Etiology of Anemia in Older Mexican Adults: The Role of Hepcidin, Vitamin A and Vitamin D.

Vanessa De La Cruz-Góngora,Salvador Villalpando,Mario Flores-Aldana,Aarón Salinas-Rodríguez

doi:10.3390/nu13113814

Vanessa De La Cruz-Góngora, Salvador Villalpando + Show 2 more

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https://doi.org/10.3390/nu13113814

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Journal: Nutrients	Publication Date: Oct 27, 2021
Citations: 6	License type: CC BY 4.0

Affiliation: Instituto Nacional de Salud Pública

Abstract

Anemia in older adults is a growing public health issue in Mexico; however, its etiology remains largely unknown. Vitamin A deficiency (VAD) and vitamin D deficiency (VDD) have been implicated in the development of anemia, though by different mechanisms. The aim of this study is to analyze the etiology of anemia and anemia-related factors in older Mexican adults. This is a cross-sectional study of 803 older adults from the southern region of Mexico in 2015. The anemia etiologies analyzed were chronic kidney disease (CKD), nutritional deficiencies (ND), anemia of inflammation (AI), anemia of multiple causes (AMC) and unexplained anemia (UEA). VAD was considered to be s-retinol ≤ 20 μg/dL, and VDD if 25(OH)D < 50 nmol/L. IL-6 and hepcidin were also measured. Multinomial regression models were generated and adjusted for confounders. Anemia was present in 35.7% of OA, independent of sex. UEA, CKD, AI and ND were confirmed in 45%, 29.3%, 14.6% and 7% of older adults with anemia, respectively. Hepcidin and log IL-6 were associated with AI (p < 0.05) and CKD (p < 0.001). VAD was associated with AI (p < 0.001), and VDD with ND and AMC (p < 0.05). Log-IL6 was associated with UEA (p < 0.001). In conclusion, anemia in older adults has an inflammatory component. VAD was associated to AI and VDD with ND and AMC.

Highlights

Descriptive characteristics of older adults are shown in Table 1; 10.9% of older adults had VB12D, 5% ID, 9% vitamin D deficiency (VDD), and 2.5% Vitamin A deficiency (VAD)
Our results showed an association between 25(OH)D and anemia, but contrary to our expectations, none were found between VDD and anemia of inflammation (AI) or chronic kidney disease (CKD); VDD was, associated with nutritional deficiencies and anemia of multiple causes (AMC)
Anemia was highly prevalent in the study population of older adults

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Anemia in older adults is a serious health problem that affects quality of life and predicts short-term survival [2]. National survey data have revealed a significant and increasing prevalence of anemia in older adults, no study has characterized the magnitude of its main causes in the Mexican population [3]. Significant variations have been documented in the magnitude of each known cause of anemia in older adults, due to different study criteria, methods and populations [4]. One third of this condition has been attributed to chronic inflammation and CKD, one third to nutritional deficiencies, and a similar proportion (≈30%) remains of unknown etiology [5]

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