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首页> 外文期刊>Annals of epidemiology >Serum ferritin and death from all causes and cardiovascular disease: the NHANES II Mortality Study. National Health and Nutrition Examination Study.
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Serum ferritin and death from all causes and cardiovascular disease: the NHANES II Mortality Study. National Health and Nutrition Examination Study.

机译：血清铁蛋白与所有原因和心血管疾病的死亡：NHANES II死亡率研究。全国健康与营养检查研究。

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PURPOSE: The purpose of this study was to assess the association between serum ferritin and death from all causes, cardiovascular diseases (CVD), CHD and myocardial infarction (MI). Positive body iron stores have been proposed as a risk factor for coronary heart disease (CHD). While most epidemiologic studies using serum ferritin and other measures of body iron stores have not found an association between iron and heart disease risk, the hypothesis remains controversial. As a result, we examined the relationship of serum ferritin, the principle blood measure of body iron stores, to risk of death in a cohort with a standardized exam and long follow-up. METHODS: The baseline data for this prospective cohort study were collected in 1976-1980 as part of the second National Health and Nutrition Examination Study (NHANES II) with mortality follow-up using the National Death Index (NDI) through December 31, 1992. The analytic sample (n = 1604) consisted of 128 black men, 658 white men, 100 black women and 718 white women 45-74 years of age at baseline who, based on self-reported data, were free of coronary heart disease at baseline and had no missing data. The main outcome measures were the relative risk of death for persons with serum ferritin levels: <50 microg/L; or 100-199 microg/L; or > or =200 microg/L was compared to persons with serum ferritin levels of 50-99 microg/L adjusted for possible confounding using the Cox proportional hazards model. RESULTS: Most of the deaths were among white men (n = 254) and women (n = 168). There were relatively few deaths among black men (n = 50) and too few in women (n = 23) to reliably model. The largest number of CVD (n = 119), CHD (n = 82), and MI (n = 49) deaths were in white men while there were 69 CVD, 45 CHD and 13 MI deaths in white women. Black men with a serum ferritin level of <50 microg/L had a significantly higher adjusted risk of death from all causes (RR = 3.1 with 95% confidence limits of 1.5-6.5). There were no other statistically significant associations for all causes mortality for the other three race/sex groups. Additionally, there were no statistically significant associations between serum ferritin and any of the cardiovascular endpoints for any of the groups. There was an apparent but nonsignificant u-shaped association between serum ferritin and all causes mortality in black men and between serum ferritin and CVD death in white women. However, in both cases very wide confidence limits preclude further interpretation. CONCLUSIONS: Overall, the results do not support the hypothesis that positive body iron stores, as measured by serum ferritin, are associated with an increased risk of CVD, CHD or MI death or between serum ferritin and all causes mortality. Most of the research to date with serum ferritin has been conducted in European men or in European American men. Our results are consistent with the primarily negative results for that race/sex group. More research is needed in women and minority groups, including an explanation of why such an association would exist in these groups but not in white men before an association can be established in them.
机译：目的：本研究的目的是评估血清铁蛋白与各种原因引起的死亡，心血管疾病（CVD），CHD和心肌梗塞（MI）之间的关联。人体中铁的正存储已被提出作为冠心病（CHD）的危险因素。尽管大多数使用血清铁蛋白和其他体内铁存储量的流行病学研究并未发现铁与心脏病风险之间存在关联，但这一假设仍存在争议。结果，我们通过标准化检查和长期随访，研究了血清铁蛋白，体内铁储备的主要血液指标与死亡风险之间的关系。方法：这项前瞻性队列研究的基线数据收集于1976-1980年，是第二次全国健康与营养检查研究（NHANES II）的一部分，该研究使用国家死亡指数（NDI）进行了随访，直至1992年12月31日。分析样本（n = 1604）由基线时基线年龄无冠心病的128位黑人，658位白人，100位黑人妇女和718位45-74岁的白​​人女性组成。并且没有丢失的数据。主要预后指标是血清铁蛋白水平<50 microg / L的人的相对死亡风险;或100-199 microg / L;使用Cox比例风险模型将血清铁蛋白水平调整为50-99 microg / L的人与≥200 microg / L的人进行比较。结果：大多数死亡病例是白人（n = 254）和妇女（n = 168）。在黑人中，死亡人数相对较少（n = 50），在女性中则很少（n = 23），无法可靠地建模。 CVD死亡最多（n = 119），CHD（n = 82）和MI（n = 49）的死亡是白人男性，而白人女性有69 CVD，45 CHD和13 MI死亡。血清铁蛋白水平<50 microg / L的黑人因各种原因死亡的调整后风险显着更高（RR = 3.1，95％置信区间为1.5-6.5）。对于其他三个种族/性别组，所有原因的死亡率都没有其他统计上显着的关联。另外，对于任何组，血清铁蛋白与任何心血管终点之间均无统计学意义的关联。在黑人男性中血清铁蛋白与所有病因死亡率之间以及白人女性中血清铁蛋白与CVD死亡之间存在明显但不显着的u型联系。但是，在这两种情况下，非常大的置信度限制都无法进一步解释。结论：总的来说，该结果不支持这样的假设，即通过血清铁蛋白测定的机体铁存储阳性与CVD，CHD或MI死亡或血清铁蛋白之间的风险增加以及所有原因导致死亡有关。迄今为止，大多数有关血清铁蛋白的研究都是在欧洲男性或欧美男性中进行的。我们的结果与该种族/性别组的主要负面结果一致。在妇女和少数群体中还需要进行更多的研究，包括解释为什么在这样的群体中会建立这样的联系，而在白人中却不存在这样的联系。

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