Liao Y, Cooper R S, McGee D L
Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, Maywood, IL 60153.
Am J Epidemiol. 1994 Apr 1;139(7):704-12. doi: 10.1093/oxfordjournals.aje.a117060.
The potential association between iron status and coronary heart disease has received increased attention recently. The authors examine this hypothesis in the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study. The study consisted of 4,237 respondents (1,827 men, 2,410 women) aged 40-74 years at baseline. During the average 13-year follow-up, 489 persons (289 men, 200 women) had an acute myocardial infarction, and 1,151 persons (633 men, 518 women) developed coronary heart disease (included myocardial infarction and other forms of chronic ischemic heart disease). In logistic regression analyses, adjusting for baseline age, systolic blood pressure, serum cholesterol, smoking status, and education, serum iron was inversely associated with the risk of myocardial infarction in women (relative risk = 0.82 for an increase of 5.4 mumol/liter (equivalent to about 1 standard deviation), 95% confidence interval (CI) 0.70-0.95), but not in men. Total iron-binding capacity and transferrin saturation were not related to myocardial infarction in either sex, while serum iron and transferrin saturation were inversely associated with coronary heart disease in both sexes. Among men, the relative risk was 0.92 (95% CI 0.85-1.00) for a 5.4-mumol/liter increase in serum iron, while a relative risk of 0.91 (95% CI 0.83-1.00) was observed for a 10% increase in transferrin saturation. For women, the corresponding relative risks were 0.86 (95% CI 0.77-0.95) and 0.88 (95% CI 0.79-0.98), respectively. Dietary iron intake based on 24-hour recall was not associated with the two disease end points. These findings from a large national sample do not support the hypothesis of a positive iron-coronary heart disease relation.
铁状态与冠心病之间的潜在关联最近受到了越来越多的关注。作者在第一次全国健康与营养检查调查（NHANES I）流行病学随访研究中检验了这一假设。该研究包括4237名基线年龄在40 - 74岁的受访者（1827名男性，2410名女性）。在平均13年的随访期间，489人（289名男性，200名女性）发生了急性心肌梗死，1151人（633名男性，518名女性）患了冠心病（包括心肌梗死和其他形式的慢性缺血性心脏病）。在逻辑回归分析中，在对基线年龄、收缩压、血清胆固醇、吸烟状况和教育程度进行调整后，血清铁与女性心肌梗死风险呈负相关（血清铁每增加5.4微摩尔/升（相当于约1个标准差），相对风险 = 0.82，95%置信区间（CI）0.70 - 0.95），但在男性中并非如此。总铁结合力和转铁蛋白饱和度与两性的心肌梗死均无关联，而血清铁和转铁蛋白饱和度与两性的冠心病均呈负相关。在男性中，血清铁每增加5.4微摩尔/升，相对风险为0.92（95% CI 0.85 - 1.00），而转铁蛋白饱和度增加10%时，相对风险为0.91（95% CI 0.83 - 1.00）。对于女性，相应的相对风险分别为0.86（95% CI 0.77 - 0.95）和0.88（95% CI 0.79 - 0.98）。基于24小时回忆的膳食铁摄入量与这两个疾病终点均无关联。来自一个大型全国样本的这些发现不支持铁与冠心病呈正相关的假设。
