Risk factors for incident anemia of chronic diseases: A cohort study
Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sec...
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| Published in | PloS one Vol. 14; no. 5; p. e0216062 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
06.05.2019
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0216062 |
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| Abstract | Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally.
A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially.
During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and ≥ 25 vs. 18.5-22.9 kg/m2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD.
The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. |
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| AbstractList | Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally. A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially. During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. [greater than or equal to] 60 ml/min/1.73 m.sup.2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and [greater than or equal to] 25 vs. 18.5-22.9 kg/m.sup.2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD. The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally.OBJECTIVEAnemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally.A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially.METHODA cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially.During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and ≥ 25 vs. 18.5-22.9 kg/m2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD.RESULTSDuring average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and ≥ 25 vs. 18.5-22.9 kg/m2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD.The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD.CONCLUSIONSThe severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. Objective Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally. Method A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially. Results During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. [greater than or equal to] 60 ml/min/1.73 m.sup.2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and [greater than or equal to] 25 vs. 18.5-22.9 kg/m.sup.2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD. Conclusions The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. ObjectiveAnemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally.MethodA cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially.ResultsDuring average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and ≥ 25 vs. 18.5-22.9 kg/m2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD.ConclusionsThe severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. Objective Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally. Method A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially. Results During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30–60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18–4.85] and 39.11 [18.50–82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12–1.27] and 2.46 [2.14–2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23–24.9 and ≥ 25 vs. 18.5–22.9 kg/m2 were 0.89 [0.78–1.00], 0.89 [0.80–0.99] and 0.78 [0.66–0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73–0.86] and 1.10 [0.99–1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD. Conclusions The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. Objective Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally. Method A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially. Results During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30–60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18–4.85] and 39.11 [18.50–82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12–1.27] and 2.46 [2.14–2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23–24.9 and ≥ 25 vs. 18.5–22.9 kg/m2 were 0.89 [0.78–1.00], 0.89 [0.80–0.99] and 0.78 [0.66–0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73–0.86] and 1.10 [0.99–1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD. Conclusions The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. Anemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally. A cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially. During average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and ≥ 25 vs. 18.5-22.9 kg/m2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD. The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD. |
| Audience | Academic |
| Author | Lee, Seung-Sei Oh, Sukjoong Lee, Yun-Gyoo Ryu, Seungho Chang, Yoosoo Kang, Jihoon Koo, Dong-Hoe |
| AuthorAffiliation | 1 Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Universita degli Studi di Perugia, ITALY 2 Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea 3 Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea |
| AuthorAffiliation_xml | – name: 2 Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea – name: 3 Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea – name: Universita degli Studi di Perugia, ITALY – name: 1 Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea |
| Author_xml | – sequence: 1 givenname: Yun-Gyoo orcidid: 0000-0002-2156-5081 surname: Lee fullname: Lee, Yun-Gyoo – sequence: 2 givenname: Yoosoo surname: Chang fullname: Chang, Yoosoo – sequence: 3 givenname: Jihoon surname: Kang fullname: Kang, Jihoon – sequence: 4 givenname: Dong-Hoe surname: Koo fullname: Koo, Dong-Hoe – sequence: 5 givenname: Seung-Sei surname: Lee fullname: Lee, Seung-Sei – sequence: 6 givenname: Seungho surname: Ryu fullname: Ryu, Seungho – sequence: 7 givenname: Sukjoong surname: Oh fullname: Oh, Sukjoong |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31059543$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1111_dom_14963 crossref_primary_10_1038_s41598_020_59336_1 crossref_primary_10_1007_s40520_024_02859_8 crossref_primary_10_3390_ijerph17093209 crossref_primary_10_3390_ijerph182010922 crossref_primary_10_18203_2320_6012_ijrms20250671 crossref_primary_10_29413_ABS_2023_8_3_23 crossref_primary_10_1017_S1368980023000319 crossref_primary_10_1136_bmjopen_2021_056100 crossref_primary_10_31482_mmsl_2023_042 |
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| Copyright | COPYRIGHT 2019 Public Library of Science 2019 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 Lee et al 2019 Lee et al |
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publication-title: Blood doi: 10.1182/blood-2005-07-3046 – volume: 2010 start-page: 276 year: 2010 ident: ref3 article-title: Anemia of inflammation publication-title: Hematology Am Soc Hematol Educ Program doi: 10.1182/asheducation-2010.1.276 – volume: 154 start-page: 289 issue: 3 year: 2011 ident: ref1 article-title: Diagnosis and management of anaemia of chronic disease: current status publication-title: Br J Haematol doi: 10.1111/j.1365-2141.2011.08741.x – volume: 18 start-page: 709 issue: 6 year: 2008 ident: ref4 article-title: Bariatric surgery can correct iron depletion in morbidly obese women: a link with chronic inflammation publication-title: Obes Surg doi: 10.1007/s11695-007-9276-y – volume: 101 start-page: 1229 issue: 6 year: 2007 ident: ref32 article-title: Non-invasive positive pressure ventilation improves lung volumes in the obesity hypoventilation syndrome publication-title: Respir Med doi: 10.1016/j.rmed.2006.10.027 – volume: 13 start-page: 150 issue: 2 year: 2012 ident: ref29 article-title: The relationship between obesity and hypoferraemia in adults: a systematic review publication-title: Obes Rev doi: 10.1111/j.1467-789X.2011.00938.x – volume: 20 start-page: 1501 issue: 9 year: 2004 ident: ref10 article-title: The prevalence of anemia in patients with chronic kidney disease publication-title: Curr Med Res Opin doi: 10.1185/030079904X2763 – volume: 91 start-page: 1235 issue: 4 year: 1998 ident: ref25 article-title: Fas ligand is present in human erythroid colony-forming cells and interacts with Fas induced by interferon gamma to produce erythroid cell apoptosis publication-title: Blood doi: 10.1182/blood.V91.4.1235 – volume: 6 start-page: 3587 issue: 9 year: 2014 ident: ref30 article-title: Obesity as an emerging risk factor for iron deficiency publication-title: Nutrients doi: 10.3390/nu6093587 – volume: 60 start-page: 860 issue: 6 year: 2011 ident: ref17 article-title: Serum uric acid levels predict incident nonalcoholic fatty liver disease in healthy Korean men publication-title: Metabolism doi: 10.1016/j.metabol.2010.08.005 – volume: 50 start-page: 232 issue: 3 year: 2013 ident: ref2 article-title: Anemia of chronic disease publication-title: Semin Hematol doi: 10.1053/j.seminhematol.2013.06.006 – volume: 99 start-page: 1127 issue: 7 year: 2014 ident: ref15 article-title: Anemia in the elderly: clinical implications and new therapeutic concepts publication-title: Haematologica doi: 10.3324/haematol.2014.109967 – volume: 2010 year: 2010 ident: ref27 article-title: Chronic inflammation in obesity and the metabolic syndrome publication-title: Mediators Inflamm doi: 10.1155/2010/289645 – volume: 352 start-page: 1011 issue: 10 year: 2005 ident: ref9 article-title: Anemia of chronic disease publication-title: N Engl J Med doi: 10.1056/NEJMra041809 – year: 2011 ident: ref18 article-title: Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity – volume: 16 start-page: 2356 issue: 10 year: 2008 ident: ref28 article-title: Is obesity associated with anemia of chronic disease? publication-title: A population-based study. 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| SubjectTerms | Adult Analysis Anemia Anemia - epidemiology Anemia - etiology Biology and Life Sciences Body mass Body Mass Index Cancer Chronic Disease - epidemiology Chronic diseases Chronic illnesses Chronic kidney failure Chronic obstructive pulmonary disease Cohort analysis Confidence intervals Cross-Sectional Studies Diabetes Diabetes Complications - epidemiology Diabetes mellitus End Stage Liver Disease - complications Environmental health Epidemiology Female Glomerular filtration rate Hemoglobin Hospitals Humans Hypertension Hypertension - complications Immune system Incidence Inflammation Internal medicine Iron Kidney diseases Liver diseases Lung diseases Male Medical research Medical screening Medicine Medicine and Health Sciences Metabolic disorders Metabolic syndrome Metabolic Syndrome - complications Obesity Obstructive lung disease Older people Population Prediabetic state Prediabetic State - complications Prehypertension - complications Prevalence studies (Epidemiology) Prospective Studies Pulmonary Disease, Chronic Obstructive - complications Republic of Korea - epidemiology Research and Analysis Methods Respiratory tract diseases Risk analysis Risk assessment Risk Factors Severity of Illness Index Studies Type 2 diabetes Womens health |
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| Title | Risk factors for incident anemia of chronic diseases: A cohort study |
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