Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort-based cross-sectional study

Authors

Mohammad Zamani 1, Hossein Poustchi 2, Amaneh Shayanrad 2, Farhad Pourfarzi 3, Mojtaba Farjam 4, Kourosh Noemani 5, Ebrahim Ghaderi 6, Vahid Mohammadkarimi 7, Mahmood Kahnooji 8, Fariborz Mansour-Ghanaei 9, Ayoob Rastegar 10, Ali Mousavizadeh 11, Shideh Rafati 12, Masoumeh Ghoddusi Johari 13, Mahmood Moosazadeh 14, Alizamen Salehifardjouneghani 15 16, Alireza Ostadrahimi 17, Iraj Mohebbi 18, Alireza Khorram 19, Fatemeh Ezzodini Ardakani 20, Maryam Sharafkhah 2, Yahya Pasdar 21, Anahita Sadeghi 22, Reza Malekzadeh 23

  1. Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  2. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  3. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
  4. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
  5. Department of Disease Prevention and Control, Deputy of Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  6. Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
  7. Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
  8. Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
  9. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  10. Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
  11. Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
  12. Social Determinants in Health Promotion Research Center, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  13. Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  14. Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
  15. Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
  16. Department of Pediatrics, College of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
  17. Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
  18. Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
  19. Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
  20. Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  21. Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  22. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  23. Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
bmj open

Abstract

Background: 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).

Methods: 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).

Results: 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.

Conclusions: 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.

How to Cite

Zamani M, Poustchi H, Shayanrad A, Pourfarzi F, Farjam M, Noemani K, Ghaderi E, Mohammadkarimi V, Kahnooji M, Mansour-Ghanaei F, Rastegar A, Mousavizadeh A, Rafati S, Johari MG, Moosazadeh M, Salehifardjouneghani A, Ostadrahimi A, Mohebbi I, Khorram A, Ardakani FE, Sharafkhah M, Pasdar Y, Sadeghi A, Malekzadeh R. Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort-based cross-sectional study. PLoS One. 2022 Feb 9;17(2):e0263795. doi: 10.1371/journal.pone.0263795. PMID: 35139138; PMCID: PMC8827433.

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Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort-based cross-sectional study

Tags: Prevalence