Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.
Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands.
Transfusion. 2024 Oct;64(10):1920-1930. doi: 10.1111/trf.17983. Epub 2024 Aug 14.
Whole blood donors are at increased risk for iron deficiency (ID). ID anemia is associated with several symptoms, such as fatigue, cognitive dysfunction, pica, and restless leg syndrome (RLS). However, it is unclear if these symptoms also occur when a donor has developed ID without anemia. This study aims to determine whether non-anemic ID (NAID) is associated with the occurrence of ID-related symptoms.
We combined data from three studies in whole blood donors (i.e., Donor Insight-III, FIND'EM, and FORTE) to create a substantial sample size (N = 12,143). The self-reported occurrence and severity of ID-related symptoms, such as physical and mental health, fatigue, cognitive functioning, pica, and RLS, was measured using validated questionnaires. Associations were studied using logistic regression modeling with ID-related symptoms derived from the questionnaires as the dependent variable and ferritin level group (0-15 μg/L, 15-30 μg/L, and >30 μg/L) as explanatory variable.
After applying inclusion and exclusion criteria, 9829 donors were eligible for analysis. In the models corrected for age, body mass index, Hb level, and cohort, only fatigue was shown to be associated with ferritin levels in men, showing lower odds (OR 1.41, 95% CI 1.11-1.79) for fatigue with higher ferritin levels.
In these studies, NAID was only associated with self-reported fatigue in male donors. Although selection bias may have led to underestimated associations, ferritin measurements in donors should be primarily considered as a measure to prevent anemia, rather than to prevent or mitigate NAID-related symptoms.
全血献血者缺铁(ID)的风险增加。缺铁性贫血与疲劳、认知功能障碍、异食癖和不宁腿综合征(RLS)等多种症状有关。然而,当献血者发生无贫血的 ID 时,是否也会出现这些症状尚不清楚。本研究旨在确定非贫血性缺铁(NAID)是否与 ID 相关症状的发生有关。
我们合并了来自三项全血献血者研究的数据(即 Donor Insight-III、FIND'EM 和 FORTE),创建了一个较大的样本量(N=12143)。使用经过验证的问卷,测量了与 ID 相关的症状(如身体和心理健康、疲劳、认知功能、异食癖和 RLS)的发生和严重程度。使用逻辑回归模型,将问卷得出的与 ID 相关的症状作为因变量,将铁蛋白水平组(0-15μg/L、15-30μg/L 和 >30μg/L)作为解释变量,研究相关性。
在应用纳入和排除标准后,9829 名献血者符合分析条件。在针对年龄、体重指数、Hb 水平和队列进行校正的模型中,只有疲劳与男性的铁蛋白水平相关,显示出更高的铁蛋白水平与较低的疲劳发生几率(比值比 1.41,95%可信区间 1.11-1.79)。
在这些研究中,NAID 仅与男性献血者报告的疲劳有关。尽管选择偏倚可能导致低估了相关性,但铁蛋白测量在献血者中应主要被视为预防贫血的措施,而不是预防或减轻与 NAID 相关的症状。