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Dietary intake of heme iron and risk of cardiovascular disease: a dose-response meta-analysis of prospective cohort studies.
Nutr Metab Cardiovasc Dis 2015; 25(1):24-35NM

Abstract

BACKGROUND AND AIMS

Iron is thought to play a fundamentally important role in the development of cardiovascular disease (CVD). This meta-analysis was performed to investigate the dose-response association between dietary intake of iron (including heme and non-heme iron) and the risk of CVD.

METHODS AND RESULTS

We performed a search of the PubMed and Embase databases for prospective cohort studies of the association between dietary iron intake and CVD risk. Thirteen articles comprising 252,164 participants and 15,040 CVD cases were eligible for inclusion. Heme iron intake was associated significantly with increased risk of cardiovascular disease, and the pooled relative risk (RR) for each 1 mg/day increment was 1.07 (95% confidence interval: 1.01 to 1.14, I² = 59.7%). We also found evidence of a curvilinear association (P < 0.05 for non-linearity). In contrast, we found no association between CVD risk and dietary non-heme (0.98, 0.96 to 1.01, I² = 15.8%) or total iron (1.00, 0.94 to 1.06, I² = 30.4%). Subgroup analyses revealed that the association between heme iron intake and CVD risk was stronger among non-fatal cases (1.19, 1.07-1.33) and American patients (1.31, 1.11-1.56).

CONCLUSIONS

Higher dietary intake of heme iron is associated with an increased risk of cardiovascular disease, whereas no association was found between CVD and non-heme iron intake or total iron intake. These findings may have important public health implications with respect to preventing cardiovascular disease.

Authors+Show Affiliations

Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; The First Affiliated Hospital, Institute for Translational Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.Department of Epidemiology & Biostatistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.The First Affiliated Hospital, Institute for Translational Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China.Departments of Epidemiology and Medicine, Brown University, Providence, RI 02912, USA.Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China. Electronic address: fwang@zju.edu.cn.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25439662

Citation

Fang, X, et al. "Dietary Intake of Heme Iron and Risk of Cardiovascular Disease: a Dose-response Meta-analysis of Prospective Cohort Studies." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 25, no. 1, 2015, pp. 24-35.
Fang X, An P, Wang H, et al. Dietary intake of heme iron and risk of cardiovascular disease: a dose-response meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis. 2015;25(1):24-35.
Fang, X., An, P., Wang, H., Wang, X., Shen, X., Li, X., ... Wang, F. (2015). Dietary intake of heme iron and risk of cardiovascular disease: a dose-response meta-analysis of prospective cohort studies. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 25(1), pp. 24-35. doi:10.1016/j.numecd.2014.09.002.
Fang X, et al. Dietary Intake of Heme Iron and Risk of Cardiovascular Disease: a Dose-response Meta-analysis of Prospective Cohort Studies. Nutr Metab Cardiovasc Dis. 2015;25(1):24-35. PubMed PMID: 25439662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary intake of heme iron and risk of cardiovascular disease: a dose-response meta-analysis of prospective cohort studies. AU - Fang,X, AU - An,P, AU - Wang,H, AU - Wang,X, AU - Shen,X, AU - Li,X, AU - Min,J, AU - Liu,S, AU - Wang,F, Y1 - 2014/09/30/ PY - 2014/06/21/received PY - 2014/08/17/revised PY - 2014/09/03/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/9/17/medline KW - Cardiovascular disease KW - Dose–response KW - Heme iron KW - Meta-analysis SP - 24 EP - 35 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 25 IS - 1 N2 - BACKGROUND AND AIMS: Iron is thought to play a fundamentally important role in the development of cardiovascular disease (CVD). This meta-analysis was performed to investigate the dose-response association between dietary intake of iron (including heme and non-heme iron) and the risk of CVD. METHODS AND RESULTS: We performed a search of the PubMed and Embase databases for prospective cohort studies of the association between dietary iron intake and CVD risk. Thirteen articles comprising 252,164 participants and 15,040 CVD cases were eligible for inclusion. Heme iron intake was associated significantly with increased risk of cardiovascular disease, and the pooled relative risk (RR) for each 1 mg/day increment was 1.07 (95% confidence interval: 1.01 to 1.14, I² = 59.7%). We also found evidence of a curvilinear association (P < 0.05 for non-linearity). In contrast, we found no association between CVD risk and dietary non-heme (0.98, 0.96 to 1.01, I² = 15.8%) or total iron (1.00, 0.94 to 1.06, I² = 30.4%). Subgroup analyses revealed that the association between heme iron intake and CVD risk was stronger among non-fatal cases (1.19, 1.07-1.33) and American patients (1.31, 1.11-1.56). CONCLUSIONS: Higher dietary intake of heme iron is associated with an increased risk of cardiovascular disease, whereas no association was found between CVD and non-heme iron intake or total iron intake. These findings may have important public health implications with respect to preventing cardiovascular disease. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/25439662/Dietary_intake_of_heme_iron_and_risk_of_cardiovascular_disease:_a_dose_response_meta_analysis_of_prospective_cohort_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(14)00288-9 DB - PRIME DP - Unbound Medicine ER -