血清铁蛋白和转铁蛋白饱和度与非贫血人群死亡风险的相关性分析  

Analysis of the correlation between serum ferritin and transferrin saturation and death risk of non-anemic population

作　　者：韩丽军[1] 谢文婷 李彦蓉 Han Lijun;Xie Wenting;Li Yanrong(Department of Internal Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院内科,100070

出　　处：《北京医学》2024年第3期186-192,共7页Beijing Medical Journal

摘　　要：目的探讨非贫血人群血清铁蛋白(serum ferritin,SF)和转铁蛋白饱和度(transferrin saturation,TSAT)与全因死亡和心血管死亡的相关性。方法选取1999—2000年和2001—2002年国家健康和营养检查调查研究(national health and nutrition examination survey,NHANES)的非贫血人群7167例,于2006年12月31日前对死亡终点进行随访,采用阈值效应分析和多因素cox回归模型分析SF和TAST与全因死亡和心血管死亡风险的相关性。结果7167例患者中男3533例、女3634例,年龄18~85岁,平均(46.1±20.0)岁,BMI平均(27.9±6.2)kg/m2。平均随访(5.1±1.2)年,共随访11623人/年,其中全因死亡452例、心血管死亡117例。SF与全因死亡和心血管死亡呈非线性相关,SF的截断值为200 ng/ml;当SF<200 ng/ml时,SF每增加100 ng/ml,全因死亡风险增加25%(HR=1.252,95%CI:1.068~1.486,P=0.008),心血管死亡风险增加37%(HR=1.370,95%CI:1.076~1.900,P=0.036)。TSAT与全因死亡率呈L型非线性相关,截断值为30%,当TSAT<30%时,TSAT每增加10%,全因死亡风险降低21%(HR=0.791,95%CI:0.681~0.914,P=0.001);TSAT与心血管死亡风险呈线性负相关(HR=0.803,95%CI:0.660~0.963,P=0.014)。结论非贫血人群的SF与全因死亡和心血管死亡呈非线性相关、截断值为200 ng/ml,TSAT与全因死亡呈L型相关、截断值为30%,且TSAT与心血管死亡呈负相关。建议将非贫血人群的SF与TSAT控制在合适范围,以降低死亡风险,并改善预后。Objective To explore the correlation between serum ferritin(SF)and transferrin saturation(TSAT)and all-cause death and cardiovascular death in non-anemic general population.Methods A total of 7167 non-anemic cases from national health and nutrition examination survey(NHANES)from 1999 to 2000 and 2001 to 2002 were selected,the end point of death was followed up before December 31,2006.Threshold effect analysis and multivariate cox regression model was used to analyze the correlation between SF and TAST and the risk of all-cause death and cardiovascular death.Results Among the 7167 patients,there were 3533 males and 3634 females,aged from 18 to 85 years,with an average age of(46.1±20.0)years,with an average BMI of(27.9±6.2)kg/m2.The patients were followed up for(5.5±1.2)years with a total of 11623 person/year,which inclued 452 all-cause deaths and 117 cardiovascular deaths.There was a nonlinear correlation between SF and all-cause death and cardiovascular death,and the cut-off value of SF was 200 ng/ml,when SF<200 ng/ml,the risk of all-cause death increased by 25%(HR=1.252,95%CI:1.068-1.486,P=0.008)and the risk of cardiovascular death increased by 37%(HR=1.370,95%CI:1.076-1.900,P=0.036)for every 100 ng/ml increase in SF.TSAT had an L-shaped correlation with all-cause mortality,and the cut-off value of TSAT was 30%,when TSAT<30%,the risk of all-cause death decreased by 21%(HR=0.791,95%CI:0.681-0.914,P=0.001)for every 10%increase in TSAT.TSAT was negatively correlated with the risk of cardiovascular death(HR=0.803,95%CI:0.660-0.963,P=0.014).Conclusions For non-anemic population,the SF value has a nonlinear correlation with all-cause death and cardiovascular death,with a cut-off value of 200 ng/ml,and TSAT value has an L-shaped correlation with all-cause death,with a cut-off value of 30%,and TSAT has a negative correlation with cardiovascular death.It is suggested that SF and TSAT in non-anemic population should be controlled in a suitable range to reduce the risk of death and improve the prognosis.

关 键 词：血清铁蛋白 转铁蛋白饱和度 全因死亡 心血管死亡 非贫血人群 

分 类 号：R446.11[医药卫生—诊断学]