Reticulocyte hemoglobin content associated with the risk iron deficiency anemia

Abstract

Abstract Background/ Objective: Reticulocyte hemoglobin content (MCHr) is considered to be a rapid and reliable marker for the investigation of iron deficiency (ID). We hypothesize that MCHr is associated with the risk of iron deficiency anemia in adults. Methods This is a dual center case-control study. A total of 668 anemia patients were recruited in Ruijin Hospital and Xinhua hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2021 to December 2021, and 302 of them were IDA. According to MCHr level, individuals were divided into two groups, i.e. normal Mchr (≥ 25 pg) and decreased Mchr (< 25 pg) group. Multivariate logistic regression analysis and adjusted subgroup analysis were conducted to estimate the relative risk between MCHr and IDA. Age, sex, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), Hematocrit (HCT), serum iron (Fe), ferritin (Ferrit), and total iron binding capacity (IBCT) were chosen as confounding factors. Results Compared with the non-IDA, the Mchr level with IDA decreased significantly. After fully adjusting the confounding factors, a decreased risk of IDA was suggested for individuals with normal level of MCHr (OR = 0.68 [0.60, 0.77], P < 0.0001) and IDA risk was up to 5 times higher for decreased MCHr. Conclusion Our findings supported the hypothesis that MCHr was associated with IDA risk in adults and extend the extensive literature regarding decreased MCHr in early stage of laboratory detection, which warrants further investigation.