Haemoglobin thresholds to define anaemia from age 6 months to 65 years: estimates from international data sources

作者：Sabine Braat, Katherine Fielding, Jiru Han, Victoria E. Jackson, Sophie Zaloumis, Jessica Xu, Gemma Moir-Meyer, Sophia M. Blaauwendraad, Vincent W. V. Jaddoe, Romy Gaillard, Patricia C. Parkin, Cornelia M. Borkhoff, Charles Keown‐Stoneman, Catherine S. Birken, Jonathon L. Maguire, Melanie Bahlo, Eliza M. Davidson, Sant‐Rayn Pasricha · 发表于：The Lancet Haematology · 年份：2024 · DOI：10.1016/s2352-3026(24)00030-9 · 被引用次数：66 · 研究领域：Iron Metabolism and Disorders、Hemoglobinopathies and Related Disorders、Erythropoietin and Anemia Treatment

BACKGROUND: Detection of anaemia is crucial for clinical medicine and public health. Current WHO anaemia definitions are based on statistical thresholds (fifth centiles) set more than 50 years ago. We sought to establish evidence for the statistical haemoglobin thresholds for anaemia that can be applied globally and inform WHO and clinical guidelines. METHODS: In this analysis we identified international data sources from populations in the USA, England, Australia, China, the Netherlands, Canada, Ecuador, and Bangladesh with sufficient clinical and laboratory information collected between 1998 and 2020 to obtain a healthy reference sample. Individuals with clinical or biochemical evidence of a condition that could reduce haemoglobin concentrations were excluded. We estimated haemoglobin thresholds (ie, 5th centiles) for children aged 6-23 months, 24-59 months, 5-11 years, and 12-17 years, and adults aged 18-65 years (including during pregnancy) for individual datasets and pooled across data sources. We also collated findings from three large-scale genetic studies to summarise genetic variants affecting haemoglobin concentrations in different ancestral populations. FINDINGS: We identified eight data sources comprising 18 individual datasets that were eligible for inclusion in the analysis. In pooled analyses, the haemoglobin fifth centile was 104·4 g/L (90% CI 103·5-105·3) in 924 children aged 6-23 months, 110·2 g/L (109·5-110·9) in 1874 children aged 24-59 months, and 114·4 g...