Abstract
BackgroundAnemia is associated with impaired quality of life (QoL). We examined the relationship between anemia and QoL in the Korean population using the EuroQol five-dimensional (EQ-5D) questionnaire.MethodsData of 30,526 subjects were included from the Korean National Health and Nutrition Examination Survey (2008–2016). The QoL was assessed using three-levels of the EQ-5D questionnaire (G1, G2, and G3). Analysis of variance was used to compare the prevalence of anemia according to the three levels of health status in each of the five dimensions of EQ-5D. Multiple linear regression analysis was used to evaluate the association between hemoglobin level and QoL, and multivariable logistic regression analysis was used to evaluate the odds ratios (ORs) and 95% confidence intervals (CIs) for low levels of each of the five dimensions of EQ-5D.ResultsAs the level of EQ-5D was worse (from G1 to G3), the prevalence of anemia increased (p for trend < 0.001). Hemoglobin level and EQ-5D showed positive association after adjusting for all covariates such as age, sex, smoking, alcohol drinking, exercise, education, income, marital status, urban living, diabetes mellitus, hypertension, hypercholesterolemia, chronic kidney disease, total calorie intake, and protein intake. Subjects with anemia had increased ORs for low levels (G2 + G3) of each dimension of EQ-5D compared to subjects without anemia. ORs and 95% CIs for mobility, self-care, and usual activities were 1.208(1.078, 1.353), 1.161(0.98, 1.376), and 1.331(1.173, 1.51), respectively, after adjusting for all covariates. Pain/discomfort and anxiety/depression were not associated with increased ORs for low levels of EQ-5D.ConclusionsIn South Korea, low QoL was associated with anemia, particularly in the mobility, self-care, and usual activities dimensions of EQ-5D.
Highlights
Anemia is associated with impaired quality of life (QoL)
Anemia is associated with morbidity and mortality [8, 9], and is the major cause of years lived with disability since 1990 [5], indicating that anemia often affects individuals with poor health who require comprehensive health care services [7]
Subjects with anemia were older and had lower protein intake, and there were lower percentage of men, smokers, alcohol drinkers, subjects with an education ≥9 years, subjects who lived in urban areas, subjects with hypercholesterolemia; there was a higher percentage of subjects with low income (Q1), who lived with their spouse, and had diabetes mellitus (DM) or Chronic kidney disease (CKD)
Summary
Anemia is associated with impaired quality of life (QoL). We examined the relationship between anemia and QoL in the Korean population using the EuroQol five-dimensional (EQ-5D) questionnaire. Hb ≤ 12 g/dL was associated with decreased QoL and functional status among patients with cancer [10, 11]. Frequent experience of anemia symptoms may have a negative impact on daily life [8, 13,14,15]. Many studies on the relationship between anemia and QoL used relatively small samples or specific populations such as the elderly [7, 14, 15], patients with cancer [10, 11, 13, 16], and middle-aged women [17]. We investigated the relationship between anemia and QoL using nationally representative data from the KNHANES
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