American Red Cross Scientific Affairs, Dedham, Massachusetts.
RTI International, Rockville, Maryland.
Transfusion. 2019 Oct;59(10):3146-3156. doi: 10.1111/trf.15448. Epub 2019 Jul 18.
The optimal approach for reducing iron depletion (ID) in blood donors may vary depending on biologic or behavioral differences across donors.
More than 12,600 successful whole blood donors were enrolled from four US blood centers for ferritin testing. The study population was enriched for racial/ethnic minorities (1605 African American, 1616 Asian, 1023 Hispanic). Subjects completed questionnaires on ID risk factors. Logistic regression identified predictors of absent iron stores (AIS; ferritin <12 ng/mL) and low ferritin (LF; ferritin <26 ng/mL).
Across all subjects, 19% had AIS and 42% had LF, with a sharp increase in risk observed with increasing donation intensity and among women a large decrease in risk in those more than 50 years old. When other factors were controlled for, African American and Asian donors showed 20% to 25% decreased risk for AIS compared to non-Hispanic Caucasian donors, while Hispanic donors had 25% higher risk. Daily iron supplementation reduced risk for LF and AIS by 30% to 40%, respectively, while the benefit from less frequent use was lower (7%-19% protection). Regular antacid use was associated with at least 20% increment to risk. Use of oral contraceptives or estrogen in females reduced risk by 16% to 22%, while males who reported supplemental testosterone use had a 50% to 125% greater risk for LF and AIS.
This study confirms high prevalence of LF and AIS in US donors and the principal risk factors of age, sex, and donation frequency. Additional demographic and behavioral risk factors of secondary importance might allow for refinement of ID mitigation strategies.
减少献血者缺铁（ID）的最佳方法可能因献血者的生物学或行为差异而有所不同。
从四个美国血液中心招募了超过 12600 名成功的全血献血者进行铁蛋白检测。该研究人群中种族/民族（1605 名非裔美国人、1616 名亚裔、1023 名西班牙裔）丰富。受试者完成了 ID 危险因素问卷。Logistic 回归确定了缺铁（铁蛋白<12ng/ml）和低铁蛋白（铁蛋白<26ng/ml）的预测因素。
在所有受试者中，19%有 AIS，42%有 LF，随着献血强度的增加和女性年龄超过 50 岁，风险显著增加。当控制其他因素时，与非西班牙裔白种人献血者相比，非裔美国人和亚裔献血者发生 AIS 的风险降低了 20%至 25%，而西班牙裔献血者的风险增加了 25%。每天补充铁可分别降低 LF 和 AIS 的风险 30%至 40%，而使用频率较低的铁（7%-19%的保护）的获益较低。经常使用抗酸剂与风险增加至少 20%相关。女性使用口服避孕药或雌激素可使 LF 和 AIS 的风险降低 16%至 22%，而报告使用补充睾酮的男性 LF 和 AIS 的风险增加 50%至 125%。
本研究证实了美国献血者 LF 和 AIS 的高患病率以及年龄、性别和献血频率等主要危险因素。次要重要的额外人口统计学和行为危险因素可能允许对 ID 缓解策略进行细化。
