The mean reticulocyte volume is a valuable index in early diagnosis of cancer-related anemia.

Background: Cancer-related anemia (CRA) is a functional iron deficient anemia, and the early diagnosis will improve the prognosis of the patients. This prospective study aimed to investigate the utility of mean reticulocyte volume (MRV) in the early diagnosis of CRA. Methods: A total of 284 first-diagnosed cancer patients were enrolled, and the subjects were assigned anemia and non-anemia groups by hemoglobin (Hb) concentrations. The mature RBC and reticulocyte indices were detected with BC-7500 blood analyzer, and the MRV, reticulocyte hemoglobin (RHE) content, and reticulocyte production index (RPI) were obtained. ROC curves were constructed in identifying anemia diagnosed by the combination of RHE and RPI. An adjusted multivariate analyse and quartiles were used to assess the associations of MRV with early CRA diagnosed by combining RBC indices (MCV, MCH and MCHC), respectively. Results: No statistical differences were observed in MCV, RHE and MRV levels between anemia and non-anemia subjects (p > 0.05). MRV exhibited a complete or high correlation with the RHE levels (r = 1.000, p < 0.001), or MCV, MCH, and MCHC in anemia patients (R: 0.575-0.820, p < 0.001). ROC curves analyse indicated a highest area under curve of 0.829 (95% CI [0.762-0.895]) and 0.884 (95% CI [0.831-0.936]) for MRV in identifying anemia in male and female patients, respectively (p < 0.001). When the optimal cutoff values of MRV were set at 100.95 fl in males and 98.35 fl in females, the sensitivity and specificity were 1.00 and 0.68, and 1.00 and 0.73, respectively. The regression analyse showed that, when being as a categorical variable, MRV showed an odds ratio of 19.111 (95% CI [6.985-52.288]; p < 0.001) for the incidence of CRA. The incidence of overall anemia demonstrated a more significant decrease trend along with the increase of MRV quartiles (p-trend < 0.001). Conclusion: This study revealed that the MRV can be used as a convenient and sensitive index in early diagnosis of cancer-related anemia, and decreased MRV level may be the powerful predictor of overt anemia in cancer patients.

A patient with the highly suspected B cell lymphoma accompanied by the erythrocytes cold agglutination: Case report.

RATIONALE: Cold agglutinins are related with B cell lymphoproliferative disorder and lymphoma, and can agglutinate red blood cells (RBCs) at an optimum temperature of 3-4°C, which is the undergoing cause of RBCs cold agglutination. RBC cold agglutination may lead to an extreme abnormality of RBC parameters of complete blood count (CBC). PATIENT CONCERNS: The present study reports a case of an old patient with severe infectious fever and anemia presenting extremely abnormal levels of RBC parameters in CBC and a sand-like appearance of blood on tube wall. The validating tests indicated the presence of the RBCs cold agglutination and the highly suspected B cell lymphoma. DIAGNOSES: The 37°C-incubation corrected the CBC results of the patient, and the microscopic observation and flow cytometry analysis of blood and marrow indicated many abnormal B lymphocytes. Subsequently, the patient was diagnosed with a highly suspected B-cell lymphoma. INTERVENTIONS: The blood with a sand-like appearance was reanalyzed to validate the cold agglutination by 37°C-water incubation. The smears of peripheral blood and marrow were made for morphological observation by using optical microscopy. Moreover, the clusters of differentiation of the white blood cells were analyzed to confirm the type of abnormal white blood cells with a flow cytometer. OUTCOMES: The RBCs cold agglutination was validated, and the highly suspected B cell lymphoma was proved as the undergoing cause. LESSONS: This case focuses on the discovery and solutions of RBCs cold agglutination, and emphasizes the importance of microscopic observation in the exploration of undergoing causes of cold agglutination.

The Function of Body Mass Index in the Older with Osteosarcopenia: A Systematic Review and Meta-analysis.

Background: Due to the aging population worldwide, diseases that frequently attack elderly people, such as sarcopenia and osteoporosis, are major public health issues. Methods: This study used a systematic review and meta-analysis to examine the associations among body mass index (BMI), sarcopenia, and bone mineral density (BMD) in a group of adults older than 60 years. Eight studies with a total of 18,783 subjects were examined using a random effect model. Results: In sarcopenia patients, total hip BMD (d=0.560; 95% confidence interval [CI], 0.438 to 0.681; P<0.01; I2=53.755%), femoral neck BMD (d=0.522; 95% CI, 0.423 to 0.621; P<0.01; I2=77.736%) and lumbar spine BMD (d=0.295; 95% CI, 0.111 to 0.478; P<0.01; I2=66.174%) were lower than in control subjects. Additionally, BMI (d=0.711; 95% CI, 0.456 to 0.996; P<0.01; I2=97.609%) correlated with the BMD of the total hip, femoral neck, and lumbar spine. That is, sarcopenia patients with low BMD levels in the total hip, femoral neck, and lumbar spine also had low fat levels. Thus, sarcopenia patients with low BMD in the total hip, femoral neck and lumbar spine and low BMI could have a higher than average risk of osteosarcopenia. No sex effects were significant (P>0.05) for any variable. Conclusion: BMI could be a key point in osteosarcopenia, suggesting that a low body weight could be facilitate the transition from sarcopenia to osteosarcopenia.

The Prevalence of Metabolic Syndrome and Its Related Risk Complications among Koreans.

There is an increasing number of metabolic syndrome (MetS) patients worldwide, and there is no exception in South Korea. The risk complications of metabolic syndrome have been investigated by many previous research studies, while no data on any current trends of MetS are available. Therefore, the present study investigates the recent prevalence of MetS and its associated risk complications in Korean adults by using the Korean National Health and Nutrition Examination Survey (KNHANES). The Survey respondents (n = 4744) were adults over the age of 30, and they had participated in KNHANES 2016, which is a health survey of a national representative sample of non-institutionalized civilian South Koreans. The cross-tabulation analysis was applied to figure out the general characteristics impacting on the prevalence of MetS; furthermore, the odds ratios and 95% confidence intervals (CIs) using multivariate logistic regression analysis were presented for the risk complications of MetS. Findings from this study indicated that subjective health status, family structure, age, income level, use of nutrition labelling and gender showed significant connections with the prevalence of MetS. The risk diseases, stroke (OR = 2.174, 95% CI = 1.377-3.433, p < 0.01), myocardial infarction (MI) (OR = 2.667, 95% CI = 1.474-4.824, p < 0.01) and diabetes (OR = 6.533, 95% CI = 4.963, p < 0.001) were explored and verified attributable to the prevalence of MetS. The findings in this study suggest that sociodemographic characteristics-concentrated strategies are vital to prevent the prevalence of MetS in South Korea, and relative risk complications ought to be cautiously dealt with as well.