Evidence map›Paper›PMID 42297144›Full record

SynthesisAdvances in nutrition (Bethesda, Md.)2026

Assessing the Discriminatory Ability of Hemoglobin Concentration to Predict Iron Stores in Cambodian Females: A Systematic Review and Individual Participant Data Meta-Analysis.

Lulu X Pei, Colleen C Farrell, Stella C Mlewa, Cassandra Sauer, Kristija Sejane, Nathalie V Kirby, James McKendry, Christopher Charles, Jordie Aj Fischer, Tim J Green and 7 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Advances in nutrition (Bethesda, Md.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

17 authors.

Lulu X PeiHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada.
Colleen C FarrellHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada.
Stella C MlewaHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada.
Cassandra SauerHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada.
Kristija SejaneHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada.
Nathalie V KirbyHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada.
James McKendryHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada.
Christopher CharlesDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Jordie Aj FischerHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada.
Tim J GreenCollege of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Caring Futures Institute, Adelaide, Australia.
Hou KroeunHelen Keller International, Phnom Penh, Cambodia.
Jan MakuratCentre of Competence for Humanitarian Relief, Münster University of Applied Sciences, Münster, Germany; Institute of Sustainable Nutrition, Münster University of Applied Sciences, Münster, Germany.
Aviva I RappaportHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada.
Kyly C WhitfieldDepartment of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada.
Frank T WieringaQualisud, University of Montpellier, CIRAD, Institut Agro, IRD, Université d'Avignon, Université de la Réunion, 34394 Montpellier, France; Department of Health Sciences, Faculty of Science, Amsterdam Public Health Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands.
Allison I DanielIndependent Consultant, Toronto, ON, Canada.
Crystal D KarakochukHuman Nutrition, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital and Women's Health Research Institutes, Vancouver, BC, Canada. Electronic address: crystal.karakochuk@ubc.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hemoglobin concentration is commonly used as a screening tool to guide iron interventions because it can be measured more quickly and easily using point-of-care devices than other, more direct measures of iron status (e.g., ferritin). However, anemia is not always caused by iron deficiency. Therefore, we aimed to assess the discriminatory ability of hemoglobin concentration to predict iron stores in Cambodian females of reproductive age, a population where iron deficiency prevalence is low and genetic hemoglobinopathies are common. We conducted a systematic review and individual participant data (IPD) meta-analysis that included 26 studies reporting on 11 databases (including n = 3497 females with available and eligible IPD that included hemoglobin, ferritin, and ≥1 inflammation biomarker measured in the same individual at the same time point). Receiver operating characteristic curve analyses were conducted to measure the area under the curve (AUC) and the 95% confidence interval (CI), representing the discriminatory ability of hemoglobin concentration to distinguish between individuals with or without iron deficiency (inflammation-adjusted ferritin <15 μg/L for nonpregnant females; unadjusted ferritin <30 μg/L for pregnant females). Random-effects models were used to estimate pooled effect sizes and 95% CIs. The pooled AUC value (95% CI) for nonpregnant females (9 studies; n = 3377) displayed "fair" discriminatory ability [0.77 (0.74, 0.79)] with high certainty evidence, and for pregnant females (2 studies; n = 120) displayed "poor" discriminatory ability [0.57 (0.47, 0.68)] with low certainty evidence. We conclude that hemoglobin is a "fair" predictor of iron status in nonpregnant Cambodian females; thus, it should be used with caution in guiding interventions such as blanket iron supplementation programs. More research is needed to understand if hemoglobin is an acceptable screening biomarker to guide interventions or justify higher doses of supplemental iron during pregnancy. The protocol was registered in PROSPERO (CRD42024578023).

Indexed as

Anemia, Iron-DeficiencyHemoglobinsIronBiomarkersCambodiaFemaleFerritinsHumansIron DeficienciesROC CurveSoutheast Asian PeopleBiomarkersFerritinsHemoglobinsIronanemiaCambodiadiscriminatoryfemalesferritinhemoglobinironpredictreceiver operating characteristic curve

Identifiers

PMID42297144
PMCPMC13355708

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.