Anemia and Cardiometabolic Risk in Indian University Students: Findings from a Health Screening Program

College students represent a population that is considered clinically at low risk; yet, early adulthood constitutes a crucial time point when nutritional and metabolic risks manifest themselves. This retrospective observational study evaluated anemia, blood pressure, and body mass index (BMI) characteristics of college students undergoing a health screening examination organized by their university in India.

Anonymized electronic health records were analyzed for 13,628 college students between the ages of 18 and 30 years old attending annual health screening from 1 June 2023 to 31 May 2024. The sample consisted of 77.2% of the eligible students. BMI, blood pressure, and hemoglobin levels were classified according to international standards. Gender-based differences were explored through chi-square tests and Cramer's V measures. Association between anemia and screening-confirmed hypertension was assessed using Pearson correlations and multiple logistic regression. In addition, model discrimination, calibration, classification parameters, and internal validation were evaluated.

There were 7,012 (51.5%) female students and 6,616 (48.5%) male students in the sample population. In total, 47.3% of the students were either overweight or obese, 8,081 (59.3%) fulfilled the criteria for high blood pressure according to the ACC/AHA guidelines, while 7,227 (53.0%) fulfilled WHO guidelines for anemia based on gender. Hypertension screening was also more common among men (66.6%) compared to women (52.4%; p < 0.001). In the adjusted models, being male was significantly linked with anemia and hypertension screening, while being overweight was significantly linked with hypertension screening.

This study showed the high prevalence of undiagnosed anemia and cardiometabolic risks among university students, suggesting the importance of health promoting universities in systematic screening programs and follow-ups.