Zhou Y, Liu T, Kang P, Jia C
Department of Epidemiology and Health Statistics, Shandong University, Jinan, China.
Intern Med J. 2014 Sep;44(9):846-50. doi: 10.1111/imj.12508.
Epidemiological evidence concerning the role of body iron in coronary artery disease (CAD) is inconsistent, which is largely explained by the lack of relatively ideal estimations of body iron stores.
The aim of the present study was to attempt to explore the ideal iron indicator that has the best effect on disease risk for further studies related to iron overload metabolism research worldwide.
A case-control study was conducted with 258 CAD cases and 282 healthy controls. The association of serum iron (SI) parameters, including SI, total iron-binding capacity (TIBC), serum ferritin (SF) and serum transferrin receptor (sTfR), and CAD risk, was evaluated with receiver operating characteristic analysis. The areas under the receiver operating characteristic curve (AUC) were compared with each other to indicate the one showing the strongest association with CAD risk.
The AUC (95% confidence interval) were 0.73 (0.69-0.77), 0.74 (0.69-0.78), 0.53 (0.48-0.58) and 0.61 (0.56-0.66) for SI, TIBC, SF and sTfR respectively. After comparing the AUC with each other, the combination of SI and TIBC (AUC (95% confidence interval): 0.86 (0.83-0.90)) was superior to other examined iron parameters or the combination of iron indicators (P < 0.05).
The present study indicated that the combination of SI and TIBC may have the best effect on CAD risk. Further studies are warranted to verify this preliminary result.
关于体内铁在冠状动脉疾病(CAD)中作用的流行病学证据并不一致,这在很大程度上是由于缺乏对体内铁储存相对理想的评估方法。
本研究旨在探索对疾病风险影响最佳的理想铁指标,以供全球范围内进一步开展与铁过载代谢研究相关的研究。
进行了一项病例对照研究,纳入258例CAD患者和282名健康对照者。通过受试者工作特征分析评估血清铁(SI)参数,包括SI、总铁结合力(TIBC)、血清铁蛋白(SF)和血清转铁蛋白受体(sTfR)与CAD风险的关联。比较受试者工作特征曲线下面积(AUC)以确定与CAD风险关联最强的指标。
SI、TIBC、SF和sTfR的AUC(95%置信区间)分别为0.73(0.69 - 0.77)、0.74(0.69 - 0.78)、0.53(0.48 - 0.58)和0.61(0.56 - 0.66)。相互比较AUC后,SI和TIBC的组合(AUC(95%置信区间):0.86(0.83 - 0.90))优于其他检测的铁参数或铁指标组合(P < 0.05)。
本研究表明,SI和TIBC的组合可能对CAD风险影响最佳。有必要进一步研究以验证这一初步结果。