Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, Arizona.
Biostatistics, Mayo Clinic, Scottsdale, Arizona.
Int J Lab Hematol. 2020 Aug;42(4):403-410. doi: 10.1111/ijlh.13205. Epub 2020 Apr 16.
To determine the presence of racial/ethnic differences in patients with anemia and serum folate deficiency.
We performed a retrospective analysis of data from patient samples collected from January 2010 to October 2018. Reference laboratory ranges were determined by Mayo Clinic Reference Laboratories. Race and ethnicity were classified according to National Institutes of Health categories.
The analysis comprised 197 974 samples. Hemoglobin, hematocrit, and SF results were available for 173 337, 173 056, and 129 760 samples, respectively. Of the samples, 46 505 (26.8%) showed anemia, with a higher prevalence among American Indian/Alaskan Natives (AI/AN) 42.9% and African Americans (AA) 47.2% (P < .001). SF deficiency was present in 897 (0.7%), with a higher prevalence among AI/AN (9, [1.4%]) and AA (78, [1.2%]) and a lower prevalence in non-Hispanic whites (NHW) (758, [0.7%]), Hispanics (40, [0.6%]), and Asians (8, [0.3%]). In multivariable analysis, the prevalence of anemia was higher in all non-NHW racial/ethnic groups: AA (OR, 3.67, [95%CI: 3.47-3.88, P < .001]), AI/AN (OR, 3.25, [95%CI: 2.71-3.90, P < .001]), Asians (OR, 1.62, [95%CI: 1.47-1.77, P < .001]), and Hispanics (OR, 1.41, [95%CI: 1.32-1.50, P < .001]). SF deficiency was more common in AA (OR, 1.48, [95%CI: 1.17-1.88, P.001]) and less common in Asians (OR, 0.35, [95%CI: 0.17-0.70, P = .003]), compared with NHW.
We showed significant racial/ethnic differences in anemia and SF deficiency. Differences were observed especially among NHW, AA, and Asians. We believe that these differences may be explained by social determinants of health. More research is needed regarding the causes of these differences and their clinical implications at a population level.
确定贫血和血清叶酸缺乏症患者中存在的种族/民族差异。
我们对 2010 年 1 月至 2018 年 10 月期间采集的患者样本数据进行了回顾性分析。参考实验室范围由梅奥诊所参考实验室确定。种族和民族按美国国立卫生研究院的类别进行分类。
该分析共包括 197974 个样本。血红蛋白、血细胞比容和 SF 结果可用于 173337、173056 和 129760 个样本。在这些样本中，46505 个（26.8%）表现为贫血，美国印第安人/阿拉斯加原住民（AI/AN）和非裔美国人（AA）的患病率较高，分别为 42.9%和 47.2%（P<.001）。SF 缺乏症的发生率为 897（0.7%），AI/AN（9 例，[1.4%]）和 AA（78 例，[1.2%]）中更为常见，而非西班牙裔白人（NHW）（758 例，[0.7%]）、西班牙裔（40 例，[0.6%]）和亚洲人（8 例，[0.3%]）中则较低。在多变量分析中，所有非 NHW 种族/民族群体的贫血患病率均较高：AA（OR，3.67，[95%CI：3.47-3.88，P<.001]）、AI/AN（OR，3.25，[95%CI：2.71-3.90，P<.001]）、亚洲人（OR，1.62，[95%CI：1.47-1.77，P<.001]）和西班牙裔（OR，1.41，[95%CI：1.32-1.50，P<.001]）。与 NHW 相比，AA 中 SF 缺乏症更为常见（OR，1.48，[95%CI：1.17-1.88，P<.001]），而亚洲人中则较少见（OR，0.35，[95%CI：0.17-0.70，P=.003]）。
我们发现贫血和 SF 缺乏症存在显著的种族/民族差异。在 NHW、AA 和亚洲人中观察到了差异。我们认为这些差异可能可以用健康的社会决定因素来解释。需要更多的研究来了解这些差异的原因及其在人群水平上的临床意义。
