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

Authors

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 ,*

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

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.