定期高频全血捐献与澳大利亚中老年献血者心血管疾病风险。

Regular high-frequency whole blood donation and risk of cardiovascular disease in middle-aged and older blood donors in Australia.

机构信息

Research and Development, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia.

School of Population Health, UNSW Australia, Sydney, New South Wales, Australia.

出版信息

Transfusion. 2023 May;63(5):1012-1022. doi: 10.1111/trf.17358. Epub 2023 Apr 14.

DOI:10.1111/trf.17358

PMID:37057641

Abstract

BACKGROUND

Previous mixed findings on the associations between whole blood (WB) donation and risk of cardiovascular diseases (CVD) may in part reflect inadequate adjustment for the "healthy donor effect" (HDE).

METHODS

We used the Sax Institute's 45 and Up Study linked with blood donation history and other health-related databases to examine the association between regular, high-frequency WB donation and the risk of CVD. To mitigate the impact of HDE, we used a "5-years qualification period," in which donors must donate at least 1 WB donation in the 1st and 5th year of "qualification period." We then compared the risk of CVD in the years following the "qualification period" between the regular high-frequency WB donors (≥2 WB donation in each qualification year) and others using Cox proportional-hazards models. Analyses were adjusted for potential confounders, such as sociodemographic, lifestyle, and health-related variables, and results are reported separately for male and female donors.

RESULTS

A total of 2736 male and 2917 female donors were included in the analyses. The median years of follow-up per donor was 5.84 years (Q1-Q3, 5.47-6.23). The rate of CVD hospitalization was 11.20 and 4.50 per 1000 person-years for males and females, respectively. In fully adjusted models, the risk (hazard ratio) of CVD in regular high-frequency donors compared to other donors was 0.93 (95% Confidence Interval (CI), 0.68-1.29) for males and 0.79 (95% CI, 0.49-1.28) for females.

CONCLUSIONS

We did not observe a statistically significant reduction of CVD risk in regular, high-frequency WB donors when adjusted for potential confounders.

摘要

背景

之前关于全血（WB）捐献与心血管疾病（CVD）风险之间关联的混合研究结果，可能部分反映了对“健康捐献者效应”（HDE）的调整不足。

方法

我们使用萨克研究所的 45 岁及以上研究，将其与献血史和其他健康相关数据库相关联，以研究定期、高频 WB 捐献与 CVD 风险之间的关联。为了减轻 HDE 的影响，我们使用了一个“5 年资格期”，在此期间，献血者必须在“资格期”的第 1 年和第 5 年至少捐献 1 次 WB。然后，我们使用 Cox 比例风险模型比较了“资格期”后几年中，定期高频 WB 捐献者（每个资格年内至少捐献 2 次 WB）与其他人的 CVD 风险。分析调整了潜在的混杂因素，如社会人口统计学、生活方式和健康相关变量，结果分别报告给男性和女性献血者。

结果

共有 2736 名男性和 2917 名女性献血者纳入分析。每位献血者的中位随访年限为 5.84 年（四分位间距 5.47-6.23）。男性和女性的 CVD 住院率分别为每 1000 人年 11.20 和 4.50 例。在完全调整的模型中，与其他献血者相比，定期高频献血者的 CVD 风险（风险比）为男性 0.93（95%置信区间，0.68-1.29），女性 0.79（95%置信区间，0.49-1.28）。