Association of iron deficiency anemia with tuberculosis in Taiwan: A nationwide population-based study
Association of iron deficiency anemia with tuberculosis in Taiwan: A nationwide population-based study
复制标题
DOI：
10.1371/journal.pone.0221908
复制
发表时间：
2019-08-30
期刊：
影响因子：
3.7
通讯作者：
Wei, James Cheng-Chung
中科院分区：
文献类型：
--
作者：
Chu, Kuo-An;Hsu, Chun-Hsiang;Wei, James Cheng-Chung
背景缺铁与细胞免疫力下降有关，这可能会使缺铁性贫血（IDA）患者患结核病（TB）的风险增加。本研究调查了台湾新诊断的 IDA 与结核感染之间的关系。方法该研究纳入了 2000-2012 年国家数据库中 21,946 名 IDA 患者和 87,555 名非 IDA 对照者的数据。 IDA 和非 IDA 受试者在年龄、性别和指数年份上按 1:4 匹配。随访期定义为从首次IDA诊断到发生结核病之日或2013年12月31日。以对照组为参考，采用Cox比例风险模型估计风险比和95%置信区间。结果与对照组相比，IDA组结核病的调整后风险比为1.99（95%置信区间为1.77-2.25）。亚组分析显示，无论性别、各年龄组，以及患有糖尿病、高脂血症、高血压、癌症、慢性阻塞性肺疾病、乙型肝炎病毒感染的患者，IDA组的结核病发病率均显着较高。在新诊断出 IDA 后的 5 年内，无论性别还是所有年龄组，这种相关性均显着增强。 结论 IDA 组的结核病发病率较高，特别是对于有合并症的患者。
BackgroundIron deficiency is associated with decreased cellular immunity, which may predispose patients with iron deficiency anemia (IDA) to increased risk of developing tuberculosis (TB). This study investigated the relationship between newly diagnosed IDA and TB infection in Taiwan.MethodsThe study included data on 21,946 patients with incident IDA and 87,555 non-IDA controls from a national database covering the period 2000-2012. IDA and non-IDA subjects were matched 1: 4 on age, gender, and index year. The follow-up period was defined as the time from the initial IDA diagnosis to the date of developing TB or 31 December 2013. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals, with the control group as the reference.ResultsThe adjusted hazard ratio of TB for the IDA group was 1.99 (95% confidence interval, 1.77-2.25) compared with the control group. The subgroup analysis showed that for both genders, all age groups, and patients with diabetes mellitus, hyperlipidemia, hypertension, cancer, chronic obstructive pulmonary disease, and hepatitis B virus infection, the IDA group had significantly higher TB incidence. The association was significantly stronger within the 5 years after new IDA diagnosis for both genders and all age groups.ConclusionsHigher TB incidence was discovered in the IDA group, especially for patients with comorbidities.