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An American retrospective records review of 190 paired ferritin and Hb-ret measurements in neonates showed that the Hb-ret makes a more accurate ID diagnosis than ferritin. The Hb-ret is proposed for IDA detection in infants who have difficulties with blood draws. The variability of AUC for Hb-ret could also be explained by the different cutoff values applied: 27.2 pg to 30.5 pg. The areas under the curve (AUC) resulting from receiver operating characteristic curve analysis for the diagnosis of absolute iron-deficiency anemia (IDA) were reported to be 0.69-0.89 and 0.64-0.84 for SF and TSAT, respectively, in contrast to 0.74-0.93 for Hb-ret. The Hb-ret level was significantly lower in non-ID anemia than in healthy controls but significantly higher than in ID. However, a study of 405 healthy adolescents (subjects with a hematological or systemic disease, present or previous infectious or febrile disease, or C-reactive protein >0.5 mg/dL excluded) found that higher body weight was associated with slightly, but significantly lower, Hb-ret with no ID associated.
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Differently, Hb-ret is not affected by any factors other than those participating in iron metabolism, as long as there is no abnormality in Hb synthesis. Traditional indices of body iron, such as serum ferritin (SF), serum iron, total iron-binding capacity, and transferrin saturation (TSAT), are affected by other factors (inflammatory state, diurnal variation, diet/malnutrition, decreased liver function) and iron metabolism. Approximately one-third of the world’s population suffers from anemia, half of which is iron deficiency (ID). Diagnosis of iron deficiency and iron-deficiency anemiaĪnemia is a significant worldwide health problem. This paper aimed to analyze more recent studies about Hb-ret and some not previously included reports, such as clinical applications of Hb-ret parameters measured by Sysmex hematology analyzers. The review covered iron metabolism in the body, hematopoiesis in the erythroid system, and the measurement principle and characteristics of Hb-ret and its application in clinical studies mainly dedicated to commercial H*3 and ADVIA hematology analyzers. Īt the beginning of 2020, an excellent review about Hb-ret was published by Chie Ogawa, et al. The hemoglobin content of reticulocytes (Hb-ret) is considered to reflect Hb synthesis potential and the iron levels used in hematopoiesis. In the bone marrow, iron is taken up from the blood during hematopoiesis and then binds to heme protein to form hemoglobin (Hb). Reticulocytes are immature red blood cells released into the blood two to three days following hematopoiesis and become mature red blood cells one to two days later.