Kotzé Sebastian R, Pedersen Ole B, Petersen Mikkel S, Sørensen Erik, Thørner Lise W, Sørensen Cecilie J, Rigas Andreas S, Hjalgrim Henrik, Rostgaard Klaus, Ullum Henrik, Erikstrup Christian
Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark.
Transfusion. 2015 Jun;55(6):1303-11. doi: 10.1111/trf.13011. Epub 2015 Feb 3.
It is well known that blood donors are at increased risk of iron deficiency and subsequent development of iron deficiency anemia. We aimed to investigate the effect of factors influencing hemoglobin (Hb) levels.
Initiated in 2010, the Danish Blood Donor Study is a population-based study and biobank. We performed multivariable linear regression analysis to assess the effects of donation activity, physiologic and lifestyle factors, and diet on Hb levels among 15,197 donors. We also performed multivariable logistic regression to evaluate the effects of these factors on the risk of having low Hb (defined as Hb below the 10th percentile among men and women, respectively) and of a decrease in Hb greater than 0.5 mmol/L (0.8 g/dL) between successive donations. All analyses were performed stratified for sex and smoking status. We also tested a previously used model for the prediction of Hb.
The strongest predictors of Hb and risk of low Hb were low ferritin (<15 ng/mL) and current use of iron supplementation (yes/no). No dietary factors were found to be consistently significant in multivariable models predicting Hb levels, risk of having low Hb, or risk of a decrease in Hb greater than 0.5 mmol/L. We found similar effects to previous studies of factors in the predictive model, with little additional effect of including smoking status and ferritin.
As ferritin was the strongest predictor of Hb, this study supports the implementation of regular ferritin measurement as a method of risk assessment among blood donors.
众所周知,献血者缺铁及随后发生缺铁性贫血的风险会增加。我们旨在研究影响血红蛋白(Hb)水平的因素的作用。
丹麦献血者研究始于2010年,是一项基于人群的研究和生物样本库。我们进行了多变量线性回归分析,以评估献血活动、生理和生活方式因素以及饮食对15197名献血者Hb水平的影响。我们还进行了多变量逻辑回归分析,以评估这些因素对Hb水平低(分别定义为男性和女性Hb低于第10百分位数)以及连续两次献血之间Hb下降大于0.5 mmol/L(0.8 g/dL)风险的影响。所有分析均按性别和吸烟状况进行分层。我们还测试了一个先前用于预测Hb的模型。
Hb及低Hb风险的最强预测因素是低铁蛋白(<15 ng/mL)和当前是否使用铁补充剂(是/否)。在预测Hb水平、低Hb风险或Hb下降大于0.5 mmol/L风险的多变量模型中,未发现饮食因素具有一致的显著性。我们发现预测模型中的因素与先前研究的效果相似,纳入吸烟状况和铁蛋白几乎没有额外影响。
由于铁蛋白是Hb的最强预测因素, 本研究支持将定期测量铁蛋白作为献血者风险评估的一种方法。