Ellervik Christina, Marott Jacob Louis, Tybjærg-Hansen Anne, Schnohr Peter, Nordestgaard Børge G
Department of Research, Nykøbing Falster Hospital, Nykøbing Falster, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark;
Clin Chem. 2014 Nov;60(11):1419-28. doi: 10.1373/clinchem.2014.229013. Epub 2014 Aug 25.
Previous population-based studies of plasma ferritin concentration have not revealed a relationship with total mortality. We tested the possible association of increased ferritin concentrations with increased risk of total and cause-specific mortality in the general population.
We examined total and cause-specific mortality according to baseline plasma ferritin concentrations in a Danish population-based study (the Copenhagen City Heart Study) of 8988 individuals, 6364 of whom died (median follow-up 23 years). We also included a metaanalysis of total mortality comprising population-based studies according to ferritin quartiles or tertiles.
Multifactorially adjusted hazard ratios (HRs) for total mortality for individuals with ferritin ≥200 vs <200 μg/L were 1.1 (95% CI 1.1-1.2; P = 0.0008) overall, 1.1 (1.0-1.2; P = 0.02) in men, and 1.2 (1.0-1.3; P = 0.03) in women. Stepwise increasing concentrations of ferritin were associated with a stepwise increased risk of premature death overall (log rank, P = 2 × 10(-22)), with median survival of 55 years at ferritin concentrations ≥600 μg/L, 72 years at 400-599 μg/L, 76 years at 200-399 μg/L, and 79 years at ferritin <200 μg/L. The corresponding HR for total overall mortality for ferritin ≥600 vs <200 μg/L was 1.5 (1.2-1.8; P = 0.00008). Corresponding adjusted HRs for ferritin ≥600 vs <200 μg/L were 1.6 (1.1-2.3; P = 0.01) for cancer mortality, 2.9 (1.7-5.0; P = 0.0001) for endocrinological mortality, and 1.5 (1.1-2.0; P = 0.01) for cardiovascular mortality. The metaanalysis random effects odds ratio for total mortality for ferritin upper vs reference quartile or tertile was 1.0 (0.9-1.1; P = 0.3) (P heterogeneity = 0.5).
Moderately to markedly increased ferritin concentrations represent a biological biomarker predictive of early death in a dose-dependent linear manner in the general population.
既往基于人群的血浆铁蛋白浓度研究未发现其与总死亡率之间存在关联。我们测试了铁蛋白浓度升高与普通人群总死亡率及特定病因死亡率增加之间可能存在的关联。
在一项基于丹麦人群的研究（哥本哈根城市心脏研究）中，我们根据基线血浆铁蛋白浓度对8988名个体的总死亡率及特定病因死亡率进行了研究，其中6364人死亡（中位随访23年）。我们还纳入了一项根据铁蛋白四分位数或三分位数进行的基于人群研究的总死亡率的荟萃分析。
铁蛋白≥200 μg/L与＜200 μg/L的个体相比，全因死亡率的多因素调整风险比（HR）总体为1.1（95%CI 1.1 - 1.2；P = 0.0008），男性为1.1（1.0 - 1.2；P = 0.02），女性为1.2（1.0 - 1.3；P = 0.03）。铁蛋白浓度逐步升高与总体过早死亡风险逐步增加相关（对数秩检验，P = 2×10⁻²²），铁蛋白浓度≥600 μg/L时中位生存期为55年，400 - 599 μg/L时为72年，200 - 399 μg/L时为76年，铁蛋白＜200 μg/L时为79年。铁蛋白≥600 μg/L与＜200 μg/L相比，全因总死亡率的相应HR为1.5（1.2 - 1.8；P = 0.00008）。铁蛋白≥600 μg/L与＜200 μg/L相比，癌症死亡率的相应调整HR为1.6（1.1 - 2.3；P = 0.01），内分泌疾病死亡率为2.9（1.7 - 5.0；P = 0.0001），心血管疾病死亡率为1.5（1.1 - 2.
Zotero 插件