Jamieson Jennifer A, Weiler Hope A, Kuhnlein Harriet V, Egeland Grace M
Department of Human Nutrition, St. Francis Xavier University, PO Box 5000, Antigonish, NS, B2G 2W5, Canada.
School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada.
Can J Public Health. 2016 Jun 27;107(1):e81-e87. doi: 10.17269/cjph.107.5173.
To identify correlates of hemoglobin (Hb) and anaemia unexplained by iron deficiency (UA) in Canadian Inuit adults.
A cross-sectional survey assessed diet, demographic information, anthropometry, fasting Hb, ferritin, soluble transferrin receptor (on a subset), high-sensitivity C-reactive protein (hs-CRP) in serum, red blood cell (RBC) fatty acid composition, blood lead, and antibodies to Helicobacter pylori in non-pregnant, Inuit adults (n = 2550), ≥18 years of age from randomly selected households in 36 Inuit communities in Inuvialuit Settlement Region, Nunavut Territory and Nunatsiavut of Northern Labrador, Canada.
Hb concentrations were lower and UA prevalence higher in Inuit men after 50 years of age. Rate of anaemia was constant among Inuit women but changed from primarily iron deficiency anaemia pre-menopause, to primarily UA in post-menopause. Low education levels and hs-CRP were associated with increased risk of UA. For Inuit men, % RBC eicosapentaenoic acid (EPA) and elevated blood lead were also associated with increased risk of UA. Frequency of traditional food intake was positively associated with Hb.
Age patterns and regional variation of anaemia suggest that ethnicity-related physiological differences cannot explain anaemia prevalence for Inuit. High RBC EPA status, inflammation and infections, and lower education levels may contribute to the prevalence of anaemia in this population, which is not related to iron status. Thus, traditional lifestyle may protect Inuit from nutritional anaemia but contribute to lower Hb through environmental exposures. The clinical significance of UA for older Inuit adults requires further investigation, as the prevalence represents a moderate public health problem.
确定加拿大因纽特成年人体内血红蛋白（Hb）以及缺铁无法解释的贫血（UA）的相关因素。
一项横断面调查评估了加拿大努纳武特地区因努伊特人定居点以及拉布拉多北部努纳齐亚武特地区36个因纽特社区中随机抽取家庭的≥18岁非妊娠因纽特成年人（n = 2550）的饮食、人口统计学信息、人体测量学指标、空腹Hb、铁蛋白、可溶性转铁蛋白受体（部分样本）、血清高敏C反应蛋白（hs-CRP）、红细胞（RBC）脂肪酸组成、血铅以及幽门螺杆菌抗体。
50岁以后的因纽特男性Hb浓度较低，UA患病率较高。因纽特女性贫血率保持稳定，但从绝经前主要为缺铁性贫血转变为绝经后主要为UA。低教育水平和hs-CRP与UA风险增加相关。对于因纽特男性，RBC二十碳五烯酸（EPA）百分比和血铅升高也与UA风险增加相关。传统食物摄入频率与Hb呈正相关。
贫血的年龄模式和地区差异表明，种族相关的生理差异无法解释因纽特人的贫血患病率。RBC EPA水平高、炎症和感染以及较低的教育水平可能导致该人群贫血患病率升高，这与铁状态无关。因此，传统生活方式可能保护因纽特人免受营养性贫血，但通过环境暴露导致Hb降低。UA对老年因纽特成年人的临床意义需要进一步研究，因为其患病率代表了一个中度的公共卫生问题。
