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Recently, a new functional definition of iron deficiency was proposed and proved strong efficacy in randomized cardiovascular clinical trials of intravenous iron supplementation. Here, we characterize the impact of iron deficiency on all-cause mortality in the non-anemic general population based on two distinct definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Gutenberg Health Study is a population-based, prospective, single-center cohort study. The 5000 individuals between 35 and 74\u00a0years underwent baseline and a planned follow-up visit at year 5. Tested definitions of iron deficiency were (1) functional iron deficiency\u2014ferritin levels below 100\u00a0\u00b5g\/l, or ferritin levels between 100 and 299\u00a0\u00b5g\/l and transferrin saturation below 20%, and (2) absolute iron deficiency\u2014ferritin below 30\u00a0\u00b5g\/l.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, a total of 54.5% of participants showed functional iron deficiency at a mean hemoglobin of 14.3\u00a0g\/dl; while, the rate of absolute iron deficiency was 11.8%, at a mean hemoglobin level of 13.4\u00a0g\/dl. At year 5, proportion of newly diagnosed subjects was 18.5% and 4.8%, respectively. Rate of all-cause mortality was 7.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009361); while, median follow-up was 10.1\u00a0years. After adjustment for hemoglobin and major cardiovascular risk factors, the hazard ratio with 95% confidence interval of the association of iron deficiency with mortality was 1.3 (1.0\u20131.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) for the functional definition, and 1.9 (1.3\u20132.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) for absolute iron deficiency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Iron deficiency is very common in the apparently healthy general population and independently associated with all-cause mortality in the mid to long term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphic abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-020-01631-y","type":"journal-article","created":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T14:02:42Z","timestamp":1585144962000},"page":"1352-1357","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Iron deficiency is a common disorder in general population and independently predicts all-cause mortality: results from the Gutenberg Health Study"],"prefix":"10.1007","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9041-3922","authenticated-orcid":false,"given":"Benedikt","family":"Schrage","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"R\u00fcbsamen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Pfeiffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp S.","family":"Wild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Beutel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Schmidtmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemarie","family":"Lott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Zeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl J.","family":"Lackner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahir","family":"Karakas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,25]]},"reference":[{"key":"1631_CR1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.cell.2010.06.028","volume":"142","author":"MW Hentze","year":"2010","unstructured":"Hentze MW, Muckenthaler MU, Galy B, Camaschella C (2010) Two to tango: regulation of Mammalian iron metabolism. 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The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results. All other authors declare no relevant conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}