DIETARY IRON INTAKE AND RISK OF CORONARY-DISEASE AMONG MEN
DIETARY IRON INTAKE AND RISK OF CORONARY-DISEASE AMONG MEN
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DOI：
10.1161/01.cir.89.3.969
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发表时间：
1994-03-01
期刊：
影响因子：
37.8
通讯作者：
STAMPFER, MJ
中科院分区：
文献类型：
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作者：
ASCHERIO, A;WILLETT, WC;STAMPFER, MJ
研究背景：我们前瞻性地研究了铁摄入量与冠心病发病率之间的关系，对44933名年龄在40 - 75岁的男性（无心血管疾病史）进行了为期4年的随访，这些男性在1986年完成了基线时的食物频率问卷调查。方法和结果我们记录了844例冠心病事件（249例非致死性心肌梗死，137例冠心病死亡，458例搭桥手术或血管成形术）。在对已确定的危险因素进行调整后，总铁摄入量与冠心病风险之间没有显著关联。总铁摄入量最高五分位数（中位数，37 mg/d）的男性与最低五分位数（中位数，11 mg/d）的男性相比，致命冠状动脉疾病或非致死性心肌梗死的相对风险（RR）为0.73（95%可信区间[CI]， 0.51, 1.06）。饮食中血红素铁的摄入——主要来自红肉——也与冠心病的风险没有显著关联。然而，血红素铁摄入量最高的五分之一男性的致命性冠状动脉疾病或非致命性心肌梗死的发生率高于最低的五分之一男性（RR, 1.42; 95% CI, 1.02, 1.98）。在调整膳食胆固醇和脂肪后，这种关联仍然存在。在参与验证研究的123名队列成员中，血红素铁而非总铁摄入量与血清铁蛋白呈正相关。结论：这些结果不支持膳食铁通常会增加男性冠状动脉风险的假设；然而，它们与高血红素铁摄入量的男性心肌梗死的风险增加是一致的，血红素铁本身与铁储存呈正相关。
Background We prospectively studied iron intake in relation to the incidence of coronary disease in a 4-year follow-up of 44 933 men (with no previous history of cardiovascular disease) aged 40 to 75 years in 1986 who completed a food frequency questionnaire at baseline.Methods and Results We documented 844 incident cases of coronary disease (249 nonfatal myocardial infarctions, 137 coronary disease fatalities, and 458 bypass operations or angioplasties). After adjustment for established risk factors, there was no significant association between total iron intake and risk of coronary heart disease. Men in the highest quintile of total iron intake (median, 37 mg/d) had a relative risk (RR) of fatal coronary disease or nonfatal myocardial infarction of 0.73 (95% confidence intervals [CI], 0.51, 1.06) compared with men in the lowest quintile of intake (median, 11 mg/d). Dietary intake of heme iron - mainly from red meat - also was not significantly associated with risk of coronary heart disease. However, incidence of fatal coronary disease or nonfatal myocardial infarction was higher among men in the top quintile of heme iron intake compared with men in the lowest quintile (RR, 1.42; 95% CI, 1.02, 1.98). This association remained after adjustment for dietary cholesterol and fats. Heme iron but not total iron intake was positively correlated with serum ferritin among 123 members of the cohort who participated in a validation study.Conclusions These results do not support the hypothesis that dietary iron in general increases coronary risk in men; they are consistent, however, with an increased risk of myocardial infarction among men with higher intake of heme iron, which is itself positively associated with iron stores.