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The Effectiveness of Hematological Indicator and Iron Biomarkers Evaluation as an Early Detection of Anemia in Adolescent Girls: A Systematic Review Kedaton, Rafi’ Andyah Arum; Devi, Nabila Sinta; Kusworini, Kusworini; Wardani, Diadjeng Setya
Media Kesehatan Politeknik Kesehatan Makassar Vol 20 No 2 (2025): Media Kesehatan
Publisher : Direktorat Politeknik Kesehatan Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32382/medkes.v20i2.1708

Abstract

Due to elevated iron requirements during growth and menstruation, anemia in adolescent girls remains a major global health concern. Hemoglobin (Hb) testing alone has low sensitivity in detecting early iron deficiency anemia (IDA). This study aims to evaluate the diagnostic accuracy of hematological indicators (MCV, MCH, MCHC) and iron biomarkers compared to Hb alone. A systematic literature review was conducted in PubMed, Cochrane Library, SAGE Journals, ScienceDirect, Wiley Online Library, Taylor and Francis, and DOAJ, covering publications from 2015 to 2025, following PRISMA guidelines. The Joanna Briggs Institute (JBI) approach was used to assess methodological quality and risk of bias. Analysis of five relevant publications showed that Hb alone often misses subclinical iron deficiency. Sensitivity and specificity improve when combined with ferritin, soluble transferrin receptor (sTfR), and adjustments for inflammatory markers such as alpha-1-acid glycoprotein (AGP) and C-reactive protein (CRP). These findings support a multifaceted approach that integrates hematological indicators, iron biomarkers, and inflammation markers for early and accurate anemia detection in adolescent girls, in line with national and international recommendations to reduce prevalence and long-term complications.
The role of serum ferritin as a biomarker of iron and inflammation in anemia: a systematic literature review Kedaton, Rafi Andyah Arum; Devi, Nabila Sinta; Kusworini, Kusworini; Wardani, Diadjeng Setya
Media Penelitian dan Pengembangan Kesehatan Vol. 36 No. 1 (2026): MEDIA PENELITIAN DAN PENGEMBANGAN KESEHATAN
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/jmp2k.v36i1.4137

Abstract

Background: Anemia remains a major global health concern, particularly in low- and middle-income countries where distinguishing Iron Deficiency Anemia (IDA) from Anemia of Inflamation (AI) remains diagnostically challenging. Hemoglobin alone cannot differentiate these conditions, necessitating more specific biomarkers. Serum ferritin, the primary iron-storage protein, reflects body iron reserves but is also elevated during inflammation through interleukin-6-mediated hepcidin induction. Objective: This review examines the dual role of ferritin as an iron biomarker and an inflammatory marker. Methods: A literature search was conducted in PubMed, ScienceDirect, SpringerLink, and the Cochrane Library with a ten-year publication limit. Of the 89 articles identified, only eight studies met the inclusion criteria and directly evaluated the relationship between ferritin, iron status, and inflammatory processes. Results: Ferritin remains a key indicator of iron reserves, but its interpretation needs to take into account the inflammatory status. Conclusion: The combination of ferritin with inflammatory biomarkers such as C-Reactive Protein (CRP)and Alpha-1-acid glycoprotein (AGP) improves the diagnostic accuracy for anemia related to both iron deficiency and inflammation.