Wang Xia, Zhang Ye, Liu Xuntao, Zhou Sutao, Cheng Peng, Zhang Bizhu, Zhang Bin
Department of Laboratory Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, People's Republic of China.
Graduate School, Hebei North University, Zhangjiakou, People's Republic of China.
Hematology. 2024 Dec;29(1):2416724. doi: 10.1080/16078454.2024.2416724. Epub 2024 Oct 16.
The use of cobalt alloys in medical implants poses a high risk of cobalt exposure, yet there is a lack of evidence regarding the association between blood cobalt levels and anemia. This study aimed to explore the link between blood cobalt levels and the onset of anemia and to identify potential threshold levels of blood cobalt that could affect anemia.
The US National Health and Nutrition Examination Survey data from 2017 to 2020 were analyzed for this cross-sectional study. This study primarily employed multivariate logistic regression, stratified interaction analysis, restricted cubic splines (RCS), and threshold effect analysis to explore the relationship between blood cobalt concentration and anemia.
The study included 5510 participants and among them 12.2% were diagnosed with anemia. Logistic regression model indicates a positive correlation between blood cobalt levels and the risk of anemia. RCS shows that the relationship between ln cobalt concentration and anemia was non-linear (J-shaped). The ln cobalt inflection point was approximately 0.81. The odds ratio of anemia with ln cobalt ≥ 0.81 was 4.00 (95% CI: 2.95-5.43, < 0.001), the odds ratio of anemia with ln cobalt < 0.81 was 0.73 (95% CI: 0.45-1.18, = 0.201).
The analysis unveiled a non-linear relationship, indicating that elevated blood cobalt levels were linked to a heightened likelihood of developing anemia in middle-aged and older adults; the cut-off value of ln cobalt was approximately 0.81. The findings of this study warrant further investigation.
钴合金在医疗植入物中的使用带来了高钴暴露风险，但缺乏关于血钴水平与贫血之间关联的证据。本研究旨在探讨血钴水平与贫血发病之间的联系，并确定可能影响贫血的血钴潜在阈值水平。
本横断面研究分析了2017年至2020年美国国家健康与营养检查调查数据。本研究主要采用多变量逻辑回归、分层交互分析、受限立方样条（RCS）和阈值效应分析来探讨血钴浓度与贫血之间的关系。
该研究纳入了5510名参与者，其中12.2%被诊断为贫血。逻辑回归模型表明血钴水平与贫血风险呈正相关。RCS显示ln钴浓度与贫血之间的关系是非线性的（J形）。ln钴拐点约为0.81。ln钴≥0.81时贫血的优势比为4.00（95%CI：2.95 - 5.43，P<0.001），ln钴<0.81时贫血的优势比为0.73（95%CI：0.45 - 1.18，P = 0.201）。
分析揭示了一种非线性关系，表明血钴水平升高与中老年人群患贫血的可能性增加有关；ln钴的临界值约为0.81。本研究结果值得进一步调查。
