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Gender disparities in the functional significance of anemia among apparently healthy adults
Author(s) -
Shouval Roni,
Katz Sharon,
Nagler Ar,
Merkel Drorit,
BenZvi Ilan,
Segev Shlomo,
Sidi Yechezkel,
Goldenberg Ilan,
Kivity Shaye,
Maor Elad
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12849
Subject(s) - medicine , anemia , pediatrics
Background Data on the functional impact of anemia on cardiorespiratory fitness ( CRF ) and survival in healthy individuals are limited. Our aim was to evaluate the association between anemia thresholds, low CRF , and survival in otherwise healthy adults. Methods Study population included 16 334 apparently healthy subjects attending annual periodic health screening examinations (71 200 annual visits), including exercise stress testing ( EST ). Anemia was defined by the World Health Organization ( WHO ) or Beutler and Waalens’ ( BW ) criteria. Low CRF was defined as the lowest fitness quintile according to the Bruce protocol. Results The mean age was 46±10 years, and 70% were men. Mean Hb levels were 13±1 and 15±1 among women and men, respectively, with higher proportion of anemia among women. The majority of anemic subjects had mild anemia. When analyzing repeated annual visits, anemia was associated with a significant 39% and 64% increased risk of low CRF according the WHO and BW criteria only in women (n=18 672). Baseline anemia at first visit was associated with 2.6‐ and 1.9‐fold increased risk of all‐cause mortality using the WHO and BW criteria, exclusively in men (n=11 511). Conclusions Overall, the functional and prognostic impact of anemia is gender dependent, based on the WHO and BW arbitrary criteria, suggesting differing mechanism and responses.