Tinner Chiara, Meyer Helene G, Sieber Chloé, Lehnick Dirk, Hug Balthasar
Internal Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland.
Biostatistics and Methodology, Clinical Trials Unit Central Switzerland, Lucerne, Switzerland.
Eur J Haematol. 2025 Aug;115(2):153-164. doi: 10.1111/ejh.14431. Epub 2025 May 9.
Despite frequent diagnosis of anemia of inflammation in hospitalized patients, little is known about patients' sex-specific differences in iron deficiency (ID) and its biomarkers. We aimed to study sex-specific differences in anemic patients with inflammation and their influence on iron biomarkers.
This retrospective cross-sectional study included anemic patients with inflammation (CRP > 5 mg/L) hospitalized at a Swiss tertiary referral center (01.01.2020-31.12.2023). ID was defined as ferritin-index (sTfR/log(ferritin)) ≥ 1.5. Patient characteristics were reported as medians for continuous variables and frequencies for categorical variables. Age, laboratory parameters, treatment, comorbidities, illness severity, and in-hospital mortality were analyzed. Sex-specific effects on ID biomarkers (ferritin-index, sTfR) were assessed using linear regression models.
Of 439 participants, 41.2% were female. 44.2% had ID (women: 49.7%, men: 40.3%, p = 0.052). Regression models showed no association between log(ferritin-index) and sex (coefficient 0.02, 95% CI -0.13 to 0.18, p = 0.76). Ferritin levels were lower in women (221.0 vs. 373 μg/L, p = 0.014). No sex differences in in-hospital mortality were observed (women 7.2%, men 4.3%, p = 0.21).
Despite no significant sex differences regarding ID biomarkers, treatment, illness severity, and mortality, we hypothesize that factors beyond sex, for example underlying diseases and inflammation itself, play a more prominent role in these patients' outcomes.
尽管住院患者中炎症性贫血的诊断很常见，但对于缺铁（ID）及其生物标志物在患者性别上的差异知之甚少。我们旨在研究炎症性贫血患者的性别差异及其对铁生物标志物的影响。
这项回顾性横断面研究纳入了在瑞士一家三级转诊中心住院的炎症性贫血患者（CRP>5mg/L）（2020年1月1日至2023年12月31日）。ID定义为铁蛋白指数（sTfR/log(铁蛋白)）≥1.5。患者特征以连续变量的中位数和分类变量的频率报告。分析了年龄、实验室参数、治疗、合并症、疾病严重程度和住院死亡率。使用线性回归模型评估性别对ID生物标志物（铁蛋白指数、sTfR）的影响。
439名参与者中，41.2%为女性。44.2%患有ID（女性：49.7%，男性：40.3%，p=0.052）。回归模型显示log(铁蛋白指数)与性别之间无关联（系数0.02，95%CI -0.13至0.18，p=0.76）。女性的铁蛋白水平较低（221.0对373μg/L，p=0.014）。未观察到住院死亡率的性别差异（女性7.2%，男性4.3%，p=0.21）。
尽管在ID生物标志物、治疗、疾病严重程度和死亡率方面没有显著的性别差异，但我们推测，性别以外的因素，例如基础疾病和炎症本身，在这些患者的预后中起着更突出的作用。
