Peach H G, Bath N E
University of Melbourne, Ballarat Health Services Base Hospital, Victoria, Australia.
J Clin Pathol. 1999 Nov;52(11):853-5. doi: 10.1136/jcp.52.11.853.
Raised plasma ferritin concentrations occur unexpectedly during iron studies done by primary care physicians. Plasma ferritin concentration has been positively associated with alcohol use among men.
To determine the post-test probability that men in the community with raised plasma ferritin concentrations are hazardous drinkers.
The subjects were 152 men, randomly selected from a city's electoral roll. Nineteen (12.5 (2.7)%, mean (SEM)) admitted to drinking hazardously. The pretest probability of a man being a hazardous drinker was 0.125. This was converted to pretest odds of 0.14. The likelihood ratio (the ratio of the probability of obtaining a raised plasma ferritin concentration in a hazardous drinker (sensitivity) to the probability of obtaining a raised plasma ferritin concentration in a non-hazardous drinker (1-specificity)) was calculated for different plasma ferritin cut off points.
A plasma ferritin level of > 652 micrograms/l gave the largest likelihood ratio, 4.16. Post-test odds were obtained by multiplying the pretest odds (0.14) by the likelihood ratio (4.16). A plasma ferritin level of > 652 micrograms/l had a post-test odds for a man being a hazardous drinker of 0.58. This was converted to a post-test probability of 0.37.
Inquiries could usefully be made into the alcohol consumption of men with a plasma ferritin concentration > 652 micrograms/l, as approximately one in three would admit to drinking hazardously.
基层医疗医生在进行铁代谢检查时,血浆铁蛋白浓度意外升高的情况时有发生。血浆铁蛋白浓度与男性饮酒量呈正相关。
确定社区中血浆铁蛋白浓度升高的男性为危险饮酒者的检测后概率。
研究对象为152名男性,从该市选民名单中随机选取。19人(12.5(2.7)%,均值(标准误))承认有危险饮酒行为。男性为危险饮酒者的检测前概率为0.125。将其转换为检测前比值为0.14。针对不同的血浆铁蛋白临界值,计算似然比(危险饮酒者血浆铁蛋白浓度升高的概率(敏感性)与非危险饮酒者血浆铁蛋白浓度升高的概率(1 - 特异性)之比)。
血浆铁蛋白水平>652微克/升时似然比最大,为4.16。检测后比值通过将检测前比值(0.14)乘以似然比(4.16)得出。血浆铁蛋白水平>652微克/升时,男性为危险饮酒者的检测后比值为0.58。将其转换为检测后概率为0.37。
对于血浆铁蛋白浓度>652微克/升的男性,询问其饮酒情况可能会有所帮助,因为大约三分之一的此类男性会承认有危险饮酒行为。