Abstract
ObjectiveAnemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally.MethodA cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially.ResultsDuring average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30–60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18–4.85] and 39.11 [18.50–82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12–1.27] and 2.46 [2.14–2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23–24.9 and ≥ 25 vs. 18.5–22.9 kg/m2 were 0.89 [0.78–1.00], 0.89 [0.80–0.99] and 0.78 [0.66–0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73–0.86] and 1.10 [0.99–1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD.ConclusionsThe severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD.
Highlights
Hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident Anemia of chronic disease (ACD)
The severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD
We examined a prospective relationship of common chronic diseases and their severity with the development of ACD in a large cohort of young and middle-aged Korean adults who underwent a regular health screening examination
Summary
Anemia of chronic disease (ACD) refers to normochromic, normocytic, hypoproliferative anemia in the context of acute or chronic inflammatory states, including infections, cancers, and autoimmune conditions.[1, 2] Some epidemiological studies have reported that ACD occurs in clinical conditions accompanied by mild but persistent inflammation including chronic kidney disease (CKD), diabetes mellitus, and aging.[3,4,5] The prevalence of anemia from most causes has decreased globally between 1990 and 2010, but ACD is expected to increase as population ages.[6,7,8] the underlying pathophysiology of ACD is multifactorial, hepcidin may play a central role in ACD.[9]. Anemia of chronic disease (ACD) refers to normochromic, normocytic, hypoproliferative anemia in the context of acute or chronic inflammatory states, including infections, cancers, and autoimmune conditions.[1, 2] Some epidemiological studies have reported that ACD occurs in clinical conditions accompanied by mild but persistent inflammation including chronic kidney disease (CKD), diabetes mellitus, and aging.[3,4,5] The prevalence of anemia from most causes has decreased globally between 1990 and 2010, but ACD is expected to increase as population ages.[6,7,8]. Hepcidin inhibits iron absorption in the intestine and release of recycled iron from macrophages, resulting in reduced efficiency of iron recycling from red blood cells. This functional iron deficiency leads to impaired proliferation of erythroid progenitor cells in the marrow, resulting in iron-restrictive anemia.[3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
