Association of elevated α₁-acid glycoprotein (AGP) and the prevalence of anemia in Nicaraguan preschool children.
BACKGROUND
Anemia status is frequently assessed in cross-sectional surveys. Recently, the assessment of acute phase proteins (APPs) has become more common, primarily for iron and vitamin A biomarkers. Although the so-called "anemia of infection" has been known for years, the relationship between APPs and anemia has been infrequently presented.


OBJECTIVE
To assess the relationship between elevated α₁-acidglycoprotein (AGP) and the prevalence of anemia among preschool children.


METHODS
A nationally representative household-based cross-sectional survey was conducted in 2003-05 in Nicaragua. Blood samples were collected from preschool children 6 to 59.9 months of age and tested for hemoglobin and AGP. Data were also obtained on sex, weight, height, use of iron supplements, maternal education, and urban or rural status.


RESULTS
Among the 1420 children assessed, the overall prevalence of anemia was 20.2% and the prevalence of elevated AGP was 24.0%. Children with elevated AGP had an anemia prevalence of 27.9%, compared with 17.8% among those with a normal AGP, for a crude prevalence odds ratio (POR) of 1.8 (p = .010). Accounting for age, maternal educational level, and year of survey using logistic regression, the adjusted POR for the association between elevated AGP and anemia was 1.5 (p = .053).


CONCLUSIONS
Children in this survey with an elevated AGP had a higher prevalence of anemia, although after controlling for covariates the p-value did not indicate a statistically significant difference (p = .053). It may be helpful to account for APPs, when this information is available, for purposes of comparing anemia prevalence across populations or within a population over time.
Rollins School of Public Health at Emory University, CNR Room 3051, 1518 Clifton Rd., NE, Atlanta, GA 30322, USA. cdckms@emory.edu
Kevin M
KM
Sullivan
Balalakshmi
B
Venugopalan
Maria E
ME
Jefferds
Eric
E
Boy
Josefina
J
Bonilla
Ivette
I
Sandino
Patricia
P
Halleslevens
D000367:Age Factors; D000740:Anemia / Q000097:blood* / Q000453:epidemiology* / Q000208:ethnology; D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D009527:Nicaragua / Q000453:epidemiology; D009961:Orosomucoid / Q000032:analysis*; D011159:Population Surveillance; D015995:Prevalence; D012423:Rural Health / Q000208:ethnology; D014504:Urban Health / Q000208:ethnology
D015415:Biomarkers; D006454:Hemoglobins; D009961:Orosomucoid