Relationship between maternal hemoglobin and birthweight in Antioquia, Colombia / Relación de la hemoglobina materna y el peso al nacer en Antioquia-Colombia

Abstract Objectives: to determine the relationship between maternal hemoglobin (HbM) per gestational trimester and birthweight (BW). Methods: this was an analytical, cross-sectional observational study that included the prenatal records of494 pregnant women who delivered live newborns in the Department of Antioquia. The maternal health data collected included HbM and BW, and gynecological and obstetric, anthropometric, and maternal health-related data. The Mann-Whitney U test was applied, supplemented by effect size (ES) to compare the study groups. Results: HbMin the third trimester was significantly associated with BW (p=0.029).It showed a significant effect size on BW as follows: first trimester: ES=0.44 (CI95%= 0.183-0.697); second trimester: ES=0.49 (CI95%= 0.187-0.79); and third trimester: ES=0.43 (CI95% = 0.202-0.658). Maternal anemia was 4.2%>, 11.2%, and 21.4%> in the first, second, and third trimester, respectively. Conclusions: as it is an inexpensive indicator and easy to determine, the timely monitoring and assessment of HbM is required owing to its importance in maternal and neonatal health, quality of life, and human capital development.

Resumen Objetivos: determinar la relación entre hemoglobina materna (HbM) por trimestre de gestación y peso al nacer (PN). Métodos: estudio observacional analítico, transversal, en 494 historias prenatales de gestantes con recién nacido vivo del departamento de Antioquia. Se tomaron datos de HbMy PN, ginecobstétricos, antropométricos y de salud materna. Para comparar los grupos de estudio, se aplicó la prueba U-Mann Whitney, complementada con el tamaño de efecto (ES). Resultados: la HbM de tercer trimestre se asoció significativamente con el PN (p=0,029); la HbM mostró un tamaño de efecto importante sobre el PN, así: primer trimestre: ES=0,44 (IC95%= 0,183 a 0,697); segundo trimestre: ES=0,49 (IC95%= 0,187 a 0,79); tercer trimestre: ES=0,43 (IC95%o= 0,202 a 0,658). La anemia materna fue 4,2°%, 11,2%o y 21,4°% en el primero, segundo y tercer trimestre, respectivamente. Conclusiones: Se necesita seguimiento y evaluación oportuna de la HbM, indicador de bajo costo y fácil determinación, por su importancia en la salud materna y neonatal, en la calidad de vida y desarrollo del capital humano.

Associação entre insegurança alimentar e níveis de hemoglobina e retinol em crianças assistidas pelo Sistema Único de Saúde no Município do Rio de Janeiro, Brasil / Association between food insecurity and hemoglobin and retinol levels in children treated in the Brazilian Unified National Health System in the city of Rio de Janeiro, Brazil / Asociación entre inseguridad alimentaria y niveles de hemoglobina y retinol en niños asistidos por el Sistema Único de Salud en el municipio de Río de Janeiro, Brasil

Neste trabalho foi analisada a associação entre insegurança alimentar e níveis de hemoglobina e retinol em crianças de 6 a 59 meses de idade. Trata-se de um estudo seccional, realizado em 2014, com amostra representativa da população de crianças nessa faixa etária, atendidas em unidades básicas de saúde do Município do Rio de Janeiro, Brasil. Para a análise dos níveis de insegurança alimentar foi utilizada a Escala Brasileira de Insegurança Alimentar e, para a determinação de hemoglobina e de retinol sérico, foi realizada a punção venosa. A associação entre as variáveis foi avaliada por intermédio de modelos de regressão quantílica. Do total de crianças estudadas, 40,3% apresentavam insegurança alimentar e as prevalências de anemia e de deficiência de vitamina A foram 13,7% e 13%, respectivamente. Os resultados do estudo revelaram associação inversa, estatisticamente significativa, entre insegurança alimentar leve e níveis de retinol. Para os demais níveis de insegurança alimentar (moderada e grave), os resultados também sugerem a presença de associação inversa para hemoglobina e, quanto aos níveis de retinol, as estimativas pontuais parecem menores em crianças com insegurança alimentar grave, entretanto, estas estimativas não foram estatisticamente significativas. Esses resultados sugerem que a insegurança alimentar pode estar associada com carências de micronutrientes em crianças menores de 5 anos.

This study analyzed the association between food insecurity and hemoglobin and retinol levels in children 6 to 59 months of age. This was a cross-sectional study in 2014 with a representative sample of children in this age bracket treated at basic health units in the city of Rio de Janeiro, Brazil. Analysis of food insecurity levels used the Brazilian Food Insecurity Scale, and venipuncture was performed for measurement of serum hemoglobin and retinol levels. The association between variables used quantile regression models. Of all the children in the sample, 40.3% presented food insecurity, and the prevalence rates for anemia and vitamin A deficiency were 13.7% and 13%, respectively. The study's results revealed a statistically significant inverse association between mild food insecurity and retinol levels. For the other levels of food insecurity (moderate and severe), the results also suggest an inverse association for hemoglobin, and for retinol levels the point estimates appear smaller in children with severe food insecurity, but these estimates were not statistically significant. These results suggest that food insecurity may be associated with micronutrient deficiencies in children under 5 years.

En este estudio se analizó la asociación entre la inseguridad alimentaria y los niveles de hemoglobina y retinol en niños de 6 a 59 meses de edad. Se trata de un estudio seccional, realizado en 2014, con una muestra representativa de la población de niños en esta franja etaria, atendida en unidades básicas de salud del Municipio de Río de Janeiro, Brasil. Para el análisis de los niveles de inseguridad alimentaria se utilizó la Escala Brasileña de Inseguridad Alimentaria y, para la determinación de hemoglobina y de retinol sérico, se realizó una punción venosa. La asociación entre las variables se evaluó a través de modelos de regresión cuantílica. Del total de niños estudiados, un 40,3% presentaban inseguridad alimentaria y las prevalencias de anemia y de deficiencia de vitamina A fueron 13,7% y 13%, respectivamente. Los resultados del estudio revelaron una asociación inversa, estadísticamente significativa, entre inseguridad alimentaria leve y niveles de retinol. Para los demás niveles de inseguridad alimentaria (moderada y grave), los resultados también sugieren la presencia de una asociación inversa para la hemoglobina, y, en cuanto a los niveles de retinol, las estimaciones puntuales parecen menores en niños con inseguridad alimentaria grave, sin embargo, estas estimaciones no fueron estadísticamente significativas. Estos resultados sugieren que la inseguridad alimentaria puede estar asociada con carencias de micronutrientes en niños menores de 5 años.

A associação entre anemia e alguns aspectos da funcionalidade em idosos / The association between anemia and some aspects of functionality in older adults

Resumo O objetivo deste artigo é avaliar a associação entre a anemia e algumas atividades de vida diária associadas à alimentação e o relato de dificuldade de mastigação e deglutição. Estudo transversal, que analisou 1.256 indivíduos de 60 anos ou mais, que fizeram parte da terceira coleta do Estudo SABE (Saúde, Bem-estar e Envelhecimento). Considerou-se anêmicos homens com hemoglobina sanguínea ≤ 13g/dL e mulheres com valores ≤ 12g/dL. Houve prevalência de anemia maior nos indivíduos que relataram redução no consumo alimentar devido a queixas de mastigação e deglutição, naqueles com dificuldade de mastigação e nos que relataram dificuldade em alimentar-se devido queixas de mastigação e deglutição. A prevalência também foi maior nos indivíduos com dificuldade de alimentar-se sozinho e de fazer compras de alimentos. Nas análises, a presença de uma queixa de mastigação e deglutição foi associada à chance de anemia quase 2 vezes maior que aqueles indivíduos sem queixas, e a presença de 2 ou 3 queixas de mastigação e deglutição foi associada à chance de 2,7. Os idosos com dificuldades de deglutição e mastigação apresentaram maior prevalência de anemia, mesmo após ajuste de outros fatores associados, com efeito dose-resposta, evidenciando a importância de um trabalho multidisciplinar com o idoso.

Abstract Aim: To evaluate the association between anemia and some activities of daily living associated with feeding and the difficulty in chewing and swallowing. Methods: Cross-sectional study, which examined 1256 individuals, aged 60 or older who were part of the third collection of the SABE Study (Health, Well-Being and Aging). We classified as anemic men with blood haemoglobin ≤ 13 g/dL and women with values ≤ 12 g/dL. Results: Prevalence of anemia was higher in individuals who reported reduction in food consumption due to chewing and swallowing complaints, in individuals with difficulty to chew and in individuals who reported difficulty to feed themselves due to chewing and swallowing complaints. Anemia was also more prevalent in those with difficulty to feed themselves and to shop for food. In the analyses, the presence of chewing and swallowing complaints was associated with a chance of anemia almost 2 times greater than for individuals without complaints, and the presence of 2 or 3 chewing and swallowing complaints was associated with a 2.7 chance of anemia. Conclusion: The presence of difficulties in chewing and swallowing were associated with higher prevalence of anemia, even after adjustment for other factors, with a dose-response effect, indicating the importance of a multidisciplinary work with older adults.

Effects of Body Mass Index (BMI) on complete blood count parameters

Background: Anemia is considered by Worl Health Organization (WHO) as a global health problem. It can be affected by the body mass index of an individual since increasing weight can result in low-grade systemic inflammation and elevation of hepcidin which results in seguestratiion of iron inside a variety of cells including macrophages, hepatocytes and enteroytes and this would lead to the development of what is known as anemia of inflammation. In this study, we aimed to evaluate the effects of BI on complete blood count parameters. Patients and methods: In this crosssectional, retrospective study: the data of 200 overweight and obese male patients aged (18-60 years) were collected. They were grouped according to BMI into everweight and obese: different CBC parameters were noted. Inter group comparison was applied regarding different blood parameters and the relations eith BMI were calculated. Results: The prevalence of anemia was 16%. An extremely significant difference was found in mean white blood cells count in relation to different BMI gropups (p=0.001). A positive linear correlation was found between BMI with RDW, WBS, and platelets. Conclusions: There were effects of increasing BMI on WBC, RDW and platelets (AU)

Clinical trial for uniform multidrug therapy for leprosy patients in Brazil (U-MDT/CT-BR): adverse effects approach

Abstract: BACKGROUND: The Clinical Trial for Uniform Multidrug Therapy for Leprosy Patients in Brazil (U-MDT/CT-BR), designed to evaluate the effectiveness of a six-months regimen, assessed the adverse effects caused by the drugs. OBJECTIVE: Describe adverse effects due to MDT in U-MDT/CT-BR, comparing the uniform regimen (U-MDT) to the current WHO regimen (R-MDT). Patients and methods: After operational classification, patients were randomly allocated to the study groups. U-MDT PB and U-MDT MB groups, received the U-MDT regimen, six doses of MB-MDT (rifampicin, dapsone and clofazimine). R-MDT PB and R-MDT MB groups, received the WHO regimens: six doses (rifampicin and dapsone) for PB and 12 doses (rifampicin, dapsone and clofazimine) for MB. During treatment, patients returned monthly for clinical and laboratorial evaluation. Patients with single lesion were not included in this trial. RESULTS: Skin pigmentation (21.7%) and xerosis (16.9%) were the most frequent complaints among 753 patients. Laboratory exams showed hemoglobin concentration lower than 10g/dL in 23.3% of the patients, glutamic oxaloacetic transaminase (GOT) above 40U/L in 29.5% and glutamic pyruvic transaminase (GPT) above 40U/L in 28.5%. Twenty-four patients (3.2%) stopped dapsone intake due to adverse effects, of whom 16.6% due to severe anemia. One case of sulfone syndrome was reported. STUDY LIMITATIONS: Loss of some monthly laboratory sample collection. CONCLUSIONS: There was no statistical difference regarding adverse effects in the R-MDT and U-MDT groups but anemia was greater in patients from R-MDT/MB group, therefore adverse effects do not represent a constraint to recommend the six-month uniform regimen of treatment for all leprosy patients.

Prevalence of anemia and consumption of iron-rich food groups in Mexican children and adolescents: Ensanut MC 2016 / Prevalencia de anemia y consumo de grupos de alimentos en niños y adolescentes mexicanos: Ensanut MC 2016

Abstract: Objective: To describe the prevalence of anemia and consumption of iron rich groups among Mexican children and adolescents who participated in the Halfway National Health and Nutrition Survey, 2016. Materials and methods: Our study sample included children and adolescents who provided full capillary hemoglobin data. Anemia was defined according to WHO criteria. Logistic regression models were used to explore the association among consumption of iron-rich food groups, sociodemographic characteristics and anemia. Results: In 2016, the prevalence of anemia was 26.9% in children aged 1 to 4 years old, 12.5% in those aged 5 to 11, and 9.6% in adolescents aged 12 to 19 years. Rates were the highest among females who lived in the southern and central parts of Mexico, belonged to an indigenous ethnic group and fell within the first tercile of the Household Wealth Index. Consumption of beef by preschoolers and viscera by adolescents was associated with lower risk for anemia; higher risk was associated with consumption of Liconsa milk and non-heme iron by preschoolers. Conclusions: Anemia is highly prevalent in Mexican children and adolescents, affecting mainly the poorest and youngest populations. Sources of heme iron are the principal dietary factor associated with low risk for anemia.

Resumen: Objetivo: Describir la prevalencia de anemia y el consumo de alimentos fuente de hierro en niños y adolescentes mexicanos participantes en la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016. Material y métodos: Se analizó la información de hemoglobina capilar de niños y adolescentes. La anemia se definió con base en el criterio de la OMS. Se usaron modelos de regresión logística para identificar los grupos de alimentos y características de los individuos asociados con anemia. Resultados: La prevalencia de anemia fue de 26.9% en niños de 1 a 4 años; 12.5% en el grupo de 5 a 11 y 9.6% para el de 12 a 19. La mayor prevalencia de anemia se dio entre las mujeres habitantes de la región Sur y Centro, indígenas y en el primer tercil de condición de bienestar. El consumo de carne de res en preescolares y de vísceras en adolescentes se asoció con menor riesgo de anemia. El consumo de leche Liconsa y el hierro no hemo en preescolares se asoció con mayor riesgo de anemia. Conclusiones: La anemia es altamente prevalente en niños y adolescentes mexicanos, afectando principalmente a la población pobre y a los más jóvenes. Las fuentes dietéticas de hierro hemo permanecen como los principales factores dietéticos asociados con menor riesgo de anemia.

Estado nutricional-hematológico y parasitosis intestinal de niños escolares de 5 a 12 años de cuatro localidades rurales de Paraguay / Nutritional-hematological status and intestinal parasitosis of school children aged 5 to 12 years in four rural localities of Paraguay

El mundo, actualmente se enfrenta a una doble carga de malnutrición que incluye la desnutrición y la alimentación excesiva. A ello se suman las parasitosis intestinales que es una enfermedad frecuente con importante morbimortalidad en la población infantil, ligadas a la pobreza y malas condiciones higiénico-sanitarias. El objetivo de este trabajo fue describir el estado nutricional-hematológico y parasitológico de niños escolares de cuatro comunidades rurales de Paraguay. Estudio observacional descriptivo de corte transverso en el que participaron 102 niños de ambos sexos de 5 a 12 años de edad. Se realizó medición de peso y talla, utilizando balanza calibrada, y un altímetro fijado a la pared. Toma de muestra sanguínea por punción venosa para determinación de parámetros hematológicos, procesados en contador hematológico por impedancia. Muestras de heces de una sola toma fueron recogidas en frascos apropiados con formol al 10%, utilizándose 4 métodos: directo, flotación de Willis, Graham y de concentración. En relación al estado nutricional-hematológico se encontró que el 3,9% de los niños estaba con desnutrición moderada y el 9,8% presentó riesgo de desnutrición; anemia se observó en el 38,2% de los niños. En relación a la parasitosis, el estudio diagnóstico se realizó a 94 niños y se encontró que el 72,2% estaba parasitado, siendo Blastocystis hominis el más frecuente. Tanto la frecuencia de anemia como de parasitosis es alta en esta población, sin embargo no se pudo establecer una relación entre ellas(AU)

Laboratory evidence for the hematopoietic potential of Beta vulgaris leaf and stalk extract in a phenylhydrazine model of anemia

This study was designed to provide laboratory evidence supporting the hematopoietic effect of Beta vulgaris (beet) leaf aqueous extract in phenylhydrazine-induced anemia model in albino rats. Extraction of the leaves/stalks was done by maceration in 30% hydro-ethanol for 48 h. An intraperitoneal injection of 20 mg/kg phenylhydrazine was applied for two consecutive days to develop hemolytic anemia on the 4th day after the 1st injection in 24 of 30 male albino rats. The animals were divided into 5 groups and received the following treatments: standard (ferrous ascorbate + folic acid; 13.5 + 0.135 mg/kg), B. vulgaris extract (100 and 200 mg/kg), or left untreated (normal and diseased controls). Blood samples were taken at 0, 4, 8, and 12 days of the experiment for hematological and clinico-chemical analysis. Beet leaf extract significantly restored the levels of red blood cells, white blood cells, hemoglobin, and hematocrit in dose- and time-dependent manners. Blood indices have been significantly corrected. Erythropoietin level was maintained at higher levels. Erythrocytic membrane oxidation biomarker (malondialdehyde) level was significantly reduced compared to the anemic untreated group. The extract exhibited potent, concentration (4-512 μg/mL)-dependent antioxidant activity indicated by the 2,2-diphenyl-1-picryl-hydrazyl (DPPH) assay, with IC50 value of 37.91 μg/mL. Beet leaf extract resulted in detection of flavonoid and phenolic compounds that may underlie its hematinic properties. These findings may indicate B. vulgaris as a good natural source for pharmaceutical preparations with hematopoietic effects and treatment of anemia and/or associated conditions.

Outcome of restrictive versus liberal blood transfusion strategies in intensive care unit admitted patients

Background: Anemia is a very common disease in critically ill patients. Approximately 29% of patients have lower than normal hemoglobin levels when admitted to an ICU, and about 95% develop anemia within 3 days of admission

Aim of the Work: The purpose of this study was to evaluate the effects of restrictive and liberal red blood cell transfusion strategies on mortality and morbidity in critically ill patients. And as a result, recommend the more beneficial and the less deleterious strategy for critically ill patients

Patients and Methods: This clinical interventional study was carried out at Intensive Care Unit, Benha Teaching Hospital, Egypt, during a period from July 2017 to November 2017. This study was approved by Ethical Committee of Faculty of Medicine, Ain Shams University, including the informed consents which were obtained from either the patient or the closest family member

Results: Mortality rates in ICU were 16 % and 20% in group A and B respectively, 24% and 28% within 60 days respectively. There were lower mortality rates with group A but with no statistically significant difference between groups according to mortality during ICU Stay and mortality within 60 days

Conclusion: Comparison between the effect of restrictive and liberal strategies of blood transfusion on mortality and morbidity in critically ill patients showed no significant differences. Restrictive strategy is at least as effective to liberal strategy in critically ill patients. Blood transfusion may be hazardous and cost-effective

Recommendations: Anemia is associated with adverse clinical outcomes. However, randomized clinical trials are required to establish if transfusion is beneficial or harmful in anemic patients. A restrictive transfusion strategy should be recommended within the well-studied patient populations and clinical conditions, and the clinicians must continue to use their experience and bedside clinical judgment to advocate the best management for their patients

Necesidades de investigación para el diagnóstico de anemia en poblaciones de altura / Diagnosis of anemia in populations at high altitudes

Tanto la deficiencia como la sobrecarga de hierro son situaciones que ponen en riesgo la salud y la vida de las personas, por lo que es importante mantener su homeostasis. Como la hemoglobina contiene 70% del hierro del organismo, la OMS recomienda su medición para determinar la prevalencia de anemia por deficiencia de hierro (ID), a pesar que ellos mismos reconocen que la anemia no es específica de ID. Como la hemoglobina aumenta con la altitud de residencia, la OMS recomienda corregir el punto de corte para definir anemia en la altura. Una objeción a esta corrección es que el aumento de la hemoglobina en la altura no es universal ni aumenta de manera lineal. Además, las poblaciones de mayor antigüedad generacional tienen menos hemoglobina que las más recientes. En infantes, niños, gestantes y adultos, la prevalencia de anemia usando hemoglobina corregida es 3-5 veces mayor que usando marcadores del estatus de hierro. Los programas estatales buscan combatir la anemia mediante la suplementación de hierro; no obstante, resultan ineficaces, especialmente en las poblaciones de altura. Entonces, ¿hay deficiencia de hierro en la altura? Los niveles de hepcidina sérica, hormona que regula la disponibilidad de hierro, son similares a los de nivel del mar indicando que en la altura no hay deficiencia de hierro. Un problema adicional al corregir la hemoglobina por la altura, es que las prevalencias de eritrocitosis disminuyen. En conclusión, la corrección del punto de corte de la hemoglobina en la altura para determinar deficiencia de hierro es inadecuada.

Iron deficiency and overload are risk factors for numerous poor health outcomes, and thus the maintenance of iron homeostasis is vital. Considering that hemoglobin contains 70% of the total iron in the body, the World Health Organization (WHO) recommends the measurement of iron levels to calculate the rate of iron deficiency anemia (IDA), although WHO recognizes that IDA is not the only cause of anemia. As hemoglobin increases with altitude, WHO recommends correcting the cut-off point to define anemia at high altitudes. An objection to this correction is that the increase in hemoglobin at high altitudes is not universal and is not linear. In addition, individuals in older age groups have lower hemoglobin levels than those in younger age groups. In infants, children, pregnant women, and adults, the prevalence of anemia using corrected hemoglobin is 3-5 times higher than that using markers of iron status. State programs seek to control anemia by means of iron supplementation. However, these programs are ineffective, particularly for high-altitude populations. Therefore, the occurrence of iron deficiency at high altitudes is controversial. The serum levels of the hormone hepcidin, which regulates iron availability, are similar in individuals at high altitudes to those of individuals at sea level, indicating that iron deficiency does not occur at high altitudes. An additional problem when correcting hemoglobin at high altitudes is that the frequency of erythrocytosis is decreased. In conclusion, the correction of the cut-off point of hemoglobin at high altitudes to determine iron deficiency is inadequate.

Variações dos níveis de ferro e ferritina séricas em pós-operatório tardio de cirurgia de Fobi-Capella: estudo retrospectivo com 862 pacientes / Variations of seric iron and ferritin levels in late postoperative course of Fobi-Capella procedure: a retrospective study with 862 patients

Introdução: No pós-operatório de pacientes submetidos à cirurgia bariátrica, o comportamento do ferro e ferritina séricos são pouco estudados. O objetivo deste estudo foi avaliar a evolução dos níveis séricos destas variáveis no pós-operatório de pacientes submetidos à cirurgia bariátrica. Método: Estudo retrospectivo incluindo pacientes submetidos à cirurgia bariátrica no período de janeiro de 2011 a dezembro de 2013. Foram excluídos pacientes menores de 18 anos, não submetidos à técnica do by-pass gástrico de Fobi-Capella (em Y-de-Roux) e que não possuíam exame laboratorial no acompanhamento ambulatorial. As variáveis registradas foram sexo, idade, data da cirurgia, hemoglobina, ferro e ferritina. Foram comparados resultados com três, seis e 12 meses de pós-operatório. Utilizou-se o teste T pareado para comparação das dosagens laboratoriais ao longo do tempo. O nível de significância adotado foi de 5% (p<0,05). Resultados: Foram analisados dados relativos a 862 pacientes (573 mulheres; 66,5%) com idade mediana de 36 (18-69) anos. Não houve diferença significante ao longo do tempo estudado em relação à hemoglobina (média (DP)=13,1±1,3 g/dl no 3º mês; 13,1±1,5 g/dl no 6º mês; e 13,0±2,0 g/dl no 12º mês; p>0.05). A dosagem de ferro sérico aumentou progressivamente do 3º para o 12º mês de pósoperatório (3º mês: 82,21±26,61 mcg/dl; 6º mês: 91,42±41,00 mcg/dl e 12º mês: 99,79±38,94 mcg/dl; p<0,001). Contrariamente, houve queda da ferritina sérica ao longo do período estudado (3º mês: 234,43±242,86 ng/ml; 6º mês: 208,46±246,64 ng/ml e 12º mês: 155,21±163,08 ng/ ml;p<0.01). Conclusão: Ferro e ferritina séricos têm variações opostas no pós-operatório tardio de cirurgia bariátrica. Entretanto, essas alterações em paciente recebendo atenção nutricional não foram suficientes para determinar anemia no seguimento de até 1 ano de pós-operatório.(AU)

Introduction: The seric changes of iron and ferritin in patients submitted to bariatric procedure are seldom reported. The aim of this study was to evaluate the evolution of the levels of iron and ferritin during the late postoperative course of patients undergoing bariatric surgery. Method: Retrospective study including patients submitted to bariatric procedure from January 2011 to December 2013 with three months of follow-up. Age less of 18 years-old, procedure other than Fobi-Capella gastric by-pass (Roux-en-Y), previous hematological disorders, and lack of postoperative laboratorial exams were items of exclusion criteria. The following variables were collected: sex, age, date of the surgical procedure, hemoglobin, seric iron and ferritin. The data were collected at 3rd; 6th; and 12th postoperative month. Paired T test were used to compare the evolution of the dosages. A 5% level of significance (p<0.05) was established. Results: We analyzed the data of 862 patients ((573 females; 66.5%) with a median age of 36 (18-69) years-old. There was no difference on the hemoglobin levels along the three-time points (mean (SD)=13.1±1.3 g/dl at 3rd month; 13.1±1.5 g/dl at 6th month; and 13.0±2.0 g/dl at 12th month; p>0.05). The seric iron significantly increased from 3rd to 12th postoperative month (3rd month: 82.21±26.61 mcg/dl; 6th month: 91.42±41.00 mcg/dl and 12th month: 99,79±38,94 mcg/dl; p<0,001). Conversely, there was a fall of the seric ferritin along the study (3rd month: 234.43±242.86 ng/ml; 6th month: 208.46±246.64 ng/ml and 12th month: 155.21±163.08 ng/ml; p<0.01). Conclusion: Serum iron and ferritin have opposite variation during late postoperative of bariatric surgery. However, these alterations in patients receiving nutritional attention were not sufficient to promote anemia in the follow-up of at least one year postoperatively.(AU)

Anemia e níveis de hemoglobina em crianças indígenas Xavante, Brasil Central / Anemia and hemoglobin levels among Indigenous Xavante children, Central Brazil

RESUMO: Objetivo: Avaliar a prevalência de anemia, os níveis médios de hemoglobina e os principais fatores nutricionais, demográficos e socioeconômicos associados em crianças Xavante, em Mato Grosso, Brasil. Métodos: Realizou-se inquérito em duas comunidades indígenas Xavante na Terra Indígena Pimentel Barbosa visando avaliar todas as crianças com menos de dez anos. Foram coletados dados de concentração de hemoglobina, antropometria e aspectos socioeconômicos/demográficos por meio de avaliação clínica e questionário estruturado. Utilizaram-se os pontos de corte recomendados pela Organização Mundial da Saúde (OMS) para a classificação de anemia. Análises de regressão linear com hemoglobina como desfecho e regressão de Poisson com variância robusta com presença ou não de anemia como desfechos foram realizadas (intervalo de confiança de 95% -IC95%). Resultados: Os menores valores médios de hemoglobina ocorreram nas crianças com menos de dois anos, sem diferença significativa entre os sexos. A anemia atingiu 50,8% das crianças, prevalecendo aquelas com menos de dois anos 2 anos (77,8%). A idade associou-se inversamente à ocorrência de anemia (razão de prevalência - RP - ajustada = 0,60; IC95% 0,38 - 0,95) e os valores médios de hemoglobina aumentaram significativamente conforme o incremento da idade. Os maiores valores de escores z de estatura-para-idade reduziam em 1,8 vez a chance de ter anemia (RP ajustada = 0,59; IC95% 0,34 - 1,00). A presença de outra criança com anemia no domicílio aumentou em 52,9% a probabilidade de ocorrência de anemia (RP ajustada = 1,89; IC95% 1,16 - 3,09). Conclusão: Elevados níveis de anemia nas crianças Xavante sinalizam a disparidade entre esses indígenas e a população brasileira geral. Os resultados sugerem que a anemia é determinada por relações complexas e variáveis entre fatores socioeconômicos, sociodemográficos e biológicos.

ABSTRACT: Objective: To evaluate the prevalence of anemia, mean hemoglobin levels, and the main nutritional, demographic, and socioeconomic factors among Xavante children in Mato Grosso State, Brazil. Methods: A survey was conducted with children under 10 years of age in two indigenous Xavante communities within the Pimentel Barbosa Indigenous Reserve. Hemoglobin concentration levels, anthropometric measurements, and socioeconomic/demographic data were collected by means of clinical measurements and structured interviews. The cut-off points recommended by the World Health Organization were used for anemia classification. Linear regression analyses with hemoglobin as the outcome and Poisson regression with robust variance and with the presence or absence of anemia as outcomes were performed (95%CI). Results: Lower mean hemoglobin values were observed in children under 2 years of age, without a significant difference between sexes. Anemia was observed among 50.8% of children overall, with the highest prevalence among children under 2 years of age (77.8%). Age of the child was inversely associated with the occurrence of anemia (adjusted PR = 0.60; 95%CI 0.38-0.95) and mean hemoglobin values increased significantly with age. Greater height-for-age z-score values reduced the probability of having anemia by 1.8 times (adjusted PR = 0.59; 95%CI 0.34-1.00). Presence of another child with anemia within the household increased the probability of the occurrence of anemia by 52.9% (adjusted PR = 1.89; 95%CI 1.16-3.09). Conclusion: Elevated levels of anemia among Xavante children reveal a disparity between this Indigenous population and the national Brazilian population. Results suggest that anemia is determined by complex and variable relationships between socioeconomic, sociodemographic, and biological factors.

Salivary Iron (Fe) Ion Levels, Serum Markers of Anemia and Caries Activity in Pregnant Women / Níveis de íon ferro (Fe) salivar, marcadores séricos de anemia, e atividade de cárie em mulheres grávidas

Abstract Introduction Anemia is a very frequent event among pregnant women. There are evidences of differences in the incidence of dental caries between pregnant and nonpregnant women, but the relationship between salivary iron (Fe) and serummarkers of anemia and caries development has not been investigated. Objective To evaluate the correlation between salivary (Fe) and serum iron (Fe, ferritin and hemoglobin) parameters in pregnant women with the development of dental caries. Methods A prospective cohort was conducted with 59 women. The outcome of interest was represented by new dental caries lesions during pregnancy, using the Nyvad criteria. Pregnant women were evaluated at three clinical times: up to the 16th week of gestational age (GA) (T1), in the last trimester of pregnancy (T2), and postpartum (T3), at the Mother and Child Unit ofUniversityHospital of the Universidade Federal doMaranhão.A stimulated saliva sample was collected for biochemical analysis of salivary Fe, and a blood sample was collected early in the morning. The correlation between salivary and serum Fe was evaluated through the Pearson correlation test. Analysis of variance (ANOVA) and Kruskal-Wallis were used to compare the means of anemia parameters at different times. The Student's t and Mann-Whitney tests were used to compare the anemia parameters between the groups of pregnant women (with and without new caries lesions). Results SerumFe concentrationswere higher in the first trimester of pregnancy and lower after delivery (p = 0.036). It was also observed that the ferritin concentrations were higher in the first trimester and lower at the end of gestation (p = 0.011). Therewas no association between the expositions of salivary iron and anemia, and the development of dental caries. There was a positive correlation between serum Fe in T1 and salivary Fe in T2 (p < 0.05). Conclusion The serummarkers of anemiaweremore prevalent in the last trimester of pregnancy.

Resumo Introdução A anemia é um evento muito frequente entre mulhres grávidas. Existem evidências de diferenças na incidência de cárie dentária entre mulheres grávidas e não grávidas,mas a relação entre o íon ferro (Fe) salivar, osmarcadores séricos de anemia e o desenvolvimento de cárie não foi investigada. Objetivo Avaliar a correlação entre os parâmetros salivares (Fe) e séricos (Fe, ferritina e hemoglobina) em gestantes e o desenvolvimento de cárie dentária. Métodos Uma coorte prospectiva foi conduzida com 59 mulheres. O desfecho de interesse foi representado por novas lesões de cárie durante a gravidez, medido pelo critério Nyvad. Mulheres grávidas foram avaliadas em três tempos clínicos: até a 16ª semana de idade gestacional (IG) (T1), no último trimestre de gravidez (T2), e no puerpério (T3), na Unidade Materno-infantil do Hospital Universitário da Universidade Federal do Maranhão. A amostra de saliva estimulada foi coletada para análise bioquímica de Fe salivar, e a amostra de sangue foi coletada no início da manhã. A correlação entre o Fe salivar e o Fe sérico foi avaliada através do teste de correlação de Pearson. Os testes ANOVA e Kruskal-Wallis foram utilizados para comparar parâmetros de anemia em diferentes momentos. Os testes t de Student e Mann-Whitney foram utilizados para comparar os parâmetros da anemia entre os grupos de gestantes (come sem lesões de cárie). Resultados As concentrações séricas de Fe foram maiores no primeiro trimestre de gestação e menores após o parto (p = 0,036). Observou-se também que as concentrações de ferritina forammaiores no primeiro trimestre emenores no final da gestação (p = 0,011). Não houve associação entre as exposições e o desenvolvimento de cárie dentária. Houve correlação positiva entre o Fe sérico em T1 e o Fe salivar em T2 (p < 0,05). Conclusão Os marcadores séricos de anemia foram mais prevalentes no último trimestre de gestação.

Prevalência de Anemia em Pacientes com Insuficiência Cardíaca / Prevalence of Anemia in Patients with Heart Failure

A prevalência de anemia bem como a morfologia das hemácias em pacientes internados porinsuficiência cardíaca (IC) não são totalmente conhecidos. Objetivo: Verificar a prevalência de anemia em pacientes diagnosticados com IC, caracterizar o seu padrão morfológico e verificar a sua associação com a classe funcional da NYHA. Métodos: Estudo transversal, retrospectivo, com 144 pacientes do Sistema Único de Saúde, internados por IC no Hospital da Cruz Vermelha, Curitiba, PR de janeiro de 2010 a julho de 2014. Dados sócio demográficos e informações do hemograma admissional foram obtidos nos prontuários dos pacientes. A análise do hemograma incluiu: níveis de hemoglobina, volume corpuscular médio (VCM), concentração de hemoglobina corpuscular média (CHCM) e índice de anisocitose (RDW). Os valores de referência para caracterizar a anemia seguiram orientação da Organização Mundial da Saúde. Resultados: População estudada com distribuição semelhante de sexo (52,8% homens), média de idade 67,8±13,8 anos e quase a totalidade (95,8%) se declarou de etnia branca. A prevalência de anemia nessa população foi 41,0%, a maioria (38,2%) correspondendo a graus leves e moderados. A classe funcional III (CF III) foi a mais prevalente (63,2%) seguida da CF IV (31,3%). A principal característica morfológica encontrada foi normocítica e hipocrômica com 49,1%. Encontrou-se correlação da anemia com o aumento da faixa etária (>60anos), com p=0,008. Conclusões: A prevalência da anemia em pacientes com IC foi maior nas faixas etárias mais avançadas, em CF III e IV, e a principal característica morfológica foi a normocítica e hipocrômica...

Background: The prevalence of anemia and the morphology of red blood cells in patients hospitalized with heart failure (HF) are not totally known. Objective: To check the prevalence of anemia in patients diagnosed with HF, characterize the morphology and check its associationwith NYHA functional class. Methods: Cross-sectional retrospective study with 144 patients from the Brazilian Public Health System hospitalized for HF atHospital da Cruz Vermelha, Curitiba, PR, January 2010 to July 2014. Sociodemographic data and admission blood count information were taken from the patients’ medical records. The blood count analysis included: hemoglobin levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and anisocytosis index (RDW). The reference values to characterize anemia followed the World Health Organization’s guidelines.Results: Population studied with similar distribution of sex (52.8% men), mean age 67.8±13.8 years and nearly all of them (95.8%) self-reported white ethnicity. Anemia prevalence in this population was 41.0%, the majority (38.2%) corresponding to mild to moderate degrees. Functional class III (FC III) was the most prevalent one (63.2%), followed by FC IV (31.3%). The main morphological characteristicfound was normocytic and hypochromic with 49.1%. Correlation of anemia with increasing age (>60 years) was found with p=0.008. Conclusions: Prevalence of anemia in patients with HF was higher in older age groups, in FC III and IV, and the main morphological characteristic was normocytic and hypochromic...

Association between Vitamin D Deficiency and Anemia in Patients with End-Stage Renal Disease: A Cross-Sectional Study

PURPOSE: Despite new treatment strategies, anemia remains the most prevalent complication in patients with end-stage renal disease (ESRD). We investigated whether 25-hydroxyvitamin D [25(OH)D3] deficiency was associated with anemia in ESRD patients. MATERIALS AND METHODS: We reviewed the medical records of 410 ESRD patients who had undergone renal transplantation (RTx) at Yonsei University Health System and who had 25(OH)D3 levels measured at the time of RTx. Patients were divided into two groups based on baseline 25(OH)D3 concentrations: group 1, 25(OH)D3 levels <10 ng/mL; and group 2, 25(OH)D3 levels ≥10 ng/mL. RESULTS: Using multivariate regression models, 25(OH)D3, age, and erythrocyte-stimulating agent (ESA) dose were found to be significantly associated with hemoglobin (Hb) levels [25(OH)D3: β=0.263, p<0.001; age: β=0.122, p=0.010; ESA dose: β=-0.069, p=0.005]. In addition, logistic regression analysis revealed that patients in group 1 had a significantly higher risk for developing anemia (Hb level <10 g/dL) compared to group 2 patients, even after adjusting for potential risk factors for anemia (odds ratio=3.857; confidence interval=1.091-13.632; p=0.036). CONCLUSION: 25(OH)D3 deficiency was significantly associated with anemia in patients with ESRD. Randomized controlled trials are needed to determine whether vitamin D supplementation can improve anemia in these patients.

Anemia and iron deficiency in Mexican elderly population: Results from the Ensanut 2012 / Anemia y deficiencia de hierro en adultos mayores mexicanos: Resultados de la Ensanut 2012

Objective. To describe de prevalence of iron deficiency (ID) and anemia in a sample of Mexican elderly population from the National Health and Nutrition Survey (Ensanut) 2012. Materials and methods. 1 920 subjects ≥60 years of age were included. Hemoglobin, serum concentrations of ferritin and CRP were measured. The risk for ID and anemia adjusted for potential confounders was assessed in logistic regression models. Results. The overall prevalence of anemia was 13.9%, 15.2% in males and 12.8% females. For ID, overall it was 4.2%, males 4.0% and females 4.3%. The greatest prevalence of ID was found in males and females over 80 years old (6.9 and 7.0%, respectively). ID was present in 1.5 of 10 Mexican elders with anemia. Conclusion. The prevalence of anemia was high in the elderly, however the prevalence of ID was low; there is a need to further investigate the causes of anemia in this age group.

Objetivo. Describir la prevalencia de deficiencia de hierro (DH) y anemia en adultos mayores (AM) mexicanos participantes de la Encuesta Nacional de Salud y Nutrición 2012. Material y métodos. 1 920 sujetos ≥60 años fueron incluidos. Se midió hemoglobina, concentraciones séricas de ferritina y PCR. El riesgo de DH y anemia ajustada por confusores fueron evaluados por medio de modelos de regresión logística. Resultados. La prevalencia de anemia fue 13.9% (15.2% hombres, 12.8% mujeres) y de DH 4.2%, (4.0% hombres, 4.3% mujeres). La mayor prevalencia de ID se encontró en mayores de 80 años (6.9% hombres, 7.0% mujeres). 1.5 de 10 adultos mayores mexicanos con anemia presentaron DH. Conclusión. La prevalencia de anemia continua siendo alta en los adultos mayores, mientras que la prevalencia de DH es baja. Es necesario investigar las causas de anemia en este grupo de edad.

Evaluation of clinical and laboratory variables associated with anemia in pediatric patients on hemodialysis / Avaliação de variáveis clínicas e laboratoriais associadas à anemia em pacientes pediátricos em hemodiálise

OBJECTIVE: To identify the occurrence of anemia in pediatric patients on hemodialysis and the association between hemoglobin levels and anemia in CKD-related variables. METHODS: This was a retrospective study. Patients aged up to 18 years with chronic kidney disease undergoing hemodialysis at this service between January of 2009 and December of 2010 were selected. Clinical and laboratory data were obtained from medical records. Statistical analysis was performed with chi-squared test, Student's t-test and general estimating equations (GEE) using SPSS 20.0, assuming a significance level of 5%. RESULTS: A total of 357 medical records depicting the monthly evolution of 29 patients were analyzed. The most common etiology for chronic kidney disease was malformations of the genitourinary tract (28%). Hemoglobin showed a mean (standard deviation) value of 9.20 (1.8) g/dL, with the occurrence of anemia in 65.3% of cases. Anemia was associated with hospitalization; antibiotic use; transfusion; use of intravenous iron hydroxide; low values of creatinine, hematocrit, and albumin; and high values of ferritin, aluminum, and equilibrated Kt/V (p < 0.05). The odds ratio for anemia with the use of intravenous iron hydroxide was 0.36 (95% CI: 0.25 to 0.89), i.e., a 2.78-fold higher chance of developing anemia without the use of this medication. CONCLUSIONS: Anemia predominated in children and adolescents with chronic kidney disease; intravenous iron hydroxide use was a protective factor. .

OBJETIVO: Identificar a ocorrência de anemia entre pacientes pediátricos em hemodiálise e a associação entre os valores de hemoglobina e variáveis relacionadas à anemia na DRC. MÉTODOS: Estudo retrospectivo. Selecionados pacientes até 18 anos com doença renal crônica em hemodiálise no serviço entre janeiro de 2009 e dezembro de 2010. Verificados prontuários para coleta de dados clínicos e laboratoriais. Análise estatística com testes de qui-quadrado, t de Student e General Estimating Equations (GEE) em programa Statistical Package for the Social Sciences 20.0, assumindo-se nível de significância de 5%. RESULTADOS: Analisadas 357 fichas de evolução médica mensal de 29 pacientes. A etiologia mais frequente para a doença renal crônica foram as malformações do trato genito-urinário (28%). Hemoglobina apresentou valor médio (desvio padrão) de 9,20 (1,8) g/dL, com ocorrência de anemia em 65,3% das consultas. Anemia associou-se a internação, uso de antibiótico, transfusão, uso de hidróxido de ferro endovenoso, valores baixos de creatinina, hematócrito e albumina e valores altos de ferritina, alumínio e Kt/V equilibrado (p < 0,05). A odds ratio para anemia com uso de hidróxido de ferro endovenoso foi 0,36 (95% IC 0,25-0,89), ou seja, uma chance 2,78 vezes maior de desenvolver anemia sem o uso dessa medicação. CONCLUSÕES: A anemia predominou em crianças e adolescentes com doença renal crônica, tendo como fator protetor o uso de hidróxido de ferro endovenoso. .

Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years / Deficiência de ferro e anemia estão associadas com baixos níveis de retinol em crianças de 1 a 5 anos

OBJECTIVE: To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. METHODS: This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n = 692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. RESULTS: The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p < 0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p < 0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r = 0.597; p < 0.001) and hemoglobin vs. retinol serum (r = 0.770; p < 0.001). CONCLUSIONS: Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency. .

OBJETIVO: Analisar a ocorrência de anemia e de deficiência de ferro em crianças de 1 a 5 anos e a associação destes desfechos com a deficiência de retinol. MÉTODOS: Trata-se de um estudo observacional analítico do tipo transversal, realizado no município de Vitória - ES, entre abril e agosto de 2008, com crianças (n = 692) saudáveis de 1 a 5 anos, residentes em áreas de abrangência de Unidades Básicas de Saúde. Foram avaliados dados sociodemográficos, econômicos, dietéticos (ingestão de energia, proteína, ferro e vitamina A), antropométricos (índice de massa corporal-por-idade e estatura-por-idade) e bioquímicos (níveis séricos de ferritina, hemoglobina e retinol). RESULTADOS: Detectou-se anemia, deficiência de ferro e deficiência de retinol em 15,7%, 28,1% e 24,7% das crianças, respectivamente. A análise univariada evidenciou maior ocorrência de anemia (RP: 4,62; IC 95%: 3,36; 6,34, p < 0.001) e de deficiência de ferro (RP: 4,51; IC 95%: 3,30; 6,17, p < 0.001) entre crianças que apresentavam deficiência de retinol. As mesmas relações se mantiveram após o ajuste pelas variáveis socioeconômicas, demográficas, dietéticas e antropométricas. Houve relação positiva entre os valores de ferritina sérica vs. retinol (r = 0,597; p < 0,001) e hemoglobina vs. retinol (r = 0,770; p < 0,001). CONCLUSÕES: A anemia e a deficiência de ferro mostraram-se associadas com baixos níveis de retinol em crianças de 1 a 5 anos, e houve correlação positiva dos níveis de retinol com os de ferritina sérica e hemoglobina. Isto torna importante iniciativas que estimulem o desenvolvimento de novos tratamentos e a ampliação de pesquisas em relação à deficiência ...

Influence of age on the haemoglobin concentration of malaria-infected patients in a reference centre in the Brazilian Amazon

Anaemia is amongst the major complications of malaria, a major public health problem in the Amazon Region in Latin America. We examined the haemoglobin (Hb) concentrations of malaria-infected patients and compared it to that of malaria-negative febrile patients and afebrile controls. The haematological parameters of febrile patients who had a thick-blood-smear performed at an infectious diseases reference centre of the Brazilian Amazon between December 2009-January 2012 were retrieved together with clinical data. An afebrile community control group was composed from a survey performed in a malaria-endemic area. Hb concentrations and anaemia prevalence were analysed according to clinical-epidemiological status and demographic characteristics. In total, 7,831 observations were included. Patients with Plasmodium falciparum infection had lower mean Hb concentrations (10.5 g/dL) followed by P. vivax-infected individuals (12.4 g/dL), community controls (12.8 g/dL) and malaria-negative febrile patients (13.1 g/dL) (p < 0.001). Age, gender and clinical-epidemiological status were strong independent predictors for both outcomes. Amongst malaria-infected individuals, women in the reproductive age had considerably lower Hb concentrations. In this moderate transmission intensity setting, both vivax and falciparum malaria are associated with reduced Hb concentrations and risk of anaemia throughout a wide age range.

Prevalência de anemia na artrite reumatoide / The prevalence of anemia in rheumatoid arthritis

Objetivos: O objetivo desse estudo foi avaliar a prevalência de anemia em pacientes com artrite reumatoide (AR). Pacientes e métodos: 89 pacientes que satisfaziam os critérios do American College of Rheumatology (ACR) para AR foram incluídos nesse estudo. A duração média da doença foi 10,9±8,8 anos. Todos os pacientes foram medicados com metotrexato (10,5±5,5 mg/semana) em combinação com ácido fólico. Hormônios esteroides foram receitados para 92% dos pacientes (19,3±3,8 mg/dia).Velocidade de hemossedimentação (VHS), níveis de hemoglobina, proteína C reativa (PCR), fator de necrose tumoral alfa (TNFα) e interleucina-1 beta (IL1β) foram avaliados em todos os pacientes. Os critérios da Organização Mundial da Saúde (OMS) para anemia utilizam um limiar para hemoglobina de <120 g/L para mulheres e de <130 g/L para homens. Resultados: Anemia foi observada em 57 (64%) dos pacientes (1º grupo); os demais pacientes (2º grupo) tinham níveis normais de hemoglobina (135,5±10,7 g/L). A duração e a atividade de AR foram significativamente maiores (p<0,05) no 1º versus 2º grupo. Os níveis médios de VHS, PCR, TNFα e IL-1β estavam significativamente aumentados (p<0,05) no 1º versus 2º grupo. Foram observadas correlações negativas entre o nível de hemoglobina e as concentrações de VHS, PCR, TNFα e IL-1β. Conclusão: Esse estudo demonstrou pela primeira vez que, na Ucrânia, 46% dos pacientes com AR apresentavam anemia. Um nível reduzido de hemoglobina foi associado à atividade intensa da doença. .

Objectives: The aim of this study was to evaluate the prevalence of anaemia in rheumatoid arthritis (RA). Patients and methods: 89 patients who fulfilled American College of Rheumatology (ACR) criteria for RA were included in this study. The mean disease duration was 10.9±8.8 years. All patients received methotrexate (10.5±5.5 mg/week) in combination with folic acid. Steroid hormones were prescribed to 92% (19.3±3.8 mg/day) of patients. Erythrocyte sedimentation rate (ESR) and levels of hemoglobin, C-reactive protein (CRP), tumour necrosis factor-alpha (TNFα) and interleukin-1 beta (IL-1β) were evaluated in all patients. The World Health Organization (WHO) criteria for anaemia uses a hemoglobin threshold of <120 g/L for women and <130 g/L for men. Results: Anaemia was observed in 57 (64%) of the patients (1st group), the other patients (2nd group) had normal levels of hemoglobin (135.5±10.7 g/L). Duration and activity of RA were significantly higher (p<0.05) in the 1st group compared with the 2nd. ESR, CRP, TNFα, and IL1β mean levels were significantly increased (p<0.05) in the 1st group when compared with the 2nd group. Negative correlations between hemoglobin level and ESR, CRP, TNFα, and IL1β concentrations were observed. Conclusion: This study showed for the first time in Ukraine that in 46% of patients with RA, anaemia was diagnosed. A reduction of hemoglobin level was associated with a high activity of disease. .