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PubMed2003

[Study on the hemoglobin levels of children under the age of three years and the prevalence of anemia at high altitude in Tibet of China].

OBJECTIVE: To study the hemoglobin status of children under the age of three years and the prevalence of anemia at high altitude. METHODS: Cross-sectional study and randomly sampling were used. Blood was collected on tip of finger and the level of hemoglobin was measured using B-Hemoglobin photometer. We adjusted the hemoglobin based on altitude, using three methods of CDC, Direen's and Dallman's and then estimated the prevalence of anemia. RESULTS: (1) 1 127 children were examined. The findings indicated that the average hemoglobin was about 120 g/L. There was no significant difference for Hb between boys and girls. Urban children had a higher hemoglobin level (123.3 g/L) than rural children (119.9 g/L). Analysis of covariance indicated that, after controlling the factor of altitude, the mean content of hemoglobin of rural children was lower than that of urban children and hemoglobin varied among districts. (2) Different method used for correction of hemoglobin caused different prevalence rates of anemia but they were higher than un-corrected prevalences: 90.4% for CDC method, 72.3% for Dirren's method and 65.0% for Dallman's method respectively. CONCLUSION: Higher altitude seemed to affect the levels of hemoglobin significantly. The prevalence of anemia in children might be higher, but current hemoglobin correction methods might not be suitable for correcting hemoglobin of Tibetan children. So we suggested that it was imperative to establish a relationship between altitude and hemoglobin of Tibetan children.

Age Factors↗
PubMed1986

Glycosylated hemoglobin levels in a benign form of sickle cell anemia in Saudi Arabia.

Glycosylated hemoglobin was determined by the thiobarbituric acid method in sickle cell anemia patients from the Eastern Province of Saudi Arabia. The level of glycosylated hemoglobin in a Saudi SS sample (4.36%, SD 0.83) is 90% of that of the sample of normals (4.85%, SD 0.51). This is in contrast with the reported value of glycosylated hemoglobin in an American Black SS sample (3.9%, SD 0.6), which is only 60% of that of the sample of normals (6.6%, SD 0.7). The fetal hemoglobin level in Saudi sickle cell patients was 12.03% (SD 4.84), which is significantly different from that of Americans of African origin at p = 0.001. There was no significant correlation (r = 0.236) between the percentages of glycosylated Hb and Hb F at the 10% confidence level. The reported positive relationship between the percentages of glycosylated Hb and Hb F in American Blacks seems to be valid in the Saudi population only up to the level of 10-12% of fetal hemoglobin. Above this threshold of Hb F no further alleviating effect is seen. The 2,3-diphosphoglycerate value in Saudi Hb SS adults was 21.7 mumol/g (SD 7.4) and accordingly only twice as high as that of normal individuals. The benign clinical course exhibited by Saudi sickle cell patients is reflected by the survival of the RBC as indexed by its content of glycosylated Hb and 2,3-diphosphoglycerate. Moreover 10-12% of fetal hemoglobin in the RBC seems sufficient to ameliorate the severity of this disease in patients from the Eastern Province of Saudi Arabia.

Anemia, Sickle Cell↗
PubMed2005

Positive impact of a weekly iron-folic acid supplement delivered with social marketing to Cambodian women: compliance, participation, and hemoglobin levels increase with higher socioeconomic status.

A social marketing program promoting weekly iron-folic acid supplementation improved hemoglobin levels in women of reproductive age in Cambodia. Supplementation was increasingly effective among women of higher socioeconomic status (SES). Among higher SES schoolgirls, 58% took the supplements, compared with 49% for lower SES (P = 0.07). Garment factory workers with an 11th- or 12th-grade education had a mean improvement in hemoglobin of 0.72 g/dL over those with a 5th-grade education or less (P = 0.04). The percentage of rural village women taking supplements increased with increasing SES (linear trend P = 0.046). These results suggest that women with lower SES be given special attention for future programs.

Adolescent↗
PubMedDate not supplied

Morbidity and mortality in patients on dialysis: the impact of hemoglobin levels.

Clinical reports supporting an association between hemoglobin (Hb) levels, morbidity, and mortality were a strong part of the dataset used by the National Kidney Foundation in recommending a target Hb level of 11 to 12 g/dL in patients on dialysis. This article provides an overview of the potential link between Hb correction and improvements in morbidity and mortality in patients on dialysis.

Anemia↗
PubMed2006

[Association between hemoglobin level of children < or = 3 years and anemia of their mother].

OBJECTIVE: To study the relationship between the hemoglobin level of children < or = 3 years and anemia of their mothers. METHODS: Multi-steps cluster sampling was adopted. In order to ensure sufficient number of babies and young children and postpartum in this survey, additional subjects were included in the sample. The subjects in study were collected in the same family. RESULTS: The average anemia prevalence of children < or = 3 years was significant different between urban and rural (26.9%, 94/350 and 32.4%, 594/1835, P < 0.05) areas. The birth weight of anemia children < or = 3 years was significant lower than nonanemic children (P < 0.05); the incidence of low birth weight of anemia children < or = 3 years was significant higher than nonanemic children (P < 0.05); the percentage of Hb < 100 g/L and < 110 g/L were 7.6% (166/2185) and 24.9% (544/2185); the Hb levels of children fed by anemia mother and nonanemic mother were significantly different (115.6 +/- 17.4) g/L, (115.2 +/- 16.7) g/L and (123.3 +/- 14.9) g/L, (122.2 +/- 15.3) g/L, P < 0.001. CONCLUSION: There should be significant relation between the Hb level of children < or = 3 years and anemia of their mother.

Adult↗
PubMed2000

RH blood groups and diabetic disorders: is there an effect on glycosylated hemoglobin level?

Recent cloning of RH genes has elucidated their structure, suggesting that RH proteins are part of an oligomeric complex with transport function in the erythrocyte. This observation prompted us to investigate a possible relationship between the RH system and the glycosylated hemoglobin level (Hb A(1c)) in diabetes. This compound is considered an important indicator- of glycemic control in diabetic disorders. We studied 278 subjects with non-insulin-dependent diabetes mellitus (NIDDM) from the population of Penne, Italy. Glycemic and glycosylated hemoglobin (Hb A(1c)) levels are associated with RH phenotype. Glucose and Hb A(1c) levels are increased in DCcEe subjects and decreased in ddccee subjects as compared to the mean values for other genotypes. Sex, age at onset of disease, duration of disease, and age of patients were also considered. Correlation analysis suggests that these variables influence glycemia directly and Hb A(1c) indirectly. The RH system, on the other hand, seems to influence the Hb A(1c) level directly. Preliminary data on 53 children with insulin-dependent diabetes mellitus (IDDM) from Sardinia seem to confirm the relationship between RH and Hb A(1c) observed in NIDDM. Since glycosylated hemoglobin is found inside red blood cells, the relationship between RH genetic variability and Hb A(1c) level suggests that RH proteins may influence glucose transport through red cell membrane and/or hemoglobin glycation.

Adult↗
PubMed2006

[Hemoglobin level and anemia in children in the State of Pernambuco, Brazil: association with socioeconomic and food consumption factors].

This study aimed to assess hemoglobin level and anemia prevalence and their association with food-consumption and socioeconomic variables. A cross-sectional survey was conducted in the State of Pernambuco, Brazil, in 1997, using three-stage sampling which included 746 6-to-59-month-old children. Hemoglobin testing and a 24-hour food recall interview were performed. The anemia rate was 40.6% and was higher in the rural area and inversely proportional to age, income, and maternal schooling. Most children (88.9%) consumed cow's milk. Anemia was associated directly with the proportion of calories from cow's milk and indirectly with the iron level. Child's age, geographic area, per capita family income, maternal schooling, iron density (total, heme, and non-heme), and the proportion of calories from cow's milk in the diet were determinants for anemia.

Anemia↗
PubMed2001

Impact of hemoglobin level and use of recombinant erythropoietin on efficacy of preoperative chemoradiation therapy for squamous cell carcinoma of the oral cavity and oropharynx.

PURPOSE: We assessed the influence of hemoglobin level and r-HuEPO administration on response to chemoradiotherapy, locoregional tumor control, and overall survival in patients treated with neoadjuvant chemoradiotherapy and surgery for a squamous cell carcinoma of the oral cavity or oropharynx. METHODS AND MATERIALS: The 191 study patients were treated with mitomycin C (15 mg/m(2) day 1), 5-fluorouracil (750 mg/m(2)/day, days 1-5), and radiotherapy (50 Gy in 25 fractions weeks 1-5), followed by resection of the primary tumor bed and neck dissection at the General Hospital Vienna, Austria, between November 1989 and October 1998 for a T2-4, N0-3, M0 SCC of the oral cavity or oropharynx. Starting in May 1996, patients with a low hemoglobin (Hgb) before or during chemoradiotherapy received r-HuEPO 10,000 IU/kg s.c. 3-6 times/week until the week of surgery. RESULTS: On multivariate analysis, Hgb level and use of r-HuEPO were independent prognostic factors for response to chemoradiotherapy and locoregional tumor control (p < 0.01). Pathologic response to neoadjuvant therapy was also predictive of locoregional control (p < 0.001). Patients with a pretreatment Hgb > or = 14.5 g/dL had significantly higher complete response, locoregional control, and survival rates than the patients with a pretreatment Hgb < 14.5 g/dL who did not receive r-HuEPO (p < 0.05). The response, control, and survival rates in patients with a pretreatment Hgb < 14.5 g/dL given r-HuEPO were significantly higher than in low Hgb patients not given r-HuEPO (p < or = 0.001) and equivalent to patients with a pretreatment Hgb > 14.5 g/dL (p > or = 0.3). CONCLUSION: Low pretreatment Hgb is a negative prognostic factor for oral cavity and oropharyngeal SCCA patients, but was completely abrogated by r-HuEpo administration during neoadjuvant chemoradiotherapy. Randomized trials of radiation and/or chemotherapy with or without r-HuEPO for patients whose Hgb level is either low at the start of therapy or is anticipated to become low during therapy are indicated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Abnormalities of glucose metabolism induced by liver cirrhosis and glycosylated hemoglobin levels in chronic liver disease.

UNLABELLED: The prevalence of impaired glucose tolerance (IGT) and diabetes mellitus (DM) such as defined by National Diabetes Data Group criteria, and glycosylated hemoglobin levels were assessed in a series of consecutive patients who had chronic active hepatitis (CAH) or cirrhosis in the absence of any known diabetogenic risk factors and who had normal fasting glycemic levels. Based on oral glucose tolerance test, the prevalence of IGT (15%) and DM (27%) in cirrhosis was significantly higher (p less than 0.005) than that observed in CAH (0%) and controls (0%). In contrast, HbA1 levels were not statistically different in cirrhotic patients (with normal or altered glucose tolerance) as compared with CAH and control subjects. IN CONCLUSION: (a) HbA1 is an unsatisfactory test in the diagnosis of altered glucose tolerance in patients with cirrhosis, and (b) Cirrhosis (but not CAH) represents itself a risk factor for the development of glucose metabolism alterations. Therefore, routine oral glucose tolerance testing is warranted in these patients.

Adult↗
PubMed2005

Correlation between fatigue and hemoglobin level in multiple myeloma patients: results of a cross-sectional study.

This cross-sectional study showed a positive correlation between fatigue-related quality of life, evaluated with the FACT-An questionnaire, and hemoglobin level in 1071 patients with multiple myeloma. Multiple regression analysis adjusting for several covariates was used. Improved FACT-An scores in women and men were associated with hemoglobin increase up to sex-specific normal values.

Fatigue↗
PubMed2005

Hemoglobin levels related to days of illness, race, and Plasmodium species in Colombian patients with uncomplicated malaria.

Prevalence of malaria-related anemia in disease-endemic regions of the American continents has been poorly studied. We describe the relationships between hemoglobin level and race, Plasmodium species, and days of illness in 150 Colombian patients with uncomplicated malaria diagnosed by thick blood smear. Hemoglobin was measured at admission and a standardized questionnaire was used to determine days of illness and other variables. Associations between hemoglobin and the variables were estimated and adjusted according to the other covariates using regression analysis. Plasmodium falciparum and P. vivax were found in similar proportions and mild anemia was present in 50% of the patients. Volunteers were classified as Afro-Colombians (61%) and non-Afro-Colombians (39%). An inverse relationship between hemoglobin and days of illness was identified, and a statistical interaction was found between race and P. falciparum infection in determining the hemoglobin concentration. These observations could guide the design of research to better understand malarial anemia.

Adolescent↗
PubMed2004

Pretreatment serum hemoglobin level and a preliminary investigation of intratumoral microvessel density in advanced ovarian cancer.

OBJECTIVE: The primary aim of this study was to evaluate the prognostic and predictive value of pretreatment serum hemoglobin level (Hb) in advanced ovarian cancer; second aim was to perform a preliminary investigation of intratumoral microvessel density (IMD). METHODS: The influence on survival and response to treatment of several clinico-pathological features, including Hb, was analyzed in 72 patients with advanced ovarian cancer. IMD was assessed in tumor specimens of 25 of the 72 patients to compare three different endothelial markers: anti-FactorVIII, anti-CD31 and anti-CD34. In this subgroup of patients, a preliminary analysis of the prognostic and predictive value of IMD, and its relationship with Hb and other clinico-pathological features, was performed. RESULTS: Hb >or= 12 g/dl was significantly associated with a better overall survival in univariate analysis (P = 0.0181) and was the only independent prognostic variable in multivariate analysis (P = 0.0160). Hb was directly related to progression-free survival (P = 0.0240) and complete response to treatment (P = 0.016). In the preliminary investigation of IMD, mean microvessel count did not show any significant difference among the three endothelial markers used, but anti-CD34 revealed a more consistent staining reaction. The relationship between IMD and complete response to treatment was found near to statistical significance (P = 0.05); Hb and IMD were inversely related (r = -0.47; P = 0.045). CONCLUSIONS: Hb has a prognostic and predictive value in advanced ovarian cancer. In our preliminary study, which was performed on a limited number of patients, we found anti-CD34 to be an optimal marker for IMD determination, IMD to be a possible predictive factor of complete response to treatment, and IMD and Hb to be inversely related.

Adult↗
PubMed2005

Effects of early intervention with epoetin alfa on transfusion requirement, hemoglobin level and survival during platinum-based chemotherapy: Results of a multicenter randomised controlled trial.

This work was conducted to evaluate the effect of early intervention with epoetin alfa (EPO) on transfusion requirements, hemoglobin level (Hb), quality of life (QOL) and to explore a possible relationship between the use of EPO and survival, in patients with solid tumors receiving platinum-based chemotherapy. Three hundred and sixteen patients with Hb12.1g/dL were randomised 2:1 to EPO 10000 IU thrice weekly subcutaneously (n = 211) or best supportive care (BSC) (n = 105). The primary end point was proportion of patients transfused while secondary end points were changes in Hb and QOL. The protocol was amended before the first patient was recruited to also prospectively collect survival data. EPO therapy significantly decreased transfusion requirements (P < 0.001) and increased Hb (P < 0.005). EPO-treated patients had significantly improved QOL compared with BSC patients (P < 0.05). Kaplan-Meier estimates showed no differences in 12-month survival (P = 0.39), despite a significantly greater number of patients with metastatic disease in the EPO group (78% vs. 61%, P = 0.001). EPO was well tolerated. This study has shown that early intervention with EPO can result in a significant reduction of transfusion requirements and increases in Hb and QOL in patients with mild anemia during platinum-based chemotherapy.

Adult↗
PubMed2003

Relationship between resistance to erythropoietin and high anomalous hemoglobin levels in hemodialysis patients with beta-thalassemia minor.

In dialysis patients beta-thalassemia is a cause of resistance to erythropoietin (EPO). The aim of the present study is to evaluate the relationship between the amount of circulating anomalous hemoglobin chain and EPO resistance in hemodialysis. Ten hemodialyzed patients with beta-thalassemia minor were studied. The mean hemoglobin level was 9.22 +/- 0.91 g/dl, the HbA2 ranging between 5.6 and 6.8%; the weekly EPO dose was 13,500 +/- 7,185 IU/week and significantly correlated with HbA2 (r = 0.965; p = 0.0001). When stratifying patients in two groups according to HbA2 level (LOW <6%, n = 4; HIGH >6%, n = 6; HbA2 levels, respectively, 5.7 +/- 0.1 and 6.4 +/- 0.3 g/dl, p = 0.002), it was evidenced that the need of EPO was 13,200 +/- 3,033 IU/week in LOW and 36,167 +/- 13,060 IU/week in HIGH (p < 0.001). The EPO Resistance Index in the two groups was 13.4 +/- 4.1 IU/kg BW/week/g Hb in LOW and 21.9 +/- 10.0 in HIGH (p < 0.05). No differences were evidenced between the two groups regarding age, dialysis, body weight, serum levels of urea nitrogen, creatinine, albumin, C-reactive protein, aluminum, ferritin, transferrin and parathyroid hormone. In conclusion, in patients with beta-thalassemia minor on chronic hemodialysis, the amount of anomalous hemoglobin chain directly correlate with EPO dose, strongly indicating the magnitude of resistance to erythropoietin.

Adult↗
PubMed2005

Association of hemoglobin levels with clinical outcomes in acute coronary syndromes.

BACKGROUND: In the setting of an acute coronary syndrome (ACS), anemia has the potential to worsen myocardial ischemia; however, data relating anemia to clinical outcomes in ACS remain limited. METHODS AND RESULTS: We examined the association between baseline hemoglobin values and major adverse cardiovascular events through 30 days in 39,922 patients enrolled in clinical trials of ACS. After adjustment for differences in baseline characteristics and index hospitalization treatments, a reverse J-shaped relationship between baseline hemoglobin values and major adverse cardiovascular events was observed. In patients with ST-elevation myocardial infarction, when those with hemoglobin values between 14 and 15 g/dL were used as the reference, cardiovascular mortality increased as hemoglobin levels fell below 14 g/dL, with an adjusted OR of 1.21 (95% CI 1.12 to 1.30, P<0.001) for each 1-g/dL decrement in hemoglobin. At the other end of the range of hemoglobin, patients with hemoglobin values >17 g/dL also had excess mortality (OR 1.79, 95% CI 1.18 to 2.71, P=0.007). In patients with non-ST-elevation ACS, with those with hemoglobin 15 to 16 g/dL used as the reference, the likelihood of cardiovascular death, myocardial infarction, or recurrent ischemia increased as the hemoglobin fell below 11 g/dL, with an adjusted OR of 1.45 (95% CI 1.33 to 1.58, P<0.001) for each 1 g/dL decrement in hemoglobin. Patients with hemoglobin values >16 g/dL also had an increased rate of death or ischemic events (OR 1.31, 95% CI 1.03 to 1.66, P=0.027). CONCLUSIONS: Anemia is a powerful and independent predictor of major adverse cardiovascular events in patients across the spectrum of ACS.

Acute Disease↗
PubMed2003

Oxygenation gain factor: a novel parameter characterizing the association between hemoglobin level and the oxygenation status of breast cancers.

Tumor hypoxia has been linked to acquired treatment resistance, tumor progression, and poor prognosis. Because anemia is a major causative factor for the development of hypoxia, the association between blood hemoglobin concentration (cHb) and breast cancer oxygenation was examined in this study. In addition, a novel parameter characterizing the relationship between oxygenation status and rising cHb is introduced: the oxygenation gain factor (OGF). In breast cancer patients, median cHb over the range 8.5-14.7 g/dl correlated positively with the median pO(2) (3-15 mm Hg), yielding an average OGF of 2 mm Hg.dl/g. In contrast, in normal tissues (normal breast, subcutis, and skeletal muscle) the median pO(2) values were substantially higher (52 mm Hg, 51 mm Hg, and 37 mm Hg, respectively) and remained constant irrespective of the hemoglobin level over the range from 10 to 16 g/dl (OGF = 0 in grade I anemia and nonanemic patients). Moderately lower median pO(2) values in subcutis and skeletal muscle were only observed in grade II anemia (8 g/dl < cHb < or =10 g/dl), although this would appear to be of no biological relevance. Conversely, in breast cancers, even mild anemia (grade I anemia) is a major causative factor for the development of hypoxia or anoxia.

Adult↗
PubMedDate not supplied

Gender differences in blood lead and hemoglobin levels in Andean adults with chronic lead exposure.

A field study of the prevalence of lead (Pb) intoxication was conducted in 158 adults (67 men and 91 women) living at 2,500-2,800 meters in Ecuadorian Andean villages with high Pb contamination from local small-scale Pb-glazing cottage industries. Venous blood samples showed mean blood lead (PbB) levels of 34.5 microg/dL (SD 22.2) for men and 27.0 microg/dL (SD 18.4) for women; this difference was significant (t-test, p = 0.022; Mann-Whitney U, p = 0.044). An ANOVA showed no significant main effect for gender (F = 0.118, p = 0.782) or age (F = 2.479, p = 0.117), and no significant gender-by-age interaction (F = 0.273, p = 0.602). In the Pb-glazing study group, 39% of the men had PbB levels > or = 40 microg/dL, while 41% of the women had PbB levels > or = 30 microg/dL (the WHO health-based biological limits). A reference group of 39 adults (24 men and 15 women) had a mean PbB level of 5.9 microg/dL (SD 2.8; range: 1.8-16.8), significantly different from that of the 158 subjects in the study group (t-test, p < 0.0001). The difference in mean PbB levels of men (6.8 microg/dL) and women (4.7 microg/dL) in the reference group was significant (t-test, p = 0.026; Mann-Whitney U, p = 0.019). The mean altitude-corrected hemoglobin levels in the study group were lower than normal, 11.3 g/dL for men and 10.9 g/dL for women.

Adolescent↗
PubMed1983

Serum lipids and glucose as associated with hemoglobin levels and copper and zinc intake in young adults.

The association of copper and zinc intake with serum total cholesterol, HDL-cholesterol, triglycerides, and glucose concentrations were studied in young adults (N=59). Three-day diet records, hair, fasting blood, and overnight urine samples were collected from each subject. Higher hemoglobin concentrations, diet zinc intake, and serum copper:zinc ratios were associated with lower HDL-cholesterol concentrations. Higher hemoglobin and hair copper concentrations were associated with higher cholesterol concentrations. Higher serum copper concentrations were associated with higher triglyceride concentrations and with lower glucose concentrations. Greater hematocrits were associated with lower triglyceride concentrations. Hemoglobin levels had the strongest relationship with cholesterol and HDL-cholesterol. These results appeared inconsistent with the hypothesis on copper:zinc imbalance and reports from animal studies.

Adolescent↗