Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
Helicobacter. 2010 Oct;15(5):467-72. doi: 10.1111/j.1523-5378.2010.00793.x.
The relationship between H. pylori infection and anemia in childhood is still unclear. The aim of the study was to examine the association between H. pylori infection and anemia or iron deficiency in school-age children and in infants.
Six- to 9-year-old Israeli Arab children (N = 202) and infants (N = 197) were examined for hemoglobin and ferritin levels. ELISA was used to detect H. pylori antigens in stool specimens collected from the participants. Household characteristics were obtained through personal interviews with the mothers.
The prevalence of anemia was 15.5 versus 5.5% in H. pylori-positive and -negative school-age children, respectively and 34.5 versus 29.8% in H. pylori-positive and -negative infants, respectively. The Mantel-Haenszel age-adjusted prevalence ratio (PR) and 95% confidence intervals (CIs) were 1.6 (95%CI 1.0, 2.6). In multivariate analysis controlling for socioeconomic variables, H. pylori infection was associated with 2.8 higher prevalence of anemia only in school-age children: adjusted PR 2.8 (95% CI 0.9, 9.3). The adjusted mean difference in hemoglobin levels between H. pylori infected school-age children and uninfected ones was -0.372 gr/dL (95% CI -0.704, -0.039) (p = .04). The respective mean ferritin difference was -6.74 μg/L (95% CI -13.38, -.011) (p = .04). Such differences were not found in infants.
H. pylori infection is associated with higher prevalence of anemia in school-age children independently of socioeconomic variables. Such association was not observed in infants. These findings are of clinical and public health importance.
幽门螺杆菌感染与儿童期贫血之间的关系尚不清楚。本研究旨在探讨学龄儿童和婴儿中幽门螺杆菌感染与贫血或铁缺乏之间的关联。
对 202 名 6 至 9 岁的以色列阿拉伯学龄儿童和 197 名婴儿进行血红蛋白和铁蛋白水平检测。采用 ELISA 法检测从参与者粪便标本中检测到的幽门螺杆菌抗原。通过与母亲进行个人访谈获得家庭特征。
幽门螺杆菌阳性和阴性学龄儿童贫血患病率分别为 15.5%和 5.5%，幽门螺杆菌阳性和阴性婴儿分别为 34.5%和 29.8%。经年龄调整后的 Mantel-Haenszel 患病率比（PR）及其 95%置信区间（CI）分别为 1.6（95%CI 1.0，2.6）。在校正社会经济变量后进行多变量分析，仅在学龄儿童中，幽门螺杆菌感染与贫血患病率增加 2.8 倍相关：调整后的 PR 为 2.8（95%CI 0.9，9.3）。与未感染的幽门螺杆菌感染的学龄儿童相比，血红蛋白水平的调整平均差异为-0.372 克/分升（95%CI-0.704，-0.039）（p=0.04）。相应的平均铁蛋白差异为-6.74μg/L（95%CI-13.38，-.011）（p=0.04）。在婴儿中未发现这种差异。
在校正社会经济变量后，幽门螺杆菌感染与学龄儿童贫血患病率升高独立相关。在婴儿中未观察到这种关联。这些发现具有临床和公共卫生意义。
