Annals of Hematology

, Volume 92, Issue 6, pp 731–737

Prevalence and incidence of anemia in the German Heinz Nixdorf Recall Study

  • Lewin Eisele
  • Jan Dürig
  • Martina Broecker-Preuss
  • Ulrich Dührsen
  • Beate Bokhof
  • Raimund Erbel
  • Susanne Moebus
  • Karl-Heinz Jöckel
  • on behalf of the Heinz Nixdorf Recall Study Investigative Group
Original Article


This study aims to determine prevalence and incidence of anemia in the general population in Germany and evaluate a potential role of serum-free light chains (FLC) as biomarker in anemia. The population-based Heinz Nixdorf Recall Study comprises 4,814 men and women aged 45–75 years. Hemoglobin <13 g/dl in men and <12 g/dl in women defined anemia. Laboratory data was used to classify cases into renal, iron deficiency (IDA), vitamin B12/folic acid deficiency, anemia of chronic disease (ACD), and unexplained anemia (UA). Follow-up data was available from annual questionnaires, death certificates, and 5-year follow-up visit (5-year FU). Anemia cases (152) were identified (prevalence 3.2 %, 95 % CI 2.7–3.7). In participants aged 65 or older, prevalence was 4.3 % (95 % CI 2.9–6.0) in both men and women. Main anemia subtypes were: IDA 19 %, ACD 25 %, and UA 44 %. Incidence increased with age and was 12.8/1,000 person-years and 10.9/1,000 person-years in men and women aged 65 or older, respectively. UA was characterized by elevated FLC. Participants with elevated FLC and high-sensitivity C-reactive protein (hsCRP) had an increased risk of anemia at 5-year FU. FLC—alone or in combination with hsCRP—may serve as biomarker indicating an increased risk of developing anemia.


Anemia Prevalence Incidence Population-based Biomarker 

Supplementary material

277_2013_1697_MOESM1_ESM.docx (566 kb)
ESM 1(DOCX 565 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lewin Eisele
    • 1
    • 3
  • Jan Dürig
    • 1
  • Martina Broecker-Preuss
    • 2
  • Ulrich Dührsen
    • 1
  • Beate Bokhof
    • 3
  • Raimund Erbel
    • 4
  • Susanne Moebus
    • 3
  • Karl-Heinz Jöckel
    • 3
  • on behalf of the Heinz Nixdorf Recall Study Investigative Group
  1. 1.Department of HematologyUniversity Hospital EssenEssenGermany
  2. 2.Department of Endocrinology Division of Laboratory MedicineUniversity Hospital EssenEssenGermany
  3. 3.Institute of Medical Informatics, Biometry and EpidemiologyUniversity Hospital EssenEssenGermany
  4. 4.West German Heart CenterUniversity Hospital EssenEssenGermany

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