{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:51:58Z","timestamp":1791276718079,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["advanced.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advanced Science"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The hematological implications of systemic glucose\u2013lipid metabolic status remain poorly understood. We investigated its association with anemia across diverse populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six analytic cohorts comprising 70,350 unique participants from China, the United States, and the United Kingdom were analyzed using cross\u2010sectional, longitudinal, and extended time\u2010to\u2010event approaches. Dose\u2013response patterns, anemia morphology, effect modification, and an exploratory renal\u2010function\u2010related pathway were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A higher glucose\u2013lipid metabolic index was consistently associated with lower odds of prevalent and incident anemia, with fully adjusted ORs ranging from 0.53 to 0.87 per 1\u2010unit increase. Extended ELSA follow\u2010up showed a similar association (HR, 0.61; 95% CI, 0.43\u20130.87). Longitudinal associations were approximately linear, whereas cross\u2010sectional relationships flattened at higher levels. The inverse association was evident for microcytic and normocytic anemia, attenuated with greater systemic inflammation, and stronger among participants with heart disease. An exploratory indirect association through cystatin C accounted for 16.33% of the observed association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher glucose\u2013lipid metabolic status was reproducibly associated with lower anemia occurrence, but this relationship varied across inflammatory, cardiovascular, and renal contexts. These findings suggest that metabolic states conventionally linked to vascular risk may carry distinct implications for hematological homeostasis and metabolic reserve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/advs.78037","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:00:53Z","timestamp":1790744453000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Context\u2010Dependent Inverse Association of Glucose\u2013Lipid Metabolic Status With Anemia: Evidence From Multinational Multicohort Analyses"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2367-4079","authenticated-orcid":false,"given":"Guosong","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Northeast Yunnan Central Hospital  Zhaotong Yunnan China"},{"name":"Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8727-5560","authenticated-orcid":false,"given":"Xinxing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Chengdu BOE Hospital  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianfeng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology First Affiliated Hospital of Gannan Medical University  Ganzhou Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenna","family":"Ding","sequence":"additional","affiliation":[{"name":"Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyong","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Northeast Yunnan Central Hospital  Zhaotong Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Northeast Yunnan Central Hospital  Zhaotong Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhibo","family":"Cui","sequence":"additional","affiliation":[{"name":"Information Technology Department Northeast Yunnan Central Hospital  Zhaotong Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiqiang","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology Chongqing General Hospital Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"Zhong","sequence":"additional","affiliation":[{"name":"Postgraduates At the First Clinical Medicine of Gannan Medical University  Ganzhou Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Ganzhou Hospital of\u00a0Nanchang University  Ganzhou Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The Second People's Hospital of Zhaotong  Zhaotong Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Lei","sequence":"additional","affiliation":[{"name":"Hematology Department Northeast Yunnan Central Hospital  Zhaotong Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0586-2000","authenticated-orcid":false,"given":"Xiaoxiao","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory The Second Affiliated Hospital &amp; Yuying Children's Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4423-2766","authenticated-orcid":false,"given":"Chi\u2010E.","family":"Qiu","sequence":"additional","affiliation":[{"name":"Hematology Department Northeast Yunnan Central Hospital  Zhaotong Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201007\u2010746446"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(23)00160\u20106"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102018\u201006\u2010856500"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.565135"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2020.12.001"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exphem.2024.104153"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2025.106506"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010020\u201001824\u20102"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010024\u201002241\u2010y"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00063.2017"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102141.2000.02047.x"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016741"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI114070"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1304127"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010019792"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010026\u201027480\u20104"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214234"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys203"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys168"},{"key":"e_1_2_14_22_1","unstructured":"National Center for Health Statistics. 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