Accuracy of Mentzer index for predicting iron deficiency anemia in adults
DOI:
https://doi.org/10.59736/IJP.22.03.916Keywords:
Mentzer index, , Mean corpuscular volume,, Red blood cells.Abstract
Background: It is of great clinical significance to differentiate between causes of microcytic, hypo chromatic anemias, iron deficiency anemia being one of them as it will improve with iron supplements. Complete blood picture is unable to differentiate. Iron studies and Hemoglobin electrophoresis are expensive tests. This necessitates the need of a cost-effective test and therefore we tried to determine the effectiveness of mentzer index in predicting iron deficiency anemia.
Methods: It was an Observational, Cross-sectional study, conducted in Department of General Medicine, Federal government polyclinic hospital, Islamabad. Patients with microcytic hypochromic anemia, both from indoor and outdoor were included in study. Iron deficiency Anemia was diagnosed by iron studies (serum ferritin, Serum Iron, TIBC and transferrin saturation) and then mentzer index was calculated to check accuracy. Patient with normocytic or macrocytic anemia or other cell lines deficiency, patients with infectious diseases or inflammatory process were excluded from study.
Results: A total of 155 patients were included in the study. Out of all the patients 145(93.5%) had mentzer index of > 13 while 10(6.5%) had mentzer index of <13. All of 150 patients (100%) had transferrin saturation lessthan 20 % indicating iron deficiency anemia against 93.5% picked up by Mentzer index. The receiver operator curves (ROC) showed that the MCV was the most important predictor of anemia while calculating mentzer index. The AUC value for MCV was 0.886(CI: 95%, 0.806-0.966, p value <0.000). MCV value between 52.6 to 63.5 fl predicted that the Mentzer index would be above 13, thus suggesting iron deficiency anemia with a sensitivity of more than 86%.
Conclusion: Study findings support the use of Mentzer index, particularly MCV, as a valuable tool for predicting iron deficiency anemia.
References
Wawer AA, Jennings A, Fairweather-Tait SJ. Iron status in the elderly: A review of recent evidence. Mech Ageing Dev. 2018 Oct; 175:55-73. Doi: 10.1016/j.mad.2018.07.003.
Habib A, Kureishy S, Soofi S, Hussain I, Rizvi A, Ahmed I, et al. Prevalence and Risk Factors for Iron Deficiency Anemia among Children under Five and Women of Reproductive Age in Pakistan: Findings from the National Nutrition Survey 2018. Nutrients. 2023 Jul 28; 15(15):3361. doi: 10.3390/nu15153361.
Ali SA, Abbasi Z, Shahid B, Moin G, Hambidge KM, Krebs NF,et al. Prevalence and determinants of anemia among women of reproductive age in Thatta Pakistan: Findings from a cross-sectional study. PLoS One. 2020 Sep 24; 15(9):e0239320. Doi: 10.1371/journal.pone.0239320.
Zulqarnain H, Nadeem MT, Shahid H, Mujtaba A, Ikram F, Arshad Z. Validity of Mentzer Index in Predicting Iron Deficiency Anaemia. Pak Armed Forces Med J 2024; 74(1): 63-66.DOI: https://doi.org/10.51253/pafmj.v74i1.
Idrees M, Khan JU, Riaz H, Shah MA, Shah H, Haris SM. Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC. Pakistan Journal of Medical & Health Sciences. 2023 Mar 22; 17(01):843.
ameel T, Baig M, Ahmed I, Hussain MB, Alkhamaly MBD. Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices. Pak J Med Sci. 2017 May-Jun; 33(3):665-669. Doi: 10.12669/pjms.333.12098.
Ntaios G, Chatzinikolaou A, Saouli Z, Girtovitis F, Tsapanidou M, Kaiafa G, et al . Discrimination indices as screening tests for β-thalassemic trait. Ann Hematol. 2007 Jul; 86(7):487-91. Doi: 10.1007/s00277-007-0302-x.
Chandrakumari AS, Sinha P, Singaravelu S, Jaikumar S. Prevalence of anemia among adolescent girls in a rural area of Tamil Nadu, India. J Family Med Prim Care. 2019 Apr; 8(4):1414-1417. Doi: 10.4103/jfmpc.jfmpc_140_19.
Luqman M, Wajid U, Ikhtiar F, Rashid R, Arif A, Naseem F, et al. Kausar T, Zahid A. Distribution Of ABO And Rh Blood Groups Among Type-II Diabetic Patients in Population Of Lahore, Pakistan. European chemical bulletin .13.74-82. Doi: 10.53555/ecb/2024.13.04.11
Mousa AO. Types of anemias with low MCV using Mentzer Index and RBC count among patients seen in Basrah Al-Sadir Teaching Hospital. Med J Babylon. 2014; 11(2):292-6.
Korom VG, Lueff S, Liposits A, Kellner A, Pavlovics A, Egyed M. Is iron deficiency anemia always microcytic? Pol Arch Intern Med. 2021 Feb 26; 131(2):199-201. Doi: 10.20452/pamw.15714.
Alkindi S, Al Musalami A, Al Wahaibi H, Althuraiya, Al S,Al Ghammari N, Panjwani V, et al. Iron deficiency and iron deficiency anemia in the adult Omani population. Journal of Applied Hematology. 2018 Jan 1; 9(1):11-5. Doi: 10.4103/joah.joah_65_17
Balcı T, Ayan D, Türkyürek C, Bayram E. Evaluation of diagnostic accuracy tests of erythrocyte indexes in the differential diagnosis of beta thalassemia minor and iron deficiency anemia: A preliminary report. Cukurova Medical Journal. 2021; 46(3):1009-17.
Jacob R, Aboko P, Eze E, Jeremiah Z. Differential diagnosis of iron deficiency anemia and beta thalassemia in Port Harcourt pregnant women using the Mentzer Index. Sanamed. 2024 Aug 9; 19(2).
Meraj, L, Ullah Khan, Z, Mateen, A, Bashir, S., Azeez, H, Yousuf, A, & Wajid,et al. Diabetic Peripheral Neuropathy and Impotence: A Cross-Sectional Analysis. History of Medicine, 2024 10(2), 1325-1330.
Sherali A, Ahad A, Tikmani SS, Sohail S. Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study. Glob Pediatr Health. 2023 Feb 11; 10:2333794X221130986. Doi: 10.1177/2333794X221130986
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