VALIDITAS DIAGNOSTIK MEAN RETICULOCYTE VOLUME (MRV) UNTUK DETEKSI DEFISIENSI BESI POPULASI DEWASA SEHAT

Mayza Candhani Kusumasari, Dr. dr.Tri Ratnaningsih, M.Kes, Sp.PK. Subsp.B.D.K.T.(K), Subsp.H.K.(K); Dr. dr. Andaru Dahesihdewi, MKes., Sp.PK, Subsp.P.I.(K), Subsp. Onk.K.(K)

2026 | Tesis-Spesialis | S2 Ilmu Patologi Klinik

Latar Belakang: Defisiensi besi merupakan masalah kesehatan global yang sering tidak terdeteksi pada tahap awal karena parameter hematologi konvensional seperti hemoglobin dan indeks eritrosit baru menunjukkan perubahan setelah terjadi anemia. Retikulosit, sebagai eritrosit muda yang berada di sirkulasi, dapat memberikan gambaran aktivitas eritropoiesis secara real-time. Mean Reticulocyte Volume (MRV) merupakan indeks retikulosit yang berpotensi menjadi penanda dini defisiensi besi, namun validitas diagnostiknya pada populasi dewasa sehat belum banyak diketahui.

Tujuan: Mengevaluasi validitas diagnostik MRV untuk deteksi defisiensi besi.

Metode: Penelitian ini menggunakan desain observasional potong lintang dengan pendekatan uji diagnostik. Standar rujukan yang digunakan adalah kadar serum feritin ?30 µg/L. Pemeriksaan MRV dilakukan menggunakan alat hematologi otomatis Mindray BC-760. Subjek penelitian adalah calon residen dan koas yang menjalani pemeriksaan kesehatan di Laboratorium Patologi Klinik FK-KMK UGM dan memenuhi kriteria inklusi serta eksklusi. Penelitian dilakukan secara tersamar dan dibutakan. Analisis data dilakukan menggunakan kurva Receiver Operating Characteristic (ROC) untuk menentukan luas Area Under Curve (AUC) dan cut-off optimal berdasarkan indeks Youden. Sensitivitas, spesifisitas, nilai ramal negatif, nilai ramal positif, likelihood ratio positif, likelihood ratio negatif, dan akurasi dinilai berdasarkan cut-off optimal

Hasil: Penelitian terhadap 302 subjek (38 subjek defisiensi besi, 264 subjek tidak defisiensi besi) menunjukkan bahwa median MRV (99,25 vs 105,6) fL dan feritin serum (17 vs 131) µg/L secara signifikan lebih rendah pada kelompok defisiensi besi (p<0>

Simpulan: Parameter MRV memiliki validitas diagnostik yang baik, pada cut-off <101>

Kata Kunci: defisiensi besi, MRV, retikulosit, uji diagnostik, feritin serum

Background: Iron deficiency is a global health problem that often goes undetected in its early stages because conventional hematological parameters, such as hemoglobin and erythrocyte indices, only show changes after anemia has developed. Reticulocytes, being young erythrocytes in the circulation, can provide a real-time picture of erythropoietic activity. Mean Reticulocyte Volume (MRV) is a reticulocyte index with the potential to serve as an early marker for iron deficiency; however, its diagnostic validity in a healthy adult population remains largely unknown.

Objective: To evaluate the diagnostic validity of MRV for the detection of iron deficiency.

Methods: This study utilized a cross-sectional observational design with a diagnostic test approach. The reference standard used was a serum ferritin level of ?30 µg/L. MRV examination was performed using a Mindray BC-760 automated hematology analyzer. The study subjects were prospective residents and clinical clerks undergoing medical check-ups at the Clinical Pathology Laboratory, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (FK-KMK UGM), who met the inclusion and exclusion criteria. The study was conducted in a masked and blinded manner. Data analysis was performed using the Receiver Operating Characteristic (ROC) curve to determine the Area Under the Curve (AUC) and optimal cut-off based on Youden index. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and accuracy were determined based on optimal cut-off.

Result: The study of 302 subjects (38 subjects with iron deficiency and 264 subjects without iron deficiency) showed that the median MRV (99.25 vs. 105.6 fL) and serum ferritin (17 vs. 131 µg/L) were significantly lower in the iron deficiency group (p<0>

Conclusion: The MRV parameter demonstrates good diagnostic validity, at a cut-off of <101>

 

Keywords: iron deficiency, MRV, reticulocyte, diagnostic test, serum ferritin

Kata Kunci : defisiensi besi, MRV, retikulosit, uji diagnostik, feritin serum