TOPLINE

The prevalence of microcytic anemia among tested adolescents increased progressively with age in females, while it decreased in males, with females overtaking males by mid-adolescence.

METHODOLOGY

• Researchers conducted a retrospective analysis of electronic health records from a database in Israel (January 2003-December 2023) to describe age- and sex-specific patterns of microcytic anemia in adolescents and to estimate screening yield.
• They analyzed over 1.3 million records of hemoglobin and mean corpuscular volume (MCV) measurements from adolescents aged 12-18 years.
• Microcytic anemia was defined as hemoglobin levels below 12 g/dL for females or below 13 g/dL for males together with MCV < 78 fL.
• They performed a sensitivity analysis lowering the hemoglobin cutoff to below 12 g/dL for boys aged 12-13 years.

TAKEAWAY

• Among tested adolescents, the prevalence of microcytic anemia in females increased steadily with age, from 7.8% at ages 12-13 to 12.5% at ages 17-18 years. The prevalence in males decreased from 18.9% at ages 12-13 to 2.1% at ages 17-18 years.
• Female and male prevalence curves crossed at around age 15 years, after which females showed higher rates than males for the rest of adolescence.
• The number of tests needed to find one case of microcytic anemia increased sharply with age in males and stayed stable for females from ages 15-18 years.
• In boys aged 12-13 years, applying a lower hemoglobin threshold of < 12 g/dL reduced the estimated prevalence of microcytic anemia from 18.9% to 7.6%.

IN PRACTICE

"[The] findings suggest that targeted screening of females during mid-adolescence may be a practical strategy for identifying microcytic anemia and, by inference, its most common underlying cause, [iron deficiency (ID)]. In contrast, the lower and declining prevalence among males suggests limited yield from routine screening," the authors of the study wrote.

SOURCE

The study was led by Tal Ben-Ami, Kaplan Medical Center in Rehovot, Israel. It was published online on August 4 in the European Journal of Pediatrics.

LIMITATIONS

Clinical indications for hemoglobin testing were not available, and tested adolescents likely differed from those not tested. Measurements of ferritin were not consistently available. Researchers could not calculate detailed red blood cell indices, assess anemia severity, or distinguish iron-deficiency anemia from thalassemia trait.

DISCLOSURES

The study did not receive any specific funding. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.