Increased Transferrin Concentrations Are Not Associated With Thrombosis in People Living at High Altitude.

IF 1.3 Q4 HEMATOLOGY
Journal of hematology Pub Date : 2025-02-01 Epub Date: 2025-01-17 DOI:10.14740/jh1388
Ricardo Amaru, Josef Prchal, Tomas Ganz, Xu Zhang, Daniela Paton, Mireya Carrasco, Emma Mancilla, Victor R Gordeuk
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引用次数: 0

Abstract

Background: Bolivian Andean Aymara highlanders, living at 4,000 m for 14,000 years, have evolved genetic adaptations to hypoxia. These include EGLN1 encoding prolyl hydroxylase 2 (PHD2), a regulator of transferrin transcription. Transferrin level increases in hypoxia and iron deficiency. Contrasting reports indicate that elevated transferrin is associated with experimentally induced thrombosis in mice undergoing short-stay at high altitude, but with decreased thrombosis in a congenital disorder of hypoxia-sensing.

Methods: A retrospective study was conducted in people living at high altitude (3,650 - 4,150 m). We analyzed serum transferrin concentration and thrombosis history in Aymara patients with high-altitude erythrocytosis (n = 149, median age 55 years, female gender 30%, iron deficiency 23%) or high-altitude anemia (n = 137, median age 43 years, female gender 86%, iron deficiency 57%).

Results: The median transferrin concentration was 339 mg/dL in erythrocytosis patients versus 310 mg/dL in anemia patients (P = 0.037); it was 367 mg/dL in iron deficient versus 312 mg/dL in iron replete patients (P < 0.001). Thrombosis history was present in 13% of erythrocytosis and 8% of anemia patients (P = 0.25) and was present in 16% of iron deficient and 7% of iron replete patients (P = 0.017). After adjustment for erythrocytosis and iron deficiency in multivariate regression analysis, the mean (95% confidence interval) transferrin concentration was 277 (237 - 316) mg/dL in 30 patients with thrombosis history versus 324 (306 - 341) mg/dL in 256 patients without thrombosis history (P = 0.018). Similar trends occurred for the subgroups of arterial thrombosis history (P = 0.044) and venous thrombosis history (P = 0.22).

Conclusions: In individuals with extreme environmental hypoxia, we found no evidence that increased transferrin is associated with increased thrombosis history. Rather, we observed a trend to decreased thrombosis history with increased transferrin levels.

高海拔地区转铁蛋白浓度升高与血栓形成无关
背景:玻利维亚安第斯高地的艾马拉人在海拔4000米的地方生活了14000年,他们已经进化出了适应缺氧的基因。其中包括编码脯氨酸羟化酶2 (PHD2)的EGLN1,它是转铁蛋白转录的调节因子。缺氧和缺铁时转铁蛋白水平升高。对比报告表明,在高海拔短暂停留的小鼠中,转铁蛋白升高与实验诱导的血栓形成有关,但与先天性缺氧感知障碍的血栓形成减少有关。方法:对生活在海拔3650 ~ 4150 m地区的艾马拉族人进行回顾性研究,分析高原红细胞增生(149例,中位年龄55岁,女性30%,缺铁23%)和高原贫血(137例,中位年龄43岁,女性86%,缺铁57%)患者血清转铁蛋白浓度和血栓形成史。结果:红细胞增多症患者转铁蛋白中位浓度为339 mg/dL,贫血症患者为310 mg/dL (P = 0.037);缺铁组为367 mg/dL,缺铁组为312 mg/dL (P < 0.001)。13%的红细胞增多症患者和8%的贫血患者有血栓形成史(P = 0.25), 16%的缺铁患者和7%的缺铁患者有血栓形成史(P = 0.017)。在多因素回归分析中调整红细胞增多和缺铁因素后,30例有血栓病史的患者转铁蛋白平均浓度(95%置信区间)为277 (237 ~ 316)mg/dL, 256例无血栓病史的患者转铁蛋白平均浓度为324 (306 ~ 341)mg/dL (P = 0.018)。动脉血栓形成史(P = 0.044)和静脉血栓形成史(P = 0.22)的亚组也出现了类似的趋势。结论:在极端环境缺氧的个体中,我们没有发现转铁蛋白升高与血栓形成史增加相关的证据。相反,我们观察到血栓形成史随着转铁蛋白水平的增加而减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of hematology
Journal of hematology HEMATOLOGY-
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