Hb level, iron intake and mortality in Chinese adults: a 10-year follow-up study

Shi, Zumin; Zhen, Shiqi; Zhou, Yonglin; Taylor, Anne

doi:10.1017/s000711451700040x

Cited by 19 publications

(13 citation statements)

References 29 publications

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“…This association can also be comparable with previous observations that increased level of sTfR had adverse effects on different health outcomes, including diabetes or insulin resistance (15,32), iron-deficiency anemia (33), and obesity (34). In this study, we also found a U-shaped relationship of Hb and CKD, which is comparable with findings from other health outcomes, such as mortality (35), birth outcome (36), and stroke severity (14).…”

Section: Discussionsupporting

confidence: 92%

Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults

Zhu

Liu

et al. 2020

Front. Med.

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Background: Even though it is well-known that iron deficiency is the result of chronic kidney disease (CKD), whether iron will affect kidney function and disease in the general population is not clear. We thus conducted a nationwide cross-sectional study using data from the China Health and Nutrition Survey (CHNS) to assess the relationship of iron status with estimated glomerular filtration rate (eGFR) and CKD among general adults. Methods: A total of 8,339 adults from the China Health and Nutrition Survey in the wave of 2009 were included to assess the association between iron status and eGFR/CKD. Serum ferritin (SF), transferrin, soluble transferrin receptor (sTfR), and hemoglobin (Hb) were measured. The relationship of iron status and eGFR was evaluated by using multi-variable linear regression model. The effect of iron status on the odds of CKD was calculated by logistic regression model. Results: For the association between iron status and eGFR, every 100 µg/L increase in SF was correlated with 0.26 ml/min per 1.73 m² (95% CI: 0.08-0.44) decrease in eGFR, and every 5 mg/L increase in sTfR was associated with a decrease of 6.00 ml/min per 1.73 m² (95% CI: 3.79-8.21) in eGFR. There were no significant associations between Hb or transferrin with eGFR. For the association between iron status and CKD, every 5 g/L increase in sTfR was associated with an odds ratio of 3.72 (95% CI: 2.16-6.13) for CKD. The concentrations of Hb were associated with the odds of CKD in a U-shaped manner, with the lowest risk in the Hb range of 136-141 g/L. There was a positive correlation between SF concentration and CKD prevalence but not in a dose-response manner. The odds of CKD for participants in the highest tertile increased by 28% (98% CI: 1-63%) compared with those in the lowest tertile. Conclusion: The concentration of SF and sTfR was positively correlated with the odds of CKD, and Hb was associated with the odds of CKD in a U-shaped manner. Further large prospective researches are warranted to confirm these findings.

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Section: Discussionsupporting

confidence: 92%

Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults

Zhu

Liu

et al. 2020

Front. Med.

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“…The potential adverse health effects of high iron status in the Chinese population have been studied. For example, high iron status was associated with increased risk of mortality in a 10-y follow-up study in Chinese adults (45). Serum ferritin was positively associated with diabetes risk in several largepopulation studies in China (46)(47)(48)(49)(50)(51)(52), which is consistent with the findings among Western populations.…”

Section: Discussionsupporting

confidence: 77%

High iron intake is associated with poor cognition among Chinese old adults and varied by weight status—a 15-y longitudinal study in 4852 adults

Shi

Wang

et al. 2019

The American Journal of Clinical Nutrition

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Background High body iron status has been shown to be associated with adverse health outcomes. However, the relation between high body iron status, body mass index (BMI), and cognition is still understudied. Objective This study aimed to examine the association between iron intake and cognitive function in Chinese adults and tested the interaction effect of iron intake and BMI on cognition. Design Longitudinal study data from a nationwide sample (n = 4852; age ≥55 y) from the China Health and Nutrition Survey during 1991–2006 were used. Of the participants, 3302 had completed cognitive screening tests in ≥2 surveys. Cognitive function was assessed in 1997, 2000, 2004, and 2006. Dietary iron intake was obtained from a 3-d food record during home visits in 1991, 1993, 1997, 2000, 2004, and 2006. Multivariable mixed linear regression and logistic regression were used. Results The cumulative mean ± SD iron intake in 1997 of tested subjects was 23.7 ± 11.3 mg/d (25.4 mg/d in men and 22.2 mg/d in women). High iron intake was associated with poor cognition. In fully adjusted models, across the quartiles of iron intake the regression coefficients (95% CIs) were 0, −0.39 (−0.77, −0.01), −0.55 (−0.95, −0.15), and −0.90 (−1.33, −0.47), respectively. Comparing extreme quartiles of iron intake (high), the OR (95% CI) for poor cognitive function was 1.30 (1.04, 1.64). There was a significant interaction between iron intake and BMI. The association between high iron intake and poor cognition was stronger among those with a high BMI than those with a low BMI. Among those with a BMI (kg/m2) >24, across quartiles of iron intake the ORs (95% CIs) for poor cognitive function were 1.00, 1.27 (0.91, 1.78), 1.41 (0.97, 2.04), and 2.04 (1.38, 3.01), respectively. Conclusion Higher iron intake is associated with poor cognition in Chinese adults, especially among those with a high BMI.

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“…Studies reported that the inter pregnancy interval [ 22 ] and history of parasitic infection [ 7 , 28 ] were associated with the prevalence of anemia, which could not be estimated in this study due to the lake of the factors. Recent studies noted that both low and high iron intake was associated with mortality among women [ 29 ] and elevated iron level may increase the risk of GDM [ 30 ]. However, the present study did not record the iron supplementation of the participants, which may have impacted the results of adverse pregnancy outcomes of anaemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, risk factors and associated adverse pregnancy outcomes of anaemia in Chinese pregnant women: a multicentre retrospective study

Wei

Zhu

Wang

et al. 2018

BMC Pregnancy Childbirth

148

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BackgroundAnaemia in pregnant women is a public health problem, especially in developing countries. The aim of this study was to assess the prevalence and related risk factors of anaemia during pregnancy in a large multicentre retrospective study (n = 44,002) and to determine the adverse pregnancy outcomes in women with or without anaemia.MethodsThe study is a secondary data analysis of a retrospective study named “Gestational diabetes mellitus Prevalence Survey (GPS) study in China”. Structured questionnaires were used to collect socio-demographic characteristics, haemoglobin levels and pregnancy outcomes from all the participants. Anaemia in pregnancy is defined as haemoglobin < 110 g/L. We used SPSS software to assess the predictors of anaemia and associated adverse pregnancy outcomes.ResultsThe overall prevalence of anaemia was 23.5%. Maternal anaemia was significantly associated with maternal age ≥ 35 years (AOR = 1.386), family per capita monthly income< 1000 CNY (AOR = 1.671), rural residence (AOR = 1.308) and pre-pregnancy BMI < 18.5 kg/m2 (AOR = 1.237). Adverse pregnancy outcomes, including GDM, polyhydramnios, preterm birth, low birth weight (< 2500 g), neonatal complications and NICU admission, increased significantly (P < 0.001) in those with anaemia than those without.ConclusionsThe results indicated that anaemia continues to be a severe health problem among pregnant women in China. Anaemia is associated with adverse pregnancy outcomes. Pregnant women should receive routine antenatal care and be given selective iron supplementation when appropriate.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1739-8) contains supplementary material, which is available to authorized users.

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Hb level, iron intake and mortality in Chinese adults: a 10-year follow-up study

Cited by 19 publications

References 29 publications

Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults

Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults

High iron intake is associated with poor cognition among Chinese old adults and varied by weight status—a 15-y longitudinal study in 4852 adults

Prevalence, risk factors and associated adverse pregnancy outcomes of anaemia in Chinese pregnant women: a multicentre retrospective study

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