Hung Shih-Han, Lin Herng-Ching, Chung Shiu-Dong
aDepartment of Otolaryngology, Taipei Medical University Hospital bSleep Research Center, Taipei Medical University Hospital, Taipei cDepartment of Surgery, Division of Urology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Blood Coagul Fibrinolysis. 2015 Jun;26(4):368-72. doi: 10.1097/MBC.0000000000000249.
Although iron-deficiency anemia (IDA) as a rare cause of cerebral sinus thrombosis was supported by several studies, the relationship between IDA and venous thromboembolisms (VTEs) remains unclear. In this study, we evaluated the association between IDA and subsequent VTEs based on a population-based coverage database. We retrieved data for this case-control study from the Taiwan Longitudinal Health Insurance Database 2000. In total, 2522 cases with VTE and 12 610 randomly selected controls were included. A conditional logistic regression was used to examine the association of VTEs with previously diagnosed IDA. The χ test indicated that there was a significant difference in the prevalence of prior IDA between subjects with a VTE and the controls (3.41 vs. 2.06%, respectively, P < 0.001). The conditional logistic regression analysis showed that the odds ratio (OR) of previous IDA for subjects with a VTE was 1.43 [95% confidence interval (CI): 1.10-1.87] compared with the controls after adjusting for monthly income, geographic region, urbanization level, cancer, inflammatory bowel disease, heart failure, hypertension, diabetes, coronary heart disease, hyperlipidemia, renal disease, obesity, and whether or not a subject was hospitalized and whether or not a subject had suffered from a fracture within 1 year prior to the index date. The adjusted OR for prior IDA in subjects with deep-vein thrombosis was 1.43 (95% CI: 1.08-1.90) compared with the controls. However, there was no significant difference in the adjusted OR of prior IDA between subjects with a pulmonary embolism and the controls (OR: 1.10; 95% CI: 0.63-1.92). We concluded that there was an association between IDA and VTEs.
尽管多项研究支持缺铁性贫血（IDA）是脑静脉窦血栓形成的罕见病因，但IDA与静脉血栓栓塞症（VTE）之间的关系仍不明确。在本研究中，我们基于一个人群覆盖数据库评估了IDA与后续VTE之间的关联。我们从台湾2000年纵向健康保险数据库中检索了该病例对照研究的数据。总共纳入了2522例VTE患者和12610例随机选择的对照。采用条件逻辑回归分析来检验VTE与先前诊断的IDA之间的关联。χ检验表明，VTE患者和对照人群中既往IDA的患病率存在显著差异（分别为3.41%和2.06%，P<0.001）。条件逻辑回归分析显示，在调整了月收入、地理区域、城市化水平、癌症、炎症性肠病、心力衰竭、高血压、糖尿病、冠心病、高脂血症、肾病、肥胖以及在索引日期前1年内是否住院和是否发生骨折等因素后，VTE患者既往IDA的比值比（OR）为1.43 [95%置信区间（CI）：1.10 - 1.87]。与对照相比，深静脉血栓形成患者既往IDA的调整后OR为1.43（95% CI：1.08 - 1.90）。然而，肺栓塞患者和对照人群中既往IDA的调整后OR无显著差异（OR：1.10；95% CI：0.63 - 1.92）。我们得出结论，IDA与VTE之间存在关联。
