Evidence map›Paper›PMID 33978187›Full record

ArticleThe Journal of nutrition2021

Baseline Hemoglobin, Hepcidin, Ferritin, and Total Body Iron Stores are Equally Strong Diagnostic Predictors of a Hemoglobin Response to 12 Weeks of Daily Iron Supplementation in Cambodian Women.

Lulu X Pei, Hou Kroeun, Suzanne M Vercauteren, Susan I Barr, Tim J Green, Arianne Y Albert, Crystal D Karakochuk

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 3 countries.

Lulu X PeiDepartment of Biostatistics, The University of British Columbia, Vancouver, Canada.
Hou KroeunHelen Keller International, Phnom Penh, Cambodia.
Suzanne M VercauterenDivision of Hematopathology, The University of British Columbia, Vancouver, Canada.
Susan I BarrDepartment of Food, Nutrition and Health, The University of British Columbia, Vancouver, Canada.ORCID 0000-0001-8701-7152
Tim J GreenSouth Australian Health and Medical Research Institute, Adelaide, Australia.
Arianne Y AlbertDepartment of Biostatistics, Women's Health Research Institute, Vancouver, Canada.
Crystal D KarakochukBC Children's Hospital Research Institute, Vancouver, Canada.ORCID 0000-0002-1025-2194
University of British Columbia · CAPhnom Penh International University · KHSouth Australian Health and Medical Research Institute · AUWomen's Health Research Institute · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundThe WHO recommends daily iron supplementation for all women in areas where the population-level anemia prevalence is ≥40%, despite the fact that hemoglobin (Hb) concentration is generally considered to be a poor prognostic indicator of iron status.

objectivesIn this secondary analysis, we investigated the predictive power of ten baseline hematological biomarkers towards a 12-week Hb response to iron supplementation.

methodsData were obtained from a randomized controlled trial of daily iron supplementation in 407 nonpregnant Cambodian women (18-45 years) who received 60 mg elemental iron as ferrous sulfate for 12 weeks. Ten baseline biomarkers were included: Hb, measured with both a hematology analyzer and a HemoCue; inflammation-adjusted ferritin; soluble transferrin receptor; reticulocyte Hb; hepcidin; mean corpuscular volume; inflammation-adjusted total body iron stores (TBIS); total iron binding capacity; and transferrin saturation. Receiver operating characteristic (ROC) curves from fitted logistic regression models were used to make discrimination comparisons and variable selection methods were used to construct a multibiomarker prognostic model.

resultsOnly 25% (n = 95/383) of women who completed the trial experienced a 12-week Hb response ≥10 g/L. The strongest univariate predictors of a Hb response were Hb as measured with a hematology analyzer, inflammation-adjusted ferritin, hepcidin, and inflammation-adjusted TBIS (AUCROC = 0.81, 0.83, 0.82, and 0.82, respectively), and the optimal cutoffs to identify women who were likely to experience a Hb response were 117 g/L, 17.3 μg/L, 1.98 nmol/L, and 1.95 mg/kg, respectively. Hb as measured with a hematology analyzer, inflammation-adjusted ferritin, and hepcidin had the best combined predictive ability (AUCROC=0.86). Hb measured with the HemoCue had poor discrimination ability (AUCROC = 0.65).

conclusionsBaseline Hb as measured with a hematology analyzer was as strong a predictor of Hb response to iron supplementation as inflammation-adjusted ferritin, hepcidin, and inflammation-adjusted TBIS. This is positive given that the WHO currently uses the population-level anemia prevalence to guide recommendations for untargeted iron supplementation.

Indexed as

Anemia, Iron-DeficiencyFerritinsAsian PeopleDietary SupplementsFemaleHemoglobinsHepcidinsHumansIronRandomized Controlled Trials as TopicFerritinsHemoglobinsHepcidinsIronCambodiaferritinHemoCuehemoglobinhepcidinironpredictorsupplementationtotal body iron storeswomen

Identifiers

PMID33978187
PMCPMC8349118
OpenAlexW3161575752

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.