单采血浆捐献对铁蓄积风险人群血清铁蛋白水平及铁蓄积率影响的初步分析

Preliminary Analysis of the Influencing of Plasmapheresis Donation on Serum Ferritin Level and Iron Accumulation Rate in People at Risk of Iron Accumulation

目的铁蓄积与骨质疏松、糖尿病等多种疾病有关,男性及绝经后女性是铁蓄积风险人群。通过调查该类人群中单采血浆捐献者血清铁蛋白(serum ferritin,SF)状况,初步探究单采血浆捐献对两类人群SF水平及铁蓄积率的影响。方法以纳入与排除标准招募男性及绝经后女性重复献浆者为调查组,新献浆者为对照组,检测SF,收集可能影响SF水平的潜在因素。采用多因素线性回归分析校正混杂因素后比较重复献浆者与新献浆者SF水平差异。以WHO铁蓄积判定标准筛查铁蓄积献浆者,采用多因素Logistic回归分析校正混杂因素后,比较重复献浆者与新献浆者铁蓄积概率差异。由于铁蛋白大部分存在于血红蛋白(hemoglobin,Hb)中,另检测受试者Hb水平,探究单采血浆捐献对Hb水平的影响。结果男性重复献浆者SF为134.78μg/L(77.57~202.52),新献浆者178.22μg/L(113.07~269.44)。绝经后女性重复献浆者SF为73.26μg/L(41.54~112.22),新献浆者97.26μg/L(57.94~152.79)。多因素线性回归结果显示男性重复献浆者SF水平显著低于新献浆者(P<0.001),绝经后女性重复献浆者SF水平显著低于新献浆者(P=0.001)。男性重复献浆者铁蓄积率为25.36%,新献浆者43.72%。绝经后女性重复献浆者铁蓄积率为4.00%,新献浆者26.60%。多因素Logistic回归结果显示男性重复献浆者铁蓄积概率显著低于新献浆者(OR=0.404,95%CI:0.262~0.623,P<0.001),绝经后女性重复献浆者铁蓄积概率显著低于新献浆者(OR=0.096,95%CI:0.02~0.47,P=0.004)。男性及绝经后女性重复献浆者与新献浆者Hb水平差异无统计学意义。结论单采血浆捐献与SF水平和铁蓄积率的降低存在统计学上的显著关联,其对铁蓄积是否有改善作用还需做进一步因果推断。

Objective Iron accumulation was related to osteoporosis,diabetes,and other diseases.Men and postmenopausal women were at risk of iron accumulation.The aim of this study was to explore the influence of plasmapheresis donors on serum ferritin(SF)level and iron accumulation rate in the two groups by investigating the status of SF in plasmapheresis donors who were men and postmenopausal women.Methods SF was detected in male and postmenopausal female regular and new plasmapheresis donors recruited according to the inclusion and exclusion criteria.Regular plasmapheresis donors were taken as the investigation group,and new plasmapheresis donors were taken as the control group.The potential factors that might affect the level of SF were collected.Multivariate linear regression analysis was used to correct for confounding factors and compare the difference in SF levels between regular and new plasmapheresis donors.The WHO iron accumulation judgment standard was used to screen the iron accumulation of plasmapheresis donors,and the multivariate logistic regression analysis was used to compare the difference in iron accumulation probability between the regular and the new plasmapheresis donors after correcting for the confounding factors.Since ferritin is mostly found in hemoglobin(Hb),we also measured the Hb level of subjects to explore the effect of plasmapheresis donation on Hb level.Results SF of male regular plasmapheresis donors was 134.78μg/L(77.57-202.52)and for new plasmapheresis donors was 178.22μg/L(113.07~269.44).The SF of postmenopausal female regular plasmapheresis donation was 73.26μg/L(41.54~112.22),97.26μg/L(57.94~152.79)for new donors.Multivariate linear regression showed that the SF level of male regular plasmapheresis donors was significantly lower than that of new plasmapheresis donors(P<0.001),and that of postmenopausal female regular plasmapheresis donors was significantly lower than that of new plasmapheresis donors(P=0.001).The iron accumulation rate of male regular plasmapheresis donors was 25.36%,and that of new plasmapheresis donors was 43.72%.The iron accumulation rate of postmenopausal female regular plasmapheresis donation was 4.00%,and that of new plasmapheresis donation was 26.60%.Multivariate logistic regression results showed that the iron accumulation probability of male regular plasmapheresis donors was significantly lower than that of new plasmapheresis donors(OR=0.404,95%CI:0.262~0.623,P<0.001),and that of postmenopausal female regular plasmapheresis donors was significantly lower than that of new plasmapheresis donors(OR=0.096,95%CI:0.02~0.47,P=0.004).There was no significant difference in Hb levels between regular and new plasmapheresis donors.Conclusion There was a statistically significant correlation between plasmapheresis donation and the reduction of SF level and iron accumulation rate.Whether it could relieve iron accumulation needs further causal inference.