RESUMEN
Objective:The study was planned to evaluate the clinical utility of microcytic anemia factor (MAF) and low hemoglobin density (LHD%) in the screening of iron deficiency in blood donors.Methods:A total of 400 blood donors, 200 male and 200 female, were randomly admitted to Fujian Blood Center from January1, 2022 to February 28, 2022 by the way of stratified sampling. According to the fourth edition of Diagnostic and therapeutic criteria for hematological diseases, the patients were divided into three groups: normal group (N=299), iron depletion group (ID, n=54) and iron deficient erythropoiesis group (IDE, n=47), Blood routine indexes including hemoglobin (HGB), mean corpuscular volume hemoglobin (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC) and iron metabolism indexes including serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and unsaturated iron binding capacity (UIBC) were measured, MAF and LHD% were calculated by formula.One-way ANOVA or Kruskal-Wallis H tests were used to analyze the differences among three groups. Spearman correlation analysis was used to analyze the correlation between MAF and LHD% and iron metabolism indexes.The Receiver Operating Characteristic (ROC) curve was used to evaluated the diagnostic value of MCH, MCHC, MAF and LHD% for iron deficiency in blood donors. Results:MAF in ID group which was 11.81±0.81 were higher than the IDE group which was 10.69±0.95 and lower than the healthy group which was 13.17±1.24, the total difference among the three groups was statistically significant ( F=110.784, P<0.001), the difference between two groups was statistically significant ( P<0.01); LHD% in ID group which was 2.61 (1.87, 3.91)% were lower than the IDE group which was5.60(2.99, 8.02)% and higher than the healthy group which was1.74 (1.22, 2.73)%, the total difference among the three groups was statistically significant ( H=62.166, P<0.001), the difference between two groups was statistically significant ( P<0.01).In 101 iron deficiency blood donors, Spearman correlation analysis showed that MAF was positively correlated with SF, SI and TS ( r=0.426, P<0.01; r=0.547, P<0.01; r=0.566, P<0.01);contrarily, LHD% was negatively correlated with SF, SI and TS ( r=-0.397, P<0.01; r=-0.400, P<0.01; r=-0.479, P<0.01).The areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic ID were 0.745, 0.646, 0.819 and 0.646, respectively;the cut-off value of MAF was 12.56, with a sensitivity of 67.90% and a specificity of 83.30%.While the areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic IDE were 0.901, 0.834, 0.941 and 0.834, respectively; the cut-off value of MAF was 11.73, with a sensitivity of 87.60% and a specificity of 87.20%. Conclusions:MAF performed a high diagnostic value of iron deficiency, especially IDE, and can be used as a marker in the diagnosis of iron deficiency in blood donors.