Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos

Mayra L. Estrella; Cynthia M. Pérez; Erick Suárez; Wilmarie Fuentes-Payán; Bharat Thyagarajan; Jonathan C. Goldsmith; Martha L. Daviglus; M. Larissa Avilés-Santa

doi:10.1016/j.eprac.2021.11.086

Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos

Mayra L. Estrella, Cynthia M. Pérez, Erick Suárez, Wilmarie Fuentes-Payán, Bharat Thyagarajan, Jonathan C. Goldsmith, Martha L. Daviglus, M. Larissa Avilés-Santa

Laboratory Medicine and Pathology

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: The objective of this study was to examine the sex-specific associations of mutually exclusive iron-anemia status categories with hemoglobin A1C (HbA1C) levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus. Methods: Baseline cross-sectional data (7247 women and 4904 men without self-reported diabetes mellitus) from the Hispanic Community Health Study/Study of Latinos were analyzed. Per the American Diabetes Association's defined criteria, based on HbA1C levels, the participants were categorized as having normoglycemia, prediabetes, or probable diabetes mellitus. The iron-anemia status categories were as follows: no anemia and no iron deficiency (reference), iron deficiency, iron deficiency anemia (IDA), and non-iron deficiency anemia (non-IDA). Survey multinomial logistic regression models were used to examine the sex-specific associations of iron-anemia status with HbA1C levels after adjusting for sociodemographic, lifestyle, and clinical factors. Results: The age-standardized prevalence of iron-anemia status categories differed by sex. Compared with those with no anemia and no iron deficiency and normoglycemia, women with IDA had higher odds of having prediabetes (odds ratio [OR], 2.18; 95% CI, 1.64-2.89) and probable diabetes mellitus (OR, 3.59; 95% CI, 1.62-7.99) based on HbA1C levels; men with non-IDA had higher odds of having probable diabetes mellitus (OR, 2.97; 95% CI, 1.13-7.78) based on HbA1C levels. All other associations did not reach statistical significance. Conclusion: Among U.S. Hispanics/Latinos without self-reported diabetes mellitus, the age-standardized prevalence of iron deficiency, IDA, and non-IDA is high and varies by sex. Women with IDA had higher odds of having prediabetes and probable diabetes mellitus, defined based on HbA1C levels. Men with non-IDA had higher odds of having probable diabetes mellitus, defined based on HbA1C levels. Iron-anemia status should be considered while interpreting elevated HbA1C levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus.

Original language	English (US)
Pages (from-to)	282-291
Number of pages	10
Journal	Endocrine Practice
Volume	28
Issue number	3
DOIs	https://doi.org/10.1016/j.eprac.2021.11.086
State	Published - Mar 2022

Bibliographical note

Funding Information:
We sincerely thank the HCHS/SOL participants and staff members. We also thank the staff members across Field Centers, whose dedication and ceaseless energy made the recruitment and baseline examination a success, and the over 16,000 participants who believed in making a difference. The baseline examination of the Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following National Institutes of Health institutes or offices collaborated and cofunded the first phase of the study: the National Institute on Minority Health and Health Disparities, the National Institute on Deafness and Other Communication Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the National Institutes of Health Office of Dietary Supplements. Dr Estrella was partially funded by a the National Heart, Lung, and Blood Institute Research Supplement to Promote Diversity in Health-Related Research 75N92019D00012 to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Chicago Field Center. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official views of the National Institute on Minority Health and Health Disparities, the National Institutes of Health, or the U.S. federal government.

Publisher Copyright:
© 2021

Keywords

Hispanics/Latinos
anemia
hemoglobin A1C
iron and anemia status
iron deficiency
probable diabetes mellitus

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.eprac.2021.11.086

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Estrella, M. L., Pérez, C. M., Suárez, E., Fuentes-Payán, W., Thyagarajan, B., Goldsmith, J. C., Daviglus, M. L., & Avilés-Santa, M. L. (2022). Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos. Endocrine Practice, 28(3), 282-291. https://doi.org/10.1016/j.eprac.2021.11.086

Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos. / Estrella, Mayra L.; Pérez, Cynthia M.; Suárez, Erick et al.
In: Endocrine Practice, Vol. 28, No. 3, 03.2022, p. 282-291.

Research output: Contribution to journal › Article › peer-review

Estrella, ML, Pérez, CM, Suárez, E, Fuentes-Payán, W, Thyagarajan, B, Goldsmith, JC, Daviglus, ML & Avilés-Santa, ML 2022, 'Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos', Endocrine Practice, vol. 28, no. 3, pp. 282-291. https://doi.org/10.1016/j.eprac.2021.11.086

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title = "Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos",

abstract = "Objective: The objective of this study was to examine the sex-specific associations of mutually exclusive iron-anemia status categories with hemoglobin A1C (HbA1C) levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus. Methods: Baseline cross-sectional data (7247 women and 4904 men without self-reported diabetes mellitus) from the Hispanic Community Health Study/Study of Latinos were analyzed. Per the American Diabetes Association's defined criteria, based on HbA1C levels, the participants were categorized as having normoglycemia, prediabetes, or probable diabetes mellitus. The iron-anemia status categories were as follows: no anemia and no iron deficiency (reference), iron deficiency, iron deficiency anemia (IDA), and non-iron deficiency anemia (non-IDA). Survey multinomial logistic regression models were used to examine the sex-specific associations of iron-anemia status with HbA1C levels after adjusting for sociodemographic, lifestyle, and clinical factors. Results: The age-standardized prevalence of iron-anemia status categories differed by sex. Compared with those with no anemia and no iron deficiency and normoglycemia, women with IDA had higher odds of having prediabetes (odds ratio [OR], 2.18; 95% CI, 1.64-2.89) and probable diabetes mellitus (OR, 3.59; 95% CI, 1.62-7.99) based on HbA1C levels; men with non-IDA had higher odds of having probable diabetes mellitus (OR, 2.97; 95% CI, 1.13-7.78) based on HbA1C levels. All other associations did not reach statistical significance. Conclusion: Among U.S. Hispanics/Latinos without self-reported diabetes mellitus, the age-standardized prevalence of iron deficiency, IDA, and non-IDA is high and varies by sex. Women with IDA had higher odds of having prediabetes and probable diabetes mellitus, defined based on HbA1C levels. Men with non-IDA had higher odds of having probable diabetes mellitus, defined based on HbA1C levels. Iron-anemia status should be considered while interpreting elevated HbA1C levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus.",

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note = "Funding Information: We sincerely thank the HCHS/SOL participants and staff members. We also thank the staff members across Field Centers, whose dedication and ceaseless energy made the recruitment and baseline examination a success, and the over 16,000 participants who believed in making a difference. The baseline examination of the Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following National Institutes of Health institutes or offices collaborated and cofunded the first phase of the study: the National Institute on Minority Health and Health Disparities, the National Institute on Deafness and Other Communication Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the National Institutes of Health Office of Dietary Supplements. Dr Estrella was partially funded by a the National Heart, Lung, and Blood Institute Research Supplement to Promote Diversity in Health-Related Research 75N92019D00012 to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Chicago Field Center. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official views of the National Institute on Minority Health and Health Disparities, the National Institutes of Health, or the U.S. federal government. Publisher Copyright: {\textcopyright} 2021",

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doi = "10.1016/j.eprac.2021.11.086",

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T1 - Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus

T2 - The Hispanic Community Health Study/Study of Latinos

AU - Estrella, Mayra L.

AU - Pérez, Cynthia M.

AU - Suárez, Erick

AU - Fuentes-Payán, Wilmarie

AU - Thyagarajan, Bharat

AU - Goldsmith, Jonathan C.

AU - Daviglus, Martha L.

AU - Avilés-Santa, M. Larissa

N1 - Funding Information: We sincerely thank the HCHS/SOL participants and staff members. We also thank the staff members across Field Centers, whose dedication and ceaseless energy made the recruitment and baseline examination a success, and the over 16,000 participants who believed in making a difference. The baseline examination of the Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following National Institutes of Health institutes or offices collaborated and cofunded the first phase of the study: the National Institute on Minority Health and Health Disparities, the National Institute on Deafness and Other Communication Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the National Institutes of Health Office of Dietary Supplements. Dr Estrella was partially funded by a the National Heart, Lung, and Blood Institute Research Supplement to Promote Diversity in Health-Related Research 75N92019D00012 to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Chicago Field Center. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official views of the National Institute on Minority Health and Health Disparities, the National Institutes of Health, or the U.S. federal government. Publisher Copyright: © 2021

PY - 2022/3

Y1 - 2022/3

N2 - Objective: The objective of this study was to examine the sex-specific associations of mutually exclusive iron-anemia status categories with hemoglobin A1C (HbA1C) levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus. Methods: Baseline cross-sectional data (7247 women and 4904 men without self-reported diabetes mellitus) from the Hispanic Community Health Study/Study of Latinos were analyzed. Per the American Diabetes Association's defined criteria, based on HbA1C levels, the participants were categorized as having normoglycemia, prediabetes, or probable diabetes mellitus. The iron-anemia status categories were as follows: no anemia and no iron deficiency (reference), iron deficiency, iron deficiency anemia (IDA), and non-iron deficiency anemia (non-IDA). Survey multinomial logistic regression models were used to examine the sex-specific associations of iron-anemia status with HbA1C levels after adjusting for sociodemographic, lifestyle, and clinical factors. Results: The age-standardized prevalence of iron-anemia status categories differed by sex. Compared with those with no anemia and no iron deficiency and normoglycemia, women with IDA had higher odds of having prediabetes (odds ratio [OR], 2.18; 95% CI, 1.64-2.89) and probable diabetes mellitus (OR, 3.59; 95% CI, 1.62-7.99) based on HbA1C levels; men with non-IDA had higher odds of having probable diabetes mellitus (OR, 2.97; 95% CI, 1.13-7.78) based on HbA1C levels. All other associations did not reach statistical significance. Conclusion: Among U.S. Hispanics/Latinos without self-reported diabetes mellitus, the age-standardized prevalence of iron deficiency, IDA, and non-IDA is high and varies by sex. Women with IDA had higher odds of having prediabetes and probable diabetes mellitus, defined based on HbA1C levels. Men with non-IDA had higher odds of having probable diabetes mellitus, defined based on HbA1C levels. Iron-anemia status should be considered while interpreting elevated HbA1C levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus.

AB - Objective: The objective of this study was to examine the sex-specific associations of mutually exclusive iron-anemia status categories with hemoglobin A1C (HbA1C) levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus. Methods: Baseline cross-sectional data (7247 women and 4904 men without self-reported diabetes mellitus) from the Hispanic Community Health Study/Study of Latinos were analyzed. Per the American Diabetes Association's defined criteria, based on HbA1C levels, the participants were categorized as having normoglycemia, prediabetes, or probable diabetes mellitus. The iron-anemia status categories were as follows: no anemia and no iron deficiency (reference), iron deficiency, iron deficiency anemia (IDA), and non-iron deficiency anemia (non-IDA). Survey multinomial logistic regression models were used to examine the sex-specific associations of iron-anemia status with HbA1C levels after adjusting for sociodemographic, lifestyle, and clinical factors. Results: The age-standardized prevalence of iron-anemia status categories differed by sex. Compared with those with no anemia and no iron deficiency and normoglycemia, women with IDA had higher odds of having prediabetes (odds ratio [OR], 2.18; 95% CI, 1.64-2.89) and probable diabetes mellitus (OR, 3.59; 95% CI, 1.62-7.99) based on HbA1C levels; men with non-IDA had higher odds of having probable diabetes mellitus (OR, 2.97; 95% CI, 1.13-7.78) based on HbA1C levels. All other associations did not reach statistical significance. Conclusion: Among U.S. Hispanics/Latinos without self-reported diabetes mellitus, the age-standardized prevalence of iron deficiency, IDA, and non-IDA is high and varies by sex. Women with IDA had higher odds of having prediabetes and probable diabetes mellitus, defined based on HbA1C levels. Men with non-IDA had higher odds of having probable diabetes mellitus, defined based on HbA1C levels. Iron-anemia status should be considered while interpreting elevated HbA1C levels among U.S. Hispanics/Latinos without self-reported diabetes mellitus.

KW - Hispanics/Latinos

KW - anemia

KW - hemoglobin A1C

KW - iron and anemia status

KW - iron deficiency

KW - probable diabetes mellitus

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Sex-Specific Associations of Iron-Anemia Status With Hemoglobin A1C Levels Among Hispanics/Latinos Without Self-Reported Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos

Abstract

Bibliographical note

Keywords

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UN SDGs

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