{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:03:06Z","timestamp":1784642586282,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deanship of Scientific Research (DSR) at King Abdulaziz University","award":["376-142-14422"],"award-info":[{"award-number":["376-142-14422"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Iron deficiency anemia (IDA) is a global health problem affecting the quality of life of more than 2 billion individuals. The current practice guidelines diagnose and monitor IDA via conventional hematological and iron biomarkers, which take several months before they are corrected under an iron-treatment plan. Reticulocyte hemoglobin equivalent (Ret-He) is used as a marker in most new hematology analyzers to assess iron incorporation into erythrocyte hemoglobin directly. This study aims to examine the efficacy of Ret-He as a marker for iron deficiency (ID) and IDA and investigate whether Ret-He is sensitive to iron therapy. Methods: Two blood samples were drawn from 182 participants for CBC and iron profile measurements. Follow-up samples were drawn from participants with a confirmed diagnosis of ID and\/or IDA. Results: Ret-He levels were lower in the ID and IDA groups compared to the control (p &lt; 0.0001), and lower in the IDA group compared to the ID group (p &lt; 0.0001). Ret-He was correlated with ferritin at ID level (&lt;30.0 mg\/mL; r = 0.39) and severe IDA (&lt;13.0 ng\/mL; p-value &lt; 0.01, r = 0.57). Cut-off values of &lt;28.25 pg for ID and &lt;21.55 pg for IDA showed a higher specificity and sensitivity (ID; AUC: 0.99, sensitivity: 92.73%, specificity: 97.87%) and (IDA; AUC: 0.94, sensitivity: 90.63%, specificity: 92.31%). Finally, Ret-He successfully reflected the iron therapy (p &lt; 0.001) when compared to hemoglobin (Hb) (p = 0.1). Conclusions: Ret-He is a potential marker for detecting and diagnosing different stages of ID with high validity and is very sensitive in reflecting the iron incorporation in a short time.<\/jats:p>","DOI":"10.3390\/jcm11195675","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T01:51:49Z","timestamp":1664329909000},"page":"5675","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Reticulocyte Hemoglobin-Equivalent Potentially Detects, Diagnoses and Discriminates between Stages of Iron Deficiency with High Sensitivity and Specificity"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6619-0287","authenticated-orcid":false,"given":"Majed N.","family":"Almashjary","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2009-3817","authenticated-orcid":false,"given":"Ahmed S.","family":"Barefah","sequence":"additional","affiliation":[{"name":"Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salem","family":"Bahashwan","sequence":"additional","affiliation":[{"name":"Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-9674","authenticated-orcid":false,"given":"Ibraheem","family":"Ashankyty","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Refaat","family":"ElFayoumi","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences in Rabigh, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Zoology Department, Faculty of Science, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Hematology Laboratory, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duaa M.","family":"Assaqaf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad S.","family":"Aljabri","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amera Y.","family":"Aljohani","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rema","family":"Muslim","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Baawad","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-1538","authenticated-orcid":false,"given":"Waleed M.","family":"Bawazir","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0956-9263","authenticated-orcid":false,"given":"Saif A.","family":"Alharthy","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia"},{"name":"Toxicology and Forensic Sciences Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"key":"ref_1","unstructured":"de Benoist, B., World Health Organization, and Centers for Disease Control and Prevention (U.S.) (2008). 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