The association of ferritin with cardiovascular and all-cause mortality in community-dwellers: The English longitudinal study of ageing
The association of ferritin with cardiovascular and all-cause mortality in community-dwellers: The English longitudinal study of ageing
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DOI：
10.1371/journal.pone.0178994
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发表时间：
2017-06-07
期刊：
影响因子：
3.7
通讯作者：
Demakakos, Panayotes
中科院分区：
文献类型：
--
作者：
Kadoglou, Nikolaos P. E.;Biddulph, Jane P.;Demakakos, Panayotes
背景铁蛋白是一种敏感的铁储存指标和多功能蛋白。关于其与一般人群死亡率相关的证据很少，而且相互矛盾。我们在基于人群的队列中调查了铁蛋白水平与全因和心血管死亡率的性别特异性相关性。方法数据来自英国老龄化纵向研究和国家死亡率登记处。样本包括5，471名年龄>= 52岁的参与者。在2004-05年基线测量铁蛋白的血液浓度。性别特异性考克斯比例风险模型估计调整年龄，主要慢性疾病，婚姻状况，教育程度，总净家庭财富，贫血，炎症标志物，体重指数，吸烟，体力活动。分层分析慢性疾病状态也performed.ResultsWe分类铁蛋白在性别特异性四分位数。在男性中，我们使用以下分类：最低（2- 69 ng/ml）、次低（70- 118 ng/ml）、次高（参考类别）（119- 193 ng/ml）和最高（194- 598 ng/ml）铁蛋白四分位数。在女性中，铁蛋白分类如下：最低（2- 44 ng/ml）、次低（45- 73 ng/ml）、次高（参考类别）（74- 115 ng/ml）和最高（116- 341 ng/ml）铁蛋白四分位数。在平均7.7年的随访时间内，记录了841例死亡，其中262例与心血管疾病相关。与参考组相比，高铁蛋白血症（194- 598 ng/ml）和无重大慢性病史的男性全因死亡风险增加[完全校正HR：1.49（95%CI 1.03-2.16）]。在调整所有协变量后，与参考组相比，铁蛋白最低四分位数（2- 44 ng/ml）的女性全因死亡风险增加[完全校正HR：1.59（95% CI 1.18-2.13）]。关于心血管死亡率，我们观察到男性铁蛋白水平与心血管死亡率呈正相关，在调整炎症标志物和生活方式参数后，铁蛋白水平降低。没有重大慢性疾病的男性，铁蛋白水平最高的四分位数，心血管死亡风险显著增加。在women.ConclusionCirculating铁蛋白水平显示性别特异性预后模式之间没有关联的铁蛋白水平和心血管疾病死亡率检测。调整协变量后，无重大慢性疾病的男性铁蛋白水平升高和所有女性铁蛋白水平降低与全因死亡率升高相关。没有重大慢性疾病的男性的高铁蛋白水平也与心血管死亡风险增加独立相关。未来的研究需要澄清铁蛋白的预后作用。
BackgroundFerritin constitutes a sensitive iron-storage index and multi-functional protein. Evidence on its association with mortality in general population is scarce and conflicting. We investigated the sex-specific associations of ferritin levels with all-cause and cardiovascular mortality in a population-based cohort.MethodsData came from the English Longitudinal Study of Ageing and the national mortality registry. The sample comprised 5,471 participants aged >= 52 years. Blood concentration of ferritin was measured at baseline in 2004-05. Sex-specific Cox proportional hazards models were estimated with adjustment for age, major chronic diseases, marital status, educational attainment, total net household wealth, anemia, inflammatory markers, body mass index, smoking, and physical activity. Stratified analyses by chronic disease status were also performed.ResultsWe categorized ferritin in sex-specific quartiles. In men, we used, the following categorization: lowest (2-69ng/ml), second lowest (70-118ng/ml), second highest (reference category) (119-193ng/ml) and highest (194-598ng/ml) ferritin quartiles. In women, ferritin was categorized as follows: lowest (2-44ng/ml), second lowest (45-73ng/ml), second highest (reference category) (74-115ng/ml) and highest (116-341ng/ml) ferritin quartiles. 841 deaths of which 262 cardiovascular disease-related were recorded over a mean follow-up time of 7.7 years. Risk for all-cause mortality was found increased in men with hyperferritinemia (194-598ng/ml) and no history of major chronic diseases compared with the reference group [fully-adjusted HR: 1.49 (95%CI 1.03-2.16)]. Among women, those in the lowest ferritin quartile (2-44ng/ml) had increased risk for all-cause mortality [fully-adjusted HR: 1.59 (95% CI 1.18-2.13)] compared with the reference group after adjustment for all covariates. Regarding cardiovascular mortality, we observed a positive association with ferritin levels in men, which was blunted after adjustment for inflammatory markers and lifestyle parameters. Men with no major chronic diseases who were in the highest ferritin quartile had a significantly increased risk of cardiovascular mortality. No association between ferritin levels and cardiovascular mortality was detected in women.ConclusionCirculating ferritin levels showed sex-specific prognostic patterns. High ferritin levels in men with no major chronic disease and low ferritin levels in all women were associated with increased all-cause mortality after adjusting for covariates. High ferritin levels in men with no major chronic diseases were also independently associated with an increased risk of cardiovascular mortality. Future research is needed to clarify the prognostic role of ferritin.