title: Hemoglobin in normal range, the lower the better?-Evidence from a study from Chinese community-dwelling participants.
abstract: OBJECTIVE
  To examine the association between hemoglobin (Hb) levels and cardiovascular risk factors in a large community-dwelling cohort.
  
  
  METHODS
  A total of 4,186 women and 4,851 men were enrolled in the study. Data on personal history, physical examination and biochemical parameters were collected. Subjects were categorized by gender and divided into different group according to the level of Hb or blood pressure, and the association between Hb levels and cardiovascular risk factors was examined using Pearson's correlation analysis.
  
  
  RESULTS
  In both men and women even with normal Hb level, tertiles of Hb levels were positively associated with body mass index (BMI), total-cholesterol (TC), triglyceride (TG), uric acid (UA), diastolic blood pressures (DBP) and fasting plasma glucose (FPG) (all P=0.000 in men and women). Furthermore, significantly increased incidence of hyperuricemia (P=0.000 both in men and women) and obesity (P=0.000 both in men and women) were observed with the gradually increased Hb level. In addition, Pearson's correlation analysis revealed obvious correlation between Hb level and various cardiovascular risk factors including blood pressure and UA. Binary logistic regression analysis further demonstrated that the level of Hb was an important risk factor for elevated blood pressure (OR =1.216; 95% CI: 1.138-1.293, P=0.000 in men; OR =1.287; 95% CI: 1.229-1.363, P=0.000 in women).
  
  
  CONCLUSIONS
  Increasing Hb levels, even in subjects with normal level were associated with increasing prevalence of cardiovascular risk factors, suggesting that a slightly low Hb level might be beneficial to Chinese community-dwelling individuals.
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Lianxiang
authors.initials: L
authors.lastname: Ren
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Gu
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Yixing
authors.initials: Y
authors.lastname: Du
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wu
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Liu
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.affiliation: 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China.
authors.forename: Junhong
authors.initials: J
authors.lastname: Wang
keywords: Hemoglobin; blood pressure; cardiovascular risk