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男性献血与冠心病风险

Blood donations and risk of coronary heart disease in men.

作者信息

Ascherio A, Rimm E B, Giovannucci E, Willett W C, Stampfer M J

机构信息

Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.

出版信息

Circulation. 2001 Jan 2;103(1):52-7. doi: 10.1161/01.cir.103.1.52.

Abstract

BACKGROUND

In experimental animals, iron overload appears to promote atherosclerosis and ischemic myocardial damage, but the results of epidemiological studies that relate iron stores to risk of coronary heart disease (CHD) have been inconsistent.

METHODS AND RESULTS

We prospectively studied blood donations, which effectively reduce body iron stores, in relation to the risk of CHD among participants in the Health Professionals Follow-up Study. The lifetime history of blood donation was assessed with a questionnaire in 1992. The 38 244 men who were free of diagnosed cardiovascular disease at that time were included in the analyses. During 4 years of follow-up, we documented 328 nonfatal myocardial infarctions and 131 coronary deaths. Although the number of lifetime blood donations was strongly associated with lower plasma ferritin levels in a subsample, the blood donation was not associated with risk of myocardial infarction or fatal CHD. The age-adjusted relative risk (RR) of myocardial infarction for men in the highest category of blood donations (>/=30) compared with never donors was 1.2 (95% CI 0. 8 to 1.8), and this RR was not materially changed after adjustment for several coronary risk factors. No significant associations were found between blood donation and the risk of myocardial infarction in analyses restricted to men with hypercholesterolemia or those who never used antioxidant supplements or aspirin.

CONCLUSIONS

The study results do not support the hypothesis that reduced body iron stores lower CHD risk.

摘要

背景

在实验动物中,铁过载似乎会促进动脉粥样硬化和缺血性心肌损伤,但将铁储存量与冠心病(CHD)风险相关联的流行病学研究结果并不一致。

方法与结果

我们前瞻性地研究了献血(可有效降低体内铁储存量)与健康专业人员随访研究参与者中冠心病风险之间的关系。1992年通过问卷调查评估献血的终生史。当时未被诊断患有心血管疾病的38244名男性纳入分析。在4年的随访期间,我们记录了328例非致命性心肌梗死和131例冠心病死亡病例。尽管在一个子样本中,终生献血次数与较低的血浆铁蛋白水平密切相关,但献血与心肌梗死风险或致命性冠心病并无关联。与从未献血者相比,献血次数最多组(≥30次)男性心肌梗死的年龄调整相对风险(RR)为1.2(95%CI 0.8至1.8),在对多个冠心病危险因素进行调整后,该RR没有实质性变化。在仅限于高胆固醇血症男性或从未使用抗氧化补充剂或阿司匹林的男性的分析中,未发现献血与心肌梗死风险之间存在显著关联。

结论

研究结果不支持体内铁储存量降低会降低冠心病风险这一假说。

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