Introducción
Borderline anemia has been linked to a higher risk of mortality according to findings from a prospective cohort study.
Among adults classified with borderline anemia—hemoglobin levels ranging from 0 to 1 g/dL above the World Health Organization (WHO) threshold for anemia—the 10-year standardized cumulative incidence of all-cause mortality was reported to be 18% higher when compared to a reference group. This was reported by Pierpaolo Pellicori, MD, from the University of Glasgow, and colleagues in a leading medical journal.
Definición de Anemia
The WHO defines anemia as hemoglobin levels below 13 g/dL for men and below 12 g/dL for women. Researchers noted that their study contributes to existing literature showing a U-shaped relationship between hemoglobin concentrations and mortality.
Comparación de Grupos de Hemoglobina
When analyzing different groups:
- More than 2 g/dL below: 12.5% (adjusted hazard ratio [aHR] 2.87, 95% CI 2.54-3.25)
- More than 1 to 2 g/dL below: 11.2% (aHR 2.53, 95% CI 2.33-2.75)
- More than 0 to 1 g/dL below: 7.9% (aHR 1.74, 95% CI 1.67-1.82)
- 0 to 1 g/dL above: 5.3% (aHR 1.18, 95% CI 1.15-1.21)
- More than 3 to 4 g/dL above: 4.7% (aHR 1.05, 95% CI 1.02-1.09)
- More than 4 g/dL above: 5.7% (aHR 1.31, 95% CI 1.21-1.41)
Both high and low levels of hemoglobin are linked to negative health outcomes in older adults, including cognitive decline, cardiovascular disease (CVD), and increased risks of hospitalization and mortality. While elevated hemoglobin levels (polycythemia) are rare, low hemoglobin levels (anemia) are common.
Consideraciones Clínicas
Pellicori and team emphasized the importance of assessing hemoglobin concentration values in clinical settings, including symptoms, repeated measurements, red blood cell indices, and signs of iron deficiency. They conclude that borderline anemia may require further investigation, especially in populations with a high prevalence of iron deficiency, such as older adults and those with cardiovascular disease.
In a press release, Pellicori noted that the current WHO thresholds have been influential in clinical practice for many years; however, their findings suggest a more complex relationship between hemoglobin concentration and long-term health than a single diagnostic cut-off can capture.
Resultados del Estudio
The study cohort included 502,188 adults from the U.K. Biobank, recruited from 2006 to 2010. The median age was 58 years, with 54.4% being women. Most participants displayed hemoglobin concentrations between 1 to 3 g/dL above the WHO anemia threshold.
When examining gender differences, women, especially those under 60, were more likely to possess lower hemoglobin concentrations. Median concentrations were 13.4 g/dL for women younger than 60, compared to 15.1 g/dL in men of the same age group.
After adjusting for numerous cardiovascular risk factors and comorbidities, borderline anemia was associated with increased mortality risks for various causes in both genders.
Limitaciones del Estudio
Pellicori and colleagues acknowledged certain limitations, such as measuring hemoglobin concentrations only once at baseline, which may overlook time-related changes. Furthermore, the U.K. Biobank participants are predominantly middle-aged, healthier, less deprived, and more ethnically homogenous, which may limit the generalizability of the findings to other populations.
Descargo de responsabilidad
Este texto es solo para fines informativos y no debe considerarse como asesoramiento médico. Siempre consulte a un profesional de la salud para obtener un diagnóstico y tratamiento adecuados.
Fuente: https://www.medpagetoday.com/hematologyoncology/anemia/122935
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