Etablissement Français du Sang, La Plaine Saint-Denis, France.
Centre de Transfusion Sanguine des Armées, Clamart, France.
Vox Sang. 2021 Jan;116(1):42-52. doi: 10.1111/vox.12991. Epub 2020 Sep 23.
The objectives of this study are to estimate the prevalence of iron deficiency (ID) among French whole-blood (WB) donors to identify factors associated with ID and to generate decision trees.
A prospective National multicentre study was performed on WB donors from March 11, to April 5th, 2019. Samples were selected randomly to perform serum ferritin. ID was defined as ferritin value under 26 ng/ml. All results were stratified by sex. Factors associated with ID were analysed using multivariate logistic regression model. CART algorithm was used for decision trees.
Eleven thousand two hundred fifty eight WB donors were included. ID was more frequent in women (39·5%) than in men (18·0%). Among 7200 repeated donors, women below 50 yo had a higher risk (OR = 2·37; [1·97-2·85] IC95) than those above 50 yo. Factors associated with ID were: haemoglobin level under the threshold at donation n-1 except for women and n-2 donation; a low mean corpuscular haemoglobin at n-1 and n-2 donations; a shorter interval since n-1 donation and between n-1 and n-2 donations except for women; and women who had given three or four times in the last year. CART algorithm defined high risk of ID subgroups within three populations of donors, new female donors, repeated male donors and repeated female donors. In these identified subgroups, prevalence of ID was up to 72·1%.
Our study showed the high prevalence of ID among French WB donors, identified well-known and new factors associated with ID and defined algorithms predicting ID in three populations.
本研究旨在评估法国全血(WB)供者铁缺乏症(ID)的患病率,确定与 ID 相关的因素,并生成决策树。
2019 年 3 月 11 日至 4 月 5 日,进行了一项前瞻性全国多中心研究,对 WB 供者进行了研究。随机选择样本进行血清铁蛋白检测。将铁蛋白值<26ng/ml 定义为 ID。所有结果均按性别分层。使用多变量逻辑回归模型分析与 ID 相关的因素。使用 CART 算法进行决策树分析。
共纳入 12580 名 WB 供者。女性(39.5%)的 ID 发生率高于男性(18.0%)。在 7200 名重复供者中,50 岁以下的女性发生 ID 的风险高于 50 岁以上的女性(OR=2.37;95%CI95:1.97-2.85)。与 ID 相关的因素包括:除女性外,n-1 和 n-2 次献血时血红蛋白水平低于阈值;n-1 和 n-2 次献血时平均红细胞血红蛋白较低;n-1 次献血后和 n-1 次献血与 n-2 次献血之间的间隔较短,除女性外;以及过去一年献血三次或四次的女性。CART 算法在三个供者群体中确定了 ID 高危亚组,包括新女性供者、重复男性供者和重复女性供者。在这些确定的亚组中,ID 的患病率高达 72.1%。
本研究显示,法国 WB 供者 ID 的患病率较高,确定了与 ID 相关的已知和新因素,并定义了三种人群中预测 ID 的算法。