Role of stored iron in atherosclerosis.
Role of stored iron in atherosclerosis.
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DOI：
10.1067/mvn.2000.111614
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发表时间：
2000-12-01
期刊：
影响因子：
--
通讯作者：
Chow, B
中科院分区：
文献类型：
--
作者：
Howes, P S;Zacharski, L R;Chow, B
心肌梗塞仍然是美国男性和女性的头号杀手，每年的死亡率为225，000，而中风是美国第三大死亡原因，每年约有600，000人受到折磨。这些疾病造成的财政负担每年约为1 340亿美元。因此，减少死亡率和痛苦的干预措施将对卫生保健系统产生重大影响。本文总结了在过去20年中进行的研究，解决的想法，储存的铁在动脉粥样硬化的发病机制中发挥作用，通过放血减少铁可能在治疗或预防动脉粥样硬化中发挥作用。男性在青春期后和女性绝经后体内铁储存量增加。这种升高通过铁诱导的低密度脂质氧化和泡沫细胞形成与动脉粥样硬化的发病机制有关。然而，关于铁假说的现有证据仍然是间接的。有必要在对照的前瞻性干预试验中减少体内铁储存，以确定储存的铁量是否与临床上有意义的血管疾病相关。这样的研究是可行的，因为铁储备的减少可以安全和可预测地实现，而不会通过分级放血诱导铁缺乏。铁和动脉粥样硬化研究（FeAST），退伍军人管理局合作研究，正在进行测试这一概念。
Myocardial infarction remains the No. 1 killer of American men and women, with a death rate of 225,000 per year, and stroke, the third leading cause of death in the United States, afflicts about 600,000 per year. The combined financial burden of these diseases is approximately $134 billion per year. Therefore, interventions that reduce mortality and suffering will have a significant impact on the health care system. This article summarizes research conducted during the last 2 decades that addresses the idea that stored iron plays a role in the pathogenesis of atherosclerosis and that iron reduction through phlebotomy may play a role in the treatment or prevention of atherosclerosis. Body iron stores rise after adolescence in men and menopause in women. This rise has been linked to the pathogenesis of atherosclerosis through iron-induced oxidation of low-density lipids and foam cell formation. However, the available evidence on the iron hypothesis remains circumstantial. Reduction of body iron stores in the setting of a controlled, prospective intervention trial is necessary to determine whether the amount of stored iron is related to clinically meaningful vascular disease. Such a study is feasible because reduction in iron stores can be achieved safely and predictably without induction of iron deficiency by graded phlebotomy. The Iron and Atherosclerosis Study (FeAST), a Veteran's Administration Cooperative Study, is under way to test this concept.