Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis

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Abstract

Aims: To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes.Methods: Data from the Fremantle Diabetes Study Phase II (FDS2; n=1,551, mean age 65.7 years, 51.9% males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2 years, 50.0% males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin ≤130 g/L males, ≤120 g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modelling identified predictors of death during 4.3±1.2 years post-recruitment.Results: The prevalence of anemia at baseline was 11.5% in FDS2 participants, 17.8% in BDS type 2 patients and 5.4% in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6%) had at least one other risk factor (serum vitamin B12 <140 pmol/L, serum ferritin <30 µg/L and/or transferrin saturation <20%, serum testosterone <10 nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60 mL/min 1.73 m², malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7% versus 8.0%; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, martial status, smoking, eGFR), anemia was associated with a 57% increase in mortality (P=0.015).Conclusions: Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors.
Original languageEnglish
Pages (from-to)1169-1174
Number of pages6
JournalJournal of Diabetes and Its Complications
Volume31
DOIs
Publication statusPublished - Jul 2017

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Type 2 Diabetes Mellitus
Anemia
Glomerular Filtration Rate
Serum
Apoferritins
Thiazolidinediones
Hemoglobinopathies
Vitamin B 12
Transferrin
Testosterone
Hemoglobins
Logistic Models
Smoking
Mortality
Neoplasms

Cite this

@article{68585964c5cc414b911a7baa8ecdb820,
title = "Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis",
abstract = "Aims: To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes.Methods: Data from the Fremantle Diabetes Study Phase II (FDS2; n=1,551, mean age 65.7 years, 51.9{\%} males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2 years, 50.0{\%} males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin ≤130 g/L males, ≤120 g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modelling identified predictors of death during 4.3±1.2 years post-recruitment.Results: The prevalence of anemia at baseline was 11.5{\%} in FDS2 participants, 17.8{\%} in BDS type 2 patients and 5.4{\%} in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6{\%}) had at least one other risk factor (serum vitamin B12 <140 pmol/L, serum ferritin <30 µg/L and/or transferrin saturation <20{\%}, serum testosterone <10 nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60 mL/min 1.73 m², malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7{\%} versus 8.0{\%}; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, martial status, smoking, eGFR), anemia was associated with a 57{\%} increase in mortality (P=0.015).Conclusions: Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors.",
author = "R. Gauci and Michael Hunter and David Bruce and Wendy Davis and Timothy Davis",
year = "2017",
month = "7",
doi = "10.1016/j.jdiacomp.2017.04.002",
language = "English",
volume = "31",
pages = "1169--1174",
journal = "Journal of Diabetes and Its Complications",
issn = "1056-8727",
publisher = "Elsevier",

}

TY - JOUR

T1 - Anemia complicating type 2 diabetes

T2 - Prevalence, risk factors and prognosis

AU - Gauci, R.

AU - Hunter, Michael

AU - Bruce, David

AU - Davis, Wendy

AU - Davis, Timothy

PY - 2017/7

Y1 - 2017/7

N2 - Aims: To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes.Methods: Data from the Fremantle Diabetes Study Phase II (FDS2; n=1,551, mean age 65.7 years, 51.9% males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2 years, 50.0% males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin ≤130 g/L males, ≤120 g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modelling identified predictors of death during 4.3±1.2 years post-recruitment.Results: The prevalence of anemia at baseline was 11.5% in FDS2 participants, 17.8% in BDS type 2 patients and 5.4% in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6%) had at least one other risk factor (serum vitamin B12 <140 pmol/L, serum ferritin <30 µg/L and/or transferrin saturation <20%, serum testosterone <10 nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60 mL/min 1.73 m², malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7% versus 8.0%; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, martial status, smoking, eGFR), anemia was associated with a 57% increase in mortality (P=0.015).Conclusions: Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors.

AB - Aims: To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes.Methods: Data from the Fremantle Diabetes Study Phase II (FDS2; n=1,551, mean age 65.7 years, 51.9% males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2 years, 50.0% males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin ≤130 g/L males, ≤120 g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modelling identified predictors of death during 4.3±1.2 years post-recruitment.Results: The prevalence of anemia at baseline was 11.5% in FDS2 participants, 17.8% in BDS type 2 patients and 5.4% in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6%) had at least one other risk factor (serum vitamin B12 <140 pmol/L, serum ferritin <30 µg/L and/or transferrin saturation <20%, serum testosterone <10 nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60 mL/min 1.73 m², malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7% versus 8.0%; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, martial status, smoking, eGFR), anemia was associated with a 57% increase in mortality (P=0.015).Conclusions: Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors.

U2 - 10.1016/j.jdiacomp.2017.04.002

DO - 10.1016/j.jdiacomp.2017.04.002

M3 - Article

VL - 31

SP - 1169

EP - 1174

JO - Journal of Diabetes and Its Complications

JF - Journal of Diabetes and Its Complications

SN - 1056-8727

ER -