Transferrin saturation ratio and risk of total and cardiovascular mortality in the general population.

Abstract

BACKGROUND:

The transferrin saturation (TSAT) ratio is a commonly used indicator of iron deficiency and iron overload in clinical practice but precise relationships with total and cardiovascular mortality are unclear.

PURPOSE:

To better understand this relationship, we explored the association of TSAT ratio (serum iron/total iron binding capacity) with mortality in the general population.

METHODS:

The relationships of TSAT ratio with total and cardiovascular mortality were explored in 15 823 subjects age 20 and older from the Third National Health and Nutrition Examination Survey (1988-94). All subjects had vital status assessed through to 2006.

RESULTS:

During follow-up, 9.7% died of which 4.4% were from cardiovascular disease. In unadjusted analysis, increasing TSAT ratio was inversely associated with mortality. With adjustment for baseline demographic and clinical characteristics, the TSAT-mortality relationship followed a j-shaped pattern. Compared with the referent group [ratio 23.7-31.3%: hazard ratio (HR) =1.00], subjects in the lowest two quartiles, <17.5 % and 17.5-23.7 %, experienced significantly higher mortality risks of 1.45 (1.19-1.77) and 1.27 (1.06-1.53), respectively, whereas subjects in the highest quartile, >31.3 %, experienced significantly higher mortality risks of 1.23 (1.01-1.49). The pattern of association was more pronounced for cardiovascular mortality with significantly higher mortality risks for the lowest two quartiles [HR = 2.09 (1.43-3.05) and 1.90 (1.33-2.72), respectively] and highest quartile HR = 1.59 (1.05-2.40).

CONCLUSIONS:

Both low and high TSAT ratios are significantly and independently associated with increased total and cardiovascular mortality. The optimal TSAT ratio associated with the greatest survival is between 24% and 40%.

• Authors: A G Stack, A I Mutwali, H T Nguyen, C J Cronin, L F Casserly, J Ferguson
• Journal: QJM : monthly journal of the Association of Physicians (QJM) Vol. 107 Issue 8 Pg. 623-33 (Aug 2014) ISSN: 1460-2393 [Electronic] England
• PMID: 24599805 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians.

Chemical References

• Biomarkers
• Hemoglobins
• Transferrin

Topics

• Adult
• Age Distribution
• Aged
• Biomarkers (blood)
• Cardiovascular Diseases (blood, mortality)
• Female
• Health Surveys
• Hemoglobins (metabolism)
• Humans
• Life Style
• Male
• Middle Aged
• Risk Assessment (methods)
• Sensitivity and Specificity
• Sex Distribution
• Socioeconomic Factors
• Transferrin (metabolism)
• United States (epidemiology)
• Young Adult