Iron deficiency is a common disorder in general population and independently predicts all-cause mortality: results from the Gutenberg Health Study
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Iron deficiency is a common disorder in general population and independently predicts all-cause mortality: results from the Gutenberg Health Study. / Schrage, Benedikt; Rübsamen, Nicole; Schulz, Andreas; Münzel, Thomas; Pfeiffer, Norbert; Wild, Philipp S; Beutel, Manfred; Schmidtmann, Irene; Lott, Rosemarie; Blankenberg, Stefan; Zeller, Tanja; Lackner, Karl J; Karakas, Mahir.
In: CLIN RES CARDIOL, Vol. 109, No. 11, 11.2020, p. 1352-1357.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Iron deficiency is a common disorder in general population and independently predicts all-cause mortality: results from the Gutenberg Health Study
AU - Schrage, Benedikt
AU - Rübsamen, Nicole
AU - Schulz, Andreas
AU - Münzel, Thomas
AU - Pfeiffer, Norbert
AU - Wild, Philipp S
AU - Beutel, Manfred
AU - Schmidtmann, Irene
AU - Lott, Rosemarie
AU - Blankenberg, Stefan
AU - Zeller, Tanja
AU - Lackner, Karl J
AU - Karakas, Mahir
PY - 2020/11
Y1 - 2020/11
N2 - BACKGROUND: Iron deficiency is now accepted as an independent entity beyond anemia. Recently, a new functional definition of iron deficiency was proposed and proved strong efficacy in randomized cardiovascular clinical trials of intravenous iron supplementation. Here, we characterize the impact of iron deficiency on all-cause mortality in the non-anemic general population based on two distinct definitions.METHODS: The Gutenberg Health Study is a population-based, prospective, single-center cohort study. The 5000 individuals between 35 and 74 years underwent baseline and a planned follow-up visit at year 5. Tested definitions of iron deficiency were (1) functional iron deficiency-ferritin levels below 100 µg/l, or ferritin levels between 100 and 299 µg/l and transferrin saturation below 20%, and (2) absolute iron deficiency-ferritin below 30 µg/l.RESULTS: At baseline, a total of 54.5% of participants showed functional iron deficiency at a mean hemoglobin of 14.3 g/dl; while, the rate of absolute iron deficiency was 11.8%, at a mean hemoglobin level of 13.4 g/dl. At year 5, proportion of newly diagnosed subjects was 18.5% and 4.8%, respectively. Rate of all-cause mortality was 7.2% (n = 361); while, median follow-up was 10.1 years. After adjustment for hemoglobin and major cardiovascular risk factors, the hazard ratio with 95% confidence interval of the association of iron deficiency with mortality was 1.3 (1.0-1.6; p = 0.023) for the functional definition, and 1.9 (1.3-2.8; p = 0.002) for absolute iron deficiency.CONCLUSIONS: Iron deficiency is very common in the apparently healthy general population and independently associated with all-cause mortality in the mid to long term.
AB - BACKGROUND: Iron deficiency is now accepted as an independent entity beyond anemia. Recently, a new functional definition of iron deficiency was proposed and proved strong efficacy in randomized cardiovascular clinical trials of intravenous iron supplementation. Here, we characterize the impact of iron deficiency on all-cause mortality in the non-anemic general population based on two distinct definitions.METHODS: The Gutenberg Health Study is a population-based, prospective, single-center cohort study. The 5000 individuals between 35 and 74 years underwent baseline and a planned follow-up visit at year 5. Tested definitions of iron deficiency were (1) functional iron deficiency-ferritin levels below 100 µg/l, or ferritin levels between 100 and 299 µg/l and transferrin saturation below 20%, and (2) absolute iron deficiency-ferritin below 30 µg/l.RESULTS: At baseline, a total of 54.5% of participants showed functional iron deficiency at a mean hemoglobin of 14.3 g/dl; while, the rate of absolute iron deficiency was 11.8%, at a mean hemoglobin level of 13.4 g/dl. At year 5, proportion of newly diagnosed subjects was 18.5% and 4.8%, respectively. Rate of all-cause mortality was 7.2% (n = 361); while, median follow-up was 10.1 years. After adjustment for hemoglobin and major cardiovascular risk factors, the hazard ratio with 95% confidence interval of the association of iron deficiency with mortality was 1.3 (1.0-1.6; p = 0.023) for the functional definition, and 1.9 (1.3-2.8; p = 0.002) for absolute iron deficiency.CONCLUSIONS: Iron deficiency is very common in the apparently healthy general population and independently associated with all-cause mortality in the mid to long term.
KW - Adult
KW - Aged
KW - Anemia, Iron-Deficiency/blood
KW - Biomarkers/blood
KW - Cause of Death/trends
KW - Female
KW - Germany/epidemiology
KW - Hemoglobins/metabolism
KW - Humans
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Prognosis
KW - Prospective Studies
KW - Registries
KW - Survival Rate/trends
U2 - 10.1007/s00392-020-01631-y
DO - 10.1007/s00392-020-01631-y
M3 - SCORING: Journal article
C2 - 32215702
VL - 109
SP - 1352
EP - 1357
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 11
ER -