Euroasian journal of hepato-gastroenterology

Register      Login

VOLUME 13 , ISSUE 2 ( July-December, 2023 ) > List of Articles

Original Article

Reticulocyte Hemoglobin Equivalent (Ret-He) as a Potential Diagnostic Marker of Iron Deficiency Anemia among Bangladeshi Adults

M Morsed Zaman Miah, Md Enayet Ali Pramanik, M Abdur Rafi, Mira Akhter

Keywords : Anemia, Iron deficiency anemia, Ret-He, Sysmex

Citation Information : Miah MM, Pramanik ME, Rafi MA, Akhter M. Reticulocyte Hemoglobin Equivalent (Ret-He) as a Potential Diagnostic Marker of Iron Deficiency Anemia among Bangladeshi Adults. Euroasian J Hepatogastroenterol 2023; 13 (2):128-132.

DOI: 10.5005/jp-journals-10018-1410

License: CC BY-NC 4.0

Published Online: 26-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Anemia involving a variety of etiological sources constitutes a common side effect of long-term liver diseases. Anemia caused by an iron deficiency (IDA) is a prominent kind of anemia among various other types. Blood ferritin levels and other iron-related indicators can be used to identify anemia. On the other hand, it is now possible to quantify reticulocyte hemoglobin equivalent (Ret-He), which indicates the reticulocyte iron concentration. It would be useful to diagnose IDA immediately if Ret-He could evaluate the ID. The effectiveness of Ret-He to diagnose ID in Bangladeshi patients was investigated in an ongoing study. Whole bloodstream numbers, blood ferritin phases, and Ret-He concentrations were measured in a cohort of 215 Bangladeshi people. Hemoglobin (Hb) values less than 12 gm/dL were considered anemia. An individual was classified as iron deficient if their blood ferritin concentration was below 12 ng/mL. Participants were split into four groups for this study: non-ID groups with anemia, IDA, ID, and control groups. In comparison to patients with IDA and ID, the concentrations of Ret-He showed a downward tendency. Serum Ret-He levels were correlated with ferritin levels in the subjects. The measurement of the area around the intercept (AUC) for Ret-He on the ROC curve was 0.906, suggesting a correlation with diagnosis. The study's results provide optimism for the therapeutic use of Ret-He value as an indicator for identification in Bangladeshi patients.


HTML PDF Share
  1. Gardner W, Kassebaum N. Global, Regional, and National Prevalence of Anemia and Its Causes in 204 Countries and Territories, 1990–2019. Curr Dev Nutr 2020;4(Suppl 2):830. DOI:10.1093/cdn/nzaa053_035.
  2. WHO. Global anaemia prevalence and number of individuals affected. WHO. 2008.
  3. Ahmed F. Anaemia in Bangladesh: A review of prevalence and aetiology. Public Health Nutr 2000;3(4):385–393. DOI: 10.1017/s1368980000000446.
  4. Rahman MA, Rahman MS, Aziz Rahman M, et al. Prevalence of and factors associated with anaemia in women of reproductive age in Bangladesh, Maldives and Nepal: Evidence from nationally-representative survey data. PLoS One 2021;16(1):e0245335. DOI: 10.1371/journal.pone.0245335.
  5. De Benoist B, Mclean E. Worldwide prevalence of anaemia 1993–2005 who Global database on anaemia. 2008. Available from: https://www.who.int/publications/i/item/9789241596657.
  6. Toki Y, Ikuta K, Kawahara Y, et al. Reticulocyte hemoglobin equivalent as a potential marker for diagnosis of iron deficiency. Int J Hematol 2017;106(1):116–125. DOI: 10.1007/s12185-017-2212-6.
  7. Buttarello M, Temporin V, Ceravolo R, et al. The new reticulocyte parameter (RET-Y) of the Sysmex XE 2100: Its use in the diagnosis and monitoring of posttreatment sideropenic anemia. Am J Clin Pathol 2004;121(4):489–495. DOI: 10.1309/W652-95DT-UWK7-U1HH.
  8. Brugnara C, Schiller B, Moran J. Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states. Clin Lab Haematol 2006;28(5):303–308. DOI: 10.1111/j.1365-2257.2006.00812.x.
  9. Brugnara C, Laufer MR, Friedman AJ, et al. Reticulocyte hemoglobin content (CHr): Early indicator of iron deficiency and response to therapy [4]. Blood 1994;83(10):3100–3101. DOI: https://doi.org/10.1182/blood.V83.10.3100.3100.
  10. Gelaw Y, Woldu B, Melku M. The role of reticulocyte hemoglobin content for diagnosis of iron deficiency and iron deficiency anemia, and monitoring of iron therapy: A literature review. Clin Lab,. Verlag Klinisches Labor GmbH 2019;65(12):10.7754/Clin.Lab.2019.190315. DOI: 10.7754/Clin.Lab.2019.190315.
  11. Uçar MA, Falay M, Dağdas S, et al. The importance of RET-He in the diagnosis of iron deficiency and iron deficiency anemia and the evaluation of response to oral iron therapy. J Med Biochem 2019;38(4):496–502. DOI: 10.2478/jomb-2018-0052.
  12. Ullrich C, Wu A, Armsby C, et al. Screening healthy infants for iron deficiency using reticulocyte hemoglobin content. JAMA 2005;294(8):924–930. DOI: 10.1001/jama.294.8.924.
  13. Ogawa C, Tsuchiya K, Nitta K, et al. Significance of content of the reticulocyte hemoglobin in the management of renal anemia. Blood Purif 2019;47 Suppl 2:70–73. DOI: 10.1159/000496641.
  14. Gonzalez-Casas R, Jones EA, Moreno-Otero R. Spectrum of anemia associated with chronic liver disease. World J Gastroenterol 2009;15(37):4653–4658. DOI: 10.3748/wjg.15.4653.
  15. Hajian-Tilaki K. Sample size estimation in diagnostic test studies of biomedical informatics. J Biomed Inform 2014;48:193–204. DOI: 10.1016/j.jbi.2014.02.013.
  16. Ali AM, Luxton AW, Walker WH. Serum ferritin concentration and bone marrow iron stores: A prospective study. Can Med Assoc J 1978;118(8):945–946. PMID: 647567.
  17. Miwa N, Akiba T, Kimata N, et al. Usefulness of measuring reticulocyte hemoglobin equivalent in the management of haemodialysis patients with iron deficiency. Int J Lab Hematol 2010;32(2):248–255. DOI: 10.1111/j.1751-553X.2009.01179.x.
  18. Short MW, Domagalski JE. Iron deficiency anemia: Evaluation and management. Am Fam Physician 2013;87(2):98–104. PMID: 23317073.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.