RETICULOCYTE SUBPOPULATION ANALYSIS AND ITS CORRELATION WITH IRON DEFICIENCY ANEMIA: A RETROSPECTIVE STUDY IN A PREDOMINANTLY FEMALE POPULATION

Background: Serum ferritin and iron have high inter-individual variability and inflammatory sensitivity, limiting its diagnostic value in several clinical settings. The Reticulocyte Subpopulation Analysis may indicate iron availability during erythropoiesis in real time. Aim: This study investigated the associations between reticulocyte parameters and various hematological and iron-related biomarkers in Iron Deficiency Anemia. Methods: In this retrospective study, 150 patients with IDA (Iron Deficiency Anemia) were included (146 females, 97.3%; 23 pregnant, 15.8%; 12 on iron treatment, 8.0%), RET-He, LFR/MFR/HFR, and IRF were correlated with iron markers. Associations between anemia severity and treatment status were examined using Spearman correlation, Kruskal–Wallis, and Mann–Whitney U analyses. Results: While other reticulocyte indices exhibited minor connections, RET-He showed strong positive correlations with ferritin (r=0.430, p<0.001), serum iron (r=0.364, p<0.001), and transferrin saturation (r=0.350, p<0.001 A significant decrease in RET-He was seen in mild anemia (24.6 pg) and severe anemia (15.2 pg, p<0.001). RET-He was marginally reduced (p=0.0750) while serum iron and transferrin saturation were considerably lower in iron-treated subjects (p=0.0023). Reticulocyte and iron characteristics did not correlate with age (p>0.05). Conclusion: A sensitive, independent biomarker of iron status, RET-He measures functional iron availability during erythropoiesis. Strong correlation and severity-stratified discrimination support in populations where inflammation confounds ferritin interpretation, RET-He inclusion into iron deficient diagnostic methods. Prospective studies are needed to establish clinical thresholds and validate RET-He in chronic renal disease, inflammatory conditions, and pregnancy-related iron metabolism.