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BMC Public Health Jan 2022Despite all recent health-related improvements, anemia remains an extensive global public health issue affecting the lives of about one-fourth of the world population in...
BACKGROUND
Despite all recent health-related improvements, anemia remains an extensive global public health issue affecting the lives of about one-fourth of the world population in a geographically heterogeneous pattern. We, therefore, aimed to illustrate the prevalence, severity, most common types, and major determinants of anemia among adults in Khuzestan, Iran, from 2016 to 2019.
METHODS
In a large population-based cross-sectional study comprising of a diverse population, each participant underwent a questionnaire-based interview and laboratory testing for hematological analysis. A hemoglobin (HGB) concentration of < 12 g/dL in non-pregnant women and < 13 g/dL in men were defined anemic. The multivariate logistic regression analysis was performed to explore the association between anemia and its potential determinants.
RESULTS
Data on 29,550 (96.87%) males and non-pregnant females between 20-65 years of age (mean age: 41.90 ± 11.88 years; female sex: 63.58%; Arab ethnicity: 48.65%), whose HGB level was available, were included in the study. The mean ± SD HGB concentration was 13.75 ± 1.65 g/dL. The age- and sex-standardized prevalence rate of anemia was 10.86% (95% CI: 10.51-11.23%). The most prevalent degree was mild anemia (7.71%, 95% CI: 7.40-8.03%) and only 0.17% were severely anemic. Of those considered anemic, the highest proportion was related to normochromic/microcytic (50.65%), followed by hypochromic/microcytic (30.29%). In the multiple logistic regression, the parameters of female gender (OR: 3.17, 95% CI: 2.68-3.76), age group of 35-49 years (OR: 1.66, 95% CI: 1.52-1.82), being underweight (OR: 1.58, 95% CI: 1.29-1.93), being unemployed or retired (OR: 1.55, 95% CI: 1.33-1.81), and living in urban areas (OR: 1.18, 95% CI: 1.09-1.29) were major determinants of anemia. Additionally, we observed a minor but significant positive association between anemia status and CKD, older ages, increased night sleep duration, being a housewife and married, as well as a negative association between anemia and factors including hookah smoking, presence of metabolic syndrome, and overweight and obesity.
CONCLUSIONS
Taken together, the anemia prevalence in this study population was of mild public health significance. The major suspected causes might be iron deficiency and chronic disease anemias. Comparably higher rates of anemia were observed amongst women, individuals aged 35-49 years, underweights, unemployed or retired subjects, and urban residents.
Topics: Adult; Aged; Anemia; Cross-Sectional Studies; Female; Hemoglobins; Humans; Iran; Male; Middle Aged; Prevalence; Risk Factors; Young Adult
PubMed: 35073904
DOI: 10.1186/s12889-022-12512-6 -
Asia Pacific Journal of Clinical... 2020The association between diet and macrocytic and hypochromic anemia in young Chinese men and women remains unclear. The present study aimed to investigate the...
BACKGROUND AND OBJECTIVES
The association between diet and macrocytic and hypochromic anemia in young Chinese men and women remains unclear. The present study aimed to investigate the relationship between dietary pattern and macrocytic and hypochromic microcytic anemia in young Chinese men and women.
METHODS AND STUDY DESIGN
Some 4,840 first-year students (2,385 men and 2,455 women) were recruited for this study from Qingdao University, China. Biochemical and hematological parameters, and food frequency questionnaires were obtained from the subjects. Based on dietary intake, participants were divided into three dietary patterns: seafood dietary pattern (SDP), vegan dietary pattern (VDP) and omnivorous dietary pattern (ODP). The risks for macrocytic and microcytic hypochromic anemia in three dietary patterns were assessed.
RESULTS
Macrocytic and hypochromic anemia were less common in participants who adhered to the omnivorous dietary pattern than to the vegan or seafood dietary patterns (p<0.05). Adhering to an omnivorous dietary pattern was negatively associated with macrocytic anemia in men [odds ratio (95% CI): 0.74 (0.62, 0.89), p<0.001] and microcytic, hypochromic anemia in both genders [men: odds ratio (95% CI): 0.64 (0.45, 0.92), p=0.01; women: odds ratio (95% CI): 0.71 (0.51, 0.99), p=0.04].
CONCLUSIONS
Adhering to an omnivorous dietary pattern was associated with less common macrocytic anemia in young men and microcytic, hypochromic anemia. Dietary diversity is important in preventing macrocytic anemia in men and also microcytic, hypochromic anemia in young men and women. Excessive alcohol intake is the most plausible explanation for macrocytosis in the young men.
Topics: Anemia; Animals; Diet; Feeding Behavior; Female; Humans; Male; Meat; Seafood; Vegans; Young Adult
PubMed: 32990611
DOI: 10.6133/apjcn.202009_29(3).0010 -
Journal of the Formosan Medical... Nov 2021Lacto-vegetarians (LVs) tend to have vitamin B12 deficiency (B12D). This study assessed whether 140 female LVs, including 16 B12D/LVs and 124 non-B12D/LVs, had...
BACKGROUND/PURPOSE
Lacto-vegetarians (LVs) tend to have vitamin B12 deficiency (B12D). This study assessed whether 140 female LVs, including 16 B12D/LVs and 124 non-B12D/LVs, had significantly higher frequencies of microcytosis, macrocytosis, and of blood hemoglobin (Hb), red blood cell (RBC), and serum vitamin B12 deficiencies than 140 healthy control subjects (HCSs).
METHODS
The complete blood count and serum vitamin B12 level in 140 female LVs and 140 female HCSs were measured and compared.
RESULTS
We found that 8.6%, 4.3%, 22.9%, 20.0%, and 11.4% of 140 LVs had microcytosis, macrocytosis, and blood Hb, RBC, and serum vitamin B12 deficiencies, respectively. The 140 LVs, 16 B12D/LVs, and 124 non-B12D/LVs had significantly higher frequencies of microcytosis as well as blood Hb and RBC deficiencies than 140 HCSs (all P-values < 0.005). Moreover, both 140 LVs and 124 non-B12D/LVs had significantly higher frequencies of macrocytosis than 140 HCSs. In this study, 32 (22.9%) of 140 LVs including 5 B12D/LVs and 27 non-B12D/LVs had anemia. Of the 5 anemic B12D/LVs, three had normocytic anemia, one had iron deficiency anemia (IDA), and one had thalassemia trait-induced anemia. Moreover, of the 27 anemic non-B12D/LVs, 18 had normocytic anemia, one had IDA, one had thalassemia trait-induced anemia, and 7 had microcytic anemia other than IDA and thalassemia trait-induced anemia.
CONCLUSION
LVs have significantly higher frequencies of microcytosis, macrocytosis, blood Hb, RBC, and serum vitamin B12 deficiencies than HCSs. Normocytic and microcytic anemias are the two most common types of anemia in our LVs.
Topics: Anemia; Anemia, Iron-Deficiency; Autoantibodies; Erythrocyte Indices; Female; Folic Acid; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Parietal Cells, Gastric; Vegetarians; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 33906782
DOI: 10.1016/j.jfma.2021.04.007 -
Blood Nov 2019As essential components of hemoglobin, iron and heme play central roles in terminal erythropoiesis. The impairment of this process in iron/heme deficiency results in... (Review)
Review
As essential components of hemoglobin, iron and heme play central roles in terminal erythropoiesis. The impairment of this process in iron/heme deficiency results in microcytic hypochromic anemia, the most prevalent anemia globally. Heme-regulated eIF2α kinase, also known as heme-regulated inhibitor (HRI), is a key heme-binding protein that senses intracellular heme concentrations to balance globin protein synthesis with the amount of heme available for hemoglobin production. HRI is activated during heme deficiency to phosphorylate eIF2α (eIF2αP), which simultaneously inhibits the translation of globin messenger RNAs (mRNAs) and selectively enhances the translation of activating transcription factor 4 (ATF4) mRNA to induce stress response genes. This coordinated translational regulation is a universal hallmark across the eIF2α kinase family under various stress conditions and is termed the integrated stress response (ISR). Inhibition of general protein synthesis by HRI-eIF2αP in erythroblasts is necessary to prevent proteotoxicity and maintain protein homeostasis in the cytoplasm and mitochondria. Additionally, the HRI-eIF2αP-ATF4 pathway represses mechanistic target of rapamycin complex 1 (mTORC1) signaling, specifically in the erythroid lineage as a feedback mechanism of erythropoietin-stimulated erythropoiesis during iron/heme deficiency. Furthermore, ATF4 target genes are most highly activated during iron deficiency to maintain mitochondrial function and redox homeostasis, as well as to enable erythroid differentiation. Thus, heme and translation regulate erythropoiesis through 2 key signaling pathways, ISR and mTORC1, which are coordinated by HRI to circumvent ineffective erythropoiesis (IE). HRI-ISR is also activated to reduce the severity of β-thalassemia intermedia in the Hbbth1/th1 murine model. Recently, HRI has been implicated in the regulation of human fetal hemoglobin production. Therefore, HRI-ISR has emerged as a potential therapeutic target for hemoglobinopathies.
Topics: Activating Transcription Factor 4; Anemia, Iron-Deficiency; Animals; Erythropoiesis; Heme; Hemoglobinopathies; Humans; Mechanistic Target of Rapamycin Complex 1; Signal Transduction; eIF-2 Kinase
PubMed: 31554636
DOI: 10.1182/blood.2019001915 -
British Journal of Haematology Apr 2017
Topics: Anemia, Iron-Deficiency; Hepcidins; Humans; Serine Endopeptidases
PubMed: 28211569
DOI: 10.1111/bjh.14558 -
AIDS (London, England) Dec 2022To establish the incidence, risk factors and prognostic effect of anemia in children living with HIV (CLWH).
OBJECTIVES
To establish the incidence, risk factors and prognostic effect of anemia in children living with HIV (CLWH).
DESIGN
Retrospective nested case-control study of patients 0-18 years in five centers in sub-Saharan Africa, 2004-2014.
METHODS
Incident cases of anemia were identified from electronic records and matched with CLWH without anemia. We calculated the incidence density of anemia and used conditional logistic regression to evaluate its association with risk factors, stratified by severity and type of anemia. We used a Cox proportional hazards model to evaluate the impact of anemia on survival.
RESULTS
Two thousand, one hundred and thirty-seven children were sampled. The incidence density of anemia was 1 per 6.6 CLWH-years. Anemia was moderate in 31.8% and severe in 17.3% of anemia cases, which had 10-year mortality hazards of 3.4 and 4.5, respectively. Microcytic anemia (36% cases) was associated with 2.3-fold hazard of 10-year mortality, and with malnutrition and CD4 + suppression. Normocytic anemia (50.5% cases) was associated with 2.6-fold hazards of 10-year mortality, and with more severe malnutrition, CD4 + suppression, and WHO stage, but inversely associated with lamivudine and nevirapine therapy. Macrocytic anemia (13.5% cases) was neither associated with higher 10-year mortality nor with severe malnutrition or CD4 + suppression but was associated with WHO stage II/III and negatively associated with lamivudine therapy.
CONCLUSION
This large multicountry study of CLWH found a high incidence density of anemia. Higher severity, normocytic and microcytic types of anemia were independently associated with long-term mortality. Laboratory studies are needed to decipher the mechanisms of anemia and how it impacts mortality in CLWH.
Topics: Child; Humans; HIV Infections; Lamivudine; Prognosis; Retrospective Studies; Case-Control Studies; Anemia; Risk Factors; Malnutrition
PubMed: 36052537
DOI: 10.1097/QAD.0000000000003374 -
Blood Aug 2022Sickle cell disease (SCD) is an inherited hemolytic anemia caused by a single point mutation in the β-globin gene of hemoglobin that leads to synthesis of sickle...
Sickle cell disease (SCD) is an inherited hemolytic anemia caused by a single point mutation in the β-globin gene of hemoglobin that leads to synthesis of sickle hemoglobin (HbS) in red blood cells (RBCs). HbS polymerizes in hypoxic conditions, leading to intravascular hemolysis, release of free hemoglobin and heme, and increased adhesion of blood cells to the endothelial vasculature, which causes painful vaso-occlusion and organ damage. HbS polymerization kinetics are strongly dependent on the intracellular HbS concentration; a relatively small reduction in cellular HbS concentration may prevent HbS polymerization and its sequelae. We hypothesized that iron restriction via blocking ferroportin, the unique iron transporter in mammals, might reduce HbS concentration in RBCs, thereby decreasing hemolysis, improving blood flow, and preventing vaso-occlusive events. Indeed, vamifeport (also known as VIT-2763), a clinical-stage oral ferroportin inhibitor, reduced hemolysis markers in the Townes model of SCD. The RBC indices of vamifeport-treated male and female Townes mice exhibited changes attributable to iron-restricted erythropoiesis: decreased corpuscular hemoglobin concentration mean and mean corpuscular volume, as well as increased hypochromic and microcytic RBC fractions. Furthermore, vamifeport reduced plasma soluble VCAM-1 concentrations, which suggests lowered vascular inflammation. Accordingly, intravital video microscopy of fluorescently labeled blood cells in the microvasculature of Townes mice treated with vamifeport revealed diminished adhesion to the endothelium and improved hemodynamics. These preclinical data provide a strong proof-of-concept for vamifeport in the Townes model of SCD and support further development of this compound as a potential novel therapy in SCD.
Topics: Anemia, Sickle Cell; Animals; Cation Transport Proteins; Disease Models, Animal; Female; Hemodynamics; Hemoglobin, Sickle; Hemoglobins; Hemolysis; Iron; Male; Mammals; Mice
PubMed: 35714304
DOI: 10.1182/blood.2021014716 -
Frontiers in Immunology 2022Pernicious anemia (PA) is a megaloblastic anemia consisting of hematological, gastric and immunological alterations. The immunopathogenesis of PA is sustained by both...
Pernicious anemia (PA) is a megaloblastic anemia consisting of hematological, gastric and immunological alterations. The immunopathogenesis of PA is sustained by both autoantibodies (e.g. intrinsic factor (IFA) antibodies and anti parietal cell (PCA) antibodies and autoreactive T cells specific for IFA and the parietal cell proton pump ATPase. Iron deficient anemia (IDA) is a microcytic anemia and represents the most common cause of anemia worldwide. Our work aimed to investigate serum levels of several interleukins (IL) of the IL-20 cytokine subfamily in patients with PA, with IDA and in healthy subjects (HC). We compared serum levels of IL-19, IL-20, IL-26, IL-28A and IL-29 in 43 patients with PA and autoimmune gastritis, in 20 patients with IDA and no autoimmune gastritis, and in 47 HC. Furthermore, we analyzed the IL-19 cytokine production by gastric lamina propria mononuclear cells (LPMC) in eight patients with PA and four HC. We found that patients with PA have significantly higher serum levels of IL-19 (163.68 ± 75.96 pg/ml) than patients with IDA (35.49 ± 40.97 pg/ml; p<0.001) and healthy subjects (55.68 ± 36.75 pg/ml; p<0.001). Gastric LPMC from all PA patients were able to produce significantly higher levels of IL-19 (420.67 ± 68.14 pg/ml) than HC (53.69 ± 10.92 pg/ml) (<0.01). Altogether, our results indicate that IL-19 serum levels are significantly increased in patients with PA but not with IDA and that IL-19 is produced in the stomach of PA patients. These data open a new perspective on PA pathogenesis and suggest that IL-19 may represent a novel important tool for the management of patients with PA.
Topics: Anemia; Anemia, Pernicious; Autoantibodies; Cytokines; Gastritis; Humans; Interleukins
PubMed: 35479078
DOI: 10.3389/fimmu.2022.887256 -
Pediatric Nephrology (Berlin, Germany) Jul 1992Aluminum intoxication is an iatrogenic disease caused by the use of aluminum compounds for phosphate binding and by the contamination of parenteral fluids. Although... (Review)
Review
Aluminum intoxication is an iatrogenic disease caused by the use of aluminum compounds for phosphate binding and by the contamination of parenteral fluids. Although organ aluminum deposition was noted as early as 1880 and toxicity was documented in the 1960s, the inability to accurately measure serum and tissue aluminum prevented delineation of its toxic effects until the 1970s. Aluminum toxicity has now been conclusively shown to cause encephalopathy, metabolic bone disease, and microcytic anemia.
Topics: Aluminum; Anemia; Brain Diseases; Child; Child, Preschool; Humans; Infant; Kidney Failure, Chronic; Osteomalacia; Renal Dialysis
PubMed: 1498007
DOI: 10.1007/BF00869743 -
Advances in Respiratory Medicine 2019Microcytic anemia is a type of anemia with smaller than normal red blood cells. Iron deficiency anemia and thalassemia are some of the major causes. The aim of the study...
INTRODUCTION
Microcytic anemia is a type of anemia with smaller than normal red blood cells. Iron deficiency anemia and thalassemia are some of the major causes. The aim of the study was to compare the pulmonary function of the subjects with microcytic anemia to the respective results of the normal population.
MATERIAL AND METHODS
This was a cross-sectional study in Bandar Abbas, Iran, conducted on the patients attending yearly occupational health checkups. Complete blood cell count and a standard spirogram were attained from each consenting participant and occupational histories of exposure to dust, fumes, solvents, and noxious gases were obtained.
RESULTS
At last, 2,199 subjects were included in the analysis, of which 335 cases had microcytic anemia. There was a significant association between having microcytic anemia and forced vital capacity (FVC) reduction, and to a lesser degree, the reduction of forced expiratory volume in the first second (FEV1). These parameters were also significantly increased together with the rise of mean corpuscular volume (MCV) in the sample population.
CONCLUSION
It can be concluded that having microcytic anemia may reduce some spirometric parameters. Even though these changes are small, adjusting for the reduced values can help prevent an overestimation of lung disorders, mostly in borderline cases.
Topics: Anemia, Hypochromic; Cross-Sectional Studies; Female; Forced Expiratory Volume; Humans; Iran; Lung; Male; Respiratory Function Tests; Spirometry; Vital Capacity
PubMed: 30830953
DOI: 10.5603/ARM.a2019.0001