{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:34:09Z","timestamp":1793723649696,"version":"4.6.1"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010814","name":"Anhui Provincial Department of Education","doi-asserted-by":"publisher","award":["2025zyxwjxalk205"],"award-info":[{"award-number":["2025zyxwjxalk205"]}],"id":[{"id":"10.13039\/501100010814","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002947","name":"Anhui Medical University","doi-asserted-by":"publisher","award":["2025xjxm85"],"award-info":[{"award-number":["2025xjxm85"]}],"id":[{"id":"10.13039\/501100002947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Complete blood count (CBC) discrimination indices are widely used as low\u2010cost triage tools for microcytosis, but their diagnostic utility in population\u2010based samples with ferritin\u2010defined iron status is uncertain. We evaluated whether commonly used indices distinguish ferritin\u2010defined iron\u2010deficient from noniron\u2010deficient microcytosis among women aged 18\u201349\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the National Health and Nutrition Examination Survey (NHANES) 2015\u20132016, 2017\u20132018, and August 2021\u2013August 2023 data among nonpregnant women aged 18\u201349\u2009years with CBC, serum ferritin, and survey design variables. Among microcytic (MCV &lt;\u200980\u2009fL) women, iron\u2010deficient microcytosis was defined as ferritin &lt;\u200915\u2009ng\/mL and noniron\u2010deficient microcytosis as ferritin \u2265\u200915\u2009ng\/mL. Mentzer, England\u2013Fraser, Srivastava, and red cell distribution width (RDW) indices were evaluated at conventional cutoffs. Sensitivity analyses used ferritin &lt;\u200930\u2009ng\/mL and C\u2010reactive protein (CRP) restrictions of \u2264\u20095 and \u2264\u20093\u2009mg\/L. All estimates were survey\u2010weighted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3991 women, 507 had microcytosis. Ferritin\u2010defined noniron\u2010deficient microcytosis comprised 40.8% (95% CI, 35.5\u201346.2) and remained 37.0% and 33.6% after CRP restrictions of \u2264\u20095 and \u2264\u20093\u2009mg\/L. With ferritin \u2265\u200930\u2009ng\/mL, the corresponding proportions were 26.5%, 22.6%, and 20.2%. All four indices showed high sensitivity (92.9%\u201397.6%) but poor specificity (6.7%\u201335.3%). RDW had the highest specificity but still misclassified most noniron\u2010deficient cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Classic CBC indices had limited utility as standalone triage tools for ferritin\u2010defined microcytosis. Ferritin\u2010based assessment, interpreted in the relevant clinical and inflammatory context, should remain central. Persistent microcytosis without evidence of reduced iron stores should prompt diagnostic reconsideration and, when appropriate, hemoglobinopathy\u2010aware evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70219","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T08:19:59Z","timestamp":1786609199000},"page":"1502-1512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Utility of Complete Blood Count Indices in Ferritin\u2010Defined Microcytosis Among United States Women Aged 18\u201349\u2009Years"],"prefix":"10.1111","volume":"48","author":[{"given":"Jinxiao","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Hematology The Second Affiliated Hospital of Anhui Medical University  Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8671-785X","authenticated-orcid":false,"given":"Xiaodong","family":"Shang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Ma'anshan General Hospital of Ranger\u2010Duree Healthcare  Maanshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5935-9331","authenticated-orcid":false,"given":"Hengwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Information Systems and Technology, Claremont Graduate University  Claremont California USA"},{"name":"Institute of Mathematical Sciences, Claremont Graduate University  Claremont California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-602X","authenticated-orcid":false,"given":"Dachuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery The Second Affiliated Hospital of Anhui Medical University  Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1401038"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1215361"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V53.2.288.288"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(73)91878\u20103"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(73)91446\u20103"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(73)90637\u20105"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12527"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7475.1134"},{"issue":"4","key":"e_1_2_11_10_1","first-page":"498","article-title":"Haemoglobinopathies in Southeast Asia","volume":"134","author":"Fucharoen S.","year":"2011","journal-title":"Indian Journal of Medical Research"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a011775"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.5937\/jomb0\u201037682"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102015\u20100179"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6936a7"},{"key":"e_1_2_11_15_1","unstructured":"American College of Obstetricians and Gynecologists \u201cHemoglobinopathies in Pregnancy. 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