Increased prevalence and incidence of anemia among adults in transforming rural China: two cross-sectional surveys

Wang, Xuecai; Wu, Zhaofan; Chen, Yue; Zhu, Jianfu; Dong, Xiaolian; Fu, Chaowei; Jiang, Qingwu

doi:10.1186/s12889-015-2671-8

Cited by 17 publications

(14 citation statements)

References 19 publications

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“…For IBD patients, there are considerable amounts of factors for shortage of iron, including an increase of iron loss from bleeding as a consequence of gastrointestinal inflammation and weakened iron absorption due to short bowl syndrome, lack of appetite, blockage of intestinal iron acquisition, and reutilization of macrophage as a result of inflammation. In our study, 63.64% UC and 57.58% CD patients were anemic, and the incidence of anemia was significantly higher than that of resident Chinese reported in a nationwide survey before [31]. And the levels of MCV, MCH, and MCHC were much lower in UC and CD patients with anemia than that in UC and CD patients without anemia, but significant differences were not observed in folate and vitamin B12.…”

Section: Discussioncontrasting

confidence: 56%

Anti-TNF-α Monoclonal Antibody Therapy Improves Anemia through Downregulating Hepatocyte Hepcidin Expression in Inflammatory Bowel Disease

Shu

Pang

et al. 2019

Mediators of Inflammation

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Anemia is one of the most common complications in patients with inflammatory bowel disease (IBD). Hepcidin as a key regulator of iron metabolism is pivotal in mediating the occurrence of anemia of chronic disease. Herein, we analyzed the levels of hepcidin in sera from IBD patients by enzyme-linked immunosorbent assay and investigated its potential role in regulating the anemia in IBD. We observed that the levels of serum hepcidin were increased in active IBD patients compared with those in remitted IBD patients and healthy controls and that serum hepcidin was associated with disease activity, CRP, and ESR, respectively. Importantly, we found that the increased levels of serum hepcidin were positively correlated with the severity of anemia and the imbalance of iron metabolism in anemic UC and CD patients. Proinflammatory factors (e.g., IL-6, IL-17, and TNF-α) were positively correlated with the concentrations of serum hepcidin in IBD patients. Interestingly, hepcidin was found to be decreased in patients with Crohn's disease after successful therapy with anti-TNF-α mAb (i.e., infliximab), indicating the underlying association between TNF-α and hepcidin expression. To investigate the specific mechanisms involved, we cultured LO2 and HepG2 cell lines in vitro under stimulation with TNF-α and observed that the levels of hepcidin mRNA were markedly upregulated in caspase-3/8- and NF-κB-dependent manners. Therefore, our data suggest that TNF-α stimulates the expression of hepcidin in IBD patients, resulting in aggravated anemia and that blockage of TNF-α or the caspase-3/8 and NF-κB pathways could downregulate hepcidin expression. This study provides inspiration for the therapy and management of anemia in IBD.

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Section: Discussioncontrasting

confidence: 56%

Anti-TNF-α Monoclonal Antibody Therapy Improves Anemia through Downregulating Hepatocyte Hepcidin Expression in Inflammatory Bowel Disease

Shu

Pang

et al. 2019

Mediators of Inflammation

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“…In women, the mortality risk increased at the level of Hb 130 g/l. However, in China, anaemia is diagnosed when Hb is below 110 g/l for women and 120 g/l for men ( 26 ) . Based on the distribution of Hb in the sample, among the anaemic participants, about 55 % had Hb levels between 120 and 130 g/l in men and 110 and 120 g/l in women, which would be diagnosed as normal based on the Chinese criteria.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Anaemia is prevalent in developing countries and is commonly Fe deficiency related. We aimed to assess the association between Fe status, Fe intake and mortality among Chinese adults. We prospectively studied 8291 adults aged 20-98 years with a mean follow-up of 9·9 years. All participants were measured for Hb at baseline in 2002. Food intake, measured by 3-d weighed food record (n 2832), and fasting serum ferritin were measured. We documented 491 deaths (including 192 CVD and 165 cancer deaths) during 81 527 person-years of follow-up. There was a U-shaped association between Hb levels and all-cause mortality. Compared with the second quartile of Hb (121 g/l), the first (105) and fourth quartile (144) had hazard ratios (HR) of 2·29 (95 % CI 1·51, 3·48) and 2·31 (95 % CI 1·46, 3·64) for all-cause mortality in women. In men, compared with third quartile of Hb (143 g/l), first (122) and fourth quartiles (154) had 61 and 65 % increased risk of all-cause mortality. Anaemia was associated with an increased risk of all-cause and CVD mortality in men but not in women after adjusting for potential confounders. Low and high Fe intake as percentage of Chinese recommended nutrient intake (RNI) were positively associated with all-cause mortality in women but not in men. In women, across quartiles of relative Fe intake, HR for all-cause mortality were 2·55 (95 % CI 0·99, 6·57), 1·00, 3·12 (95 % CI 1·35, 7·18) and 2·78 (95 % CI 1·02, 7·58). Both low and high Hb levels are related to increased risk of all-cause mortality. Both low and high intake of Fe as percentage of RNI was positively associated with mortality in women.

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“…Dyslipidemia was defined as serum total cholesterol higher than 5.72 mmol/L or treatment with antihyperlipidemic drugs. Anemia was defined as Hb level < 12 g/dl for men and < 11 g/dl for women according to Chinese criteria ( 20 ). WBC count, red blood cell (RBC), Hb level, serum creatinine, and other serum parameters were measured at admission while fasting and abstaining from smoking.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Value of Preoperative Hemoglobin Levels for Long-Term Outcomes of Acute Type B Aortic Dissection Post-thoracic Endovascular Aortic Repair

Gao

Qin

et al. 2020

Front. Cardiovasc. Med.

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Background and Aims: There is scant information available about the prognostic value of preoperative hemoglobin (Hb) levels on the long-term outcomes of acute type B aortic dissection (ABAD) following thoracic endovascular aortic repair (TEVAR). Methods: A retrospective analysis of consecutive patients from 2010 to 2018 regarding the relationship between Hb level and long-term outcomes was conducted. The primary endpoint was all-cause mortality. Major adverse cardiovascular events (MACEs) included all-cause death, recurrent ruptures, and secondary procedures. Results: In total, 391 subjects treated by TEVAR were enrolled, with a mean age of 57.1 ± 12.0 years; 79.5% of them were male. Cox multivariate analysis showed that the preoperative Hb level was independently associated with all-cause death [adjusted hazard ratio (HR) 0.797 (per 1 g/dl), 95% confidence interval (CI) 0.693–0.918, p = 0.002] and MACEs (adjusted HR 0.795, 95% CI 0.672–0.871, p = 0.000). The area under the receiver operating characteristic curve of Hb for all-cause death and MACEs were 0.617 (95% CI 0.548–0.687, p = 0.008) and 0.617 (95% CI 0.551–0.684, p = 0.005), respectively. In the linear trend test, Hb concentration was significantly related to all-cause mortality ( p for trend = 0.001) and MACEs ( p for trend = 0.000). Moreover, in Kaplan–Meier analysis, lower Hb levels (< 12 g/dl) were significantly different from higher Hb (≥12 g/dl) levels for both all-cause death (log-rank p = 0.001) and MACEs (log-rank p = 0.001). Similar results were found when assessing the prognostic value of red blood cell count and anemia. Conclusions: Preoperative Hb may serve as a prognostic marker for long-range adverse outcomes for ABAD patients post-TEVAR.

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Increased prevalence and incidence of anemia among adults in transforming rural China: two cross-sectional surveys

Cited by 17 publications

References 19 publications

Anti-TNF-α Monoclonal Antibody Therapy Improves Anemia through Downregulating Hepatocyte Hepcidin Expression in Inflammatory Bowel Disease

Anti-TNF-α Monoclonal Antibody Therapy Improves Anemia through Downregulating Hepatocyte Hepcidin Expression in Inflammatory Bowel Disease

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

Prognostic Value of Preoperative Hemoglobin Levels for Long-Term Outcomes of Acute Type B Aortic Dissection Post-thoracic Endovascular Aortic Repair

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