Tzonou A, Lagiou P, Trichopoulou A, Tsoutsos V, Trichopoulos D
Department of Hygiene and Epidemiology, University of Athens Medical School, Goudi, Greece.
Am J Epidemiol. 1998 Jan 15;147(2):161-6. doi: 10.1093/oxfordjournals.aje.a009429.
The authors investigated the association between dietary iron intake and risk of coronary heart disease by means of a case-control study conducted in Athens, Greece, in January 1990 to April 1991. The case series comprised 329 patients with electrocardiographically confirmed first coronary infarct, or a first positive coronary arteriogram, or both, while the controls were 570 patients from the same study base who presented with minor conditions believed to be unrelated to diet. After adjustment by logistic regression for 14 potentially confounding variables of sociodemographic, life-style and nutritional nature, dietary iron intake was found to be positively associated with risk for coronary disease among men aged 60 years or older (odds ratio (OR) for a monthly increment of 50 mg of iron = 1.47, with 95% confidence interval (CI) 1.02-2.12) and particularly women aged 60 years or older (OR for a similar increment of iron = 3.61, with 95% CI 1.45-9.01). Additional adjustment for blood cholesterol, as well as systolic blood pressure and blood glucose level, reduced the iron regression coefficient among older men from 1.47 to 1.36, and among older women from 3.61 to 3.51; however, it is not clear whether the change reflects control of residual confounding or blocking of an intermediate pathway. These data are compatible with the hypothesis that excess dietary iron intake increases the risk of coronary heart disease, particularly among older women and men.
1990年1月至1991年4月，作者在希腊雅典开展了一项病例对照研究，以调查膳食铁摄入量与冠心病风险之间的关联。病例组包括329例经心电图确诊为首次冠状动脉梗死、首次冠状动脉造影阳性或两者兼有的患者，而对照组为来自同一研究基地的570例患有与饮食无关的轻微疾病的患者。在通过逻辑回归对社会人口统计学、生活方式和营养性质的14个潜在混杂变量进行调整后，发现膳食铁摄入量与60岁及以上男性的冠心病风险呈正相关（铁摄入量每月增加50毫克的优势比（OR）=1.47，95%置信区间（CI）为1.02 - 2.12），在60岁及以上女性中尤其如此（铁摄入量类似增加的OR = 3.61，95%CI为1.45 - 9.01）。对血胆固醇、收缩压和血糖水平进行额外调整后，老年男性的铁回归系数从1.47降至1.36，老年女性从3.61降至3.51；然而，尚不清楚这种变化是反映了对残余混杂因素的控制还是对中间途径的阻断。这些数据与过量膳食铁摄入会增加冠心病风险这一假设相符，尤其是在老年女性和男性中。
