Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort–based cross-sectional study
Mohammad Zamani, Formal analysis, Investigation, Methodology, Software, Writing – original draft, 1 , ‡Hossein Poustchi, Conceptualization, Methodology, Project administration, Resources, Writing – review & editing, 2 , ‡Amaneh Shayanrad, Methodology, Visualization, 2 Farhad Pourfarzi, Conceptualization, Data curation, Writing – review & editing, 3 Mojtaba Farjam, Methodology, Writing – review & editing, 4 Kourosh Noemani, Investigation, Writing – review & editing, 5 Ebrahim Ghaderi, Methodology, Writing – review & editing, 6 Vahid Mohammadkarimi, Conceptualization, Writing – review & editing, 7 Mahmood Kahnooji, Writing – review & editing, 8 Fariborz Mansour-Ghanaei, Data curation, Methodology, 9 Ayoob Rastegar, Conceptualization, Writing – review & editing, 10 Ali Mousavizadeh, Data curation, Writing – review & editing, 11 Shideh Rafati, Data curation, Methodology, 12 Masoumeh Ghoddusi Johari, Conceptualization, Writing – review & editing, 13 Mahmood Moosazadeh, Conceptualization, Writing – review & editing,14 Alizamen Salehifardjouneghani, Data curation, Methodology, 15 , 16 Alireza Ostadrahimi, Conceptualization, Validation,17 Iraj Mohebbi, Data curation, Validation, 18 Alireza Khorram, Methodology, Writing – review & editing, 19Fatemeh Ezzodini Ardakani, Data curation, Writing – review & editing, 20 Maryam Sharafkhah, Formal analysis, Software, 2 Yahya Pasdar, Investigation, Writing – review & editing, 21 Anahita Sadeghi, Investigation, Writing – review & editing, 22 and Reza Malekzadeh, Conceptualization, Project administration, Resources, Writing – review & editing 23 ,*
So far, no comprehensive studies have been performed to assess burden and determinants of anemia in Iran. In the present study, we aimed to answer this query using the data obtained from the Prospective Epidemiological Research Studies in IrAN (PERSIAN).
In this cross-sectional study, we included 161,686 adult participants (aged 35 years and older) from 16 provinces of Iran. Anemia was defined as a hemoglobin concentration of <13 g/dL in males and <12 g/dL in females. To evaluate the association between anemia and different factors, we used the multivariable Poisson regression analysis with robust variance by applying adjusted prevalence ratio (PR) with 95% confidence interval (CI).
Of the total number of subjects, 72,387 (44.77%) were male and others were female. Mean age was 49.39±9.15 years old. The overall age- and sex-standardized prevalence of anemia was 8.83% (95% CI: 8.70–8.96%) in the included population. The highest and the lowest age- and sex-standardized prevalence of anemia pertained to Hormozgan (37.41%, 95% CI: 35.97–38.85%) and Kurdistan (4.57%, 95% CI: 3.87–5.27%) provinces, respectively. Being female (PR = 2.97), rural residence (PR = 1.24), being retired (PR = 1.53) and housewife (PR = 1.11), third and fourth wealth status quartiles (PR = 1.09 and PR = 1.11, respectively), being underweight (PR = 1.49), drug user (PR = 1.35), inadequate sleep (PR = 1.16), poor physical activity (PR = 1.15), diabetes (PR = 1.09), renal failure (PR = 2.24), and cancer (PR = 1.35) were associated with increased risk of anemia. On the other hand, illiteracy (PR = 0.79) and abdominal obesity (PR = 0.77) decreased the risk of anemia.
According to the results, a variable prevalence of anemia was observed across the included provinces. We tried to provide an informative report on anemia prevalence for health professionals and authorities to take measures for identification and management of the cases of anemia in high-prevalence areas.