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Diagnostic Significance of Red Cell Indices in Non-anemic Iron Deficiency and Iron Deficiency Anemia: Reevaluation with ROC Curve

Journal of the Korean Pediatric Society 1994;37(1):33-39.
Published online January 15, 1994.
Diagnostic Significance of Red Cell Indices in Non-anemic Iron Deficiency and Iron Deficiency Anemia: Reevaluation with ROC Curve
Hwang Min Kim, Won Kyu Choi, Jae Seung Yang, Jong Soo Kim
Department of Pediatrics, Yonsei University, Wonju College of Medicine, Wonju, Korea, Department of Radiology
철결핍성빈혈과 철결핍상태의 진단시 각종 적혈구지수의 의의 : RPC curve를 이용한 재조명
김황민, 최원규, 양재승, 김종수
연세대학교 원주의과대학 소아과학교실
Abstract
To validate the diagnostic significance of red cell indices in non-anemic iron deficiency and iron deficiency anemia, complete blood count, serum iron, total iron binding capacity, and serum ferritin were measured in 208 middle school girls between 13 and 15 years age. We used Reciever Operating Characteristic (ROC) curve to compare the diagnostic significances of various red cell indices (MCV, MCH, MCHC, RDW). We also established the ideal cutoff values of red cell indices for the diagnosis of iron deficiency anemia. The results were as follows: 1) The prevalence of iron deficiency anemia and non-anemic iron deficiency were 4.8% and 11.1% respectively. 2) For the diagnosis of non-anemic iron deficiency, MCV had the highest diagnostic capacity, and MCH was the secondly useful one. 3) For the diagnosis of non-anemic iron deficiency, MCV had the highest diagnostic capacity, buty the sensitivity and specificity of the 4 red cell indices (MCV, MCH, MCHC, RDW) were so low that they could not be used as screening or confirmative tests. 4) The sensitivity and specificity of MCV were 1 for the diagnosis of iron deficiency anemia (cutoff value: MCV=79fl). In case of MCH, the sensitivity was 1 and the specificity was 0.995 for the diagnosis of iron deficiency anemia (cutoff value : MCH=25pg). In cases of MCHC, the sensitivity was 1 and the specificity was 0.69 for the diagnosis of iron deficiency anemia (cutoff value: MCH =33g/dl). In case of RDW, the sensitivity was 0.9 and the specificity was 0.96 for the diagnosis of iron deficiency anemia (cutoff value: RDW=13.5%). With above results, we could conclude that MCV and MCH were very useful screening tests for iron deficiency anemia and MCV could be used as a confirmative test of iron deficiency anemin.
Key Words: Iron deficiency, Red cell indices, Reciever operating characteristic curve


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