title: Proxy indicators for identifying iron deficiency among anemic vegetarians in an area prevalent for thalassemia and hemoglobinopathies.
abstract: OBJECTIVE
  The study aimed to determine the proportion of iron deficiency (ID) anemia (IDA) among vegans in northeast Thailand and to explore whether mathematical formulas derived from red blood cell (RBC) indices are applicable for IDA screening in the study population.
  
  
  METHODS
  Blood samples from 234 individuals (age 6-45 years) living in a vegan community were taken. Complete blood cell count, serum ferritin, hemoglobin profiles and DNA analysis for α-thalassemia were determined. Anemia was defined using the WHO criteria adjusted for age and sex. Serum ferritin <15 ng/ml was considered as ID. A number of mathematical formulas derived from RBC indices were applied to screen ID among anemic individuals.
  
  
  RESULTS
  Anemia was found in 41.5% (95% CI = 35.1-48.1%) of the study participants. The overall proportion of thalassemia and hemoglobinopathies was 56.4% (95% CI = 49.8-62.9%). Of the anemic participants, 45.4% had ID. Based on the receiver-operating characteristic curve analysis, 4 formulas were applicable for predicting ID among anemic individuals (highest sensitivity of 86.4%).
  
  
  CONCLUSIONS
  The proposed formulas might be used as proxy indicators for the identification of ID among anemic children and adult vegans if more sophisticated laboratory determinations are not available due to limited financial resources.
authors.affiliation: Center for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
authors.forename: Kasama
authors.initials: K
authors.lastname: Wongprachum
authors.forename: Kanokwan
authors.initials: K
authors.lastname: Sanchaisuriya
authors.forename: Pattara
authors.initials: P
authors.lastname: Sanchaisuriya
authors.forename: Sirivara
authors.initials: S
authors.lastname: Siridamrongvattana
authors.forename: Suwanna
authors.initials: S
authors.lastname: Manpeun
authors.forename: Frank P
authors.initials: FP
authors.lastname: Schlep
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D003937:Diagnosis, Differential; D014676:Diet, Vegetarian / Q000009:adverse effects*; D004909:Erythrocyte Indices; D005260:Female; D005838:Genotype; D006453:Hemoglobinopathies / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D013785:Thailand / Q000453:epidemiology; D013789:Thalassemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D055815:Young Adult