The Impact Of Plasmapheresis Donation On Iron Metabolism And The Development And Validation Of A Predictive Model For Iron Deficiency In Plasmapheresis Donors

Objective:Iron is an essential trace element for the human body.Numerous studies have shown that whole blood donation can cause iron loss.With the development of the plasmapheresis donation,the health of single plasma donors is receiving increasing attention.However,we know very little about the iron metabolism status of single plasma donors.The aim of this study is to explore the impact of plasma donation on iron metabolism,screen and identify individuals at risk of iron deficiency and their influencing factors,and further establish and validate an iron deficiency risk prediction model to achieve early warning and intervention for high-risk individuals,thereby protecting the health and safety of plasma donors.Section 1:Study on the Effect of Plasmapheresis Donation on Iron MetabolismMethods:Recruit single plasma donors from five single plasma collection stations in Hunan,Yunnan,Henan,and Sichuan provinces.Recruit new plasma donors as the control group,and plasma donors(repeat donors)who have exhibited plasma donation behavior in the past year as the investigation group.Detect serum ferritin(SF)and hemoglobin(Hb)in two groups of people.Exploring the impact of plasma donation on SF and Hb detection values after adjusting for confounding factors using multiple linear regression.Exploring the effect of plasma donation alone on the incidence of iron metabolism abnormalities after adjusting for confounding factors using multivariate logistic regression.Results:A total of 726 new donors and 767 repeat donors were included.After adjusting for confounding factors,the SF levels of plasma donors in the high plasma donation frequency group(plasma donation frequency>16 times/year)were significantly lower than those in the new plasma donors(male:P<0.001;female:P=0.008).The Hb levels of female repeat plasma donors were significantly lower than those of new plasma donors(P<0.001),while there was no significant difference in Hb levels between male repeat plasma donors and new plasma donors.The iron accumulation rate of male repeated plasma donors was 38.97%,while that of female repeated plasma donors was 8.49%.The iron accumulation rate of male plasma donors with high plasma frequency and high total plasma frequency arrays was significantly lower than that of new plasma donors(high plasma frequency group vs.new plasma donors:P=0.001;high total plasma frequency array vs.new plasma donors:P<0.001).The iron deficiency rate of male repeat plasma donors was 0.78%,while that of female repeat plasma donors was 28.38%.The iron deficiency rate of female repeat plasma donors in the high frequency group was significantly higher than that of new plasma donors(P=0.01).Conclusions:Under the current single plasma donation standards in China,a higher frequency and total number of plasma donations will to some extent reduce donor SF.Single plasma donation can to some extent reduce the risk of iron accumulation in male donors,but it also increases the risk of iron deficiency in female plasma donors.Section 2:Analysis of Risk Factors for Iron Deficiency in Female Repeated Plasma Donors and Development and Validation of Predictive modelsMethod:Applying multivariate logistic regression analysis to explore independent risk factors for iron deficiency in female repeat plasma donors.Randomly assign female repeat plasma donors in a 7:3 ratio to the modeling and validation queue.Incorporate independent risk factors into a multivariate logistic regression model and construct a predictive model using stepwise regression forward backward method.Recruit female repeat plasma donors from another region as an external validation queue.The receiver operator characteristic curve(ROC)and Hosmer-Lemeshow Goodness of fit test were used to evaluate the discrimination and calibration of the constructed prediction model in the modeling and validation queue,and the clinical decision curve was used to evaluate the clinical value of the model.Result:Due to the high iron deficiency rate among female repeat plasma donors,we conducted a risk factor analysis on iron deficiency among female repeat plasma donors.The results showed that donation frequency,age,Hb test value,Body Mass Index(BMI),and premenopausal women were independent risk factors for iron deficiency(P<0.05).A risk prediction model for iron deficiency in female repeat plasma donors was established and validated based on the results of independent risk factor analysis.The prediction model has good discrimination(AUC>0.7)and calibration(P>0.05)in the modeling queue,internal and validation queues,and external validation queues.The model has a good consistency between predicted risks and actual risks,and the model has a high prediction accuracy.Conclusion:Age,BMI,frequency of plasma donation,Hb detection value,and menstrual history are highly correlated with the occurrence of iron deficiency in female repeat plasma donors.Menstrual history is the most important predictor of iron deficiency in female repeat plasma donors.Among them,age,BMI,and Hb detection values are negatively correlated with the risk of iron deficiency;The frequency of plasma donation is positively correlated with the risk of iron deficiency;Premenopausal women have a higher risk of iron deficiency.The established iron deficiency risk prediction model has good discrimination and calibration,and has certain predictive ability.