Predicting the emergence of anemia — A large cohort study

• In a large cohort we show that in a follow-up of 4.7 years, 3% develop anemia.
• In men, diabetes mellitus, older age, low MCV and elevated platelet count predict anemia.
• In women, high total serum protein level and low triglycerides predict anemia.
• These populations warrant a closer follow-up for early identification of anemia.

Background and objectivesWe aimed to find predictors for development of anemia in a large cohort of adults.Patients and methodsCohort study of a large health database from a screening center at the Rabin Medical Center in Israel, between the years 2000–2013. We asked which variables, known at the first visit, would predict anemia at the last visit. Multivariable analysis was conducted using stepwise logistic regression analysis. Odds ratios (ORs) for anemia with 95% confidence intervals (CIs) were calculated.ResultsOur cohort included 10,577 people. At baseline 4.4% were diagnosed with anemia and excluded. Therefore, 10,093 subjects, with a mean age of 42.3 ± 9 years comprised our study sample. At the end of follow-up of 4.7 ± 3.1 years, 307 developed anemia (3%). In men, independent predictors for development of anemia were diabetes mellitus (OR 3.00, 95% CI 1.41–6.39), age (OR 1.03, 95% CI 1.03–1.05, for 1 year increment), low MCV (OR 0.92, 95% CI 0.89–0.96, for every 1 fL unit increment) and elevated platelet count (OR 1.004, 95% CI 1.00–1.01 for 1000/μL unit increment). For women, high total serum protein level was a strong predictor for anemia (OR 3.44, 95% CI 2.33–5.08 for 1 mg/dL increment) as well as low triglycerides (OR 0.996, 95% CI 0.993–1.000 for 1 mg/dL increment).ConclusionsSubgroups who are prone to develop anemia include men with diabetes, and women with an elevated serum protein level and low triglycerides.