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Dery L, Stern J, Shimon I, Rudman Y, Kushnir S, Shochat T, Fleseriu M, Akirov A. Impact of etiology, sex, diabetes mellitus and remission status on erythrocytic profile in patients with cushing's syndrome: a large population database study. Pituitary 2024; 27:389-402. [PMID: 38769229 DOI: 10.1007/s11102-024-01399-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE The study aimed to characterize the erythrocytic profile in patients with cushing's syndrome (CS) versus controls from the normal population according to etiology, sex, presence of diabetes mellitus (DM) and hypercortisolemia remission status. METHODS This retrospective cohort analysis compared erythrocytic parameters between patients with CS of pituitary (CD) and adrenal (aCS) etiology and age, sex, body mass index (BMI) and socioeconomic status-matched controls in a 1:5 ratio. Laboratory values at baseline were calculated as mean values during the year preceding CS diagnosis, and over one year thereafter. RESULTS The cohort included 397 CS patients (68.26% female; mean age 51.11 ± 16.85 years) and 1970 controls. Patients with CS had significantly higher baseline median levels of hemoglobin (Hgb) (13.70 g/dL vs. 13.12 g/dL [p < 0.0001]) and hematocrit (Hct) (41.64% vs. 39.80% [p < 0.0001]) compared to controls. These differences were observed for both CD and aCS and for both sexes. Patients who attained remission had Hgb and Hct levels comparable to controls (13.20 g/dL and 40.08% in patients with CD and aCS vs. 13.20 g/dL and 39.98% in controls). Meanwhile, those with persistent/recurrent disease maintained elevated levels. Patients with comorbid DM had similar Hgb but higher Hct (p = 0.0419), while patients without DM showed elevated erythrocytic values compared to controls (p < 0.0001). CONCLUSION Our data illustrates that erythrocytic parameters are directly influenced by glucocorticoid excess as Hgb and Hct are higher in patients with CS, and normalize after remission. We have identified the influence of DM on erythrocytic parameters in patients with CS for the first time.
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Affiliation(s)
- Laura Dery
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Julia Stern
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Shimon
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Yaron Rudman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Shiri Kushnir
- Research Authority, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Tzipora Shochat
- Biostatistics Unit, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Maria Fleseriu
- Departments of Medicine and Neurological Surgery, Pituitary Center, Oregon Health & Science University, Portland, OR, USA
| | - Amit Akirov
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
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Wong HS, Tay JEF, Kaur S, Gan WY, Che'Ya NN, Tan CH, Tung SEH. Knowledge and practices in preventing nutritional anaemia of the urban poor adolescents in Kuala Lumpur, Malaysia. Nutr Health 2024; 30:331-340. [PMID: 36036393 DOI: 10.1177/02601060221122182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Background: Anaemia has been identified as a major public health problem that affects both developed and developing countries, including Malaysia. To prevent anaemia, knowledge is a key parameter for changing attitudes and practices. Aim: This present study aims to determine the association of knowledge and practices in preventing nutritional anaemia with anaemia status of urban poor adolescents in Kuala Lumpur, Malaysia. Methods: A total of 209 urban poor adolescents (50.7% males and 49.3% females) aged 10 to 17 years old were recruited from eight low-cost flats (People Housing Programme) in Kuala Lumpur, Malaysia. A self-administered questionnaire was used to assess the sociodemographic characteristics, knowledge and practices in preventing nutritional anaemia. Anaemia status from the haemoglobin level concentration was determined using HemoCue® 201 + hemoglobinometer. Results: The prevalence of anaemia among urban poor adolescents was 58.4%, particularly prevalent among females (p < 0.001) and household size of six and above (p = 0.036). Only 29.2% and 10.0% of them were found to have good levels of knowledge and practices in preventing nutritional anaemia, respectively. Adolescents with high knowledge level tended to be anaemic as compared to poor knowledge level (AOR(95% CI) = 2.20 (1.02, 5.61), p < 0.05) after adjusting for sex, household size and monthly household income. Conclusion: Findings showed high prevalence of anaemia and low levels of knowledge and practices of nutritional anaemia prevention among the urban poor adolescents. Nutrition education and intervention are needed to improve the anaemia status of the urban poor adolescents.
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Affiliation(s)
- Hwee Shan Wong
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Janice Ee Fang Tay
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Satvinder Kaur
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Nik Norasma Che'Ya
- Department of Agriculture Technology, Faculty of Agriculture, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Choon Hui Tan
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Serene En Hui Tung
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia
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Wubet HB, Mengistu LH, Gobezie NZ, Mekuriaw BY, Mebratie AF, Sahile WA. The incidence and factors associated with anemia in elective surgical patients admitted to a surgical intensive care unit: a retrospective cohort study. Eur J Med Res 2024; 29:290. [PMID: 38764061 PMCID: PMC11103962 DOI: 10.1186/s40001-024-01887-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/15/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND Anemia is a frequently reported and commonly documented issue in intensive care units. In surgical intensive care units, more than 90% of patients are found to be anemic. It is a hematologic factor that contributes to extended mechanical ventilation, sepsis, organ failure, longer hospitalizations in critical care units, and higher mortality. Thus, this study aimed to determine the incidence and identify factors associated with anemia in elective surgical patients admitted to the surgical intensive care unit. METHODS A retrospective follow-up study involving 422 hospitalized patients was carried out between December 2019 and December 2022 in the surgical intensive care unit after elective surgery at Tikur-Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data were gathered from the patients' charts, and study participants were chosen using methods of systematic random sampling. SPSS 26 (the statistical software for social science, version 26) was used to analyze the data. Bivariable and multivariable binary logistic regression were used to examine associations between variables. RESULTS The incidence of anemia in elective surgical patients admitted to the intensive care unit was 69.9% (95% CI 65.4-74.5%). American Society of Anesthesiologists' class III (ASA III) [AOR: 8.53, 95% CI 1.92-13.8], renal failure [AOR:2.53, 95% CI (1.91-5.81)], malignancy [AOR: 2.59, 95% CI (1.31-5.09)], thoracic surgery [AOR: 4.07, 95% CI (2.11-7.87)], urologic surgery [AOR: 6.22, 95% CI (2.80-13.80)], and neurosurgery [AOR: 4.51, 95% CI (2.53-8.03)] were significantly associated with anemia in surgical patients admitted to the intensive care unit. CONCLUSION More than two-thirds of the intensive care unit-admitted surgical patients experienced anemia. An American Society of Anesthesiologists' (ASA III score), renal failure, malignancy, thoracic surgery, urologic surgery, and neurosurgery were significantly associated with this condition. Early identification helps to institute preventive and therapeutic measures.
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Affiliation(s)
- Habtie Bantider Wubet
- Department of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Lidya Haddis Mengistu
- Department of Anesthesia, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Negesse Zurbachew Gobezie
- Department of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Begizew Yimenu Mekuriaw
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemie Fentie Mebratie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wosenyeleh Admasu Sahile
- Department of Anesthesia, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Kranjčec I, Matijašić Stjepović N, Buljan D, Ružman L, Malić Tudor K, Jović Arambašić M, Pavlović M, Rajačić N, Lovrinović Grozdanić K, Brković T, Šantić K, Roganović J. Management of Childhood Iron Deficiency Anemia in a Developed Country-A Multi-Center Experience from Croatia. Diagnostics (Basel) 2023; 13:3607. [PMID: 38132191 PMCID: PMC10742559 DOI: 10.3390/diagnostics13243607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Iron deficiency anemia (IDA) continues to be a global public health concern, mostly in the developing countries. However, precise epidemiological data on childhood IDA in Croatia are lacking. In order to establish its frequency, underlying etiologies, the rationale for tertiary care visits, diagnostic practices, and current treatment regimens of IDA, medical records of children referred to pediatric hematologists for iron deficiency in a five-year period at tertiary institutions (Zagreb, Rijeka, Split, Osijek) throughout Croatia were retrospectively analyzed. Eight hundred and sixty-four children, predominately of preschool age, were referred mainly by the primary care pediatricians, who, in general, performed basic diagnostics but failed to initiate oral iron therapy in half of the patients. Approximately one-third of patients were symptomatic, with inadequate nutrition prevailing as underlying etiology. Dextriferron was the preferred iron formulation among hematologists, with a median dose of 5 mg/kg, with acceptable compliance rates (63.5-93.2%). Hospital admission rates varied among the centers (9.4-35%), and so did transfusion policies (6.4-22.9%). The greatest difference was observed in the frequency of parenteral iron administration (0.3-21.5%). In conclusion, the burden of childhood IDA, even in a high-income country, remains substantial, necessitating consistent implementation of national guidelines and additional education of primary health care providers.
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Affiliation(s)
- Izabela Kranjčec
- Department of Oncology and Hematology, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (N.M.S.); (D.B.); (M.P.); (N.R.)
| | - Nuša Matijašić Stjepović
- Department of Oncology and Hematology, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (N.M.S.); (D.B.); (M.P.); (N.R.)
| | - Domagoj Buljan
- Department of Oncology and Hematology, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (N.M.S.); (D.B.); (M.P.); (N.R.)
| | - Lucija Ružman
- Department of Pediatrics, Division of Hematology, Oncology and Clinical Genetics, University Hospital Center Rijeka, 51000 Rijeka, Croatia; (L.R.); (K.L.G.); (J.R.)
| | - Karolina Malić Tudor
- Department of Pediatrics, University Hospital of Split, 21000 Split, Croatia; (K.M.T.); (T.B.)
| | | | - Maja Pavlović
- Department of Oncology and Hematology, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (N.M.S.); (D.B.); (M.P.); (N.R.)
| | - Nada Rajačić
- Department of Oncology and Hematology, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (N.M.S.); (D.B.); (M.P.); (N.R.)
| | - Kristina Lovrinović Grozdanić
- Department of Pediatrics, Division of Hematology, Oncology and Clinical Genetics, University Hospital Center Rijeka, 51000 Rijeka, Croatia; (L.R.); (K.L.G.); (J.R.)
| | - Tomislava Brković
- Department of Pediatrics, University Hospital of Split, 21000 Split, Croatia; (K.M.T.); (T.B.)
| | - Krešimir Šantić
- Department of Pediatrics, University Hospital Osijek, 31000 Osijek, Croatia; (M.J.A.); (K.Š.)
| | - Jelena Roganović
- Department of Pediatrics, Division of Hematology, Oncology and Clinical Genetics, University Hospital Center Rijeka, 51000 Rijeka, Croatia; (L.R.); (K.L.G.); (J.R.)
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Silva CSS, Bensenor IM, Goulart AC, Lotufo PA, Santos IS. Anaemia and its causes at the Brazilian Longitudinal Study of Adult Health: a cross-sectional analysis of baseline data. Fam Pract 2023:cmad102. [PMID: 37951231 DOI: 10.1093/fampra/cmad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Most anaemia studies focus on children and women of childbearing age. We assessed the frequency and main aetiologies of anaemia according to sociodemographic characteristics at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of middle-aged adults. METHODS The primary analyses included 15,051 participants aged 35-74 years with a valid blood cell count. We built logistic models to analyse the association between socioeconomic characteristics and anaemia diagnosis. We also described the main aetiologies in a subset (n = 209) of participants with anaemia. RESULTS Anaemia was present in 3.0% (95% confidence interval [95%CI]: 2.6-3.4%) of men and 7.4% (95%CI: 6.9-8.0%) of women. The frequency of anaemia diagnosis was higher in women in all subgroups except for the oldest age stratum (65-74 years). The frequency of anaemia was particularly high in Blacks (6.0% and 15.5% in men and women, respectively). The most common causes of anaemia were iron deficiency (in women), chronic kidney disease, and chronic inflammation (in men). The frequency of unexplained anaemia was respectively 33.3% and 34.2% for men and women, and this condition was more frequent among participants of Black or Mixed races. CONCLUSIONS Anaemia was associated with age, female sex, Black race, and low socioeconomic status. Unexplained anaemia was common and more frequent in individuals of Black and Mixed races. ELSA-Brasil follow-up data may provide further insight into the relevance of unexplained anaemia in this setting.
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Affiliation(s)
- Cássia S S Silva
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
| | - Isabela M Bensenor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Alessandra C Goulart
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Epidemiologia, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Itamar S Santos
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Azinge IE, Ogunyemi A, Ogamba CF, Jimoh RO. Prevalence of anemia and associated factors among adults in a select population in Lagos, Southwest Nigeria. J Public Health Afr 2023; 14:2224. [PMID: 37347070 PMCID: PMC10280247 DOI: 10.4081/jphia.2023.2224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/08/2022] [Indexed: 06/23/2023] Open
Abstract
Background Anemia is a public health problem affecting people in both the developed and developing world and has serious consequences on health. Objective This study determines the prevalence of anemia amongst people of different socioeconomic levels, associated factors, and the prevalence of anemia in populations other than children or pregnant women. Methods This is a descriptive cross-sectional study using a pretested interviewer-administered questionnaire to collect data from 387 residents. A multi-stage random sampling technique was used. Analysis of blood samples using the HemoCue301 system and data analysis using SPSS 20. Chi-square test and binary logistic regression were used to test association and determine predictors of anemia respectively, with P<0.05 considered statistically significant. Results The mean age of respondents was 35±11.8 years, with 28.9% of respondents being anemic. Female respondents (52.7%) were more than male respondents (47.3%). Female respondents (39.2%) had a higher prevalence of anemia than male respondents (17.5%). There was a significant association between sex, level of education, and anemia status. Being female, having no formal education, or only having a primary school level of education were significant predictors of anemia [odds ratio (OR)=2.55; 95% confidence interval (CI)=1.54, 4.23; P=0.00; OR=12.57; 95%CI=2.39, 66.27; P=0.00; and OR=2.54; 95%CI=1.16, 5.58; P=0.02 respectively]. Conclusion There was a higher prevalence of anemia among women, younger people, and those with no or only primary levels of formal education. Awareness programs targeted at women and people with lower levels of education are necessary to reduce the overall prevalence of anemia in this region.
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Affiliation(s)
- Ifeoma Elaine Azinge
- Department of Community Health and Primary Care, College of Medicine, University of Lagos
| | - Adedoyin Ogunyemi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos
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Anemia and Idiopathic Intracranial Hypertension: A Case-Control Study. J Neuroophthalmol 2023; 43:63-68. [PMID: 36166812 DOI: 10.1097/wno.0000000000001664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Idiopathic intracranial hypertension (IIH) is a condition that mostly affects obese women of childbearing age but has been reported to be temporally related to new diagnoses of anemia. Despite these reports, the association between anemia and IIH remains controversial. The present study aimed to understand the strength of association between anemia and IIH through a case-control design. METHODS Consecutive IIH patients were recruited from neuro-ophthalmology clinics and matched by age and sex to consecutive patients attending neuro-ophthalmology clinics with diagnoses other than IIH. Complete blood counts (CBCs) were reviewed within 6 months of neuro-ophthalmology presentation, and anemia was diagnosed by hemoglobin of <120 g/L in women and <130 g/L in men. Anemia was classified as microcytic (mean corpuscular volume (MCV) < 80 fL), normocytic (MCV 80-100 fL), and macrocytic (MCV > 100 fL) as well as mild (hemoglobin >110 g/L), moderate (hemoglobin 80-109 g/L), and severe (hemoglobin <80 g/L). RESULTS One hundred twenty-three IIH patients and 113 controls were included in the study. More IIH patients than controls had anemia (22.8%, 28/123 vs 10.6%, 12/113, P = 0.01) with an odds ratio of 2.48 (95% CI: 1.19, 5.16). There were no differences in severity of anemia or MCV between IIH patients and controls, with anemia most often being mild (57.1%, 16/28 vs 75%, 9/12) and normocytic (50.0%, 14/28 vs 50.0%, 6/12). However, 17.9% (5/28) of IIH patients had severe anemia compared with zero in the control group. IIH patients had a higher mean platelet count than controls ( P < 0.001), and there were no differences on leukocyte counts. CONCLUSION Idiopathic intracranial hypertension patients have a higher prevalence of anemia compared with non-IIH neuro-ophthalmology patients. The anemia was mostly mild and may be explained by other factors related to worse health status and obesity, including low socioeconomic status, poor nutrition, and polycystic ovary syndrome. However, as a CBC is a widely available test and anemia may influence the IIH disease course, we propose that this test be obtained in all patients with new papilledema.
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A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries. Anemia 2023; 2023:6406286. [PMID: 36636253 PMCID: PMC9831712 DOI: 10.1155/2023/6406286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/15/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction Identifying the root causes of iron deficiency anaemia is a prerequisite for effective management and prevention in adolescents. This systematic review assessed risk factors of iron deficiency anaemia among adolescents living in developing countries. Method Electronic databases such as PubMed, Cochrane Library, Science Direct, Google Scholar, and SCOPUS were comprehensively searched for studies published between 1990 and 2020 that involved risk factors of iron deficiency anaemia among adolescents living in developing countries. The quality of the included studies was assessed using the American Dietetic Association Quality Criteria Checklist. Results A total of 2,252 publications were reviewed, and only fifteen cross-sectional studies were eligible for inclusion, eight of which focused on female adolescents and seven on both genders. Direct risk factors contributing to anaemia among adolescents included food intake practices (n = 10 studies), female adolescents (n = 8 studies), menstruation (n = 5 studies), and parasitic infection (n = 6 studies). Indirect risk factors found to be associated with anaemia among adolescents included low educational status (n = 4 studies) and low socioeconomic status (n = 3 studies). All fifteen studies were of good quality. Conclusion Food intake practices, female adolescents, menstruation, parasitic infection, and low educational status were the leading risk factors of iron deficiency anaemia among adolescents. Further research should concentrate on assessing the effectiveness and efficacy of existing interventions aimed at preventing iron deficiency among vulnerable groups in developing countries.
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Srivastava S, Kumar P, Paul R, Debnath P. Effect of change in individual and household level characteristics on anemia prevalence among adolescent boys and girls in India. BMC Public Health 2022; 22:1478. [PMID: 35922790 PMCID: PMC9351076 DOI: 10.1186/s12889-022-13863-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Anemia is a significant public health challenge that affects the population of all nations. Anemia among adolescents emerged as an alarming public health issue as it harms an individual’s physical capacity and cognitive and work performance. The study aims to determine the effect of changes in individual and household level factors on the prevalence of anemia among adolescent boys and girls. Method The study utilized data from two waves of the “Understanding the lives of adolescent and young adults” (UDAYA) survey, conducted in Bihar and Uttar Pradesh during 2015–16 (wave-1) and 2018–19 (wave-2). The sample size for the present study was 4216 and 5974 unmarried adolescent boys and girls aged 10–19 years in both waves. We performed descriptive analysis to observe the characteristics of adolescents during 2015–16. Further, changes in selected independent variables from wave-1 to wave-2 were examined using the proportion test. Moreover, random-effect regression models were employed to examine the association of changes in individual and household level factors with anemia prevalence among adolescents. Results The prevalence of anemia decreased over time among adolescent boys (33 to 30%), whereas it increased among adolescent girls (59 to 63%). The results from the random-effect model show that adolescent boys who used shared toilets were more anemic than those who used a private restroom [β:0.05, 95% CI:(0.01, 0.08)]. Moreover, underweight [β:0.05, CI:(0.01, 0.09)] and thin [β:0.04, CI:(0.00, 0.07)] adolescent boys were more likely to be anemic compared to their normal counterparts. Additionally, boys who belonged to the poorest [β:0.08, CI:(0.02, 0.14)] households had a higher risk of anemia than the richest household. Conclusion The anemia prevalence was higher among adolescents aged 10–19 years in Uttar Pradesh and Bihar. This study has filled an information gap by providing state-level representative estimates indicating underweight status and thinness as the common factors behind the anemia prevalence among adolescent boys than in girls. Iron deficiency anemia is the most prevalent in certain age groups in India. Hence, Anemia prevention efforts and iron-folic acid (IFA) supplementation programs are currently being strengthened in India, targeting the high-risk population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13863-w.
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Affiliation(s)
- Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Pradeep Kumar
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Ronak Paul
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - Paramita Debnath
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Khokhar J, Akbar A, Akhtar S, Layla A, Lazarte C, Abbas MA, Asif M, Shah ZA, Ismail T. Prevalence and determinants of anemia among resident female university students from Southern Punjab, Pakistan. Women Health 2022; 62:488-501. [DOI: 10.1080/03630242.2022.2085845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Javeria Khokhar
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Atif Akbar
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Saeed Akhtar
- Institute of Food Science & Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Anam Layla
- National Institute of Food Science & Technology, University of Agriculture, Faisalabad, Pakistan
| | - Claudia Lazarte
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Muhammad Asif Abbas
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Asif
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Zarnain Ali Shah
- Institute of Food Science & Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Tariq Ismail
- Institute of Food Science & Nutrition, Bahauddin Zakariya University, Multan, Pakistan
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
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Li S, Zhao L, Yu D, Ren H. Attention Should Be Paid to Adolescent Girl Anemia in China: Based on China Nutrition and Health Surveillance (2015-2017). Nutrients 2022; 14:nu14122449. [PMID: 35745178 PMCID: PMC9228540 DOI: 10.3390/nu14122449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Adolescent girls are in the key stages of rapid physical and psychological development and have a great demand for iron. Anemia affects adolescent girls’ health, future development, and even the health of their offspring. There has been limited study of adolescent girl anemia at the national and provincial levels in China. We investigated the anemia status of adolescent girls in China based on data from the China Nutrition and Health Surveillance (CNHS, 2015−2017). The anemia prevalence in Chinese adolescent girls aged 10−17 years is 8.5%, with mild anemia and moderate anemia accounting for 65.9 and 31.8%, respectively, and severe anemia accounting for only 2.3%. Significant urban−rural disparities and regional disparities were found in adolescent girl anemia. The anemia prevalence in adolescent girls varied from 3 to 13.4% in different provinces, and 90% of the provinces had anemia prevalence higher than 5%. Having started menstruating (OR = 2.58, p < 0.01) and living in rural areas (OR = 1.18, p < 0.05) were risk factors for anemia; having a mother with higher education was a protective factor (OR = 0.87, p < 0.05). As for food intake, consuming meat ≥35 g per day was a protective factor (OR = 0.90, p < 0.05). Consuming vegetables ≥3 times per day was also a protective factor (OR = 0.72, p < 0.01), while consuming vegetables ≥400 g per day was a risk factor (OR = 1.24, p < 0.01). Special attention should be paid to adolescent girls, especially to those already having started menstruating, living in rural areas, to those whose mother has a low education level, and to those with a relatively unbalanced diet. Comprehensive measures, including paying special attention to vulnerable areas and vulnerable subgroups of adolescent girls, would reduce the risk of anemia.
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Affiliation(s)
- Shujuan Li
- NHK Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (S.L.); (L.Z.)
| | - Liyun Zhao
- NHK Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (S.L.); (L.Z.)
| | - Dongmei Yu
- NHK Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (S.L.); (L.Z.)
- Correspondence: (D.Y.); (H.R.)
| | - Hongyan Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- Correspondence: (D.Y.); (H.R.)
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Prevalence and predictors of anaemia among adolescents in Bihar and Uttar Pradesh, India. Sci Rep 2022; 12:8197. [PMID: 35581388 PMCID: PMC9114399 DOI: 10.1038/s41598-022-12258-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 04/22/2022] [Indexed: 11/08/2022] Open
Abstract
In adolescents, anaemia has been linked to affecting physical disorders, growth, and mental retardation and also increases reproductive morbidities among adolescent girls during their womanhood. It is believed that with increasing age, females are more prone to anaemia than their male counterparts. Unfortunately, the anaemia intervention program, such as the National Nutrition Anaemia Prophylaxis Programme, primarily targets infants, young children, pregnant and lactation women, and not adolescents. Therefore, this study tries to fill this gap and study the prevalence of anaemia and the associated factors among adolescent boys and girls residing in Uttar Pradesh and Bihar, India. Secondary data analysis was performed on cross-sectional survey data from the Understanding the Lives of Adolescents and Young Adults survey. The sample size was 20,594 adolescents aged 10-19 years in Uttar Pradesh and Bihar, India. The outcome variable was anaemia, and the explanatory variables were age, education, working status, media exposure, marital status, received IFA and deworming tablets, BMI status, stunting status, wealth index, caste, religion, residence, and States. Descriptive statistics and bivariate analysis were used to find the preliminary results. Multinomial regression analysis was carried out to provide the adjusted estimates. Overall, anaemia was more prevalent among adolescent girls than adolescent boys (20% vs. 8.7%). Moderate/severe anaemia was 0.24 and 0.49 times less likely among adolescent boys and girls, respectively, who had 10 and above years of schooling than adolescents with no schooling (p < 0.01). Rural adolescent boys were 1.49 times (p < 0.05) more likely to suffer from moderate/severe anaemia than urban counterparts. The odds for moderate/severe anaemia among adolescent boys were relatively higher among late adolescents, with no mass-media exposure, stunted, and rural adolescents. Similarly, odds for moderate/severe anaemia among adolescent girls were higher among late adolescents and adolescents without schooling and mass-media exposure. Prevalence of anaemia was higher among adolescent girls than in boys. Lower education status, rural residence, late adolescence, no exposure to mass media, and stunting were the predictors of moderate/severe anaemia among adolescents. Anaemia among adolescents must be addressed through effective public health policy targeting adolescents residing in rural areas. There is a need to disseminate information about anaemia-related programs, such as National Iron Plus Initiative (NIPI), through mass media, and subsequently, the public health system may be prepared to tailor the needs of adolescent boys and girls.
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Endris BS, Dinant GJ, Gebreyesus SH, Spigt M. Risk factors of anemia among preschool children in Ethiopia: a Bayesian geo-statistical model. BMC Nutr 2022; 8:2. [PMID: 34996515 PMCID: PMC8740428 DOI: 10.1186/s40795-021-00495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The etiology and risk factors of anemia are multifactorial and varies across context. Due to the geospatial clustering of anemia, identifying risk factors for anemia should account for the geographic variability. Failure to adjust for spatial dependence whilst identifying risk factors of anemia could give spurious association. We aimed to identify risk factors of anemia using a Bayesian geo-statistical model. METHODS We analyzed the Ethiopian Demographic and Health Survey (EDHS) 2016 data. The sample was selected using a stratified, two- stage cluster sampling design. In this survey, 9268 children had undergone anemia testing. Hemoglobin level was measured using a HemoCue photometer and the results were recorded onsite. Based on the World Health Organization's cut-off points, a child was considered anaemic if their altitude adjusted haemoglobin (Hb) level was less than 11 g/dL. Risk factors for anemia were identified using a Bayesian geo-statistical model, which accounted for spatial dependency structure in the data. Posterior means and 95% credible interval (BCI) were used to report our findings. We used a statistically significant level at 0.05. RESULT The 9267 children in our study were between 6 and 59 months old. Fifty two percent (52%) of children were males. Thirteen percent (13%) of children were from the highest wealth quintile whereas 23% from the lowest wealth quintile. Most of them lived in rural areas (90%). The overall prevalence of anemia among preschool children was 57% (95% CI: 54.4-59.4). We found that child stunting (OR = 1.26, 95% BCI (1.14-1.39), wasting (OR = 1.35, 95% BCI (1.15-1.57), maternal anemia (OR = 1.61, 95% BCI (1.44-1.79), mothers having two under five children (OR = 1.2, 95% BCI (1.08-1.33) were risk factors associated with anemia among preschool children. Children from wealthy households had lower risk of anemia (AOR = 0.73, 95% BCI (0.62-0.85). CONCLUSION Using the Bayesian geospatial statistical modeling, we were able to account for spatial dependent structure in the data, which minimize spurious association. Childhood Malnutrition, maternal anemia, increased fertility, and poor wealth status were risk factors of anemia among preschool children in Ethiopia. The existing anaemia control programs such as IFA supplementation during pregnancy should be strengthened to halt intergenerational effect of anaemia. Furthermore, routine childhood anaemia screening and intervention program should be part of the Primary health care in Ethiopia.
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Affiliation(s)
- Bilal Shikur Endris
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Geert-Jan Dinant
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Seifu H Gebreyesus
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mark Spigt
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø, Tromsø, Norway
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Suboptimal iron deficiency screening in pregnancy and the impact of socioeconomic status in a high-resource setting. Blood Adv 2021; 5:4666-4673. [PMID: 34459878 PMCID: PMC8759118 DOI: 10.1182/bloodadvances.2021004352] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022] Open
Abstract
Iron deficiency (ID) anemia in pregnancy is associated with poor maternal and childhood outcomes, yet ferritin testing, the standard test for ID, is not considered part of routine prenatal bloodwork in Canada. We conducted a retrospective cohort study of 44 552 pregnant patients with prenatal testing at community laboratories in Ontario, Canada, to determine the prevalence of ferritin testing over 5 years. Secondary objectives were to determine the prevalence and severity of ID and to identify clinical and demographic variables that influence the likelihood of ID screening. A total of 59.4% of patients had a ferritin checked during pregnancy; 71.4% were ordered in the first trimester, when the risk of ID is lowest. Excluding patients with abnormally elevated ferritins, 25.2% were iron insufficient (30-44 µg/L) and 52.8% were iron deficient (≤29 µg/L) at least once in pregnancy. A total of 8.3% were anemic (hemoglobin <105 g/L). The proportion of anemic patients with a subsequent ferritin test in pregnancy ranged from 22% to 67% in the lowest and highest anemia severity categories, respectively. Lower annual household income was negatively associated with the odds of a ferritin test; compared with those in the fifth (ie, highest) income quintile, the odds of ferritin testing for patients in the first, second, and fourth quintiles were 0.83 (95% confidence interval [CI], 0.74-0.91), 0.82 (95% CI, 0.74-0.91), and 0.86 (95% CI, 0.77-0.97), respectively. These data highlight gaps in prenatal care and issues of health equity that warrant harmonization of obstetrical guidelines to recommend routine ferritin testing in pregnancy.
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Endris BS, Dinant GJ, Gebreyesus SH, Spigt M. Geospatial inequality of anaemia among children in Ethiopia. GEOSPATIAL HEALTH 2021; 16. [PMID: 34726035 DOI: 10.4081/gh.2021.1036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Anaemia remains a severe public health problem among children in Ethiopia and targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. An analysis was performed using Ethiopia Demographic and Health Survey 2016 data. Blood specimens for anaemia testing were collected from 9268 children aged 6-59 months. A child was considered as anaemic if the bloodhaemoglobin count was less than 11.0 g/dL. We applied Kulldorf's spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran the local indicator of spatial association and the Getis-Ord Gi* statistics to detect and locate hotspots and multilevel multivariable analysis to identify risk factors for anaemia clustering. More than half of children aged 6-59 months (57%) were found to be anaemic in Ethiopia. We found significant geospatial inequality of anaemia among children and identified clusters (hotspots) in the eastern part of Ethiopia. The odds of anaemia among children found within the identified cluster was 1.5 times higher than children found outside the cluster. Women anaemia, stunting and high fertility were associated with anaemia clustering.
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Affiliation(s)
- Bilal Shikur Endris
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa.
| | - Geert-Jan Dinant
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht.
| | - Seifu H Gebreyesus
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa.
| | - Mark Spigt
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø.
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16
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Rahfiludin MZ, Arso SP, Joko T, Asna AF, Murwani R, Hidayanti L. Plant-based Diet and Iron Deficiency Anemia in Sundanese Adolescent Girls at Islamic Boarding Schools in Indonesia. J Nutr Metab 2021; 2021:6469883. [PMID: 34552766 PMCID: PMC8452436 DOI: 10.1155/2021/6469883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/13/2021] [Accepted: 09/02/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adolescent girls are at risk for iron deficiency anemia (IDA) due to the higher demand of iron for growth and the loss of blood during menstruation. Consumption of foods containing iron that have higher bioavailability can reduce the risk of IDA although diets that are largely plant-based, like those consumed by many Sundanese people, may not contain sufficient bioavailable iron. Here, we investigated the correlation between plant-based diets and IDA in adolescent Sundanese girls who were students at Islamic boarding schools in Indonesia. METHODS A total of 176 girls from seven Islamic boarding schools in Tasikmalaya were recruited. Nutritional intake data were obtained using 24-hr dietary recall. Blood samples were analyzed with a Sysmex-XNL instrument to measure several parameters including hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). RESULTS The prevalence of IDA in the study population was 22.2%. Iron intake was 6.59 mg/day, which was lower than the recommended amount. The molar ratio of phytic acid to iron and vitamin C to iron was 8.72 and 0.03, respectively. There was a correlation between heme iron and both hemoglobin (p=0.009) and hematocrit (p=0.018). Iron from meat, fish, and poultry was correlated with hemoglobin (p=0.009) and hematocrit (p=0.011). CONCLUSION The Sundanese plant-based diet did not affect the IDA status. Instead, IDA was associated with consumption of less animal-based foods that have iron with higher bioavailability. Increased access to an animal-based menu at the school cafeteria could be an approach to prevent IDA in students at Islamic boarding schools in Indonesia.
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Affiliation(s)
- Mohammad Zen Rahfiludin
- Department of Public Health Nutrition, Faculty of Public Health, Diponegoro University, Semarang 50275, Indonesia
| | - Septo Pawelas Arso
- Department of Health Policy Administration, Faculty of Public Health, Diponegoro University, Semarang 50275, Indonesia
| | - Tri Joko
- Department of Environmental Health, Faculty of Public Health, Diponegoro University, Semarang 50275, Indonesia
| | - Alfa Fairuz Asna
- Department of Public Health Nutrition, Faculty of Public Health, Diponegoro University, Semarang 50275, Indonesia
| | - Retno Murwani
- Department of Nutrition and Feed Science, Faculty of Animal and Agriculture, Diponegoro University, Semarang 50275, Indonesia
| | - Lilik Hidayanti
- Department of Nutrition, Faculty of Health Science, Siliwangi University, Tasikmalaya 46115, Indonesia
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Anemia Is a Risk Factor for the Development of Ischemic Stroke and Post-Stroke Mortality. J Clin Med 2021; 10:jcm10122556. [PMID: 34207841 PMCID: PMC8226740 DOI: 10.3390/jcm10122556] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND anemia is known to be a risk factor for developing ischemic stroke in long-term follow-up studies, and it is also known to increase the risk of death in ischemic stroke patients. We aimed to determine the association of anemia with the risk of ischemic stroke and the risk of death after ischemic stroke. METHODS The study included patients from National Health Insurance Service cohort, from January 2005 to December 2015. Anemia patients were defined as those with confirmed diagnostic codes and related medications in the sample cohort, and patients under the age of 18 were excluded. To perform a comparative analysis with the control group, twice as many patients were extracted by propensity score matching. The effects of anemia on the development of ischemic stroke were analyzed. RESULTS A total of 58,699 patients were newly diagnosed with anemia during the study period. In anemia group, the rate of ischemic stroke occurring within 1 year was 0.550%, and the rate was 0.272% in the control group. The odds ratio of anemia related to ischemic stroke was 1.602 (95% confidence intervals (CI) 1.363-1.883). During the follow-up period, 175 out of 309 (56.6%) died in anemia group, and 130 out of 314 (41.4%) died in control group. The anemia group showed a higher risk of death than the control group (Hazard ratio 1.509, 95% CI 1.197-1.902). CONCLUSION Analysis of the nationwide health insurance data revealed that anemia is one of the risk factors for the development of ischemic stroke, and also an independent prognostic factor affecting post-stroke mortality.
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Ernawati F, Syauqy A, Arifin AY, Soekatri MYE, Sandjaja S. Micronutrient Deficiencies and Stunting Were Associated with Socioeconomic Status in Indonesian Children Aged 6-59 Months. Nutrients 2021; 13:nu13061802. [PMID: 34073270 PMCID: PMC8228349 DOI: 10.3390/nu13061802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 01/21/2023] Open
Abstract
Micronutrient deficiencies and stunting are known as a significant problem in most developing countries, including Indonesia. The objective of this study was to analyze the association between micronutrient deficiencies and stunting with socioeconomic status (SES) among Indonesian children aged 6–59 months. This cross-sectional study was part of the South East Asian Nutrition Surveys (SEANUTS). A total of 1008 Indonesian children were included in the study. Anemia, iron deficiency, vitamin A deficiency, vitamin D deficiency, and stunting were identified in this study. Structured questionnaires were used to measure SES. Differences between micronutrient parameters and anthropometric indicators with the SES groups were tested using one-way ANOVA with post-hoc test after adjusted for age, area resident (rural and urban), and sex. The highest prevalence of anemia, stunting, and severe stunting were found to be most significant in the lowest SES group at 45.6%, 29.3%, and 54.5%, respectively. Children from the lowest SES group had significantly lower means of Hb, ferritin, retinol, and HAZ. Severely stunted children had a significantly lower mean of Hb concentration compared to stunted and normal height children. Micronutrient deficiencies, except vitamin D, and stunting, were associated with low SES among Indonesian children aged 6–59 months.
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Affiliation(s)
- Fitrah Ernawati
- Center of Research and Development for Biomedical and Basic Technology of Health, National Institute of Health Research and Development, Jakarta 10560, Indonesia; (F.E.); (A.Y.A.)
| | - Ahmad Syauqy
- Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Jawa Tengah 50275, Indonesia
- Center of Nutrition Research (CENURE), Diponegoro University, Jawa Tengah 50275, Indonesia
- Correspondence: ; Tel./Fax: +62-24-76402881
| | - Aya Yuriestia Arifin
- Center of Research and Development for Biomedical and Basic Technology of Health, National Institute of Health Research and Development, Jakarta 10560, Indonesia; (F.E.); (A.Y.A.)
| | - Moesijanti Y. E. Soekatri
- Nutrition Department, Health Polytechnic Ministry of Health of Jakarta II, Jakarta 12120, Indonesia;
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Skolmowska D, Głąbska D. Analysis of Environmental Determinants of Heme and Nonheme Iron Intake in a National Sample of Polish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5252. [PMID: 34069219 PMCID: PMC8156536 DOI: 10.3390/ijerph18105252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Abstract
Intake of sufficient amounts of iron by adolescents is a matter of great concern. Therefore, it is crucial to determine the factors that may influence iron intake in this specific population. The present study aimed to analyze the environmental determinants of the intake of heme and nonheme iron in a national homogenous sample of Polish adolescents. Adolescents (aged 15-20 years) were randomly chosen from all the regions of Poland by performing a sampling of secondary schools (random quota sampling). The total iron intake, as well as the intake of heme iron, nonheme iron, animal iron, plant iron, and iron from various food products, was assessed among 1385 female respondents and 1025 male respondents using the validated IRON Intake Calculation-Food Frequency Questionnaire (IRONIC-FFQ). The intake was compared between the subgroups stratified by meat intake in the region, gross domestic product (GDP) in the region, and size of the city (rural vs. urban environment). It was observed that meat intake in the region did not influence the intake of total iron, as well as the intake of heme iron, nonheme iron, animal iron, plant iron, and iron from various food products (p > 0.05). However, GDP and the size of the city were determined as the most influencing factors, as they were associated with iron intake in both female and male adolescents, with the most prominent differences between the subgroups found in the case of females. Female adolescents from high-GDP regions had significantly higher intake of heme iron (p = 0.0047) and animal iron (p = 0.0029), and lower intake of nonheme iron compared to those from low-GDP regions (p = 0.0342). The total iron intake was higher among female adolescents who were from medium cities than those from big cities (p = 0.0350), but significantly higher animal iron intake (p = 0.0404) and plant iron intake (p = 0.0385) were observed among females from villages and small towns compared to females from other groups. Based on the results, it may be concluded that size of the city and the economic status of the region are the most important environmental determinants of iron intake in adolescents and, hence, they should be taken into account while developing educational programs, especially for the female adolescent population.
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Affiliation(s)
| | - Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland;
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Chen J, Luo S, Liang X, Luo Y, Li R. The relationship between socioeconomic status and childhood overweight/obesity is linked through paternal obesity and dietary intake: a cross-sectional study in Chongqing, China. Environ Health Prev Med 2021. [DOI: https://doi.org/10.1186/s12199-021-00973-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
The prevalence of obesity and overweight in childhood has increased dramatically over the past decades globally. Thus, the risk factors of overweight and obesity in children and adolescents must be studied.
Objectives
This study aimed to reveal the prevalence of childhood obesity and examine the relationship between socioeconomic status (SES) and z-body mass index (z-BMI) via parental obesity and dietary intake using path analysis.
Methods
Stratified cluster sampling was used to select 17,007 participants aged 6–12 years on two avenues per region in urban, suburban, and rural areas. Path analysis was conducted to examine the mediators between SES and z-BMI.
Results
The prevalence rates of overweight and obesity were 13.36% and 8.60%, respectively, and were positively correlated with the father’s education level, family income, a birth weight > 3000g, a parental obesity history, vegetable intake and red meat intake (all P < 0.05). Four mediators (paternal obesity history, red meat intake, vegetable intake, and nutritional supplements) were observed, and the four path analyses were significant (all P < 0.05). The adjusted total effects on z-BMI were significant for income (βTot = 0.03; P < 0.01), father’s education (βTot = 0.05; P < 0.001), and region (βTot = 0.11; P<0.001), and the total mediation effects were 20.69%, 16.67%, and 5.36%, respectively. All the variables accounted for 12.60% of the z-BMI variance.
Conclusions
The prevalence of overweight/obesity in children was notable, and the relationship between SES and z-BMI was mediated by paternal obesity history and dietary intake.
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Chen J, Luo S, Liang X, Luo Y, Li R. The relationship between socioeconomic status and childhood overweight/obesity is linked through paternal obesity and dietary intake: a cross-sectional study in Chongqing, China. Environ Health Prev Med 2021; 26:56. [PMID: 33947324 PMCID: PMC8097861 DOI: 10.1186/s12199-021-00973-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prevalence of obesity and overweight in childhood has increased dramatically over the past decades globally. Thus, the risk factors of overweight and obesity in children and adolescents must be studied. OBJECTIVES This study aimed to reveal the prevalence of childhood obesity and examine the relationship between socioeconomic status (SES) and z-body mass index (z-BMI) via parental obesity and dietary intake using path analysis. METHODS Stratified cluster sampling was used to select 17,007 participants aged 6-12 years on two avenues per region in urban, suburban, and rural areas. Path analysis was conducted to examine the mediators between SES and z-BMI. RESULTS The prevalence rates of overweight and obesity were 13.36% and 8.60%, respectively, and were positively correlated with the father's education level, family income, a birth weight > 3000g, a parental obesity history, vegetable intake and red meat intake (all P < 0.05). Four mediators (paternal obesity history, red meat intake, vegetable intake, and nutritional supplements) were observed, and the four path analyses were significant (all P < 0.05). The adjusted total effects on z-BMI were significant for income (βTot = 0.03; P < 0.01), father's education (βTot = 0.05; P < 0.001), and region (βTot = 0.11; P<0.001), and the total mediation effects were 20.69%, 16.67%, and 5.36%, respectively. All the variables accounted for 12.60% of the z-BMI variance. CONCLUSIONS The prevalence of overweight/obesity in children was notable, and the relationship between SES and z-BMI was mediated by paternal obesity history and dietary intake.
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Affiliation(s)
- Jingyu Chen
- Department of Ultrasound, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shunqing Luo
- Department of Pediatric General Medicine, Children's Hospital of Chongqing Medical University, Jinyu Avenue No.20, Yubei, Chongqing, 400010, China
| | - Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, 400016, China.
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, 400016, China
| | - Rina Li
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, 400016, China
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Srivastava S, Kumar S. Does socio-economic inequality exist in micro-nutrients supplementation among children aged 6-59 months in India? Evidence from National Family Health Survey 2005-06 and 2015-16. BMC Public Health 2021; 21:545. [PMID: 33740942 PMCID: PMC7980608 DOI: 10.1186/s12889-021-10601-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Globally, about 25% of children suffer from subclinical vitamin A deficiency (VAD), and approximately 300 million children globally had anemia as per 2011 estimates. Micronutrient deficiencies are generally referred to as “hidden hunger” because these deficiencies developed gradually. The present study determines the socio-economic inequalities in vitamin A supplementation (VAS) and Iron supplementation (IS) among children aged 6–59 months in India and to estimate the change in the percent contribution of different socio-economic correlates for such inequality from 2005 to 06 to 2015–16. Methods Data from National Family Health Survey (NFHS) 2005–06 and 2015–16 was used for the analysis. Bivariate analysis and logistic regression analysis was used to carve out the results. Moreover, Wagstaff decomposition analysis was used to find the factors which contributed to explain socio-economic status-related inequality among children in India. Results It was revealed that the percentage of children who do not receive vitamin A supplementation was reduced from 85.5% to 42.1%, whereas in the case of IS, the percentage reduced from 95.3% to 73.9% from 2005-06 to 2015–16 respectively. The child’s age, mother’s educational status, birth order, breastfeeding status, place of residence and empowered action group (EAG) status of states were the factors that were significantly associated with vitamin A supplementation and iron supplementation among children in India. Moreover, it was found the children who do not receive vitamin A supplementation and iron supplementation got more concentrated among lower socio-economic strata. A major contribution for explaining the gap for socio-economic status (SES) related inequality was explained by mother’s educational status, household wealth status, and empowered action group status of states for both vitamin A supplementation and iron supplementation among children aged 6–59 months in India. Conclusion Schemes like the Integrated Child Development Scheme (ICDS) would play a significant role in reducing the socio-economic status-related gap for micro-nutrient supplementation among children in India. Proper implementation of ICDS will be enough for reducing the gap between rich and poor children regarding micro-nutrient supplementation.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - Shubham Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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Zhu Z, Sudfeld CR, Cheng Y, Qi Q, Li S, Elhoumed M, Yang W, Chang S, Dibley MJ, Zeng L, Fawzi WW. Anemia and associated factors among adolescent girls and boys at 10-14 years in rural western China. BMC Public Health 2021; 21:218. [PMID: 33499861 PMCID: PMC7836596 DOI: 10.1186/s12889-021-10268-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 01/19/2021] [Indexed: 11/11/2022] Open
Abstract
Background Evidence on anemia and associated factors among young adolescent girls and boys in rural western China is limited. Methods We used data from a follow-up study of adolescents (10–14 years) born to women who participated in a randomized trial of antenatal micronutrient supplementation in western China. Anemia was defined by World Health Organization standards. Logistic regression was used to examine the factors associated with anemia. Results The overall prevalence of anemia was 11.7% (178/1517). Female adolescents were 1.73 (95% CI 1.21, 2.48) times more likely to have anemia as compared to males. Adolescents whose mothers had completed high school were 0.35 (95% CI 0.13, 0.93) times less likely to be anemic, compared to those of whom had < 3 years of formal education. Household wealth was also inversely associated with anemia. The association of puberty status with anemia was modified by adolescent sex (P-value for interaction was 0.04); males with greater than mild pubertal development had reduced odds (OR 0.35, 95% CI 0.15, 0.83) of anemia while there was no association among females (OR 0.72, 95% CI 0.29, 1.78). Consumption of flesh foods (OR 0.58, 95% CI 0.38, 0.89), eggs (OR 0.60, 95% CI 0.38, 0.93), and having a meal frequency of three times or more per day (OR 0.68, 95% CI 0.48, 0.96) were also associated with a lower likelihood of anemia. Conclusions Anemia was a mild public health problem among young adolescents in rural western China. Nutritional and social determinants were identified as predictors, warranting interventions to reduce the risk of anemia among this critical age group. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10268-z.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Shaoru Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.,National Institute of Public Health Research (INRSP), BP. 695, Nouakchott, Mauritania
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Suying Chang
- United Nations Children's Fund, China Office, Beijing, 100600, People's Republic of China
| | - Michael J Dibley
- The Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Prevalence of anemia and iron profile among children and adolescent with low socio-economic status. Int J Pediatr Adolesc Med 2019; 7:88-92. [PMID: 32642542 PMCID: PMC7335819 DOI: 10.1016/j.ijpam.2019.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 10/17/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
Abstract
Background A national health survey in Indonesia conducted in 2013 showed that the prevalence of anemia in school-aged children and adolescents tripled from a survey conducted in 2007. Children and adolescents are particularly susceptible to iron deficiency anemia (IDA) and iron deficiency (ID) because of their rapid growth and puberty. Teenage girls are at risk because of their menstrual bleeding. Low socioeconomic status in children and adolescents is also a strong risk factor for experiencing iron deficiency. Studies regarding the prevalence of ID and IDA in Indonesia still vary and are lacking. This study aims to describe the prevalence of anemia in children and adolescents with low socioeconomic conditions. Methods This is a cross-sectional study conducted at two schools in the suburbs of Jakarta on children and adolescents aged 6–18 years old. Personal data and laboratory identities (complete peripheral blood count, reticulocyte hemoglobin content, ferritin, transferrin saturation, and C-reactive protein) were collected to determine iron status. Analysis was performed using SPSS program version 22.0. Results The overall prevalence of anemia was 14.0%. The prevalence of IDA, ID without anemia, and iron depletion was 5.8%, 18.4%, and 4.3%, respectively. The prevalence of IDA, ID, and iron depletion was higher in females than in males. Conclusion The overall prevalence of anemia in children and adolescents is lower than the national data. Special consideration needs to be taken for the female population, who are more at risk of developing ID and IDA.
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Kumar J. Effectiveness of iron-fortified infant cereals on prevalence of anemia among children. J Family Med Prim Care 2018; 7:836-837. [PMID: 30234064 PMCID: PMC6132012 DOI: 10.4103/jfmpc.jfmpc_123_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jogender Kumar
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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26
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Kang E, Lee J, Kim HJ, Han M, Kim SW, Lee KB, Sung S, Yoo TH, Chung W, Ahn C, Oh KH. The association between socioeconomic disparities and left ventricular hypertrophy in chronic kidney disease: results from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD). BMC Nephrol 2018; 19:203. [PMID: 30115015 PMCID: PMC6097450 DOI: 10.1186/s12882-018-1005-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 08/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Left ventricular hypertrophy (LVH) is one of the risk factors for cardiovascular (CV) disease and mortality. However, the relationship between socioeconomic status (SES) and LVH in chronic kidney disease remains unclear. Methods Data were collected from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD, NCT01630486 at http://www.clinicaltrials.gov). Subjects with CKD and aged ≥50 were included. SES was characterized based on monthly income and educational attainment, each of which was divided into three strata. LVH was defined as LV mass/height2.7 ≥ 47 g/m2.7 in female and ≥ 50 g/m2.7 in male. Age, sex, diabetes, CKD stage, body mass index, blood pressure and physical activity were included as covariates. Results A total of 1361 patients were included. Mean age was 60.9 ± 6.9 years, and 63.2% were men. Higher education level was associated with higher monthly income (P for trend < 0.001). The lowest education level was independently associated with LVH (lower than high school, adjusted odds ratio [OR] 1.485, 95% CI 1.069–2.063, P = 0.018; completed high school, adjusted OR 1.150, 95% confidence interval [CI] 0.834–1.584, P = 0.394; highest education level as the reference). Monthly income level was marginally associated with LVH after adjusting for covariates ($1500-4500, adjusted OR 1.230, 95% CI 0.866–1.748, P = 0.247; < $1500, adjusted OR 1.471, 95% CI 1.002–2.158, P = 0.049; > $4500; reference). Conclusions In the CKD population, lower SES, defined by educational attainment and low income level exhibited a significant association with LVH, respectively. Longitudinal follow-up will reveal whether lower SES is associated with poor CKD outcomes.
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Affiliation(s)
- Eunjeong Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joongyub Lee
- School of Medicine, Inha University, Incheon, Korea.,Department of Prevention and Management, Inha University Hospital, Incheon, Korea
| | - Hyo Jin Kim
- Department of Internal Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Miyeun Han
- Department of Internal Medicine, Pusan National University Hospital, Pusan, Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Kyu-Beck Lee
- Division of Nephrology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suah Sung
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Madjdian DS, Azupogo F, Osendarp SJ, Bras H, Brouwer ID. Socio-cultural and economic determinants and consequences of adolescent undernutrition and micronutrient deficiencies in LLMICs: a systematic narrative review. Ann N Y Acad Sci 2018. [DOI: 10.1111/nyas.13670] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Dónya S. Madjdian
- Department of Social Sciences, Sociology of Consumption and Households; Wageningen University and Research; Wageningen the Netherlands
| | - Fusta Azupogo
- Department of Human Nutrition, Nutrition and Health over the Life Course; Wageningen University and Research; Wageningen the Netherlands
- Department of Family and Consumer Sciences, Faculty of Agriculture; University for Development Studies; Tamale Ghana
| | - Saskia J.M. Osendarp
- Department of Human Nutrition, Nutrition and Health over the Life Course; Wageningen University and Research; Wageningen the Netherlands
| | - Hilde Bras
- Department of Social Sciences, Sociology of Consumption and Households; Wageningen University and Research; Wageningen the Netherlands
| | - Inge D. Brouwer
- Department of Human Nutrition, Nutrition and Health over the Life Course; Wageningen University and Research; Wageningen the Netherlands
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Is there a mismatch between who gets iron supplementation and who needs it? A cross-sectional study of iron supplements, iron deficiency anaemia and socio-economic status in Australia. Br J Nutr 2016; 115:703-8. [PMID: 26824733 DOI: 10.1017/s0007114515004912] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fe deficiency anaemia (IDA) is more prevalent in lower socio-economic groups; however, little is known about who actually receives Fe supplements. This paper aims to determine whether the groups most likely to have IDA are the most likely to be taking Fe supplements. Logistic regression analysis was conducted using the cross-sectional, nationally representative National Nutrition and Physical Activity Survey and National Health Measures Survey. After adjusting for other factors, those whose main language spoken at home was not English had twice the odds of having IDA compared with those whose main language spoken at home was English (95% CI 1·00, 4·32). Those who were not in the labour force also had twice the odds of having IDA as those who were employed (95% CI 1·16, 3·41). Those in income quintile 1 had 3·7 times the odds of having IDA compared with those in income quintile 5 (95% CI 1·42, 9·63). Those whose main language spoken at home was not English were significantly less likely to take Fe supplements (P=0·002) than those whose main language spoken at home was English. There was no significant difference in the likelihood of taking Fe supplements between those who were not in the labour force and those who were employed (P=0·618); between those who were in income quintile 1 and in higher income quintiles; and between males and females (P=0·854), after adjusting for other factors. There is a mismatch between those who are most in need of Fe supplements and those who currently receive them.
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Ko B, Lim J, Kim YZ, Park HS. Trends in type 2 diabetes prevalence according to income levels in Korea (1998-2012). Diabetes Res Clin Pract 2016; 115:137-9. [PMID: 26830075 DOI: 10.1016/j.diabres.2016.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/05/2015] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
Abstract
There was no significant association between diabetes prevalence and income levels for either sex in 1998. However, the high income level in men and the low income level in women positively related to the odds of diabetes in 2011-2012. Preventive strategies for diabetes should consider the gender-specific economic discrepancy.
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Affiliation(s)
- B Ko
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 100-742, South Korea
| | - J Lim
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Y Z Kim
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - H S Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea.
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Bhandari S, Sayami JT, Thapa P, Sayami M, Kandel BP, Banjara MR. Dietary intake patterns and nutritional status of women of reproductive age in Nepal: findings from a health survey. ACTA ACUST UNITED AC 2016; 74:2. [PMID: 26823976 PMCID: PMC4730652 DOI: 10.1186/s13690-016-0114-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/08/2016] [Indexed: 11/10/2022]
Abstract
Background Improper dietary intake pattern in women of reproductive age in Nepal has resulted in the deficiency of essential nutrients. Adequate nutritional status and proper dietary intake pattern of women improves maternal and child health. The objective of this study was to assess the nutritional status and dietary intake pattern among the women and associated factors. Methods Data collection at households and health check-up camps were conducted in selected Village Development Committees of nine districts in three ecological regions (Mountain, Hill and Terai) of Nepal from September 2011 to August 2012. Women of reproductive age (15 to 49 years) were the study subjects. At the household interview, structured questionnaires were used to obtain information on socio-demographic characteristics, anthropometric measurements, dietary intake pattern, consumption of junk foods, animal rearing, agricultural products, possession of kitchen garden, pregnancy status and anemia. Dietary intake pattern was determined by information collected through the structured questionnaires comprising of food items-cereals, pulses/legumes, vegetables, meat, fruits and milk and milk products. Health check-up camps were conducted in the local health facilities where qualified doctors, nurses and laboratory technicians performed physical examination of the women, confirmed their pregnancy and conducted hematocrit tests. The data was entered and analyzed using SPSS. Results Altogether 21,111 women were interviewed. More than a quarter of the women in Terai were malnourished as indicated by low body mass index (BMI < 18.5 Kg/m2). Among the dietary intake pattern, the majority of women consumed cereals at least once a day in all three ecological regions. The majority of women in Mountain consumed pulses/legumes thrice a week. In Terai, the majority of women consumed vegetables thrice a week. In all three ecological regions, the majority of women consumed meat and meat products and fruits once a week. About thirty percent of women consumed milk and milk products once a day in all three ecological regions. The non-use of iodized salt by Terai women was the highest (5.3 %, n = 303). In all the ecological regions, cereals and vegetables were produced in the majority of the participants’ households in comparison of fruits, poultry and goat/sheep. The women of age 15 to 24 years were 2.7 times more likely to be malnourished than women of 35 to 49 years age (aOR = 2.7, CI = 2.5,3.0). The unemployed women had nearly two times more chances of being malnourished than women doing manual work (aOR = 1.9, 95 % CI = 1.5,2.2). In Terai, women were five times more likely to be malnourished (aOR = 0.2, CI = 0.1,0.2) and 20 times more likely to be anemic (aOR = 0.05, CI = 0.04,0.07) than women in Mountain. The pregnant women were five times more likely to be anemic than non-pregnant women (aOR = 0.2, CI = 0.2,0.3). Conclusions The nutritional status of women of reproductive age is still poor especially in Terai and the dietary intake pattern is not adequate. It suggests improving nutritional status and feeding habits especially intake of meat, fruits and vegetables focusing on reproductive aged women.
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Affiliation(s)
- Shiva Bhandari
- Multivitamin-mineral Supplementation Project, Health Resources Consultancy Pvt. Ltd., Kuleshwor Kathmandu, Nepal ; Public Health and Infectious Disease Research Center (PHIDReC), New Baneshwor Kathmandu, Nepal ; Central Department of Microbiology, Tribhuvan University, Kirtipur Kathmandu, Nepal
| | - Jamuna Tamrakar Sayami
- Multivitamin-mineral Supplementation Project, Health Resources Consultancy Pvt. Ltd., Kuleshwor Kathmandu, Nepal ; National Center for Health Professions Education, Institute of Medicine, Tribhuvan University, Maharajgunj Kathmandu, Nepal
| | - Pukar Thapa
- Department of Internal Medicine, Lumbini Medical College, Kathmandu University, Tansen, Palpa Nepal
| | - Matina Sayami
- Department of Internal Medicine, Maharajgunj Medical College, Institute of Medicine, Tribhuvan University, Maharajgunj Kathmandu, Nepal
| | - Bishnu Prasad Kandel
- Department of Surgery, Institute of Medicine, Tribhuvan University, Maharajgunj Kathmandu, Nepal
| | - Megha Raj Banjara
- Multivitamin-mineral Supplementation Project, Health Resources Consultancy Pvt. Ltd., Kuleshwor Kathmandu, Nepal ; Central Department of Microbiology, Tribhuvan University, Kirtipur Kathmandu, Nepal
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Lee JA, Hwang JS, Hwang IT, Kim DH, Seo JH, Lim JS. Low vitamin D levels are associated with both iron deficiency and anemia in children and adolescents. Pediatr Hematol Oncol 2015; 32:99-108. [PMID: 25551430 DOI: 10.3109/08880018.2014.983623] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND We aimed to examine the association between vitamin D deficiency and anemia in a nationally representative sample of Korean children and adolescents. METHODS Cross-sectional data on 2526 children and adolescents aged 10-20 years from the Korea National Health and Nutrition Examination Survey-V (2010-2012) were used. Anemia was defined according to specifications of the World Health Organization. Iron deficiency was defined as serum ferritin level of <12 ng/mL and transferrin saturation (TSAT) <16%. RESULTS The prevalence of vitamin D deficiency in Korean children and adolescents was high especially in female (35.7% vs. 50.9%, P < 0.001). The prevalence of anemia was also higher in female (1.1% vs. 6.8%; P < 0.001). In logistic regression, risk factors for anemia were female sex, old age, post-menarche, low household income, vitamin D deficiency, and iron deficiency. The Odds Ratio for anemia, iron deficiency and iron deficiency anemia (IDA) in subjects with vitamin D deficiency (<15 ng/mL) were 1.81(95% CI, 1.13-2.88), 1.94(95% CI, 1.27-2.97), and 2.26 (95% CI, 1.20-4.24) after controlling for other risk factors. However, after examining the sexes separately, only female subjects showed statistical significance. After further controlling for iron deficiency, the risk of anemia was not significant (P = 0.261). CONCLUSIONS Vitamin D deficiency is associated with increased risk of anemia, especially iron deficiency anemia, in healthy female children and adolescents. However, the association is attenuated after adjustment for iron deficiency. Further studies are needed to determine whether vitamin D deficiency is the cause of anemia, or bystander of nutritional deficiency which cause iron deficiency.
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Affiliation(s)
- Jun Ah Lee
- 1Department of Pediatrics, Korea Cancer Center Hospital , Republic of Korea, Seoul
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Racial disparity in breast cancer survival: the impact of pre-treatment hematologic variables. Cancer Causes Control 2014; 26:45-56. [PMID: 25359303 DOI: 10.1007/s10552-014-0481-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 10/16/2014] [Indexed: 01/01/2023]
Abstract
PURPOSE A survival disparity of black versus white breast cancer patients has been extensively documented but not adequately explained. Blacks and whites also have significant differences in hematologic traits including hemoglobin (HGB). However, a link between survival disparity and hematologic differences has not been reported. We aimed to explore the effect of pre-treatment hematologic variables on this survival disparity. METHODS We sequentially matched 443 black patients, using a minimum distance approach, to four different sets of 443 whites on demographics (age, year of diagnosis, smoking, and drinking status), tumor presentation (all demographic variables plus tumor stage, grade, and hormone receptor status), treatment (all presentation variables plus surgery, chemotherapy, radiation therapy, and hormone therapy), and presentation plus pre-treatment hematologic variables. Racial survival for each matched dataset was analyzed by Cox proportional hazards model. RESULTS We found that white patients matched on demographic characteristics had more favorable survival than blacks [hazard ratio (HR) 0.57, 95 % confidence interval (CI) 0.42-0.77, p log-rank = 0.0002]. Presentation match diminished this disparity [HR 0.72 (0.54-0.95), p log-rank = 0.0199], which was not further reduced in treatment match [HR 0.73 (0.55-0.96), p log-rank = 0.0249]. However, the survival disparity was largely reduced when pre-treatment level of HGB or red blood cell distribution width was further matched in addition to presentation match [HR 0.83 (0.64-1.09), p log-rank = 0.1819 and HR 0.83 (0.64-1.09), p log-rank = 0.1760, respectively]. CONCLUSIONS We found that in our patient population, differences in tumor presentation and certain pre-treatment hematologic traits, but not treatment, were associated with the survival disparity between black and white breast cancer patients.
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