Anemia

Nissenson, Allen R.; Goodnough, Lawrence T.; Dubois, Robert W.

doi:10.1001/archinte.163.12.1400

Cited by 183 publications

(49 citation statements)

References 59 publications

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“…Possible causes include blood loss (i.e., neoplastic disease or gastrointestinal opportunistic infection), bone marrow infiltration or suppression, drug- or infection-related hemolysis, nutritional deficiencies (iron, folic acid or cobalamin), hypogonadism and myelo-suppressive drugs [18]. It is clear that anemia is associated with decreased survival in several other chronic conditions [19, 20]. With HIV infection, however, questions remain as to whether anemia is an epiphenomenon as a consequence of the underlying severe disease or is causally related to morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Markers of inflammation and activation of coagulation are associated with anaemia in antiretroviral-treated HIV disease

Borges

Weitz

Collins³

et al. 2014

Aids

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Objective to determine the relationship between inflammatory (IL-6 and hsCRP) and coagulation (D-dimer) biomarkers and the presence and type of anemia among HIV+ individuals. Design cross-sectional study Methods cART-treated adults participating in an international HIV trial with hemoglobin and mean corpuscular volume (MCV) measurements at entry were categorized by presence of anemia (hemoglobin ≤ 14 g/dL in men and ≤ 12 g/dl in women) and, for those with anemia, by type (microcytic [MCV< 80 fL], normocytic [80–100], macrocytic [>100]). We analyzed the association between inflammation (IL-6 and hsCRP) and coagulation (D-dimer) and hemoglobin, controlling for demographics (age, race, and gender), body mass index, HIV plasma RNA levels, CD4+ T cell counts (nadir and baseline), Karnofsky score, previous AIDS diagnosis, hepatitis B/C co-infection and use of zidovudine. Results Among 1,410 participants, 313 (22.2%) had anemia. Of these, 4.1%, 27.2% and 68.7% had microcytic, normocytic and macrocytic anemia, respectively. When compared with participants with normal hemoglobin values, those with anemia were more likely to be older, black, male and on zidovudine. They also had lower baseline CD4+ T cell counts and lower Karnofsky scores. Adjusted relative odds of anemia per two fold higher biomarker levels were 1.22 (P= 0.007) for IL-6, 0.99 for hsCRP (P= 0.86) and 1.35 (P< 0.001) for D-dimer. Similar associations were seen in those with normal and high MCV values. Conclusions Persistent inflammation and hypercoagulation appear to be associated with anemia. Routine measurements of hemoglobin might provide insights into the inflammatory state of treated HIV infection.

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Section: Discussionmentioning

confidence: 99%

Markers of inflammation and activation of coagulation are associated with anaemia in antiretroviral-treated HIV disease

Borges

Weitz

Collins³

et al. 2014

Aids

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“…Anemia is prevalent in the general population and is more common among cancer patients; 27% to 50% of patients undergoing cancer treatment are estimated as having baseline anemia [19,20]. Intratumoral bleeding from a friable tumor surface can result in substantial blood loss, and, therefore, anemia may be commonly seen in cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

An association between preoperative anemia and poor prognostic factors and decreased survival in early stage cervical cancer patients

et al. 2014

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ObjectiveTo evaluate correlation of preoperative anemia with clinical outcomes in patients with early stage cervical cancer who were treated with radical hysterectomy and lymph node dissection.MethodsPatients who underwent radical hysterectomy and lymph node dissection for cervical cancer from January 2001 to February 2012 were included in this study. Clinicopatholgoical factors included in univariate and multivariate analysis were age, tumor histology, FIGO (International Federation of Gyneocology and Obstetrics) stage, preoperative hemoglobin, depth of invasion, tumor size, parametrial involvement, resection margin, and lymph node status.ResultsA total of 387 patients were retrospectively analyzed in this study; 141 patients (36.4%) had preoperative anemia (hemoglobin <12 g/dL) and 16 out of 141 patients (11.3%) received blood transfusion for correction of preoperative anemia. Patients with preoperative anemia showed significant association with age <50 years, more advanced stage, non-squamous cell carcinoma histology, larger tumor size, deeper stromal invasion, and lymph node metastasis (P<0.05). Both relapse-free survival and overall survival were worse in patients with preoperative anemia in univariate analysis. In multivariate analysis, overall survival was worse in patients with preoperative anemia, but relapse-free survival was not associated with preoperative anemia. In the intergroup analysis of anemic patients for the effect of preoperative blood transfusion, preoperative anemia correction did not affect survival.ConclusionPreoperative anemia was not an independent prognostic factor for survival in patients with early cervical cancer. However, it was associated with poor prognostic factors. Further study in large population is needed.

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“…Some data suggest anemia has an independent effect on mortality and that correcting anemia may reduce morbidity from cardiovascular or kidney disease and certain cancers [38]. Anemia may also act together with common comorbidities to increase risk of outcomes like frailty.…”

Section: Discussionmentioning

confidence: 99%

Hemoglobin and hip fracture risk in older non-Hispanic white adults

Looker

2014

Osteoporos Int

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Purpose The few studies to date that have examined the relationship between hemoglobin and fracture risk have focused on low hemoglobin values. The present study examined hip fracture risk across the hemoglobin distribution in older non-Hispanic white adults from the third National Health and Nutrition Examination Survey (NHANES III, 1988–1994). Methods Hemoglobin was measured using a Coulter S-plus Jr.® (Coulter Electronics, Hialeah, FL) in 2122 non-Hispanic whites age 65 years and older. Hip fracture cases were identified using linked Medicare and mortality records obtained through 2007. Cox proportional hazards models were used to assess the best-fitting model and to estimate the hazards ratio (HR) for hip fracture by hemoglobin decile before and after adjusting for selected confounders. Results There were 239 hip fracture cases in the analytic sample. The best fitting model was quadratic. When compared to values in the middle of the distribution, those with hemoglobin in the lowest and highest deciles had increased hip fracture risk (HRlowest decile =2.96, 95% CI 1.44–6.08; HRhighest decile = 2.06, 95% CI 1.09–3.92) after adjusting for age and sex. Both HRs remained significant after adjusting for additional confounders (HRlowest decile =2.24, 95% CI 1.09–3.92; HRhighest decile = 2.37, 95% CI 1.35–4.16). Conclusions Both low and high hemoglobin values were associated with increased hip fracture risk. The mechanism underlying the relationship is not clear, but there was some suggestion that it may differ for low versus high hemoglobin.

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Anemia

Cited by 183 publications

References 59 publications

Markers of inflammation and activation of coagulation are associated with anaemia in antiretroviral-treated HIV disease

Markers of inflammation and activation of coagulation are associated with anaemia in antiretroviral-treated HIV disease

An association between preoperative anemia and poor prognostic factors and decreased survival in early stage cervical cancer patients

Hemoglobin and hip fracture risk in older non-Hispanic white adults

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