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.