A population-based study of hemoglobin, race, and mortality in elderly persons
A population-based study of hemoglobin, race, and mortality in elderly persons
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DOI：
10.1093/gerona/63.8.873
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发表时间：
2008-08-01
影响因子：
5.1
通讯作者：
Evans, Denis
中科院分区：
文献类型：
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作者：
Dong, XinQi;de Leon, Carlos Mendes;Evans, Denis
背景贫血与死亡风险增加有关。轻度低血红蛋白浓度（Hb）对死亡风险的影响尚不清楚，尤其是在黑人中。我们研究了Hb和死亡率之间的种族差异。这是一项基于人群的研究，从1993年到2006年，在伊利诺伊州芝加哥的一个地理定义的社区。分层随机抽样1806名65岁或以上的参与者，其中50%为黑人，他们参加了芝加哥健康老龄化项目并接受了临床评价。使用国家死亡指数确定死亡率。考克斯比例风险模型用于评估Hb与死亡风险的独立关系。根据世界卫生组织（WHO）标准（男性Hb < 13.0 g/dL，女性< 12.0 g/dL），黑人中贫血的参与者比例为39%，白人为17%。黑人的平均Hb（12.6 +/- 1.5 g/dL）低于白人（13.5 +/- 1.5 g/dL）。在多变量分析中，贫血与黑人（风险比[HR]，1.90; 95%置信区间[CI]，1.43-2.53）和白人（HR，1.85：95% CI，1.32-2.59）的死亡风险增加相关。在黑人中，与血红蛋白高于贫血临界值0 - 0.9 g/dL相比，血红蛋白低于贫血临界值0-0.9 g/dL与死亡风险增加相关（HR，1.84; 95% CI，1.21-2.79），Hb高于贫血临界值1.1-2.0 g/dL（HR，1.35：95% CI，0.88-2.05）和Hb高于贫血临界值2.1-3.0 g/dL（HR，2.24：95% CI，1.12-4.47）。黑人种族/人种和贫血之间的相互作用表明，黑人与白人相比，死亡风险没有统计学显著差异。交互作用项的亚组分析表明，血红蛋白高于贫血临界值0.1-1.0 g/dL组，在血红蛋白轻度低正常范围内，与白人相比，黑人可能具有较低的死亡风险（p = .02）。在老年黑人和白人中，WHO标准的贫血和Hb轻度降低均与死亡风险增加有关。
Background. Anemia is associated with increased mortality risk. The impact of mildly low hemoglobin concentration (Hb) on risk for mortality remains unclear, especially among blacks. We examined the racial differences between Hb and mortality.Methods. This was a population-based study conducted from 1993 through 2006, in a geographically defined community of Chicago, Illinois. A stratified, random sample of 1806 participants 65 years old or older and 50% black, who were participating in the Chicago Health Aging Project and underwent clinical evaluation. Mortality was ascertained using the National Death Index. Cox proportional hazard models were used to assess the independent relation of Hb to mortality risk.Results. The proportion of participants with anemia by World Health Organization (WHO) criteria (Hb < 13.0 g/dL for men and < 12.0 g/dL for women) was 39% among blacks, and 17% among whites. Blacks had lower mean Hb (12.6 +/- 1.5 g/dL) than did whites (13.5 +/- 1.5 g/dL). In multivariable analysis, anemia was associated with increased mortality risk in blacks (hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.43-2.53) and in whites (HR, 1.85: 95% CI, 1.32-2.59). Among blacks, Hb 0-0.9 g/dL below the anemia threshold is associated with increased mortality risk compared to Hb 0-0.9 g/dL above the anemia cutoff (HR, 1.84; 95% CI, 1.21-2.79), Hb 1.1-2.0 g/dL above the anemia cutoff (HR, 1.35: 95% CI, 0.88-2.05) and Hb 2.1-3.0 g/dL above the anemia cutoff (HR, 2.24: 95% CI, 1.12-4.47). The terms for interaction between black ethnicity/race and anemia suggested that blacks did not have a statistically significant difference in mortality risk compared to whites. Subgroup analyses of interaction terms suggested that Hb 0.1-1.0 g/dL above anemia cutoff group, blacks may have lower mortality risk compared to whites in the mildly low normal ranges of Hb (p = .02).Conclusion. Both anemia by WHO criteria and mild reductions in Hb were related to increased risk of mortality in older blacks and whites.