Research Article
Volume 9 Issue 12 - 2020
Hemoglobin Vs Serum Ferritin as Assessors of Iron Deficiency Anemia, Preference for Age and Gender Groups, Using Inferential, Binary Logistic Regression and Bivariate Correlation Statistics
Hamzullah Khan1*, Neelum Shehzadi2, Khalid Khan3, Mohammad Khalid4, Saadullah Afridi5 and Sarwat6
1Associate Professor of Hematology, Nowshera Medical College, Nowshera, Pakistan
2Associate Professor of Gynecology and Obstetrics, Nowshera Medical College, Nowshera, Pakistan
3Assistant Professor of Pediatrics, Nowshera Medical College, Nowshera, Pakistan
4Associate Professor of Medicine, Nowshera Medical College, Nowshera, Pakistan
5Director Public Health, Sarhad University, Peshawar, Pakistan
6Assistant Professor of Gynecology and Obstetrics, Bacha khan Medical College, Mardan, Pakistan
*Corresponding Author: Hamzullah Khan, Associate Professor of Hematology, Director Research and Development, Nowshera Medical College, Nowshera, Pakistan.
Received: June 26, 2020; Published: November 28, 2020


Objectives: To assess the hemoglobin vs serum ferritin as predictors of Iron deficiency anemia, using binary logistic regression, bivariate correlation and inferential statistics.

Materials and Methods: This cross sectional study was conducted in the Pathology department, Qazi Hussain Ahmed Medical Complex, Medical Teaching Institution Nowshera, from 20th February 2019 to 21st January 2020. Relevant information’s were entered in SPPS Version 25th for descriptive and inferential analysis.

Results: Out of 381,149 patients enrolled with Hb < 11 g/dl. Twenty (13.4%) were males and 129 (86.6%) females. Mean age with SD was 30 ± 6.2 years. The Mean Ferritin level with SD was 64.35 ± 33.45. The Mean Hemoglobin level with SD was 9 ± 1.8 g/dl. There was a statistically significant difference in Mean ± SD hemoglobin between gender groups (8.5 g/dl ± 1.43-Males) (9.14g/dl ± 1.86-Females) (p = 0.053) on Independent Sample Test and vice versa for ferritin. Ninety (60.4%) patients had serum ferritin less than 15 ng/ml. The Positive Predictive Value (PPV) of Hemoglobin as predictors of IDA was 39.1%, while 60.4% for serum ferritin. There was a significant positive relationship between Hb% and ferritin (p = 0.01, r = 0.4). There was an inverse relation of Hb% and ferritin with an increase in age (p = 0.185, r = -0.1), (p = 0.38, r = -.07) respectively. Odds ratio of 3.2 times was noted for low iron stores in patient with low hemoglobin (p = 0.01, OR-3.2). The probability of ferritin less than 15ng/ml was 2.7 times in female gender (p = 0.022, OR = 2.7).

Conclusion: We concluded that the PPV of serum ferritin is higher than Hb% for prediction of iron deficiency anemia.

Keyword: Hb% vs Ferritin; Iron Deficiency Anemia; Predictor of IDA


  1. Khan MA and Jalil F. “Nutritional anaemia: Classification and effect of therapeutic trial for proposed fortification programme”. Islamabad, Nutrition Cell, Planning and Development Division (1985).
  2. Molla A., et al. “Prevalence of iron deficiency anemia in children of the urban slums of Karachi”. Journal of Pakistan Medical Association 42 (1992): 118-121.
  3. Jeffrey Levy MC. Journal of the American Board of Family Practice: Thrombocytopenia in Pregnancy (2000).
  4. Akhtar S., et al. “Iron status of the Pakistani population-current issues and strategies”. Asia Pacific Journal of Clinical Nutrition3 (2013): 340-347.
  5. Milman N. “Anemia-still a major health problem in many parts”. Annals of Hematology 90 (2011): 369-377.
  6. Babaei M., et al. “Ability of serum ferritin to diagnose iron deficiency anemia in an elderly cohort”. The Revista Brasileira de Hematologia e Hemoterapia 3 (2017): 223-228.
  7. Mehta S., et al. “Reticulocyte Hemoglobin vis-a-vis Serum Ferritin as a Marker of Bone Marrow Iron Store in Iron Deficiency Anemia”. Journal of the Association of Physicians of India 11 (2016): 38-42.
  8. Guyatt GH., et al. “Laboratory diagnosis of iron-deficiency anemia”. Journal of General Internal Medicine2 (1992): 145-153.
  9. Auerbach M and Adamson JW. “How we diagnose and treat iron deficiency anemia”. American Journal of Hematology 1 (2016): 31-36.
  10. Khan N., et al. “Diagnostic accuracy of reticulocyte haemoglobin equivalent (RETHE) in detecting iron deficiency anaemia keeping serum ferritin as gold standard”. Pakistan Armed Forces Medical Journal5 (2019): 1010-1014.
  11. World Health Organization, WHO Report. Family and reproductive health coverage of maternity care. Geneva, WHO (1997): 205-220.
  12. World Health Organization and Centers for Disease Control and Prevention. “Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia”. B. de Benoist, E. McLean, E. Egli, and M. Cogeswell, Eds., WHO (2018).
  13. World Bank. “World development report”. New York: Oxford University Press (1993).
  14. Franchin M and Salvagno GL. “Serum ferritin levels correlate with haemoglobin concentration: a report on 589 outpatients from a single centre”. Blood Transfusion4 (2007): 244-245.
  15. Saxena Y., et al. “Effect of gender on correlation of anaemia with body mass index in medical students”. Indian Journal of Physiology and Pharmacology 4 (2011): 364-369.
  16. World Health Organization and Centres for Disease Control and Prevention. “Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia”. B. de Benoist, E. McLean, E. Egli, and M. Cogeswell, Eds., WHO (2018).
  17. Ahmad MS., et al. “Frequency of Anemia and Iron Deficiency among Children Starting First Year of School Life and Their Association with Weight and Height”. ANEMIA (2018).
  18. Abuaisha M., et al. “Prevalence of Iron Deficiency (ID) without anemia in the general population presenting to primary care clinics: a cross-sectional study”. Journal of Postgraduate Medicine 22 (2020): 1-6.
  19. Mistry R., et al. “Antenatal tobacco use and iron deficiency anemia: integrating tobacco control into antenatal care in urban India”. Reproductive Health 1 (2018): 72-76.
  20. Tiwari LM., et al. “Correlation of haemoglobin and red cell indices with serum ferritin in Indian women in second and third trimester of pregnancy”. Medical Journal Armed Forces India 69 (2013): 31-36.
  21. Rigvardhan Raghav V., et al. “Correlation of Serum Ferritin with Red Cell Indices and Hemoglobin in Indian Women in Second and Third Trimester of Pregnancy”. International Journal of Contemporary Medical Research 10 (2016): 3069-3071.
  22. Franchini M., et al. “Serum ferritin levels correlate with haemoglobin concentration: a report on 589 outpatients from a single centre”. Blood Transfusion 5 (2007): 244-245.
Citation: Hamzullah Khan., et al. “Hemoglobin Vs Serum Ferritin as Assessors of Iron Deficiency Anemia, Preference for Age and Gender Groups, Using Inferential, Binary Logistic Regression and Bivariate Correlation Statistics”. EC Gynaecology 9.12 (2020): 42-49.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before October 26, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to