Abstract: Objective To explore association between serum aldehydes and red blood cell count and hemoglobin concentration in the real world. Methods The associations between serum aldehydes and anemia in US adults from the National Health and Nutrition Examination Survey were analyzed. Results Isopentanaldehyde was the primary contributor to the association between aldehyde exposure and anemia with the highest posterior inclusion probability value of 0.872. In addition, differential associations between isopentanaldehyde and anemia were identified in men and women. The isopentanaldehyde Q4 concentration exhibited a positive association with the anemia T2 group in the male population, while the isopentanaldehyde Q4 concentration manifested negative correlations with both the anemia T1 and T3 groups in the female population. Furthermore, each 1 ng/mL increment in isopentanaldehyde was associated with a 2.55 g/L increase in hemoglobin in females (P=0.006) and a 0.114×10¹²/L decrease in RBC count in males (P=0.002). Conclusion Serum isopentanaldehyde are related to anemia in adults in the real word and the association appeared difference between male and female groups. For cases with basically normal hemoglobin concentrations but presenting with unexplained anemia symptoms, isopentanaldehyde may become a pontential biomarker to assist evaluating disease status.

Key words: Serum aldehydes, Isopentanaldehyde, Anemia, Red blood cell, Hemoglobin