A New Formula Based on Simple Blood Indices to Differentiate Beta Thalassemia Trait from Iron Deficiency Anemia
Abstract
Background: Thalassemia is an inherited blood disorder with a defect in the sufficient production of a protein called hemoglobin. We aimed to investigate the simple blood indices of patients with Beta Thalassemia Trait (BTT) and Iron Deficiency Anemia (IDA) to propose a new formula using logistic regression for differentiate two characteristics from each other.
Methods: Among the 702 records of the BTT Counseling Center (Khoy, Iran-2022), 292 cases (219 iron deficiency anemia (IDA) and 73 BTT) were eligible for the study. Blood indices such as RBC, HGB, HbA2 described and used to diagnose two types of participants. Blood indices had high multicollinearity that was modified. Logistic regression for blood indices fitted and goodness of fit indices with Area Under ROC curve (AUC) estimated.
Results: The average age of the participants was 24.56 yr. The status of Multicollinearity between independent variables was modified. The HGB, MCV, HbA2, and HbA variables were used in the model and only HbA2 status was significant (P<0.001). According to the output of the model, for each unit increase in HbA2, the chance of having BTT was about 8.5 times higher than IDA. The sensitivity, specificity, AUC curve, and accuracy of the final model were estimated to be 97, 72, 84, and 93%, respectively. A regression formula to differentiate BTT from IDA proposed.
Conclusion: In studies related to the differentiation of the BTT from IDA, the presence of the HbA2 index in the model and prediction is very necessary.
2. Modell B, Darlison M (2008). Global epidemiology of haemoglobin disorders and derived service indicators. Bull World Health Organ, 86 (6):480-7.
3. Yolanda S (2021) Thalassemia Prevalence. News-Medical.
4. Khodaei GH, Farbod N, Zarif B, et al. (2013). Frequency of Thalassemia in Iran and Khorasan Razavi. Int J Pediatr, 1 (1):45-50.
5. Miri M, Tabrizi Namini M, Hadipour Dehshal M, et al (2013). Thalassemia in Iran in Last Twenty Years: the Carrier Rates and the Births Trend. Iranian Journal of Blood and Cancer, 6 (1):11-17.
6. Hashemieh M, Timori Naghadeh H, et al (2015). The Iran Thalassemia Prevention Program: Success or Failure? Iran J Ped Hematol Oncol, 5 (3):161-166.
7. Jahangiri M, Rahim F, Saki Malehi A, et al. (2020). Differential Diagnosis of Microcytic Anemia, Thalassemia or Iron Deficiency Anemia: A Diagnostic Test Accuracy Meta-Analysis. Mod Med Lab J, 3 (1):16-29.
8. Jameel T, Baig M, Ahmed I, et al. (2017). Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices. Pak J Med Sci, 33 (3):665-669.
9. Jaripour ME, Hayatigolkhatmi K, Iranmanesh V, et al (2018). Prevalence of β-Thalassemia Mutations among Northeastern Iranian Population and their Impacts on Hematological Indices and Application of Prenatal Diagnosis, a Seven-Years Study. Mediterr J Hematol Infect Dis, 10 (1):e2018042.
10. Joosten E (2018). Iron deficiency anemia in older adults: A review. Geriatr Gerontol Int, 18 (3):373-379.
11. Arora S, Rana D, Kolte S, et al. (2018). Validation of new indices for differentiation between iron deficiency anemia and beta thalessemia trait, a study in pregnant females. Int J Sci Rep, 4:26.
12. Kabootarizadeh L, Jamshidnezhad A, Koohmareh Z (2019). Differential Diagnosis of Iron-Deficiency Anemia from β-Thalassemia Trait Using an Intelligent Model in Comparison with Discriminant Indexes. Acta Inform Med, 27 (2):78-84.
13. Kutner M.H, Nachtsheim C.J, Neter J, W L (2004). ALSM. In. Ed(s): McGraw-Hill Irwin, pp. 409.
14. Ebrahimpour Sadagheyani H, Sharafkhani R, Sakhaei S, et al. (2022). The Evaluation of Results of Twenty Common Equations for Differentiation of Beta Thalassemia Trait from Iron Deficiency Anemia: A Cross-Sectional Study. Iran J Public Health, 51(4):929-938.
15. Baliyan M, Kumar M, Nangia A, Parakh N (2019). Can RBC Indices be Used as Screening Test for Beta-Thalassemia in Indian Antenatal Women? J Obstet Gynaecol India, 69 (6):495-500.
16. Xiao H, Wang Y, Ye Y, et al (2021). Differential diagnosis of thalassemia and iron deficiency anemia in pregnant women using new formulas from multidimensional analysis of red blood cells. Ann Transl Med, 9 (2):141.
Files | ||
Issue | Vol 53 No 5 (2024) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijph.v53i5.15601 | |
Keywords | ||
Beta thalassemia Iron deficiency anemia Logistic regression Blood index Differentiation formula |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |