Haematinic Deficiency and Macrocytosis in Middle-Aged and Older Adults

Hdl Handle:
http://hdl.handle.net/10147/322365
Title:
Haematinic Deficiency and Macrocytosis in Middle-Aged and Older Adults
Authors:
McNamee, Therese; Hyland, Trish; Harrington, Janas; Cadogan, Sharon; Honari, Bahman; Perera, Kanthi; Fitzgerald, Anthony P.; Perry, Ivan J.; Cahill, Mary R.; Collins, James F.
Citation:
Haematinic Deficiency and Macrocytosis in Middle-Aged and Older Adults 2013, 8 (11):e77743 PLoS ONE
Journal:
PLoS ONE
Issue Date:
7-Nov-2013
URI:
http://hdl.handle.net/10147/322365
DOI:
10.1371/journal.pone.0077743
Additional Links:
http://dx.plos.org/10.1371/journal.pone.0077743
Abstract:
Objective To assess the prevalence and determinants of haematinic deficiency (lack of B12 folate or iron) and macrocytosis in blood from a national population-based study of middle-aged and older adults. Methods A cross-sectional study involving 1,207 adults aged ≥45 years, recruited from a sub-study of the Irish National Survey of Lifestyle Attitudes and Nutrition (SLÁN 2007). Participants completed a health and lifestyle questionnaire and a standard food frequency questionnaire. Non-fasting blood samples were obtained for measurement of full blood count and expert morphological assessment, serum ferritin, soluble transferrin receptor assay (sTfR), B12, folate and coeliac antibodies. Blood samples were also assayed for thyroid function (T4, TSH), liver function, aminotransferase (AST) and gamma-glutamyl transferase (GGT). Results The overall prevalence (95% C.I.) of anaemia (Hb <13.5g/dl men and 11.3 g/dl women) was 4.6% (2.9%–6.4%) in men and 1.0% (0.2%–1.9%) in women. Iron deficiency (ferritin <17ng/ml men and <11ng/ml in women) was detected in 6.3% of participants (3.7% in males and 8.7% in females, p<0.001). Based on both low ferritin and raised sTfR (>21nmol/ml) only 2.3% were iron-deficient. 3.0% and 2.7% were found to have low levels of serum folate (<2.3ng/ml) and serum B12 (<120ng/l) respectively. Clinically significant macrocytosis (MCV>99fl) was detected in 8.4% of subjects. Strong, significant and independent associations with macrocytosis were observed for lower social status, current smoking status, moderate to heavy alcohol intake, elevated GGT levels, deficiency of folate and vitamin B12, hypothyroidism and coeliac disease. The population attributable fraction (PAF) for macrocytosis associated with elevated GGT (25.0%) and smoking (24.6%) was higher than for excess alcohol intake (6.3%), folate deficiency (10.5%) or vitamin B12 (3.4%). Conclusions Haematinic deficiency and macrocytosis are common in middle-aged/older adults in Ireland. Macrocytosis is more likely to be attributable to an elevated GGT and smoking than vitamin B12 or folate deficiency.
Item Type:
Article
Language:
en
ISSN:
1932-6203

Full metadata record

DC FieldValue Language
dc.contributor.authorMcNamee, Thereseen_GB
dc.contributor.authorHyland, Trishen_GB
dc.contributor.authorHarrington, Janasen_GB
dc.contributor.authorCadogan, Sharonen_GB
dc.contributor.authorHonari, Bahmanen_GB
dc.contributor.authorPerera, Kanthien_GB
dc.contributor.authorFitzgerald, Anthony P.en_GB
dc.contributor.authorPerry, Ivan J.en_GB
dc.contributor.authorCahill, Mary R.en_GB
dc.contributor.authorCollins, James F.en_GB
dc.date.accessioned2014-07-03T14:00:16Z-
dc.date.available2014-07-03T14:00:16Z-
dc.date.issued2013-11-07-
dc.identifier.citationHaematinic Deficiency and Macrocytosis in Middle-Aged and Older Adults 2013, 8 (11):e77743 PLoS ONEen_GB
dc.identifier.issn1932-6203-
dc.identifier.doi10.1371/journal.pone.0077743-
dc.identifier.urihttp://hdl.handle.net/10147/322365-
dc.description.abstractObjective To assess the prevalence and determinants of haematinic deficiency (lack of B12 folate or iron) and macrocytosis in blood from a national population-based study of middle-aged and older adults. Methods A cross-sectional study involving 1,207 adults aged ≥45 years, recruited from a sub-study of the Irish National Survey of Lifestyle Attitudes and Nutrition (SLÁN 2007). Participants completed a health and lifestyle questionnaire and a standard food frequency questionnaire. Non-fasting blood samples were obtained for measurement of full blood count and expert morphological assessment, serum ferritin, soluble transferrin receptor assay (sTfR), B12, folate and coeliac antibodies. Blood samples were also assayed for thyroid function (T4, TSH), liver function, aminotransferase (AST) and gamma-glutamyl transferase (GGT). Results The overall prevalence (95% C.I.) of anaemia (Hb <13.5g/dl men and 11.3 g/dl women) was 4.6% (2.9%–6.4%) in men and 1.0% (0.2%–1.9%) in women. Iron deficiency (ferritin <17ng/ml men and <11ng/ml in women) was detected in 6.3% of participants (3.7% in males and 8.7% in females, p<0.001). Based on both low ferritin and raised sTfR (>21nmol/ml) only 2.3% were iron-deficient. 3.0% and 2.7% were found to have low levels of serum folate (<2.3ng/ml) and serum B12 (<120ng/l) respectively. Clinically significant macrocytosis (MCV>99fl) was detected in 8.4% of subjects. Strong, significant and independent associations with macrocytosis were observed for lower social status, current smoking status, moderate to heavy alcohol intake, elevated GGT levels, deficiency of folate and vitamin B12, hypothyroidism and coeliac disease. The population attributable fraction (PAF) for macrocytosis associated with elevated GGT (25.0%) and smoking (24.6%) was higher than for excess alcohol intake (6.3%), folate deficiency (10.5%) or vitamin B12 (3.4%). Conclusions Haematinic deficiency and macrocytosis are common in middle-aged/older adults in Ireland. Macrocytosis is more likely to be attributable to an elevated GGT and smoking than vitamin B12 or folate deficiency.en_GB
dc.language.isoenen
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0077743en_GB
dc.rightsArchived with thanks to PLoS ONEen_GB
dc.titleHaematinic Deficiency and Macrocytosis in Middle-Aged and Older Adultsen_GB
dc.typeArticleen
dc.identifier.journalPLoS ONEen_GB
dc.description.fundingHRB Health Research Boarden
dc.description.provinceMunsteren
dc.description.peer-reviewpeer-reviewen
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