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轻度贫血与表面健康的韩国老年人全因、心血管疾病和癌症死亡风险

Mild Anemia and Risk for All-Cause, Cardiovascular and Cancer Deaths in Apparently Healthy Elderly Koreans.

作者信息

Han Sil Vi, Park Minseon, Kwon Young-Min, Yoon Hyung-Jin, Chang Yoosoo, Kim Ho, Lim Youn-Hee, Kim Su Gyeong, Ko Ahryoung

机构信息

Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Department of Family Medicine, Sahmyook Medical Center, Seoul, Korea.

出版信息

Korean J Fam Med. 2019 May;40(3):151-158. doi: 10.4082/kjfm.17.0089. Epub 2019 Jan 17.

Abstract

BACKGROUND

Being common, mild anemia is sometimes considered a mere consequence of aging; however, aging alone is unlikely to lead to anemia. Therefore, this study aimed to investigate the association between mild anemia and total mortality and cause-specific mortality in apparently healthy elderly subjects.

METHODS

A retrospective cohort study was conducted on 10,114 apparently healthy elderly individuals who underwent cancer screening and routine medical check-ups at one Health Promotion Center between May 1995 and December 2007. We defined mild anemia as a hemoglobin concentration between 10.0 g/dL and 11.9 g/dL in women and between 10.0 g/dL and 12.9 g/dL in men. We assessed the relationship between the overall, cardiovascular (CV), and cancer mortality and mild anemia using Cox proportional hazard models.

RESULTS

Mild anemia was present in 143 men (3.1%) and 246 women (6.1%). During an average follow-up of 7.6 years, 495 deaths occurred, including 121 CV and 225 cancer deaths. After adjustments, mild anemia was associated with a 128% increase in the risk of all-cause mortality hazard ratio (HR, 2.28; 95% confidence interval [CI], 1.54- 3.37) in men and cancer-related mortality (HR, 2.25; 95% CI, 1.22-4.13), particularly lung cancer (HR, 2.70; 95% CI, 1.03-7.08) in men, but not in women. In the subgroup analyses based on smoking status, obesity, and age, the associations were more prominent in never or former smoker groups and the older group.

CONCLUSION

The present study shows that overall and cancer-related mortality was associated with mild anemia in elderly men. Future prospective studies are needed to consolidate our findings.

摘要

背景

轻度贫血较为常见,有时被认为仅仅是衰老的结果;然而,仅衰老不太可能导致贫血。因此,本研究旨在调查明显健康的老年受试者中轻度贫血与全因死亡率及特定病因死亡率之间的关联。

方法

对1995年5月至2007年12月期间在一家健康促进中心接受癌症筛查和常规体检的10114名明显健康的老年人进行了一项回顾性队列研究。我们将轻度贫血定义为女性血红蛋白浓度在10.0 g/dL至11.9 g/dL之间,男性在10.0 g/dL至12.9 g/dL之间。我们使用Cox比例风险模型评估了总体、心血管(CV)和癌症死亡率与轻度贫血之间的关系。

结果

143名男性(3.1%)和246名女性(6.1%)存在轻度贫血。在平均7.6年的随访期间,发生了495例死亡,包括121例心血管死亡和225例癌症死亡。调整后,轻度贫血与男性全因死亡风险增加128%相关(风险比[HR],2.28;95%置信区间[CI],1.54 - 3.37),与男性癌症相关死亡(HR,2.25;95% CI,1.22 - 4.13)相关,尤其是肺癌(HR,2.70;95% CI,1.03 - 7.08),但女性不存在这种关联。在基于吸烟状况、肥胖和年龄的亚组分析中,这种关联在从不吸烟或曾经吸烟的人群以及年龄较大的人群中更为显著。

结论

本研究表明,老年男性的总体死亡率和癌症相关死亡率与轻度贫血有关。需要未来的前瞻性研究来巩固我们的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2dc/6536909/bcdbdbe3eaa7/kjfm-17-0089f1.jpg

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