Yu Xiaochen, Li Min, Chen Bingxing, Qi Yuan, Guan Xiuru
Department of Laboratory Diagnostics, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Front Nutr. 2024 Sep 25;11:1457236. doi: 10.3389/fnut.2024.1457236. eCollection 2024.
There is controversy regarding the relationship between serum iron levels and atherosclerotic cardiovascular disease (ASCVD).
To investigate the relationship between serum iron levels and ASCVD among older adults using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES).
We performed a cross-sectional analysis involving 8,682 participants aged 60 years and older, with complete data on serum iron levels and confirmed ASCVD status, sourced from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression models were used to examine the association between serum iron levels and ASCVD. To assess the consistency of this association across different demographic groups, subgroup analyses, and interaction tests were performed.
The group with the highest serum iron levels (fourth quartile, 100-369 μg/dL) exhibited several distinct characteristics: they were the youngest on average (69.57 ± 6.91 years), had the highest proportion of males (61.42%), and the highest hemoglobin levels (14.43 ± 1.33 g/dL). This group also showed the lowest iron supplement usage (19.71 ± 12.85 mg/30 days), white blood cell counts (6.73 ± 2.41 1,000 cells/μL), and serum creatinine levels (0.98 ± 0.45 mg/dL). Moreover, they had higher levels of education and income, a higher likelihood of being married, and a lower body mass index (BMI). Additionally, they had significantly lower rates of diabetes, hypertension, stroke, and heart attacks (all < 0.05). After adjusting for potential confounders, a linear relationship between serum iron levels and ASCVD was initially observed (OR = 0.97; 95% CI, 0.95-0.99, < 0.05). However, further analysis using a two-part logistic regression model with an inflection point at 131 μg/dL revealed more nuanced results. For serum iron levels below 131 μg/dL, each 10 μg/dL increase was associated with a 4% decrease in the odds of ASCVD (OR = 0.96; 95% CI, 0.93-0.98, < 0.001). Conversely, for serum iron levels above 131 μg/dL, each 10 μg/dL increase corresponded to a 1% increase in the odds of ASCVD, though this finding was not statistically significant (OR = 1.01; 95% CI, 0.98-1.08, > 0.05).
In the US elderly population, serum iron levels are negatively associated with ASCVD, particularly when serum iron levels are below 131 μg/dL.
血清铁水平与动脉粥样硬化性心血管疾病（ASCVD）之间的关系存在争议。
利用2009 - 2018年美国国家健康与营养检查调查（NHANES）的数据，研究老年人血清铁水平与ASCVD之间的关系。
我们进行了一项横断面分析，纳入了8682名60岁及以上的参与者，他们来自2009 - 2018年美国国家健康与营养检查调查（NHANES），拥有血清铁水平的完整数据以及确诊的ASCVD状态。使用多变量逻辑回归模型来检验血清铁水平与ASCVD之间的关联。为了评估这种关联在不同人口统计学群体中的一致性，进行了亚组分析和交互作用检验。
血清铁水平最高的组（第四四分位数，100 - 369μg/dL）呈现出几个明显特征：他们平均年龄最小（69.57±6.91岁），男性比例最高（61.42%），血红蛋白水平最高（14.43±1.33g/dL）。该组还显示出最低的铁补充剂使用量（19.71±12.85mg/30天）、白细胞计数（6.73±2.41×1000个细胞/μL）和血清肌酐水平（0.98±0.45mg/dL）。此外，他们的教育程度和收入较高，结婚可能性较大，体重指数（BMI）较低。另外，他们患糖尿病、高血压、中风和心脏病发作的几率显著较低（均P<0.05）。在调整潜在混杂因素后，最初观察到血清铁水平与ASCVD之间存在线性关系（OR = 0.97；95%CI，0.95 - 0.99，P<0.05）。然而，使用拐点为131μg/dL的两部分逻辑回归模型进行的进一步分析揭示了更细微的结果。对于血清铁水平低于131μg/dL的情况，每增加10μg/dL与ASCVD几率降低4%相关（OR = 0.96；95%CI，0.93 - 0.9⑧，P<0.001）。相反，对于血清铁水平高于131μg/dL的情况，每增加10μg/dL对应于ASCVD几率增加1%，尽管这一发现无统计学意义（OR = 1.01；95%CI，0.98 - 1.0⑧，P>0.05）。
在美国老年人群中，血清铁水平与ASCVD呈负相关，尤其是当血清铁水平低于131μg/dL时。
