Total Mortality by Transferrin Saturation Levels: Two General Population Studies and a Metaanalysis
Total Mortality by Transferrin Saturation Levels: Two General Population Studies and a Metaanalysis
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DOI：
10.1373/clinchem.2010.156802
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发表时间：
2011-03-01
影响因子：
9.3
通讯作者：
Nordestgaard, Borge G.
中科院分区：
文献类型：
--
作者：
Ellervik, Christina;Tybjaerg-Hansen, Anne;Nordestgaard, Borge G.
背景：有证据表明临床明显遗传性血色素沉着症患者的死亡率增加。作为铁超负荷指标的转铁蛋白饱和度 (TS) 升高是否与一般人群死亡率增加相关，目前尚不清楚。 方法：我们在 2 项基于丹麦人群的随访研究（哥本哈根一般人群研究和哥本哈根城市心脏研究）中根据基线 TS 检查了死亡率，该研究共纳入 45 159 名个体，其中 4568 人在长达 18 年的随访期间死亡，而在 荟萃分析包括本研究和一项额外的一般人群研究。 结果：在联合研究中，TS >= 50% 与 < 50% 的个体的累积生存率降低（对数秩 P < 0.0001）。经多因素调整后，TS ≥ 50% 与 < 50% 总死亡率的风险比总体为 1.4 (95% CI 1.2-1.6；P < 0.001)，男性为 1.3 (1.1-1.6；P = 0.003)，女性为 1.5 (1.1-2.0；P = 0.005)。如果单独考虑这两项研究，结果相似。随着 TS 水平逐步增加（对数秩 P < 0.0001），观察到总死亡率风险逐步增加，其中 TS >= 80% 与 TS < 20% 赋予的风险最高，风险比为 2.2（1.4 -3.3；P < 0.001）。在 TS >= 50% 和 < 50% 个体的综合研究中，人群归因的总死亡率风险为 0.8%。在荟萃分析中，固定效应模型下 TS >= 50% 与 < 50% 的总死亡率比值比为 1.3 (1.2-1.5；P < 0.001)。结论：一般人群中 TS >= 50% 与 < 50% 的个体过早死亡的风险增加。 (C) 2010 美国临床化学协会
BACKGROUND: There is evidence for increased mortality in patients with clinically overt hereditary hemochromatosis. Whether increased transferrin saturation (TS), as a proxy for iron overload is associated with increased mortality in the general population is largely unknown.METHODS: We examined mortality according to baseline TS in 2 Danish population-based follow-up studies (the Copenhagen General Population Study and the Copenhagen City Heart Study) comprising a total of 45 159 individuals, of whom 4568 died during up to 18 years of follow-up, and in a metaanalysis comprising the present studies and an additional general population study.RESULTS: In combined studies, the cumulative survival was reduced in individuals with TS >= 50% vs < 50% (log-rank P < 0.0001). Multifactorially adjusted hazard ratios for total mortality for TS >= 50% vs < 50% were 1.4 (95% CI 1.2-1.6; P < 0.001) overall, 1.3 (1.1-1.6; P = 0.003) in men, and 1.5 (1.1-2.0; P = 0.005) in women. Results were similar if the 2 studies were considered separately. A stepwise increased risk of total mortality was observed for stepwise increasing levels of TS (log-rank P < 0.0001), with the highest risk conferred by TS >= 80% vs TS < 20% with a hazard ratio of 2.2 (1.4 -3.3; P < 0.001). The population-attributable risk for total mortality in the combined studies in individuals with TS >= 50% vs < 50% was 0.8%. In metaanalysis, the odds ratio for total mortality for TS >= 50% vs < 50% was 1.3 (1.2-1.5; P < 0.001) under the fixed-effects model.CONCLUSIONS: Individuals in the general population with TS >= 50% vs < 50% have an increased risk of premature death. (C) 2010 American Association for Clinical Chemistry