营养摄入可影响主要不良心血管事件(MACE)。膳食铁有两种形式:仅在动物来源中发现的血红素铁(HI)和主要存在于植物来源中的非血红素铁(NHI)。
我们评估了膳食铁摄入量与MACE和铁状态生物标志物之间的关联。
前瞻性队列研究。
男性健康与老龄化项目,悉尼,澳大利亚。
539名居住在社区的75岁及以上的澳大利亚老年男性。
使用经过验证的饮食史问卷对男性进行营养评估。条目被转换为食物组和营养素。饮食计算用于从总铁摄入量中得出HI和NHI摄入量。使用线性回归分析铁摄入量与铁状态生物标志物,使用Cox回归分析MACE和个体终点。五点MACE包括全因死亡率,心肌梗死(MI),充血性心力衰竭(CCF),冠状动脉血运重建,和/或缺血性中风。四点MACE包括MI的四个端点,CCF,冠状动脉血运重建,和/或缺血性中风,并排除全因死亡率。
在中位数为5.3(4.6-6.3)年的随访中,发病率为:31.2%(n=168)五点MACE,17.8%(n=96)排除全因死亡率的四点MACE,20.1%(n=111)全因死亡率,11.3%(n=61)CCF,和3.1%(n=15)冠状动脉血运重建。在调整后的分析中,更高的HI摄入量(每1mg增量)与增加的五点MACE(HR:1.45[95%CI:1.16,1.80,P=.001])相关,排除全因死亡率的四点MACE(HR:1.64[95%CI:1.26,2.15,P<.001]),全因死亡率(HR:1.51[95%CI:1.15,1.99,P=0.003]),CCF(HR:2.08[95%CI:1.45,2.98,P<.001]),和冠状动脉血运重建(HR:1.89[95%CI:1.15,3.10,P=0.012])。与NHI摄入量的底部三元相比,NHI摄入量的中三分位数与全因死亡率风险降低相关(HR:0.56[95%CI:0.33,0.96,P=.035]).总铁摄入量与MACE和个体终点无关。膳食铁摄入量与血清铁和血红蛋白无关。
较高的血红素铁摄入量与五点MACE的风险增加独立相关,不包括全因死亡率的四点MACE,全因死亡率,CCF,和5岁以上老年男性的冠状动脉血运重建。
Nutritional intake can influence major adverse cardiovascular events (MACE). Dietary iron is found in two forms: haem-iron (HI) only found in animal sources and non-haem iron (NHI) present mostly in plant sources.
We evaluated the associations between dietary iron intakes with MACE and iron status biomarkers.
Prospective cohort study.
The Concord Health and Ageing in Men Project, Sydney, Australia.
539 community-dwelling older Australian men aged 75 years and older.
Men underwent nutritional assessment using a validated diet history questionnaire. Entries were converted to food groups and nutrients. The dietary calculation was used to derive HI and NHI intakes from total iron intakes. Analyses of iron intakes with iron status biomarkers were conducted using linear regression, and with MACE and individual endpoints were conducted using Cox regression. Five-point MACE comprised of all-cause mortality, myocardial infarction (MI), congestive cardiac failure (CCF), coronary revascularisation, and/or ischaemic stroke. Four-point MACE included the four endpoints of MI, CCF, coronary revascularisation, and/or ischaemic stroke, and excluded all-cause mortality.
At a median of 5.3 (4.6 - 6.3) years follow-up, the incidences were: 31.2% (n = 168) five-point MACE, 17.8% (n = 96) four-point MACE excluding all-cause mortality, 20.1% (n = 111) all-cause mortality, 11.3% (n = 61) CCF, and 3.1% (n = 15) coronary revascularisation. In adjusted analyses, higher HI intake (per 1mg increment) was associated with increased five-point MACE (HR: 1.45 [95% CI: 1.16, 1.80, P = .001]), four-point MACE excluding all-cause mortality (HR: 1.64 [95% CI: 1.26, 2.15, P <.001]), all-cause mortality (HR: 1.51 [95% CI: 1.15, 1.99, P = .003]), CCF (HR: 2.08 [95% CI: 1.45, 2.98, P <.001]), and coronary revascularisation (HR: 1.89 [95% CI: 1.15, 3.10, P = .012]). Compared with the bottom tertile of NHI intake, the middle tertile of NHI intake was associated with reduced risk of all-cause mortality (HR: 0.56 [95% CI: 0.33, 0.96, P = .035]). Total iron intake was not associated with MACE and individual endpoints. Dietary iron intakes were not associated with serum iron and haemoglobin.
Higher haem iron intake was independently associated with increased risks of five-point MACE, four-point MACE excluding all-cause mortality, all-cause mortality, CCF, and coronary revascularisation in older men over 5 years.