Anemia and hemodilution: analysis of a single center cohort based on 2,858 red cell mass measurements

Drevon, Louis; Maslah, Nabih; Soret-Dulphy, Juliette; Dosquet, Christine; Ravdan, Odno; Vercellino, Laëtitia; Belkhodja, C; Parquet, Nathalie; Brignier, Anne; Schlageter, Marie‐Hélène; Cassinat, Bruno; Kiladjian, Jean‐Jacques; Chomienne, Christine; Giraudier, Stéphane

doi:10.3324/haematol.2020.249409

Cited by 6 publications

(3 citation statements)

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“…Hemoglobin (Hb) decline was 1.93G/dl with a mean Hb level of BT of 12.86 G/dl vs. 11.01 G/dl AT ( n = 13, p = 0.0003, Figure 1 ). RBC loss was thus of 15.9% (or less since a small part of the hemoglobin drop was due to hemodilution AT ( Levin et al, 2001 ; Drevon et al, 2021 ). During the same period, the loss of iRBC was 5.9%, and the gain of pitted RBC was 5.1% of all RBC, corresponding to a net loss of 0.8% of total RBC.…”

Section: Resultsmentioning

confidence: 99%

Altered Subpopulations of Red Blood Cells and Post-treatment Anemia in Malaria

et al. 2022

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In acute malaria, the bulk of erythrocyte loss occurs after therapy, with a nadir of hemoglobin generally observed 3–7 days after treatment. The fine mechanisms leading to this early post-treatment anemia are still elusive. We explored pathological changes in RBC subpopulations by quantifying biochemical and mechanical alterations during severe malaria treated with artemisinin derivatives, a drug family that induce “pitting” in the spleen. In this study, the hemoglobin concentration dropped by 1.93 G/dl during therapy. During the same period, iRBC accounting for 6.12% of all RBC before therapy (BT) were replaced by pitted-RBC, accounting for 5.33% of RBC after therapy (AT). RBC loss was thus of 15.9%, of which only a minor part was due to the loss of iRBC or pitted-RBC. When comparing RBC BT and AT to normal controls, lipidomics revealed an increase in the cholesterol/phosphatidylethanolamine ratio (0.17 versus 0.24, p < 0.001) and cholesterol/phosphatidylinositol ratio (0.36 versus 0.67, p = 0.001). Using ektacytometry, we observed a reduced deformability of circulating RBC, similar BT and AT, compared to health control donors. The mean Elongation Index at 1.69Pa was 0.24 BT and 0.23 AT vs. 0.28 in controls (p < 0.0001). At 30Pa EI was 0.56 BT and 0.56 AT vs. 0.60 in controls (p < 0.001). The retention rate (rr) of RBC subpopulations in spleen-mimetic microsphere layers was higher for iRBC (rr = 20% p = 0.0033) and pitted-RBC (rr = 19%, p = 0.0031) than for healthy RBC (0.12%). Somewhat surprisingly, the post-treatment anemia in malaria results from the elimination of RBC that were never infected.

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Section: Resultsmentioning

confidence: 99%

Altered Subpopulations of Red Blood Cells and Post-treatment Anemia in Malaria

et al. 2022

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“…Conversely, a body water percentage above normal was positively correlated with anemia in men. Recent studies have demonstrated that increasing plasma volume is due to hemodilution, which can be explained by approximately half of the cases of anemia [ 65 ]. A previous study found that a high total body water percentages were associated with a high erythropoietin resistance index, thus decreasing the red blood cell production [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Associations of dietary, sociodemographic, and anthropometric factors with anemia among the Zhuang ethnic adults: a cross-sectional study in Guangxi Zhuang Autonomous Region, China

Wen,

Long,

Zhu

et al. 2023

BMC Public Health

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Background After decades of rapid economic development, anemia remains a significant public health challenge globally. This study aimed to estimate the associations of sociodemographic, dietary, and body composition factors with anemia among the Zhuang in Guangxi Zhuang Autonomous Region, China. Methods Our study population from the baseline survey of the Guangxi ethnic minority Cohort Study of Chronic Diseases consisted of 13,465 adults (6,779 women and 6,686 men) aged 24–82 years. A validated interviewer-administered laptop-based questionnaire system was used to collect information on participants’ sociodemographic, lifestyle, and dietary factors. Each participant underwent a physical examination, and hematological indices were measured. Least absolute shrinkage and selection operator (LASSO) regression was used to select the variables, and logistic regression was applied to estimate the associations of independent risk factors with anemia. Results The overall prevalences of anemia in men and women were 9.63% (95% CI: 8.94–10.36%) and 18.33% (95% CI: 17.42─19.28%), respectively. LASSO and logistic regression analyses showed that age was positively associated with anemia for both women and men. For diet in women, red meat consumption for 5–7 days/week (OR = 0.79, 95% CI: 0.65–0.98, p = 0.0290) and corn/sweet potato consumption for 5–7 days/week (OR = 0.73, 95% CI: 0.55–0.96, p = 0.0281) were negatively associated with anemia. For men, fruit consumption for 5–7 days/week (OR = 0.75, 95% CI: 0.60–0.94, p = 0.0130) and corn/sweet potato consumption for 5–7 days/week (OR = 0.66, 95% CI: 0.46–0.91, p = 0.0136) were negatively correlated with anemia. Compared with a normal body water percentage (55–65%), a body water percentage below normal (< 55%) was negatively related to anemia (OR = 0.68, 95% CI: 0.53–0.86, p = 0.0014). Conversely, a body water percentage above normal (> 65%) was positively correlated with anemia in men (OR = 1.73, 95% CI: 1.38–2.17, p < 0.0001). Conclusions Anemia remains a moderate public health problem for premenopausal women and the elderly population in the Guangxi Zhuang minority region. The prevention of anemia at the population level requires multifaceted intervention measures according to sex and age, with a focus on dietary factors and the control of body composition.

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“…Fluid retention causes hematocrit to be reported lower due to a dilutional mechanism. Such phenomenon happens in hypervolemic states including pregnancy, heart failure, excess uid administration and of course, cirrhosis (19). Hence, an increase in plasma volume rather than true RBC mass reduction might be considered in interpreting the laboratory reports in the mentioned conditions.…”

Section: A Hemodilutionmentioning

confidence: 99%

A Meticulous Review of Diverse Etiologies and Pathophysiology of Anemia in Chronic Liver Disease

Azadeh

2022

Preprint

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Background Anemia in chronic liver diseases is a common condition with a wide variety of etiologic factors, some of which are life-threatening and need immediate evaluation and intervention. Furthermore, the severity of anemia has been associated with a poor disease prognosis and quality of life of patients. Herein, we have investigated the current literature regarding the spectrum of anemia in advanced liver diseases. Results Anemia of chronic disease, gastrointestinal bleeding, malnutrition, iron deficiency anemia and hypersplenism are the common etiologies of anemia accompanied by liver diseases. Medication side effects, viral-induced aplastic anemia and alcohol related hematologic abnormalities constitute the other parts of spectrum of anemia in liver diseases. Conclusion Among the various mechanisms of anemia in liver diseases, some are life-threatening and some can be controlled. Investigation of etiology of anemias in chronic liver diseases is recommended, as disease-specific treatments will ameliorate the anemia and enhance patients’ quality of life.

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Anemia and hemodilution: analysis of a single center cohort based on 2,858 red cell mass measurements

Cited by 6 publications

References 5 publications

Altered Subpopulations of Red Blood Cells and Post-treatment Anemia in Malaria

Altered Subpopulations of Red Blood Cells and Post-treatment Anemia in Malaria

Associations of dietary, sociodemographic, and anthropometric factors with anemia among the Zhuang ethnic adults: a cross-sectional study in Guangxi Zhuang Autonomous Region, China

A Meticulous Review of Diverse Etiologies and Pathophysiology of Anemia in Chronic Liver Disease

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