Diagnosing Iron Deficiency Anemia (IDA) is challenging because there is no gold standard, and different organizations claim different cut-off. Also, most of primary health care units in Korea request blood tests to commercial laboratories where run tests night time after collecting samples daytime. Time lag between sampling and testing is known to change some RBC indices. In this study, we used samples requested to a commercial laboratory in order to identify which parameters could distinguish between control and iron deficiency(ID) group and between IDA group and anemia of chronic disease(ACD) group. Based on the results of hemoglobin(Hb), ferritin, and CRP, samples were divided into four groups: 90 controls, 10 ID group, 90 IDA group, and 20 ACD groups. Following parameters were evaluated: MCV, MCHC, MCH, CHr, %Hypo, MRV, Rsf, Maf, LHD%, soluble transferrin receptors(sTfR) and body iron. Comparing control with ID group, %Hypo and body iron showed AUC over 0.9 with cutoff of 20.3 and 7.57 mg/kg, respectively. Comparing IDA group ACD group, MCH showed the largest AUC, which is 0.862, with cutoff 28.55 pg. With proper cutoff for primary healthcare unit to detect iron deficiency, %Hypo and MCH can be used with time and cost saving. Also, body iron can be useful parameter substituting ferritin. Because the storage time and temperature of samples changes some hematologic parameters, MCV, MCHC, CHr, Maf, MRV, Rsf and sTfR showed no effectiveness in distinguishing ID from control or IDA from ACD. Even %Hypo, body iron and MCH which demonstrated validity in group comparisons, cutoff values were different from previous studies. Therefore, there should be further studies to aid primary health care doctors to distinguish different iron status.
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