Investigating the Association Between Anemia and Biochemical Factors in Relation to New Anthropometric Metrics in an Iranian Cohort: A Cross‐Sectional Study

Background and Aims: Obesity has become one of the most significant health issues worldwide, and the relationship between obesity and anemia remains controversial. This study aims to assess the relationship between lipid-based obesity parameters, new anthropometric indices, and anemia in the Kurdish population of Iran. Methods: 9810 participants (48.2% male and 51.8% female) were evaluated in the present study. Study data were collected from the initial phase of the Ravansar non-communicable disease cohort study (RaNCD). All anthropometric and laboratory factors were measured using standard guidelines and methods. Results: The prevalence of anemia was 8.95%, with 72% of cases in females and 27% in males. No significant difference was observed in body mass index (BMI) between groups. Anemic individuals exhibited significantly higher levels of waist circumference (WC), hip circumference (HC), weight-adjusted weight (WWI), body adiposity index (BAI), and a body shape index (ABSI) compared to non-anemic individuals. In contrast to BMI, these parameters showed a negative association with RBC count, HCT, and HB. ABSI presented the highest odds for anemia (OR = 2.26; 95% CI: 1.68-3.03), followed by lipid accumulation product (LAP) (OR = 1.6 in males and 1.55 in females), BAI (OR = 1.39), and HC (OR = 1.34). BMI was conversely associated with anemia (OR = 0.71; 95% CI: 0.51-0.93). Quadratic fit plots by gender revealed a positive correlation between BMI and HGB levels in males with BMI < 30. Additionally, WC and HC in females and WWI and ABSI in males were negatively correlated with Hb levels. Conclusion: Current results suggest that the shape of obesity and local fat accumulation may have a more significant association with anemia. Therefore, anthropometric indices reflecting localized obesity could be more practical parameters for anemia assessment.