Mild Anemia and Risk for All-Cause, Cardiovascular and Cancer Deaths in Apparently Healthy Elderly Koreans
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Being common, mild anemia is sometimes considered a mere consequence of aging; however, aging alone is unlikely to lead to anemia. Therefore, this study aimed to investigate the association between mild anemia and total mortality and cause-specific mortality in apparently healthy elderly subjects.Methods: A retrospective cohort study was conducted on 10,114 apparently healthy elderly individuals who under-went cancer screening and routine medical check-ups at one Health Promotion Center between May 1995 and De-cember 2007. We defined mild anemia as a hemoglobin concentration between 10.0 g/dL and 11.9 g/dL in women and between 10.0 g/dL and 12.9 g/dL in men. We assessed the relationship between the overall, cardiovascular (CV), and cancer mortality and mild anemia using Cox proportional hazard models.Results: Mild anemia was present in 143 men (3.1%) and 246 women (6.1%). During an average follow-up of 7.6 years, 495 deaths occurred, including 121 CV and 225 cancer deaths. After adjustments, mild anemia was associat-ed with a 128% increase in the risk of all-cause mortality (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.54–3.37) in men and cancer-related mortality (HR, 2.25; 95% CI, 1.22–4.13), particularly lung cancer (HR, 2.70; 95% CI, 1.03–7.08) in men, but not in women. In the subgroup analyses based on smoking status, obesity, and age, the associations were more prominent in never or former smoker groups and the older group.Conclusion: The present study shows that overall and cancer-related mortality was associated with mild anemia in elderly men. Future prospective studies are needed to consolidate our findings.
Abstract
Background: Being common, mild anemia is sometimes considered a mere consequence of aging; however, aging alone is unlikely to lead to anemia. Therefore, this study aimed to investigate the association between mild anemia and total mortality and cause-specific mortality in apparently healthy elderly subjects.Methods: A retrospective cohort study was conducted on 10,114 apparently healthy elderly individuals who under-went cancer screening and routine medical check-ups at one Health Promotion Center between May 1995 and De-cember 2007. We defined mild anemia as a hemoglobin concentration between 10.0 g/dL and 11.9 g/dL in women and between 10.0 g/dL and 12.9 g/dL in men. We assessed the relationship between the overall, cardiovascular (CV), and cancer mortality and mild anemia using Cox proportional hazard models.Results: Mild anemia was present in 143 men (3.1%) and 246 women (6.1%). During an average follow-up of 7.6 years, 495 deaths occurred, including 121 CV and 225 cancer deaths. After adjustments, mild anemia was associat-ed with a 128% increase in the risk of all-cause mortality (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.54–3.37) in men and cancer-related mortality (HR, 2.25; 95% CI, 1.22–4.13), particularly lung cancer (HR, 2.70; 95% CI, 1.03–7.08) in men, but not in women. In the subgroup analyses based on smoking status, obesity, and age, the associations were more prominent in never or former smoker groups and the older group.Conclusion: The present study shows that overall and cancer-related mortality was associated with mild anemia in elderly men. Future prospective studies are needed to consolidate our findings.
참고문헌 (27)
- World Health Organization, "Global database on anemia: worldwide prevalence of anemia 1993-2005" (2005), World Health Organization
- Ania BJ, "Incidence of anemia in older people : an epidemiologic study in a well defined population", J Am Geriatr Soc, 45, pp.825~831 (1997)
- Riva E, "Association of mild anemia with hospitalization and mortality in the elderly : the Health and Anemia population-based study", Haematologica, 94, pp.22~28 (2009)
- Zauber NP, "Hematologic data of healthy very old people", JAMA, 257, pp.2181~2184 (1987)
- Lipschitz D, "Medical and functional consequences of anemia in the elderly", J Am Geriatr Soc, 51(3 Suppl), pp.S10~S13 (2003)
- Culleton BF, "Impact of anemia on hospitalization and mortality in older adults", Blood, 107, pp.3841~3846 (2006)
- Archbold RA, "Hemoglobin concentration is an independent determinant of heart failure in acute coronary syndromes : cohort analysis of 2310 patients", Am Heart J, 152, pp.1091~1095 (2006)
- Chalmers KA, "Long-term mortality risks associated with mild anaemia in older persons : the Busselton Health Study", Age Ageing, 41, pp.759~764 (2012)
- Botev R, "Estimating glomerular filtration rate : Cockcroft-Gault and Modification of Diet in Renal Disease formulas compared to renal inulin clearance", Clin J Am Soc Nephrol, 4, pp.899~906 (2009)
- Proctor MJ, "A comparison of inflammation-based prognostic scores in patients with cancer : a Glasgow Inflammation Outcome Study", Eur J Cancer, 47, pp.2633~2641 (2011)
- "2005 Annual report on the cause of death statistics: based on vital registration" (2005)[URL]
- 박민선, "Physical Activity and Physical Fitness as Predictors of All-Cause Mortality in Korean Men", Journal of Korean Medical Science, 24(1), pp.13~19 (2009), 대한의학회
- International Association for the Study of Obesity, "The Asia-Pacific perspective: redefining obesity and its treatment" (2002), World Health Organization Western Pacific Region
- Price EA, "Unexplained aspects of anemia of inflammation", Adv Hematol, 2010, pp.508739~ (2010)
- Duh MS, "Anaemia and the risk of injurious falls in a community-dwelling elderly population", Drugs Aging, 25, pp.325~334 (2008)
- Caro JJ, "Anemia as an independent prognostic factor for survival in patients with cancer : a systemic, quantitative review", Cancer, 91, pp.2214~2221 (2001)
- Lavey RS, "Clinical trial experience using erythropoietin during radiation therapy", Strahlenther Onkol, 174(Suppl 4), pp.24~30 (1998)
- Dubsky P, "Anemia is a significant prognostic factor in local relapse-free survival of premenopausal primary breast cancer patients receiving adjuvant cyclophosphamide", methotrexate, Clin Cancer Res, pp.2008, 14[DOI]
- Ko YJ, "Highsensitivity C-reactive protein levels and cancer mortality", Cancer Epidemiol Biomarkers Prev, 21, pp.2076~2086 (2012)
- Sun K, "The prognostic significance of the prognostic nutritional index in cancer : a systematic review and metaanalysis", J Cancer Res Clin Oncol, 140, pp.1537~1549 (2014)
- The third Korea National Health and Nutrition Examination Survey (KNHANES III), "Korea Centers for Disease Control and Prevention", Korea Centers for Disease Control and Prevention, ~ (2005)
- Aronow WS, "Effect of cigarette smoking and breathing carbon monoxide on cardiovascular hemodynamics in anginal patients", Circulation, 50, pp.340~347 (1974)
- Allred EN, "Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease", N Engl J Med, 321, pp.1426~1432 (1989)
- Piper AJ, "Current perspectives on the obesity hypoventilation syndrome", Curr Opin Pulm Med, 13, pp.490~496 (2007)
- Lee Y, "Frailty and body mass index as predictors of 3-year mortality in older adults living in the community", Gerontology, 60, pp.475~482 (2014)
- Fried LP, "Frailty in older adults : evidence for a phenotype", J Gerontol A Biol Sci Med Sci, 56, pp.M146~56 (2001)
- Sanchez-Lara K, "Association of nutrition parameters including bioelectrical impedance and systemic inflammatory response with quality of life and prognosis in patients with advanced non-small-cell lung cancer : a prospective study", Nutr Cancer, 64, pp.526~534 (2012)
