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A U-shaped relationship between haematocrit and mortality in a large prospective cohort study

Boffetta, P. and Islami, F. and Vedanthan, R. and Pourshams, A. and Kamangar, F. and Khademi, H. and Etemadi, A. and Salahi, R. and Semnani, S. and Emadi, A. and Abnet, C.C. and Brennan, P. and Pharoah, P.D. and Dawsey, S.M. and Malekzadeh, R. (2013) A U-shaped relationship between haematocrit and mortality in a large prospective cohort study. International Journal of Epidemiology, 42 (2). pp. 601-615. ISSN 03005771 (ISSN)

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Abstract

Background: Only a limited number of studies have investigated the correlation between haematocrit (HCT) and mortality in the general population, and few of those studies have had data on a wide range of low and high levels of HCT. We investigated the association between baseline HCT and mortality in a prospective cohort study of 49 983 adult subjects in Iran with a broad spectrum of HCT values. Methods: Data on socio-demographic and life-style factors, past medical history, and levels of HCT were collected at enrollment. During a mean follow-up of 5 years (follow-up success rate ±99%), 2262 deaths were reported. Cox proportional hazards regression models were used to estimate hazard ratios and corresponding 95% confidence intervals. Results: There was a U-shaped relationship between categories of HCT and mortality in both sexes: both low and high levels of HCT were associated with increased overall mortality and mortality from cardiovascular disease. The U-shaped relationship persisted after several sensitivity analyses were done, including analyses restricted to non-smokers and non-users of opium; analyses excluding deaths from accidents and other external causes as well as deaths of persons with self-reported ischemic heart disease at the baseline interview for the study; and analyses excluding the first 2 years of follow-up. Self-reported past medical history and lack of data about lipids and other cellular blood components were the major limitations of the study. Conclusions: Low and high levels of HCT are associated with increased mortality in the general population. The findings in the present study can be of particular importance for low- and middle-income countries in which a substantial proportion of the population lives with suboptimal levels of HCT. © Published by Oxford University Press on behalf of the International Epidemiological Association 2013.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Int. J. Epidemiol. [Field not mapped to EPrints] C2 - 23569195 [Field not mapped to EPrints] AD - Institute for Transitional Epidemiology and the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, United States [Field not mapped to EPrints] AD - International Prevention Research Institute, Lyon, France [Field not mapped to EPrints] AD - Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran [Field not mapped to EPrints] AD - The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, United States [Field not mapped to EPrints] AD - Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, United States [Field not mapped to EPrints] AD - International Agency for Research on Cancer, Lyon, France [Field not mapped to EPrints] AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States [Field not mapped to EPrints] AD - Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Division of Hematology and Oncology, Department of Medicine, School of Medicine, University of Maryland Greenebaum Cancer Center, Baltimore, MD, United States [Field not mapped to EPrints] AD - Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Anaemia, Cancer, Cardiovascular disease, Erythrocytosis, Haematocrit, Mortality, lipid, adult, anemia, cancer, cardiovascular disease, cohort analysis, data acquisition, medical geography, mortality, regression, accident, adult, aged, article, blood component, cardiovascular disease, female, follow up, hematocrit, human, Iran, ischemic heart disease, lifestyle, major clinical study, male, mortality, priority journal, proportional hazards model, prospective study, self report, sensitivity analysis, Adult, Aged, Cause of Death, Female, Hematocrit, Humans, Iran, Life Style, Male, Middle Aged, Mortality, Proportional Hazards Models, Prospective Studies, Rural Population, Sex Distribution, Socioeconomic Factors, Urban Population
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 18 Apr 2015 05:13
Last Modified: 10 May 2015 04:25
URI: http://eprints.goums.ac.ir/id/eprint/1894

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