Evidence map›Paper›PMID 40968580›Full record

ArticleEndocrinology, diabetes & metabolism2025

Revisiting the Obesity-Anaemia Paradox: Inflammation and Iron Homeostasis in the BMI-Haemoglobin Relationship.

Ali Hemade, Pascale Salameh

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In one paragraph

Article in Endocrinology, diabetes & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Ali HemadeDivision of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Naef K. Bassile Cancer Institute, Beirut, Lebanon.ORCID https://orcid.org/0009-0006-0172-0538
Pascale SalamehFaculty of Pharmacy, Lebanese University, Hadat, Lebanon.ORCID https://orcid.org/0000-0002-4780-0772

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity and anaemia are global epidemics with complex, overlapping pathophysiology. While excess adiposity is known to induce chronic inflammation that disrupts iron homeostasis, multiple population studies paradoxically report higher haemoglobin levels and lower anaemia prevalence among obese individuals. The nonlinear and potentially suppressive role of inflammation in this relationship remains understudied.

methodsWe analysed adults aged 18-64 from the 2015-2023 National Health and Nutrition Examination Survey (NHANES). Haemoglobin was modelled as a function of body-mass index (BMI) using survey-weighted linear regression with restricted cubic splines. Interactions with log-transformed CRP were assessed, and ferritin was corrected for inflammation using BRINDA regression-residual methods. Causal mediation analysis decomposed the total effect of BMI on haemoglobin into indirect (mediated by CRP) and direct effects. Secondary models examined anaemia (Hb < 13.0 g/dL in men, < 12.0 g/dL in women) using logistic regression.

resultsHaemoglobin increased steeply across lower BMI ranges but plateaued above 30 kg/m

conclusionsBMI is positively associated with haemoglobin in a non-linear, CRP-dependent fashion. Inflammation significantly suppresses the haematologic benefit of excess adiposity, while inflammation-adjusted ferritin plays a minimal mediating role. These findings underscore the importance of modelling non-linearity and correcting iron biomarkers for inflammation when studying obesity-related anaemia.

Indexed as

AnemiaBody Mass IndexHemoglobinsInflammationIronObesityAdolescentAdultC-Reactive ProteinFemaleFerritinsHomeostasisHumansMaleMiddle AgedNutrition SurveysC-Reactive ProteinFerritinsHemoglobinsIronanaemiacausal mediationhaemoglobininflammationNHANESnonlinear modelsobesity

Identifiers

PMID40968580
PMCPMC12446570

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.