Farag Tamer H, Stoltzfus Rebecca J, Khalfan Sabra S, Tielsch James M
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Am J Trop Med Hyg. 2007 Mar;76(3):541-8.
Helicobacter pylori infection has recently been associated with iron deficiency and anemia in developed countries. To determine the association of H. pylori and anemia in a tropical region, we measured hemoglobin concentration (Hb) and H. pylori infection by the 13C urea breath test among 857 pregnant women attending antenatal care clinics. Parasitology, anthropometry, obstetric history, sociodemographic and dietary variables were also assessed. Logistic regression showed an odds ratio of 7.63 (95% confidence interval=1.73-33.55) for H. pylori infection comparing women with and without severe anemia (Hb<7 g/dL), controlling for hookworm infection, body mass index and parity, but only among women with a diet low in foods containing heme iron. Infection with H. pylori with low bacterial load was associated with lower Hb concentration while high bacterial load was associated with higher Hb concentration. Further research is needed to establish causality because high worldwide prevalence means that even a small associated risk would be of public health significance.
在发达国家，幽门螺杆菌感染最近被认为与缺铁和贫血有关。为了确定热带地区幽门螺杆菌与贫血之间的关联，我们对857名到产前护理诊所就诊的孕妇进行了13C尿素呼气试验，以测量血红蛋白浓度（Hb）和幽门螺杆菌感染情况。还评估了寄生虫学、人体测量学、产科病史、社会人口统计学和饮食变量。逻辑回归显示，在控制钩虫感染、体重指数和产次的情况下，比较有和没有严重贫血（Hb<7 g/dL）的女性，幽门螺杆菌感染的比值比为7.63（95%置信区间=1.73 - 33.55），但仅在血红素铁含量低的食物摄入较少的女性中如此。低细菌载量的幽门螺杆菌感染与较低的Hb浓度相关，而高细菌载量与较高的Hb浓度相关。由于全球患病率高，即使是很小的相关风险也具有公共卫生意义，因此需要进一步研究以确定因果关系。
