1999-2020年全国健康与营养调查数据中儿童和孕妇血红蛋白和红细胞压积的一致性

IF 3.7 3区医学 Q2 NUTRITION & DIETETICS

Journal of Nutrition Pub Date : 2025-03-01 DOI:10.1016/j.tjnut.2024.12.029

Maren E Wolf , Maria Elena D. Jefferds , Lisa D Gardner , Zuguo Mei , Christine M Pfeiffer , O. Yaw Addo

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引用次数: 0

摘要

背景：血红蛋白和红细胞压积是临床上用于识别贫血的两种最常见的生物标志物，但它们的结果并不总是一致的。目的：探讨血红蛋白和红细胞压积在1岁儿童贫血诊断中的一致性。方法：孕妇和1岁儿童。结果：分析样本包括7052名儿童和1437名孕妇，其中1119名有妊娠资料。在儿童中，基于血红蛋白的贫血患病率为3.7% (95% CI: 3.1-4.3)，基于血细胞比容的贫血患病率为5.5% （95% CI: 4.7-6.3）。在孕妇中，基于血红蛋白的贫血患病率为7.7% (95% CI: 5.9-9.5)，基于红细胞压积的贫血患病率为12.4% （95% CI: 10.1-14.6）。Kappa总分和社会人口学特征在儿童中为0.64-0.75（中度一致性），在孕妇中为0.53-0.78（弱至中度一致性）。在至少一项检测中有贫血的人中，53.5%的儿童和61.5%的孕妇在两项检测中都有贫血。结论：我们发现两种生物标志物之间存在实质性的不一致；大约50%的儿童和40%的孕妇仅通过两种生物标志物中的一种来识别。由于血红蛋白和红细胞压积在临床中可以互换使用，贫血患者可能会被遗漏，没有得到治疗，因此有较高的不良妊娠、分娩和发育结果的风险。

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Concordance between Hemoglobin and Hematocrit among Children and Pregnant Persons in National Health and Nutrition Examination Survey Data, 1999–2020

Background

Hemoglobin and hematocrit are the 2 most common biomarkers used to identify anemia in clinical settings, but their results do not always agree.

Objectives

To examine agreement between hemoglobin and hematocrit in identifying anemia among children aged 1 to <5 y and pregnant persons.

Methods

Pregnant persons and children aged 1 to <5 y with hemoglobin and hematocrit results from the same whole blood sample in National Health and Nutrition Examination Survey (1999–2020) were included. We used the Centers for Disease Control and Prevention anemia cutoff values for children, pregnancy status, trimester, and smoking adjustments. We examined concordance of anemia, sensitivity, and specificity among those with anemia based on ≥1 test overall and by race/ethnicity, sex, and income level. Cohen’s kappa was used to measure concordance.

Results

Analytic samples included 7052 children and 1437 pregnant persons, of whom 1119 had trimester data. Among children, anemia prevalence was 3.7% [95% confidence interval (CI): 3.1, 4.3] based on hemoglobin and 5.5% (95% CI: 4.7, 6.3) based on hematocrit. Among pregnant persons, anemia prevalence was 7.7% (95% CI: 5.9, 9.5) based on hemoglobin and 12.4% (95% CI: 10.1, 14.6) based on hematocrit. Kappa scores overall and by sociodemographic characteristics ranged from 0.64 to 0.75 (moderate concordance) among children and from 0.53 to 0.78 (weak to moderate concordance) among pregnant persons. Among those with anemia on ≥1 test, 53.5% of children and 61.5% of pregnant persons had anemia based on both tests.

Conclusions

We found substantial discordance between the 2 biomarkers; ∼50% of children and 40% of pregnant women were identified by only 1 of the 2 biomarkers. Because hemoglobin and hematocrit may be used interchangeably in the clinical setting, individuals with anemia may be missed, not receive treatment, and therefore be at higher risk of adverse pregnancy, birth, and developmental outcomes.

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来源期刊

Journal of Nutrition 医学-营养学

CiteScore

7.60

自引率

4.80%

发文量

260

审稿时长

39 days

期刊介绍： The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.