Correlation of iron deficiency and left ventricular remodeling in patients with iron dediciency anemia
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摘要: 目的：探讨缺铁性贫血患者铁指标与心脏彩超左室质量指数（LVMI）的相关性，验证缺铁引起的铁指标异常作为左心室重构危险因素的可行性。方法：纳入2013-2018年武汉大学中南医院收治的83例缺铁性贫血患者。收集患者临床血常规、生化检查、铁指标、心脏彩超检查等结果。任何其他并发疾病均列为排除标准。对其中66例患者计算LVMI，根据LVMI （男性>115 g/m2，女性>95 g/m2）结果分为正常组和异常组，对两组患者的所有研究指标进行两两比较。在83例患者中，采用相关性分析分别评估血红蛋白、总铁结合力（TIBC）与其他研究指标的相关性。以log变换后的LVMI作为应变量，采用线性回归分析log变换LVMI与其他研究指标的线性相关性。采用logistic回归分析贫血及TIBC水平与心室重构的关系。结果：在LVMI异常组中可以观察到更高的TIBC水平。线性相关分析显示，HGB与RDW、血清铁、TS、LVM明显相关，TIBC与年龄、MCV、铁蛋白、TS、LVM、SV、白蛋白明显相关，TIBC与HGB无相关性。多重线性回归分析显示，log变换LVMI与年龄、TIBC及HGB有明显相关性。logistic回归分析显示，贫血程度及TIBC与左心室重构发生风险相关，在调整贫血影响后，TIBC仍与左心室重构相关。结论：在缺铁性贫血患者中，TIBC与LVMI密切相关，升高的TIBC可增加这一患病群体发生左心室重构的风险。Abstract: Objective: To evaluate associations between iron parameters and left ventricular mass index in patients with iron deficiency anemia (IDA) and to verify the feasibility of iron deficiency-induced abnormalities as risk factors for left ventricular remodeling.Method: A total of 83 patients with IDA, who admitted to Zhongnan Hospital of Wuhan University from 2013 to 2018 were enrolled.The data of routine blood test, biochemical examination, iron index and color Doppler echocardiography were collected.Any other complications were excluded.Subsequently, these patients were divided into normal group and abnormal group according to lft ventricular mass index (LVMI, >115 g/m2 in male and >95 g/m2 in female).All research indexes of two groups were compared.In 83 patients, the correlation between hemoglobin (HGB), total iron binding capacity (TIBC) and other indicators was evaluated by correlation analysis.Linear regression analysis was used to analyze the correlation between log-transformed LVMI and other research indicators, taking log-transformed LVMI as the strain variable.Logistic regression was used to analyze the relationship between anemia, TIBC levels and ventricular remodeling.Result: Higher TIBC levels were observed in LVMI abnormal group.Linear correlation analysis showed that HGB was significantly associated with red blood cell distribution width (RDW), serum iron, transferrin saturation (TS) and LVM, TIBC was significantly correlated with age, mean corpuscular volume (MCV), ferritin, TS and LVM, SV and albumin, while there was no correlation between TIBC and HGB.Multiple linear regression analysis showed that log-transformed LVMI was significantly correlated with age, TIBC and HGB.Logistic regression analysis showed that the degree of anemia and TIBC were associated with the risk of left ventricular remodeling.After adjusting for the effect of anemia, TIBC was still associated with left ventricular remodeling.Conclusion: Upregulated total iron binding capacity is found and associated with increased LVMI in patients with IDA.Thus, the rising serum TIBC concentration could serve as a novel predictor of IDA patients with cardiac remodeling.
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