The association between neutrophilic hypersegmentation and iron deficiency with regard to folate status in 16-30 year-old women.
BACKGROUND
Neutrophilic hypersegmentation (NH) is a hematological anomaly that is mainly related to the deficiency of folic acid and/or cobalamin. There are also controversial studies showing that NH relates to iron deficiency anemia (IDA). The aim of this study was to investigate this relationship by comparing two groups: iron deficient (ID) and IDA. The effect of low normal folate level on this relationship was also investigated.


METHODS
In this prospective cohort study, performed in Mashhad, Iran in 2011, ninety 16 - 30 year-old women were selected and divided into three groups, ID, IDA, and control. NH was examined in peripheral blood smears by two experts. CBC was done on a Sysmex K-21 hematologic analyzer. Colorimetric methods were utilized to measure the serum iron and total iron binding capacity. Serum ferritin as well as folate and cobalamin were measured by radioimmunoassay methods. Data was analyzed with SPSS 11.5 software. A p-value < 0.05 was considered to be significant.


RESULTS
Twenty nine ID, thirty IDA, and thirty one control participants were studied. Chi square tests showed statically significant differences in NH values among these three groups (p-value = 0.001), and a correlation between NH and decreased serum iron/ferritin levels (p-value = 0.001). With logistic regression analysis, it was observed that the relation between NH and ID/IDA is due to concomitant low normal folate levels (p-value = 0.044).


CONCLUSIONS
The detection of NH in a peripheral blood smear of patients with ID/IDA is a possible reason for a coexistence of mild folate deficiency. It is suggested that in addition to ID/IDA, latent folate deficiency should be investigated in these patients.
Lida
L
Manavifar
Mohammad Reza
MR
Keramati
Jamshid
J
Jamali
Samaneh
S
Tavakkoli
Hassan
H
Mansouritorghabeh
Seyed Isaac
SI
Hashemy
D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D009504:Neutrophils / Q000166:cytology*; D011446:Prospective Studies; D055815:Young Adult
D005492:Folic Acid