The Relationship Between Anemia and Biomarkers of Inflammation (CRP and AGP) in Women of Papua New Guinea Public
Kanago, Meredith Laree (2011)
Published
Abstract
The Relationship Between Anemia and Biomarkers of
Inflammation
(CRP and AGP) in Women of Papua New Guinea
By Meredith Kanago
Background: Anemia is a major public health problem
worldwide, but its burden is
greatest where risk factors such as poor nutrition and low
socioeconomic status are
common. Because biomarkers of inflammation have been shown to
affect certain
micronutrient measures, including hemoglobin, the primary indicator
of anemia status, it
is important to understand this relationship in order to properly
assess micronutrient
status in populations.
Objective: This study seeks to evaluate any possible
association between anemia status
and the acute-phase protein biomarkers C-reactive protein (CRP) and
α-(1) - acid
glycoprotein (AGP) and anemia in non-pregnant women aged 18-49 who
participated in
the 2005 Papua New Guinea National Micronutrient Survey.
Methods: The 2005 Papua New Guinea National
Micronutrient Survey was a stratified
PPS survey with a 2-stage cluster design carried out from May to
October 2005. Logistic
models were used to analyze data on 662 women to assess the
relationship between
anemia and elevated CRP and between anemia and elevated AGP.
Results: The overall weighted prevalence of anemia in
this population was 34.9%. The
weighted prevalence of elevated CRP was 10.43%, and the prevalence
of elevated AGP
was 7.96%. Controlling for region and recent birth, anemia was
significantly associated
with elevated CRP, with an odds ratio of 2.74 (95% CI: 1.23, 6.15)
among those in rural
areas. There did not appear to be a similar association among those
in urban locations. In
addition, after controlling for region and urban/rural location,
anemia was significantly
associated with elevated AGP, with an odds ratio of 3.98 (95% CI:
1.54, 10.26).
Conclusions: This study found that there is a clear
association between anemia status and
elevated levels of acute phase proteins in women in Papua New
Guinea, suggesting that
the presence of infection could have an effect on assessment of
anemia in a population. This
finding underscores the importance of collecting information on
inflammatory
biomarkers in nutritional surveys. Future studies should further
investigate the
geographic factors involved in this association, including the
interaction between
elevated CRP and urban/rural location.
Table of Contents
1. INTRODUCTION..........................................................................1
2. BACKGROUND
2.1 Anemia Overview.............................................................. 2 2.2 Acute Phase Response....................................................... 42.3 Acute Phase Response and Micronutrient Status..................... 6
2.4 Papua New Guinea............................................................. 73. METHODS
3.1 Null Hypothesis................................................................. 8 3.2 Study Design.................................................................... 8 3.3 Data Collection................................................................. 10 3.4 Analysis........................................................................... 12 3.5 Logistic Regression Modeling................................................ 134. RESULTS
4.1 Descriptive Statistics......................................................... 15 4.2 Prevalence of Anemia......................................................... 164.3 Prevalence of Elevated CRP and Elevated AGP.......................... 17
4.4 Association Between Anemia Status and CRP........................... 18
4.5 Association Between Anemia Status and AGP........................... 19
4.6 Association Between Anemia Status and Infection Category....... 20
5. DISCUSSION
5.1 Association Between Anemia Status and CRP........................... 21
5.2 Association Between Anemia Status and AGP........................... 22
5.3 Strengths......................................................................... 22 5.4 Limitations........................................................................ 22 5.5 Summary......................................................................... 23 REFERENCES...................................................................................25 TABLES.........................................................................................27 APPENDICES
Appendix I: Data Collection
Forms
Appendix II: Assessment of Interaction and
Confounding for CRP Model
Appendix III: Assessment of Interaction
and Confounding for AGP Model
Appendix IV: Infection Category Table
About this Master's Thesis
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