Chen Zhi, Chen Jing, Song Chenyang, Sun Jun, Liu Wenge
Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, China.
Front Nutr. 2022 Jul 11;9:941093. doi: 10.3389/fnut.2022.941093. eCollection 2022.
Iron deficiency or overload may contribute to complications associated with diseases, but the link between iron status and skeletal muscle disorder is poorly understood. This study aimed to investigate the relationship between serum iron status, reflected by serum ferritin concentration, and muscle mass in U.S. adults.
We utilized data from National Health and Nutrition Examination Survey (NHANES) 2015-2018 for analysis. Data on serum ferritin, appendicular skeletal muscle mass (ASM), body mass index (BMI) and confounding factors were extracted and analyzed. Multivariate linear regression analyses and smooth curve fittings were employed to investigate the association between serum ferritin and muscle mass. Subgroup analysis based on iron status, age, gender and race were performed.
A total of 2,078 participants were included, and divided into iron deficiency ( = 225), normal iron status ( = 1,366), and iron overload ( = 487) groups. Participants with iron overload had significantly lower ASM and appendicular skeletal muscle index (ASMI) (ASM: 19.329 ± 4.879, ASMI: 0.709 ± 0.138) compared to those with iron deficiency (ASM: 22.660 ± 6.789, ASMI: 0.803 ± 0.206) and normal iron status (ASM: 22.235 ± 6.167, ASMI: 0.807 ± 0.201). The serum ferritin was negatively linked with muscle mass after adjusting for potential confounders (β = -0.0001, 95% CI: -0.0001, -0.0000). When stratified by iron status, the trend test between them remained significant (P for trend: 0.008). Furthermore, subgroup analysis identified a stronger association in men (β = -0.0001, 95% CI: -0.0002, -0.0001), age ≥ 40 years (β = -0.0001, 95% CI: -0.0002, -0.0000), non-Hispanic black (β = -0.0002, 95% CI: -0.0003, -0.0001) and other races (β = -0.0002, 95% CI: -0.0003, -0.0000).
Our study revealed an inverse relationship between serum iron status and muscle mass in adults. This finding improves our understanding of the impact of serum iron status on muscle mass, and sheds new light on the prevention and treatment of muscle loss.
铁缺乏或铁过载可能导致与疾病相关的并发症，但铁状态与骨骼肌疾病之间的联系尚不清楚。本研究旨在调查美国成年人中血清铁蛋白浓度所反映的血清铁状态与肌肉量之间的关系。
我们利用2015 - 2018年美国国家健康与营养检查调查（NHANES）的数据进行分析。提取并分析血清铁蛋白、四肢骨骼肌量（ASM）、体重指数（BMI）及混杂因素的数据。采用多元线性回归分析和平滑曲线拟合来研究血清铁蛋白与肌肉量之间的关联。基于铁状态、年龄、性别和种族进行亚组分析。
共纳入2078名参与者，分为铁缺乏组（n = 225）、铁状态正常组（n = 1366）和铁过载组（n = 487）。与铁缺乏组（ASM：22.660±6.789，ASMI：0.803±0.206）和铁状态正常组（ASM：22.235±6.167，ASMI：0.807±0.201）相比，铁过载参与者的ASM和四肢骨骼肌指数（ASMI）显著更低（ASM：19.329±4.879，ASMI：0.709±0.138）。在调整潜在混杂因素后，血清铁蛋白与肌肉量呈负相关（β = -0.0001，95%CI：-0.0001，-0.0000）。按铁状态分层时，两者之间的趋势检验仍具有显著性（趋势P值：0.008）。此外，亚组分析显示在男性（β = -0.0001，95%CI：-0.0002，-0.0001）、年龄≥40岁者（β = -0.0001，95%CI：-0.0002，-0.0000）、非西班牙裔黑人（β = -0.0002，95%CI：-0.0003，-0.0001）和其他种族（β = -0.0002，95%CI：-0.0003，-0.0000）中存在更强的关联。
我们的研究揭示了成年人血清铁状态与肌肉量之间的负相关关系。这一发现增进了我们对血清铁状态对肌肉量影响的理解，并为肌肉量减少的预防和治疗提供了新的思路。
