a relatively lower level in infants than in other age groups. The value below the age-specific lower limit of the reference range of RET-He can be used as a limit for preliminary iron-deficiency screening.
Related Concept Videos
01:14Erythropoiesis
01:20Overview of Hematopoiesis
Developmental Phases of Hematopoiesis
Initially, HSCs are formed in the embryonic yolk sac, a critical site for early blood cell production. These stem cells subsequently migrate to other...