圍絕經(jīng)期婦女鐵蛋白水平及與慢性疾病危險性分析
發(fā)布時間：2019-02-20 21:30
【摘要】：目的圍絕經(jīng)期是指婦女絕經(jīng)前后的一段時期(從45歲左右開始至停經(jīng)后12個月內(nèi)的時期),是正常的生理變化時期。血清鐵蛋白水平可反映機體鐵的營養(yǎng)狀況,不同生理狀況可影響機體對鐵的吸收和利用,鐵含量的過高或過低都將影響機體的正常生理功能。以往研究發(fā)現(xiàn)女性絕經(jīng)后鐵蛋白水平升高,但研究對象多是西方人群,且圍絕經(jīng)期鐵蛋白與慢病的研究在國內(nèi)外較為少見。本研究的目的就是分析圍絕經(jīng)期婦女血清鐵蛋白水平的年齡變化特征及與慢性疾病的關(guān)系,為深入探討鐵過載對人群健康的影響及疾病預防提供參考。方法采用流行病學橫斷面研究方法。選取2014年6月—2015年10月青島市某醫(yī)院體檢的40~65歲女性2635例作為研究對象,平均年齡49歲,按年齡分組為40~44歲、45~49歲、50~54歲、55~59歲和60~65歲;收集研究對象體格檢查、生化檢測、鐵蛋白水平等檢測結(jié)果,并結(jié)合問卷調(diào)查其既往病史,充分了解研究對象的健康狀況。按體質(zhì)指數(shù)(BMI)分組為體重過低(18.5 kg/m2)、正常(18.5~23.9 kg/m2)、超重(24.0~27.9 kg/m2)和肥胖(≥28.0 kg/m2),按鐵蛋白水平分組為鐵缺乏(15μg/L)、鐵正常(15~150μg/L)和鐵過載(150μg/L),分析年齡和BMI與不同鐵蛋白水平的關(guān)系及影響。分別計算高脂血癥、高血壓、糖尿病和高尿酸血癥四種常見慢病在不同年齡組、BMI組和鐵蛋白水平組的患病率,采用多因素logistic回歸分析鐵過載對慢性疾病患病風險的影響。結(jié)果研究對象平均鐵蛋白水平為38.6(16.9,67.7)μg/L,隨年齡增長,鐵蛋白水平呈上升趨勢,其中50至59歲迅速升高。隨年齡增長鐵缺乏檢出率下降,而鐵過載檢出率升高,兩者在55~56歲之間相交;隨BMI增加,鐵蛋白水平升高,肥胖者鐵蛋白濃度46.2(21.7,87.3)μg/L高于體重正常者33.8(14.7,62.0)μg/L,P0.05。多因素logistic回歸分析結(jié)果表明,50~54歲、45~49歲和40~44歲組鐵過載患病風險分別是60~65歲組的7.529、4.057和9.197倍(95%CI分別為:2.203~7.472,4.132~13.717,5.043~16.772),而55~59歲和60~65歲組鐵過載患病風險分別是40~44歲組的4.470和4.346倍(95%CI分別為:1.987~10.057,1.840~10.266)。鐵過載組高脂血癥、高血壓、高尿酸血癥和糖尿病患病率均明顯高于鐵缺乏和鐵正常組(P均0.05)。多因素logistic回歸分析結(jié)果表明,鐵過載組高脂血癥患病風險是鐵正常組的1.782倍(95%CI:1.127~2.818,P0.05),高血壓患病風險是鐵正常組的1.700倍(95%CI:1.031~2.803,P0.05),糖尿病患病風險是鐵正常組的2.832倍(95%CI:1.479~5.426,P0.05),高尿酸血癥患病風險是鐵正常組的2.374倍(95%CI:1.097~5.138,P0.05)。結(jié)論圍絕經(jīng)期婦女鐵蛋白水平在50歲時鐵蛋白水平迅速升高導致鐵過載檢出率增高,提示應(yīng)避免過度補鐵。絕經(jīng)引起的鐵蛋白水平升高可增加機體患慢病的風險,提示鐵蛋白對于慢性疾病的診斷可能具有早期預警作用。因此,圍絕經(jīng)期婦女應(yīng)定期進行健康體檢,根據(jù)自身鐵儲量和生理狀況適量補鐵以維持鐵蛋白在150μg/L以下;同時積極鍛煉控制體重,避免鐵過載危害并預防慢性疾病的發(fā)生。
[Abstract]:Perimenopausal period is a period of time before and after menopause (from about 45 to 12 months after the menopause), which is a normal period of physiological change. The serum ferritin level can reflect the nutritional status of iron in the body. Different physiological conditions can affect the absorption and utilization of iron, and the excessive or too low iron content will affect the normal physiological function of the body. In the past, the level of post-menopausal ferritin in women was increased, but the number of subjects in the study was the western population, and the study of perimenopausal and slow-disease was rare at home and abroad. The purpose of this study is to analyze the age-changing characteristics of serum ferritin in perimenopausal women and the relationship with the chronic diseases, and to provide a reference for the further study of the effect of iron overload on the health of the population and the prevention of the disease. Methods The epidemiological cross-sectional study was used. A total of 2635 women aged from 40 to 65 years of age, aged from 40 to 44 years, 45 to 49 years, 50 to 54 years, 55 to 59 years and 60 to 65 years of age, were selected from June, 2014 to October, 2015. The results of physical examination, biochemical test and ferritin level were collected. and the health status of the study object was fully understood in combination with the previous medical history of the questionnaire. According to the body mass index (BMI) group, the body weight was too low (18. 5 kg/ m2), normal (18. 5-23. 9 kg/ m2), overweight (24. 0-27. 9 kg/ m2) and obesity (24.0kg/ m2), and the iron deficiency (15. mu.g/ L), the normal iron (15-150. mu.g/ L) and the iron overload (150. mu.g/ L) were grouped according to the ferritin level. The relationship and effect of age and BMI with different levels of ferritin were analyzed. The prevalence of four common slow diseases of hyperlipidemia, hypertension, diabetes and hyperuricemia in different age group, BMI group and ferritin level group were calculated, and the effect of iron overload on the risk of chronic disease was analyzed by multi-factor logistic regression. Results The mean ferritin level in the study was 38. 6 (16. 9, 67. 7). m u.g/ L, and the level of ferritin increased with age, of which 50 to 59 years of age increased rapidly. The rate of iron deficiency decreased with age, and the rate of iron overload increased, both of which were in the range of 55 to 56 years; with the increase of BMI, the level of ferritin increased, and the concentration of ferritin in the obesity group was 46. 2 (21.7, 87.3). m The multiple-factor logistic regression analysis showed that the risk of iron overload in the 50-54-year-old, 45-49-year-old group and 40-44-year-old group was 7.529, 4.057 and 9.197-fold (95% CI: 2.203-7.472, 4.132-13.717, 5.043-16.772), while the risk of iron overload in the 55-59-and 60-65-year-old group was 4.470 and 4.346-fold (95% CI: 1.987-10.057, 1.840-10.266, respectively). The prevalence of hyperlipidemia, hypertension, hyperuricemia and diabetes in the iron overload group was significantly higher than that of the iron deficiency group and the iron normal group (P 0.05). Multivariate logistic regression analysis showed that the risk of hyperlipidemia in the iron overload group was 1.782 (95% CI: 1.127-2.818, P0.05). The risk of hypertension was 1.700-fold (95% CI: 1. 031-2.803, P0.05), and the risk of diabetes was 2.832-fold (95% CI: 1.479-5.426, P0.05). The risk of hyperuricemia was 2.374-fold (95% CI: 1.097-5.138, P0.05). Conclusion The level of ferritin in perimenopausal women was increased rapidly at the age of 50, and the rate of iron overload was increased, and it was suggested that excessive iron supplementation should be avoided. The increase of the level of ferritin in the menopause can increase the risk of slow disease in the body, and it is suggested that the diagnosis of the chronic diseases may have an early warning effect. Therefore, the women in the perimenopausal period should carry out the health examination on a regular basis and make a proper amount of iron supplementation according to their iron reserves and physiological conditions to maintain the ferritin below 150 & mu; g/ L; and meanwhile, actively exercise the control of body weight, avoid the harm of iron overload and prevent the occurrence of chronic diseases.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R173
本文編號：2427298
[Abstract]:Perimenopausal period is a period of time before and after menopause (from about 45 to 12 months after the menopause), which is a normal period of physiological change. The serum ferritin level can reflect the nutritional status of iron in the body. Different physiological conditions can affect the absorption and utilization of iron, and the excessive or too low iron content will affect the normal physiological function of the body. In the past, the level of post-menopausal ferritin in women was increased, but the number of subjects in the study was the western population, and the study of perimenopausal and slow-disease was rare at home and abroad. The purpose of this study is to analyze the age-changing characteristics of serum ferritin in perimenopausal women and the relationship with the chronic diseases, and to provide a reference for the further study of the effect of iron overload on the health of the population and the prevention of the disease. Methods The epidemiological cross-sectional study was used. A total of 2635 women aged from 40 to 65 years of age, aged from 40 to 44 years, 45 to 49 years, 50 to 54 years, 55 to 59 years and 60 to 65 years of age, were selected from June, 2014 to October, 2015. The results of physical examination, biochemical test and ferritin level were collected. and the health status of the study object was fully understood in combination with the previous medical history of the questionnaire. According to the body mass index (BMI) group, the body weight was too low (18. 5 kg/ m2), normal (18. 5-23. 9 kg/ m2), overweight (24. 0-27. 9 kg/ m2) and obesity (24.0kg/ m2), and the iron deficiency (15. mu.g/ L), the normal iron (15-150. mu.g/ L) and the iron overload (150. mu.g/ L) were grouped according to the ferritin level. The relationship and effect of age and BMI with different levels of ferritin were analyzed. The prevalence of four common slow diseases of hyperlipidemia, hypertension, diabetes and hyperuricemia in different age group, BMI group and ferritin level group were calculated, and the effect of iron overload on the risk of chronic disease was analyzed by multi-factor logistic regression. Results The mean ferritin level in the study was 38. 6 (16. 9, 67. 7). m u.g/ L, and the level of ferritin increased with age, of which 50 to 59 years of age increased rapidly. The rate of iron deficiency decreased with age, and the rate of iron overload increased, both of which were in the range of 55 to 56 years; with the increase of BMI, the level of ferritin increased, and the concentration of ferritin in the obesity group was 46. 2 (21.7, 87.3). m The multiple-factor logistic regression analysis showed that the risk of iron overload in the 50-54-year-old, 45-49-year-old group and 40-44-year-old group was 7.529, 4.057 and 9.197-fold (95% CI: 2.203-7.472, 4.132-13.717, 5.043-16.772), while the risk of iron overload in the 55-59-and 60-65-year-old group was 4.470 and 4.346-fold (95% CI: 1.987-10.057, 1.840-10.266, respectively). The prevalence of hyperlipidemia, hypertension, hyperuricemia and diabetes in the iron overload group was significantly higher than that of the iron deficiency group and the iron normal group (P 0.05). Multivariate logistic regression analysis showed that the risk of hyperlipidemia in the iron overload group was 1.782 (95% CI: 1.127-2.818, P0.05). The risk of hypertension was 1.700-fold (95% CI: 1. 031-2.803, P0.05), and the risk of diabetes was 2.832-fold (95% CI: 1.479-5.426, P0.05). The risk of hyperuricemia was 2.374-fold (95% CI: 1.097-5.138, P0.05). Conclusion The level of ferritin in perimenopausal women was increased rapidly at the age of 50, and the rate of iron overload was increased, and it was suggested that excessive iron supplementation should be avoided. The increase of the level of ferritin in the menopause can increase the risk of slow disease in the body, and it is suggested that the diagnosis of the chronic diseases may have an early warning effect. Therefore, the women in the perimenopausal period should carry out the health examination on a regular basis and make a proper amount of iron supplementation according to their iron reserves and physiological conditions to maintain the ferritin below 150 & mu; g/ L; and meanwhile, actively exercise the control of body weight, avoid the harm of iron overload and prevent the occurrence of chronic diseases.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R173
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