Aim We investigated the potential of reticulocyte haemoglobin equivalent (RET-He) as an early marker of responsiveness to iron supplementation.
Methods Data were obtained from a randomised controlled trial of daily iron supplementation in 356 Cambodian women (18–45 y) who received 60 mg elemental iron for 12 weeks. A fasted venous blood specimen was collected at baseline, 1-week and 12-week timepoints. Whole blood haemoglobin (g/L) and RET-He (pg) were measured using a Sysmex haematology analyser. RET-He measures were evaluated for their predictive ability on haemoglobin response to iron supplementation (defined as ≥10 g/L at 12 weeks). Receiver operating characteristic (ROC) curves were used to assess discrimination performance, and the area under the ROC curve (AUCROC) served as a measure of the ability of each predictor to discriminate between women likely or unlikely to elicit a haemoglobin response.
Results Predictive ability (AUCROC (95% CI)) of baseline, 1-week, and change from baseline to 1-week RET-He on haemoglobin response was 0.70 (0.63 to 0.76), 0.48 (0.41 to 0.56) and 0.81 (0.75 to 0.87), respectively. Based on the Youden index, an absolute increase in RET-He of ~1.1 pg or a percentage increase of ~4.4% over 1 week were optimal thresholds to predict responsiveness to iron supplementation.
Conclusion Single timepoint RET-He measures have poor predictive ability; however, change in RET-He after 1 week was a strong predictor of haemoglobin response among Cambodian women receiving 60 mg elemental iron and can be measured easily and quickly after only 1 week of iron therapy.
- Reticulocyte Count
- Nutritional Sciences
Data availability statement
Data are available upon reasonable request.
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Handling editor Tahir S Pillay.
Contributors LXP and CDK contributed to the conception of the study. LXP conducted the statistical analysis. LXP and CDK drafted the manuscript. HK provided operational oversight and administrative support of the trial in Cambodia. All authors have reviewed and approved the final version. CDK accepts responsiblility for the overall content as guarantor.
Funding The original trial was funded by the Canadian Institutes of Health Research, the Micronutrient Initiative and Sight and Life Foundation. CDK is supported by a Michael Smith Foundation for Health Research Scholar Award. LXP was funded by the University of British Columbia work-learn program.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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