Program in International and Community Nutrition, Department of Nutrition, University of California Davis, Davis, California.
Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon.
Ann N Y Acad Sci. 2019 Aug;1450(1):105-125. doi: 10.1111/nyas.14096. Epub 2019 May 10.
WHO recommendations for hemoglobin (Hb) cutoffs to define anemia are based on a handful of studies conducted in the 1960s that did not include participants from all life stages. To evaluate whether there is a need to update Hb cutoffs, we conducted a narrative review of the literature to identify more recent studies that have reported Hb cutoffs in males and females in various life stages. We compiled information from 60 studies conducted around the globe between 1975 and 2018. Many studies reported cutoffs that were similar to WHO recommendations, but cutoffs identified in studies of infants, young children, premenopausal women, and the elderly tended to be lower than WHO recommendations, while cutoffs identified in studies of men tended to be higher than WHO cutoffs. Few studies excluded individuals with iron deficiency or inflammation, which limits the conclusions that can be drawn regarding normal reference ranges. Further research using more stringent exclusion criteria is needed to develop revised recommendations for Hb cutoffs to define anemia.
世界卫生组织（WHO）的血红蛋白（Hb）诊断贫血切点建议是基于 20 世纪 60 年代的少数几项研究制定的，这些研究并未纳入所有生命阶段的参与者。为了评估是否有必要更新 Hb 诊断切点，我们对文献进行了叙述性综述，以确定更多最近的研究报告了在不同生命阶段的男性和女性的 Hb 诊断切点。我们从全球范围内 1975 年至 2018 年开展的 60 项研究中收集了信息。许多研究报告的诊断切点与 WHO 建议相似，但在婴儿、幼儿、绝经前妇女和老年人研究中确定的切点往往低于 WHO 建议，而在男性研究中确定的切点则高于 WHO 切点。很少有研究排除了缺铁或炎症患者，这限制了关于正常参考范围的结论。需要使用更严格的排除标准开展进一步的研究，以制定修订后的 Hb 诊断切点建议，用于诊断贫血。
