Effect of iron intake on iron status: a systematic review and meta-analysis of randomized controlled trials
Effect of iron intake on iron status: a systematic review and meta-analysis of randomized controlled trials
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DOI：
10.3945/ajcn.112.040626
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发表时间：
2012-10-01
影响因子：
7.1
通讯作者：
Fairweather-Tait, Susan J.
中科院分区：
文献类型：
--
作者：
Casgrain, Amelie;Collings, Rachel;Fairweather-Tait, Susan J.
背景：状态生物标志物对铁供应增加的反应取决于几个生理和环境因素，这使得预测干预的结果变得困难。目的：我们评估了基线铁状态、性别、绝经状态、干预时间、铁形态和每日剂量对铁补充反应的铁状态变化的影响。设计：系统地回顾了铁补充和强化试验的随机对照试验(RCT)，这些试验评估了对血红蛋白、血清铁蛋白(SF)、可溶性转铁蛋白受体或体铁的影响。结果：共纳入41篇随机对照试验，无一例评价存在低偏倚风险。随机效应荟萃分析表明，补充铁显着改善了铁的状况，但具有高度的异质性。荟萃回归可解释研究间效应大小约四分之一的差异。随研究年限(SF浓度/wk增加：0.51mU/wk；95%CI：0.02，1.00 mU/L；P=0.04)和剂量(SF浓度/g铁增加：0.10mU/g/L；95%CI：0.01，0.20mg/L；基础铁水平[-0.08g/dL(95%可信区间：0.15，0.00g/dL)]和基础铁水平[-0.08g/dL(95%CI：0.150.00g/dL)]。没有足够的数据来评估对身体铁、性别或更年期状态的影响。结论：基础铁状态、研究持续时间和铁剂量之间的定量关系对铁状态生物标记物的变化的影响来自荟萃分析，可用于预测补铁和强化试验的效果，并设计铁干预方案。AM J Clin Nutr 2012；96：768-80。
Background: The response of status biomarkers to an increase in iron supply depends on several physiologic and environmental factors, which make it difficult to predict the outcome of an intervention.Objective: We assessed effects of baseline iron status, sex, menopausal status, duration of intervention, iron form, and daily dose on the change in iron status in response to iron supplementation.Design: A systematic review of randomized controlled trials (RCTs) of iron-supplementation and -fortification trials that assessed effects on hemoglobin, serum ferritin (SF), soluble transferrin receptor, or body iron was conducted. Subgrouping and straight-line and curved metaregression were used to describe the magnitude and dose-responsiveness of effect modifiers with respect to changes in status.Results: Forty-one RCTs were included; none of the RCTs were judged at low risk of bias. Random-effects meta-analyses showed that iron supplementation significantly improved iron status but with high levels of heterogeneity. Metaregression explained approximately one-quarter of between-study variance in effect size. There were clear effects on SF with study duration (increase in SF concentration/wk: 0.51 mu g/L; 95% CI: 0.02, 1.00 mu g/L; P = 0.04) and dose (increase in SF concentration/g Fe: 0.10 mu g/L; 95% CI: 0.01, 0.20 mu g/L; P = 0.036) and on hemoglobin concentrations with baseline iron status [-0.08 g/dL (95% CI: 0.15, 0.00 g/dL) per 10-mu g/L increase in baseline SF concentration; P = 0.02]. Insufficient data were available to assess effects on body iron, sex, or menopausal status.Conclusion: Quantitative relations between baseline iron status, study duration, and iron dose on changes in iron-status biomarkers, which were generated from the meta-analyses, can be used to predict effects of trials of iron supplementation and fortification and to design iron-intervention programs. Am J Clin Nutr 2012;96:768-80.