Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies
Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies
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DOI：
10.1017/s0007114517001349
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发表时间：
2017-05
影响因子：
3.6
通讯作者：
K. Yokoi;Aki Konomi
中科院分区：
文献类型：
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作者：
K. Yokoi;Aki Konomi
摘要铁缺乏是一种常见的营养性疾病，疲劳是普通人群和患者的常见症状。缺铁无贫血(IDNA)和疲劳之间的联系尚不清楚。在这里，我们进行了一项荟萃分析，以评估铁对IDNA患者疲劳的治疗效果，以及IDNA与人群疲劳之间的关系。对PubMed数据库截至2016年1月19日的文章进行系统检索。总共确定了六项相关的随机对照试验(RCT)和六项相关的横断面研究。所有结果都被换算成效果大小。在6项随机对照试验的Meta分析中，我们发现铁对IDNA疲劳患者有显著的治疗作用(合并效应大小为0·33；95%CI为0·17，0·48；I2=0·0%；P<；0·0001)。敏感度分析发现，总体结果(即显著关联)是稳健的。在6项横断面研究的Meta分析中，IDNA与疲劳的相关性不显著(合并效应大小为0·10；95%CI−为0·11，0·31；I2=5 7·4%；P=0·362)。敏感度分析发现，总体结果(即没有显著相关性)并不可靠；删除一项研究使结果显著。这些荟萃分析表明，改善铁的状况可能会减少疲劳。有必要进行进一步的研究，以确定选择可能受益于铁疗法的疲劳患者的诊断标准，并评估IDNA合并疲劳在普通人群中的患病率。
Abstract Fe deficiency is a prevalent nutritional disease, and fatigue is a common complaint in the general and patient population. The association between Fe deficiency without anaemia (IDNA) and fatigue is unclear. Here, we performed a meta-analysis to evaluate the therapeutic effect of Fe on fatigue in patients with IDNA and the association between IDNA and fatigue in the population. Articles from the PubMed database up to 19 January 2016 were systematically searched. A total of six relevant randomised controlled trials (RCT) and six relevant cross-sectional studies were identified. All outcomes were converted into effect sizes. In the meta-analysis of the six RCT, we identified a significant therapeutic effect of Fe in fatigue patients with IDNA (pooled effect size 0·33; 95 % CI 0·17, 0·48; I 2=0·0 %; P<0·0001). A sensitivity analysis found that the overall results (i.e. significant association) were robust. In the meta-analysis of the six cross-sectional studies, the association between IDNA and fatigue was not significant (pooled effect size 0·10; 95 % CI −0·11, 0·31; I 2=57·4 %; P=0·362). A sensitivity analysis found that the overall results (i.e. no significant association) were not robust; removal of one study made the outcomes significant. These meta-analyses suggest that improving Fe status may decrease fatigue. Further research is necessary to identify diagnostic criteria for selecting fatigue patients who might benefit from Fe therapy and to assess the prevalence of IDNA with fatigue in the general population.