Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN.
J Nutr. 2014 Mar;144(3):359-66. doi: 10.3945/jn.113.185124. Epub 2014 Jan 8.
The link between iron intake as well as body iron stores and coronary heart disease (CHD) has been contentiously debated, and the epidemiologic evidence is inconsistent. We aimed to quantitatively summarize the literature on the association between dietary iron intake/body iron stores and CHD risk by conducting a meta-analysis of prospective cohort studies. PubMed was used to find studies published through June 2013 in peer-reviewed journals. Embase or a hand search of relevant articles was used to obtain additional articles. The pooled RRs of CHD incidence and mortality with 95% CIs were calculated by using either a random-effects or fixed-effects model, as appropriate. Twenty-one eligible studies (32 cohorts) including 292,454 participants with an average of 10.2 y of follow-up were included. Heme iron was found to be positively associated with CHD incidence (RR: 1.57; 95% CI: 1.28, 1.94), whereas total iron was inversely associated (RR: 0.85; 95% CI: 0.73, 0.999). Neither heme-iron nor total iron intakes were significantly associated with CHD mortality. Both transferrin saturation and serum iron were inversely related to CHD incidence [RR (95% CI): 0.76 (0.66, 0.88) and 0.68 (0.56, 0.82), respectively], but only transferrin saturation was inversely associated with CHD mortality (RR: 0.85; 95% CI: 0.73, 0.99). In conclusion, total iron intake and serum iron concentrations were inversely associated with CHD incidence, but heme iron intake was positively related to CHD incidence. Elevated serum transferrin saturation concentration was inversely associated with both CHD incidence and mortality. Future research is needed to establish the causal relation and to elucidate potential mechanisms.
铁摄入量和体内铁储存与冠心病（CHD）之间的关系一直存在争议，且流行病学证据并不一致。我们旨在通过对前瞻性队列研究进行荟萃分析，定量总结关于饮食铁摄入量/体内铁储存与 CHD 风险之间关系的文献。我们使用 PubMed 检索在同行评审期刊上发表的截至 2013 年 6 月的研究。使用 Embase 或相关文章的手工检索获取额外的文章。使用随机效应或固定效应模型（视情况而定）计算 CHD 发病率和死亡率的合并 RR 及其 95%CI。纳入了 21 项符合条件的研究（32 项队列），共包括 292454 名参与者，平均随访时间为 10.2 年。发现血红素铁与 CHD 发病率呈正相关（RR：1.57；95%CI：1.28，1.94），而总铁呈负相关（RR：0.85；95%CI：0.73，0.999）。血红素铁或总铁摄入量与 CHD 死亡率均无显著相关性。转铁蛋白饱和度和血清铁均与 CHD 发病率呈负相关[RR（95%CI）：0.76（0.66，0.88）和 0.68（0.56，0.82）]，但仅转铁蛋白饱和度与 CHD 死亡率呈负相关（RR：0.85；95%CI：0.73，0.99）。总之，总铁摄入量和血清铁浓度与 CHD 发病率呈负相关，而血红素铁摄入量与 CHD 发病率呈正相关。血清转铁蛋白饱和度升高与 CHD 发病率和死亡率均呈负相关。需要进一步的研究来确定因果关系并阐明潜在的机制。
