Diagnostisk Center, Regionshospitalet Silkeborg, Hospitalsenhed Midt, Silkeborg, Denmark.
Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Clin Chem. 2019 Jan;65(1):180-188. doi: 10.1373/clinchem.2018.292763. Epub 2018 Nov 20.
Moderately increased plasma ferritin, as a biomarker of iron overload, has been associated with higher rates of cardiovascular death and heart failure. However, the association of moderately increased plasma ferritin with risk of atrial fibrillation in the general population is unknown.
We examined the association of plasma ferritin concentrations with risk of atrial fibrillation and heart failure in metaanalyses of 35799 men and women from 3 studies of the Danish general population: the Copenhagen City Heart Study, the Danish General Suburban Population Study, and the Copenhagen General Population Study.
Multivariable adjusted fixed effects odds ratios for atrial fibrillation were 1.23 (95% CI, 1.05-1.44; = 0.005) in men for ferritin concentration ≥300 μg/L vs <300 μg/L, 1.13 (95% CI, 0.93-1.38; = 0.22) in women for ≥200 μg/L vs <200 μg/L, and 1.19 (95% CI, 1.06-1.35; = 0.005) in both sexes combined ( = 0.52). Corresponding fixed effects odds ratios for heart failure were 1.16 (95% CI, 0.98-1.37; = 0.08) in men, 0.86 (95% CI, 0.67-1.10; = 0.23) in women, and 1.05 (95% CI, 0.91-1.21; = 0.45) in both sexes combined ( = 0.05). Multivariable adjusted fixed effects odds ratio for atrial fibrillation per step increase in ferritin concentrations was 1.13 (95% CI, 1.06-1.21; = 0.0005) in both sexes combined ( = 0.59); the corresponding value for heart failure was 1.03 (95% CI, 0.95-1.11; = 0.47) ( = 0.08). In sensitivity analyses, there was no evidence of U-shaped relationships between plasma ferritin concentrations and risk of atrial fibrillation or heart failure in men or women.
Increased ferritin concentration is associated with increased risk of atrial fibrillation in the general population.
作为铁过载的生物标志物，中等程度升高的血浆铁蛋白与更高的心血管死亡和心力衰竭发生率相关。然而，一般人群中中等程度升高的血浆铁蛋白与心房颤动风险的关联尚不清楚。
我们在三项丹麦普通人群研究（哥本哈根城市心脏研究、丹麦普通郊区人群研究和哥本哈根普通人群研究）的荟萃分析中，检查了血浆铁蛋白浓度与心房颤动和心力衰竭风险的关系。
多变量调整的固定效应比值比（OR）显示，对于男性，铁蛋白浓度≥300μg/L 与<300μg/L 相比，心房颤动的风险为 1.23（95%CI，1.05-1.44；P=0.005），对于女性，铁蛋白浓度≥200μg/L 与<200μg/L 相比，风险为 1.13（95%CI，0.93-1.38；P=0.22），在男女两性中综合为 1.19（95%CI，1.06-1.35；P=0.005）（P=0.52）。对于心力衰竭，男性固定效应 OR 为 1.16（95%CI，0.98-1.37；P=0.08），女性为 0.86（95%CI，0.67-1.10；P=0.23），男女两性综合为 1.05（95%CI，0.91-1.21；P=0.45）（P=0.05）。在男女两性中，血浆铁蛋白浓度每升高一个单位，心房颤动的多变量调整固定效应 OR 为 1.13（95%CI，1.06-1.21；P=0.0005）（P=0.59）；心力衰竭的相应值为 1.03（95%CI，0.95-1.11；P=0.47）（P=0.08）。在敏感性分析中，在男性或女性中，均未发现血浆铁蛋白浓度与心房颤动或心力衰竭风险之间存在 U 型关系的证据。
在一般人群中，铁蛋白浓度升高与心房颤动风险增加相关。
