Chang Yen-Liang, Hung Shih-Han, Ling Wells, Lin Herng-Ching, Li Hsien-Chang, Chung Shiu-Dong
Department of Otolaryngology Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan ; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan.
PLoS One. 2013 Dec 9;8(12):e82952. doi: 10.1371/journal.pone.0082952. eCollection 2013.
Very little is known about the relationship between non-sickle cell anemia and stroke. The purpose of this study is to evaluate the association of iron-deficiency anemia (IDA) with stroke based on a nationwide coverage database in Taiwan.
The case-control study subjects were obtained from the Taiwanese Longitudinal Health Insurance Database 2000. We included 51,093 subjects with stroke as cases and randomly selected 153,279 controls (3 controls per case) in this study.Separate conditional logistic regression analyses were used to calculate the odds ratio (OR) for having been previously diagnosed with IDA between cases and controls.We further analyzed the association between stroke and IDA by stroke subtype.
Results showed that 3,685 study subjects (1.81%) had been diagnosed with IDA prior to the index date; of those subjects, 1,268 (2.48%) were cases and 2,417 (1.58%) were controls (p<0.001). Conditional logistic regression shows that the OR of having previously received an IDA diagnosis among cases was 1.49 (95% CI: 1.391.60; p < 0.01) that of controls after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, atrial fibrillation, heart failure, hyperlipidemia, tobacco use disorder, and alcohol abuse/alcohol dependency syndrome. Furthermore, the adjusted OR of prior IDA for cases with ischemic stroke was found to be 1.45 (95% CI: 1.341.58) compared to controls. However, we did not find any significant relationship between IDA and subarachnoid/intracerebral hemorrhage even adjusting for other confounding factors (OR=1.17, 95% CI=0.97~1.40).
There is a significant association between prior IDA and ischemic stroke.
关于非镰状细胞性贫血与中风之间的关系，人们了解甚少。本研究的目的是基于台湾的一个全国性覆盖数据库，评估缺铁性贫血（IDA）与中风之间的关联。
病例对照研究对象来自台湾纵向健康保险数据库2000。在本研究中，我们纳入了51093名中风患者作为病例，并随机选取了153279名对照（病例与对照之比为1:3）。采用单独的条件逻辑回归分析来计算病例组和对照组之前被诊断为IDA的比值比（OR）。我们还按中风亚型进一步分析了中风与IDA之间的关联。
结果显示，3685名研究对象（1.81%）在索引日期之前被诊断为IDA；在这些对象中，1268名（2.48%）为病例，2417名（1.58%）为对照（p<0.001）。条件逻辑回归显示，在调整了月收入、地理区域、高血压、糖尿病、冠心病、心房颤动、心力衰竭、高脂血症、烟草使用障碍和酒精滥用/酒精依赖综合征后，病例组之前接受IDA诊断的OR为1.49（95%CI：1.39至1.60；p<0.01），对照组为1.49。此外，与对照组相比，缺血性中风病例之前IDA的调整后OR为1.45（95%CI：1.341.58）。然而，即使调整了其他混杂因素，我们也未发现IDA与蛛网膜下腔/脑出血之间存在任何显著关系（OR=1.17，95%CI=0.97~1.40）。
之前的IDA与缺血性中风之间存在显著关联。
