Early detection of iron deficiency in elite athletes: could microcytic anemia factor (Maf) be useful?

Abstract

Introduction: The aim of this study was to establish the sensitivity and specificity of the microcytic anemia factor (Maf((R))), which is generated by the Coulter LH 750 analyzer in the evaluation of iron depletion and iron-deficient erythropoiesis in athletes. Methods: A total of 142 athletes were divided into three groups: with iron depletion, with iron-deficient erythropoiesis, and controls. The following parameters were measured: RBCs (red blood cells), Hb (hemoglobin), Hct (hematocrit), MCV (mean cellular volume), MCH (mean cell hemoglobin), MCHC (mean cell hemoglobin corpuscular), RDW (red cell distribution width), Maf((R)), Reticulocytes, Ferritin, sTfR (soluble transferrin receptor), Transferrin, Haptoglobin, IL- 6 (Interleukin-6), hs-CRP (high-sensitivity C-reactive protein). Results: The best Maf((R)) value to exclude iron depletion in athletes was 130.3, showing a sensitivity of 72.6% and a specificity of 57.3%. The AUC was 0.690 (CI 95% 0.607-0.765, P lt 0.001). ROC curve analysis for Maf((R)) in the diagnosis of iron-deficient erythropoiesis indicates sensitivity of 61.5%, and specificity of 93.0%, with AUC=0.826 (CI 95% 0.754-0.885, P lt 0.001) and on cutoff value 114. Conclusions: This study shows that Maf((R)), generated by the Coulter LH 700 Series hematology analyzers, performs very well in discriminating healthy athletes and those with different stages of iron deficiency. Also, in cost/benefit terms, monitoring of Maf((R)) is justified as a low cost, effective screening parameter for determining iron status in athletes.