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Erythrocyte Indices and Hemoglobin Analysis for α-Thalassemia Screening in an Area with High Carrying Rate

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Carriers of α-thalassemia exhibit hypochromic microcytosis with mean corpuscular volume (MCV) < 80 fL, mean corpuscular hemoglobin (MCH) < 27 pg, and reduced hemoglobin A2 (HbA2). We studied the distribution and diagnostic efficiencies of these indicators and their combinations in patients with and without alpha-thalassemia. Based on genetic diagnosis, 10,883 participants were divided into alpha-thalassemia group (n = 1655) and negative-for-alpha-thalassemia group (n = 9228). Erythrocyte parameters and hemoglobin analysis of the groups were analyzed. Moreover, we compared the four screening schemes (MCV/MCH, MCV/MCH/HbA2, MCV + MCH, MCV + MCH + HbA2) to find the best for α-thalassemia screening. The genotypes of --SEA/αα, and -α3.7/αα are the most prevalent with 54.9% and 27.6% in Fujian Province, China. There were significant differences in the distribution of MCV, MCH, and HbA2 in the two groups. Among the three, MCH exhibited the highest sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Although the four screening schemes have their advantages, there are significant differences in their sensitivity and specificity. MCV + MCH had the best diagnostic performance (72.6% sensitivity, 89.0% specificity) as well as the highest Youden index (61.59%). Our results showed that MCH could be used to screen α-thalassemia instead of MCV and HbA2. However, it is recommended that MCV/MCH/HbA2 screening be used in areas with high α-thalassemia incidence to increased sensitivity.

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Funding

The National Natural Science Foundation of China (ID 81970170).

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Authors and Affiliations

  1. Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No.18 Daoshan Road, Gulou District, Fuzhou, 350001, Fujian, China

    Lin Zheng, Hailong Huang, Xiaoqing Wu, Qingmei Shen, Meihuan Chen, Meiying Wang, Linjuan Su & Liangpu Xu

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  1. Lin Zheng
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  2. Hailong Huang
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  3. Xiaoqing Wu
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  4. Qingmei Shen
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  5. Meihuan Chen
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  6. Meiying Wang
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  7. Linjuan Su
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  8. Liangpu Xu
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Correspondence to Liangpu Xu.

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The authors declare no potential conflicts of interest.

Ethical Approval

The present study was approved by the Protection of Human Ethics Committee of Fujian Maternity and Child Health Hospital, affiliated hospital of Fujian Medical University (NO.2016-101).

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Written consent taken from each patient and/or their legal guardians at the entry into the study.

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Zheng, L., Huang, H., Wu, X. et al. Erythrocyte Indices and Hemoglobin Analysis for α-Thalassemia Screening in an Area with High Carrying Rate. Indian J Hematol Blood Transfus 38, 352–358 (2022). https://doi.org/10.1007/s12288-021-01449-2

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  • DOI: https://doi.org/10.1007/s12288-021-01449-2

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