摘要
Abstract
Objective To investigate the association between anemia and premature death as well as the impact of different types of anemia on premature death.Methods It was a retrospective cohort study.Demographic and clinical data on participants were extracted from the National Health and Nutrition Examination Survey(NHANES)from 1999 to 2010 with a baseline associated with the 2019 National Death Index records.Anemia,as well as iron-deficiency anemia,was defined according to World Health Organization indicators.Premature deaths were defined as deaths occurring before the age of 75 years.The weighted univariate and multivariate Cox proportional risk models were used for covariate screening and exploring the association between anemia as well as iron deficiency anemia and other types of anemia with all-cause premature death.The evaluation metrics were hazard ratios(HR)and 95％confidence intervals(CI).The Kaplan-Meier curves were used to assess survival in different subgroups of participants.In addition,subgroup analyses stratified by multiple covariates were performed.Results A total of 1 054 all-cause premature deaths occurred during the follow-up period.After adjusting for covariates including gender,age,race,poverty-to-income ratio(PIR),marital status,smoking status,drinking status and obesity,the total anemia population had a higher risk of premature death compared with the non-anemic population(HR=1.40,95％CI:1.09-1.78,P=0.007).When the total anemia population was divided into the iron-deficiency anemia population and the other types of anemia population,iron-deficiency anemia did not have a significant effect on the risk of premature death compared to the non-anemia population(HR=0.76,95％CI:0.40-1.46,P=0.416),and the other types of anemia were positively associated with the risk of premature death(HR=1.66,95％CI:1.29-2.14,P＜0.001).The trends were generally consistent across subgroups.Conclusion Anemia is a risk factor for premature death.Iron deficiency anemia or other types of anemia has a different impact on all-cause premature death.There may be an association between the type of anemia and the risk of all-cause premature death.关键词
贫血/缺铁性贫血/过早死亡/NHANES数据库Key words
anemia/iron deficiency anemia/premature death/NHANES database分类
临床医学
