Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, The Netherlands.
Eur J Heart Fail. 2010 Apr;12(4):348-53. doi: 10.1093/eurjhf/hfq007.
Anaemia is highly prevalent and associated with poor prognosis in patients with chronic heart failure (CHF). Reduced erythroid proliferation capacity of haematopoietic progenitor cells is associated with reduced telomere length, a marker of cellular ageing. We hypothesize that short telomere length contributes to the susceptibility to develop anaemia in patients with CHF.
We studied 875 CHF patients, of whom 254 (29%) fulfilled the WHO criteria of anaemia. Telomere length in DNA from peripheral leucocytes was measured with real-time quantitative polymerase chain reaction. Age, gender, and baseline differences adjusted telomere length was correlated with haemoglobin levels (partial r = 0.130; P = 0.011). One standard deviation shorter telomere length was associated with an increased risk of having anaemia [odds ratio (OR), 1.31; 95% confidence interval (CI), 1.12-1.53; P = 0.001]. This observation was not affected by adjustment for potential confounders (OR, 1.38; 95% CI, 1.05-1.81; P = 0.021 after adjustment for age, gender, erythropoietin levels, renal function, left ventricular ejection fraction, age of CHF onset, blood pressure, history of stroke, diabetes, and B-type natriuretic peptide levels).
Shorter telomere length increases the odds of having anaemia in CHF patients. This finding supports the hypothesis that cellular ageing in CHF contributes to the susceptibility to develop anaemia.
贫血在慢性心力衰竭（CHF）患者中非常普遍，并与预后不良相关。造血祖细胞的红细胞生成能力降低与端粒缩短有关，端粒是细胞衰老的标志物。我们假设端粒缩短导致 CHF 患者易发生贫血。
我们研究了 875 例 CHF 患者，其中 254 例（29%）符合贫血的 WHO 标准。使用实时定量聚合酶链反应测量外周白细胞 DNA 中的端粒长度。年龄、性别和基线差异调整后的端粒长度与血红蛋白水平相关（部分 r = 0.130；P = 0.011）。端粒长度缩短一个标准差与发生贫血的风险增加相关[比值比（OR），1.31；95%置信区间（CI），1.12-1.53；P = 0.001]。这一观察结果不受潜在混杂因素调整的影响（OR，1.38；95%CI，1.05-1.81；P = 0.021，在调整年龄、性别、促红细胞生成素水平、肾功能、左心室射血分数、CHF 发病年龄、血压、中风史、糖尿病和 B 型利钠肽水平后）。
端粒缩短增加了 CHF 患者发生贫血的几率。这一发现支持了这样一种假设，即 CHF 中的细胞衰老导致了发生贫血的易感性。
