Overview of Anemia; risk factors and solution offering

Relationship between anemia and its correlates and cognitive function in Chinese patients with chronic schizophrenia: A large cross-sectional study

Background

Although both anemia and schizophrenia (SCZ) can cause cognitive decline, it is unclear whether anemia worsens cognitive decline in patients with SCZ. The primary objective of this study was to investigate the prevalence of anemia and the relationship between anemia, SCZ symptom severity, and cognitive function in patients with SCZ.

Methods

We obtained demographic and clinical data from 1690 inpatients with SCZ. All psychiatric symptoms and cognitive functioning were assessed by the Positive and Negative Syndrome Scale (PANSS), the Mini-Mental State Examination (MMSE), and the Repeated Battery for the Assessment of Neuropsychological Status (RBANS). Hemoglobin (HGB) values as well as red blood cell (RBC) counts were collected by routine blood tests.

Results

The proportion of anemia in patients with SCZ was 26.36 % (383/1453). Compared to SCZ patients without anemia, SCZ patients with anemia were older, had a lower bodyweight, a smaller waist circumference and lower apolipoprotein B levels, but longer QT intervals. Further logistic regression analysis revealed that anemia was associated with age, gender, and weight. In addition, there was no difference in cognitive function between SCZ patients with and without anemia.

Conclusion

Our findings suggest a high proportion of anemia in patients with chronic SCZ in the Han Chinese population. Several demographic and clinical variables are associated with anemia in SCZ patients.

Hospitalization of patients with nutritional anemia in the United States in 2020

Background

Nutritional anemia is highly prevalent and has triggered a globally recognized public health concern worldwide.

Objective

To better understand the prevalence of anemia and the state of nutritional health in developed countries to inform global nutritional health and better manage the disease.

Method

We employed the Healthcare Cost and Utilization Project (HCUP)-2020 National Inpatient Health Care Data (NIS), administered by The Agency for Healthcare Research and Quality. Nutritional anemia was diagnosed according to the International Classification of Diseases, 10th Revision (ICD-10). Matching analysis and multivariate regression were used to adjust for patient and hospital characteristics. Controls were obtained by stratifying and matching for age and sex.

Results

The 2020 HCUP-NIS database encompassed a survey over 6.4 million hospitalized patients, among which 1,745,350 patients diagnosed with anemia, representing approximately 26.97% of the hospitalized population, over 310,000 were diagnosed with nutritional anemia, and 13,150 patients were hospitalized for nutritional anemia as primary diagnosis. Hospitalization rate for nutritional anemia exhibited an increased age-dependent increase nationwide, especially among females, who displayed 1.87 times higher than males. Notably, in comparison to the control group, individuals of the Black race exhibit a higher prevalence of nutritional anemia (case group: 21.7%, control group: 13.0%, p < 0.001). In addition, hospitalization rates were higher among low-income populations, with lower rates of private insurance (case group: 18.7%, control group: 23.5%, p < 0.001) and higher rates of Medicaid insurance (case group: 15.4%, control group: 13.9%, p < 0.001). In areas characterized by larger urban centers and advanced economic conditions within the urban-rural distribution, there was an observed increase in the frequency of patient hospitalizations. Iron deficiency anemia emerged as the predominant subtype of nutritional anemia, accounting for 12,214 (92.88%). Secondary diagnosis among patients hospitalized for nutritional anemia revealed that a significant number faced concurrent major conditions like hypertension and renal failure.

Conclusion

In economically prosperous areas, greater attention should be given to the health of low-income individuals and the older adult. Our findings hold valuable insights for shaping targeted public health policies to effectively address the prevalence and consequences of nutritional anemia based on a overall population health.

Association between different types of preoperative anemia and tumor characteristics, systemic inflammation, and survival in colorectal cancer

Background

Patients with colorectal cancer often have anemia and other symptoms after diagnosis, especially in patients with advanced colorectal cancer. This study explored the association between different types of preoperative anemia and tumor characteristics and inflammatory response in patients with colorectal cancer and to evaluate the prognosis of patients with different types of anemia before operation.

Methods

The clinical data of 95 patients with colorectal cancer treated in the Fourth Hospital of Hebei Medical University from February 2016 to January 2018 were retrospectively analyzed. According to the hemoglobin concentration (Hb), mean corpuscular volume (MCV), mean hemoglobin content (MCH) and mean hemoglobin concentration (MCHC), the patients were divided into the non-anemia group, normal cell anemia group, and small cell anemia group. The three groups' general data, oncological characteristics, and mGPS scores were compared. The patients were followed up for five years, and the survival analysis was carried out. The cox proportional hazard regression model was used to analyze the prognostic factors of patients with colorectal cancer.

Results

The preoperative anemia rate of patients with colorectal cancer was 43.15% (41/95). There were significant differences in gender, weight loss, CA724, tumor location, tumor size, TNM stage, mGPS score, and positive expression rate of Ki-67 among different anemia groups. There was a significant difference in survival time among a non-anemia group, small cell anemia group, and normal cell anemia group (P < 0.05). Multivariate analysis showed that tumor size, TNM stage, distant metastasis, mGPS score, Ki-67 positive expression rate, and anemia type were independent risk factors affecting the prognosis of colorectal cancer patients (P < 0.05).

Conclusion

The oncological characteristics of colorectal cancer patients with different types of preoperative anemia are different. Preoperative anemia and systemic inflammatory status are independent risk factors for the prognosis of colorectal cancer patients.

Prediction of plasma volume and total hemoglobin mass with machine learning

Hemoglobin concentration ([Hb]) is used for the clinical diagnosis of anemia, and in sports as a marker of blood doping. [Hb] is however subject to significant variations mainly due to shifts in plasma volume (PV). This study proposes a newly developed model able to accurately predict total hemoglobin mass (Hbmass) and PV from a single complete blood count (CBC) and anthropometric variables in healthy subject. Seven hundred and sixty-nine CBC coupled to measures of Hbmass and PV using a CO-rebreathing method were used with a machine learning tool to calculate an estimation model. The predictive model resulted in a root mean square error of 33.2 g and 35.6 g for Hbmass, and 179 mL and 244 mL for PV, in women and men, respectively. Measured and predicted data were significantly correlated (p < 0.001) with a coefficient of determination (R2 ) ranging from 0.76 to 0.90 for Hbmass and PV, in both women and men. The Bland-Altman bias was on average 0.23 for Hbmass and 4.15 for PV. We herewith present a model with a robust prediction potential for Hbmass and PV. Such model would be relevant in providing complementary data in contexts such as the epidemiology of anemia or the individual monitoring of [Hb] in anti-doping.

Nutritional and health status of adult Syrian refugees in the early years of asylum in Germany: a cross-sectional pilot study

BACKGROUND

Migration is usually accompanied by changes in the social, cultural, and religious environment, socioeconomic status, and housing conditions, all of which affect nutritional health. In a cross-sectional study, we assessed the dietary intake as well as nutritional and health situation in a population of Syrian refugees who have resided in Germany for at least six months up to four years since 2015. The primary aim of this pilot study was to evaluate the nutritional and health status in comparison to reference values.

METHODS

Between December 2018 and March 2020, 114 adult Syrian refugees were included in the study. The subjects filled out questionnaires on sociodemographic variables, exercise, and nutrition behavior (three-day nutrition record). After a fasting blood draw, the subjects were examined for anthropometric parameters (height, weight, body mass index, waist circumference, waist-hip ratio, and body composition via a bioelectrical impedance analyzer). Various blood markers including iron status, hematological parameters, Vitamin D status, lipid metabolism, glucose metabolism, and total homocysteine (tHcy) were measured.

RESULTS

About half of the participants (71 male, 43 female) had lived in Germany for less than three years. Over 60% of men and 30% of women were overweight (BMI 25-30 kg/m2) or obese (BMI > 30 kg/m2), while 79% of men and 74% of women observed an elevated body fat mass. The evaluation of the three-day nutrition records revealed an unfavorable supply situation for numerous critical nutrients. More than half of the women (53.5%) had depleted iron stores (serum ferritin < 15 µg/l). The 25-OH-Vitamin D blood levels showed a high prevalence of Vitamin D insufficiency (25-49.9 nmol/l: 38% of men and 21% of women) and deficiency (< 25 nmol/l: 44% of men and 70% of women). 83% of men and 67% of women showed tHcy levels in plasma > 10 nmol/l. Fasting insulin levels and the HOMA-IR index indicate a risk for insulin resistance. Hyperlipidemia was prevalent, especially in males with 24% showing hypertriglyceridemia (> 150 mg/dl) and LDL-hypercholesterolemia (> 130 mg/dl).

CONCLUSIONS

The nutritional and health status of the cohort of Syrian refugees in Germany examined in this study is unsatisfactory, and many of the investigated refugees are at risk for developing cardiovascular disease and type 2 diabetes mellitus. Further studies are required to investigate the nutritional and health situation of refugees. This is obligatory to find ways to avoid malnutrition with all its associated health, sociodemographic, and economic consequences.