title: Low hemoglobin density potential marker of iron availability.
abstract: BACKGROUND
  Low hemoglobin density (LHD%) is a new parameter provided by Beckman-Coulter derived from the mean cell hemoglobin concentration, using the mathematical sigmoid transformation LHD% = 100×√(1-(1/(1 + e(1.8(30-MCHC)))). This study investigated the reliability of LHD% for the assessment of iron status in the presence of inflammation.
  
  
  METHODS
  Healthy subjects (n = 90) and patients with iron deficiency (IDA, n = 110), chronic kidney disease (CKD, n = 65) and anemia of chronic disease (ACD, n = 85; 24 were iron deficient and 61 were iron sufficient) were analyzed on a LH 780 analyzer (Beckman Coulter Inc., Miami, FL, USA). Independent samples U test and receiver operating characteristic (ROC) curve analysis were applied. To determine the concordance between LHD% and soluble transferrin receptor (sTrR) Cohen's κ index was calculated.
  
  
  RESULTS
  LHD % values showed no statistical difference in patients with IDA and patients with ACD accompanied with IDA (P = 0.6427); LHD% values in these patients were significantly different (P < 0.0001) compared with the iron-sufficient patients with ACD. ROC analysis for LHD% in the detection of iron deficiency showed the following: area under curve 0.903; cut off 5.5%, sensitivity 88.6%, specificity 76.9%; κ index, 0.65.
  
  
  CONCLUSIONS
  LHD% is a reliable parameter for the detection of iron deficiency in patients with anemia in the presence of inflammation.
authors: Hematology Laboratory, Hospital Galdakao-Usansolo, Galdakao, Vizcaya, Spain. eloisa.urrechagaigartua@osakidetza.net
authors: E
authors: E
authors: Urrechaga
authors: M
authors: M
authors: Unceta
authors: L
authors: L
authors: Borque
authors: J F
authors: JF
authors: Escanero
mesh_terms: D000740:Anemia / Q000175:diagnosis / Q000209:etiology; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000209:etiology; D002908:Chronic Disease; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications; D007501:Iron / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male
chemical_list: D007501:Iron