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缺铁与长期护理机构中老年人患心血管疾病和全因死亡率增加有关。

Iron deficiency is associated with increased risk for cardiovascular disease and all-cause mortality in the elderly living in long-term care facilities.

机构信息

Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.

出版信息

Nutrition. 2013 May;29(5):737-43. doi: 10.1016/j.nut.2012.10.015. Epub 2013 Jan 22.

DOI:10.1016/j.nut.2012.10.015
PMID:23352175
Abstract

OBJECTIVE

The association between serum iron status, cardiovascular disease (CVD), and all-cause mortality remains controversial in the elderly. In the present study, we aim to determine the relevance of serum iron level on the incidences of CVD and all-cause mortality in an elderly population.

METHODS

A baseline cohort of 336 participants, aged ≥65 y, was recruited from eight long-term care facilities between 2002 and 2003. The degree of iron deficiency was defined based on the serum iron level (mild: 40 mg/dL ≤serum iron <60 mg/dL; severe: serum iron <40 mg/dL). Cox proportional hazard regression analyses were adopted to evaluate the relative risks (RRs) of CVD and all-cause death. Taiwan's Department of Health provided the mortality data.

RESULTS

There were 210 deaths during a 5-y follow-up period, 62 of which were due to CVD. The prevalence of iron deficiency among the subjects was 50.3%. Age, sex, body mass index, waist circumference, mean arterial pressure, performance status, lifestyle factors, blood glucose, hemoglobin, lipid, albumin, and high sensitivity C-reactive protein levels were adjusted to compare the RRs of the subjects. The RRs (95% confidence interval) of CVD and all-cause mortality among mildly iron-deficient subjects were 1.08 (0.51-2.29) and 1.63 (1.14-2.31), respectively, and 2.77 (1.28-5.99) and 1.96 (1.26-3.04), respectively, among severely iron-deficient subjects. The severity of iron deficiency was positively associated with CVD and all-cause mortality.

CONCLUSIONS

These results suggest that iron deficiency is independently associated with CVD and all-cause mortality in elderly Taiwanese living in long-term care facilities.

摘要

目的

血清铁状态与心血管疾病(CVD)和全因死亡率之间的关系在老年人中仍存在争议。本研究旨在确定血清铁水平与老年人群 CVD 和全因死亡率发生率的相关性。

方法

本研究招募了 2002 年至 2003 年间来自 8 个长期护理机构的 336 名年龄≥65 岁的参与者,建立基线队列。根据血清铁水平(轻度:40mg/dL≤血清铁<60mg/dL;重度:血清铁<40mg/dL)来定义缺铁程度。采用 Cox 比例风险回归分析评估 CVD 和全因死亡的相对风险(RR)。台湾卫生署提供死亡率数据。

结果

在 5 年随访期间,有 210 人死亡,其中 62 人死于 CVD。研究对象中缺铁的患病率为 50.3%。调整年龄、性别、体重指数、腰围、平均动脉压、表现状态、生活方式因素、血糖、血红蛋白、血脂、白蛋白和高敏 C 反应蛋白水平后,比较了研究对象的 RR。轻度缺铁组发生 CVD 和全因死亡的 RR(95%置信区间)分别为 1.08(0.51-2.29)和 1.63(1.14-2.31),重度缺铁组分别为 2.77(1.28-5.99)和 1.96(1.26-3.04)。缺铁严重程度与 CVD 和全因死亡率呈正相关。

结论

这些结果表明,铁缺乏与台湾长期护理机构老年人的 CVD 和全因死亡率独立相关。

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