Abstract
Background As regular blood donors are prone to iron deficiency, importance of extended red blood cell (eRBC) parameters in identifying donors with depleted iron stores was investigated. Thrombocytosis has been well documented in patients affected with IDA. Thus, significance of eRBC parameters in identifying iron deficiency associated thrombocytosis was also examined in this cohort.
Methods Blood samples were collected in EDTA tubes from consenting donors for analyses of routine haematological and eRBC parameters. Serum samples were isolated for estimation of iron parameters.
Results Iron deficient donors had significantly altered eRBC parameters. Among them, Ret-He with a cut-off of ≥32 pg had high AUC (0.822) and showed relatively high sensitivity & specificity in detecting iron deficiency. Combination of Ret-He with CCI increased sensitivity & specificity to 90.6% and 98.2%, in detection of donors affected with iron restricted erythropoiesis. This cohort had increased platelet counts, which showed significant association with Ret-He (β= -0.373), RBC-He (β= -0.384), CCI (β= 0.384), Hypo-He (β=0.494) and Micro-R (β= 0.299). Elevated platelet counts also showed significant correlations with these eRBC parameters, which was absent in iron replete donors.
Conclusions eRBC parameters are sensitive indicators of non-anaemic iron deficiency, which may be enhanced by combining them. Their significant association with elevated platelet counts in iron deficient donors, highlights their importance in reflecting iron deficiency associated thrombocytosis.
Impact Statement The present study discusses utility of eRBC parameters in detecting non-anaemic iron deficiency, in regular voluntary blood donors. Previous reports have investigated the importance of these parameters in identifying IDA in blood donors. The present study is the first one which indicates combining different eRBC parameters such as Ret-He and CCI increases their accuracy of detection. They were also significantly associated with elevated platelet counts in iron deficient donors, which was absent in iron replete individuals. This link between eRBC parameters and higher platelet counts in healthy donors affected with non-anaemic iron deficiency has not been reported before.
Competing Interest Statement
The authors have declared no competing interest.
