Kim Mi-Hye, Kim Yong-Hwan, Lee Duk-Chul
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean J Fam Med. 2018 Mar;39(2):85-89. doi: 10.4082/kjfm.2018.39.2.85. Epub 2018 Mar 22.
Although chronic obstructive pulmonary disease is a known cause of secondary polycythemia with elevated erythropoietic demands in response to hypoxemia, anemia is relatively common in patients with chronic obstructive pulmonary disease and is related to increased mortality. However, little is currently known about the relationship between various iron parameters and disease severity in chronic obstructive pulmonary disease patients.
Data from the fifth Korean National Health and Nutrition Examination Survey, a population-based epidemiologic survey conducted in 2010-2012, were used. A total of 1,129 patients with chronic obstructive pulmonary disease were examined to reveal the associations between the forced expiratory volume in 1 second (FEV1) and hemoglobin and iron parameters, including serum iron, ferritin, total iron binding capacity, and transferrin saturation, using Spearman correlations and multiple linear regression analyses.
The FEV1 was positively correlated with serum hemoglobin (γ=0.37, P<0.001), iron (γ=0.20, P<0.001), transferrin saturation (γ=0.19, P<0.001), and ferritin (γ=0.22, P<0.001), and negatively correlated with age (γ=-0.40, P<0.001) and lower in female patients (γ=-0.56, P<0.001) in the Spearman correlation. The FEV1 was independently associated with serum iron (β=0.049, P=0.035) and transferrin saturation (β=0.049, P=0.035) after adjusting for age, sex, and body mass index in the multiple linear regression analyses.
The serum iron and transferrin saturation levels were independently associated with FEV1 as a marker of chronic obstructive pulmonary disease severity.
虽然慢性阻塞性肺疾病是继发性红细胞增多症的已知病因，机体因低氧血症而产生的促红细胞生成需求增加，但贫血在慢性阻塞性肺疾病患者中相对常见，且与死亡率增加相关。然而，目前对于慢性阻塞性肺疾病患者各种铁参数与疾病严重程度之间的关系知之甚少。
使用2010 - 2012年进行的韩国第五次全国健康与营养检查调查的数据，该调查为基于人群的流行病学调查。共检查了1129例慢性阻塞性肺疾病患者，采用Spearman相关性分析和多元线性回归分析，以揭示一秒用力呼气容积（FEV1）与血红蛋白及铁参数（包括血清铁、铁蛋白、总铁结合力和转铁蛋白饱和度）之间的关联。
在Spearman相关性分析中，FEV1与血清血红蛋白（γ = 0.37，P < 0.001）、铁（γ = 0.20，P < 0.001）、转铁蛋白饱和度（γ = 0.19，P < 0.001）和铁蛋白（γ = 0.22，P < 0.001）呈正相关，与年龄（γ = - 0.40，P < 0.001）呈负相关，且在女性患者中较低（γ = - 0.56，P < 0.001）。在多元线性回归分析中，调整年龄、性别和体重指数后，FEV1与血清铁（β = 0.049，P = 0.035）和转铁蛋白饱和度（β = 0.049，P = 0.035）独立相关。
血清铁和转铁蛋白饱和度水平与作为慢性阻塞性肺疾病严重程度标志物的FEV1独立相关。
