血红蛋白水平对未来健康事件的影响仍然没有定论。由于其在人类止血过程中的重要作用，高血红蛋白和低血红蛋白水平都可能在其他健康成年人中对未来心血管事件的发展起到重要作用。本研究分析了欧洲前瞻性癌症研究（EPIC）-InterAct队列的数据。在13,648名个体中，对体力活动、身体质量指数、心血管事件家族史、肾功能、吸烟状况、血压和低密度脂蛋白（LDL）水平进行了建模，与同时血红蛋白水平相关，并与21年期间的临床明显心血管事件和死亡情况进行了相关分析。使用特定性别的Cox回归分析以确定心血管事件和全因死亡的风险比（HR）。贫血（男性血红蛋白水平<13.0 g/dl，非孕妇女性血红蛋白水平<12.0 g/dl）与男性全因死亡率增加相关，而与女性无关（男性贫血HR 1.4 (1.2; 1.6)，p=<0.0001）。这在年龄增大时尤为明显。考虑到多种心血管风险因素的各种性别特异Cox回归模型证实了这些结果。在男性中，潜在的血红蛋白水平显著影响未来心血管事件和心肌梗死的发生，而在女性中未观察到此影响。血红蛋白水平对未来心血管事件的影响受性别影响。在男性基线贫血出现的情况下，随着年龄的增长，整体生存率降低。在调整了多种心血管风险因素后，异常血红蛋白水平可以作为男性临床明显未来心血管事件的一个风险因素。在女性中没有观察到这些效应。版权所有©2023欧洲内科学联合会。保留所有权利。

The impact of hemoglobin levels on the occurrence of future health events remains equivocal. Due to its integral role in human hemostasis, both, high and low hemoglobin levels may play a significant role in the development of future cardiovascular (CV) events in otherwise healthy adults.Data from the European Prospective Investigation into Cancer (EPIC)-InterAct cohort was analyzed. In 13.648 individuals, physical activity, body mass index, family history of cardiovascular events, kidney function, smoking status, blood pressure and LDL levels were modelled to concomitant hemoglobin levels and correlated to the occurrence of clinically-overt cardiovascular events and death over a 21-year period. (Sex specific) cox regression analysis were used to develop hazard ratios (HRs) for CV events and all-cause mortality.Anemia (hemoglobin (HGB) levels < 13.0 g/dl in men and < 12.0 g/dl in non-pregnant women) were associated with an increased all-cause mortality in men but not in women (HR anemia in men 1.4 (1.2; 1.6)) p=<0.0001).This was particularly visible with increasing age. Various sex specific Cox regression models, accounting for several CV risk factors confirmed these results. The incidence of future CV events and myocardial infarction was significantly influenced by underlying HGB levels in men with increasing age but not in women.The influence of HGB levels on future cardiovascular events is sex-dependent. In men, presenting with anemia at baseline, the overall survival probability was impaired with increasing age. After adjusting for several CV risk factors, abnormal hemoglobin levels could be identified as a risk factor for the development of clinically-apparent future CV events in men. None of these effects were observed in women.Copyright © 2023 European Federation of Internal Medicine. All rights reserved.