Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Halo Medical Foundation, Andur, India.
Trop Med Int Health. 2021 Mar;26(3):327-334. doi: 10.1111/tmi.13524. Epub 2020 Nov 27.
This study tested the hypothesis that systemic inflammation is inversely associated with haemoglobin levels in adolescent girls in India.
The study population consisted of adolescent girls aged between 10 and 19 years living in a remote rural region in Maharashtra State, India. Data were collected on anthropometric measures, and a venous blood sample was taken and tested for complete blood count and C-reactive protein (CRP).
Of 679 individuals who were invited to the research site to participate, data were available from 401 participants giving a response rate of 59%. Median blood CRP was 1.26 mg/l (Range 0.00 to 26.33), and 167 (41.6%) participants had CRP level < 1.0 mg/l. The mean haemoglobin was 12.24 g/dl (standard deviation [SD] 1.51), and the mean total white blood cells (WBC) count was 9.02 × 10 /μl (SD 2.00). With each g/dl increase in blood haemoglobin, the risk of having an elevated CRP of ≥ 1 mg/l increased with an odds ratio of 1.16 (95% CI 1.01 to 1.33, P = 0.03). Total WBC count was also positively associated with blood haemoglobin, increasing by 0.24 × 10 /μl (95% CI 0.11 to 0.37, P < 0.001) per g/dl increase in haemoglobin. Both analyses were adjusted for age.
In this population, blood haemoglobin levels were positively associated with two measures of systemic inflammation, contrary to the primary hypothesis being tested. Other unmeasured environmental exposures may modify haemoglobin levels in this population. Understanding this observation may help design better public health interventions to improve the well-being of adolescent girls in India.
本研究旨在检验以下假设，即系统性炎症与印度青春期少女的血红蛋白水平呈负相关。
研究人群为居住在印度马哈拉施特拉邦偏远农村地区的 10 至 19 岁青少年女孩。收集了人体测量学指标的数据，并采集了静脉血样，用于检测全血细胞计数和 C 反应蛋白（CRP）。
在受邀前往研究现场参加研究的 679 人中，有 401 人提供了数据，应答率为 59%。中位血 CRP 为 1.26mg/L（范围 0.00 至 26.33），167 名（41.6%）参与者 CRP 水平<1.0mg/L。平均血红蛋白为 12.24g/dl（标准差[SD]1.51），平均总白细胞（WBC）计数为 9.02×10 /μl（SD 2.00）。血红蛋白每增加 1g/dl，CRP 升高至≥1mg/L 的风险比为 1.16（95%置信区间 1.01 至 1.33，P=0.03）。WBC 计数也与血红蛋白呈正相关，血红蛋白每增加 1g/dl，WBC 计数增加 0.24×10 /μl（95%置信区间 0.11 至 0.37，P<0.001）。这两种分析均根据年龄进行了调整。
在该人群中，血红蛋白水平与两种系统性炎症的衡量指标呈正相关，与正在检验的主要假设相反。其他未测量的环境暴露可能会改变该人群的血红蛋白水平。了解这一观察结果可能有助于设计更好的公共卫生干预措施，以改善印度青春期少女的健康状况。
