Kotzé Sebastian R, Pedersen Ole B, Petersen Mikkel S, Sørensen Erik, Manh Dinh Khoa, Agergård Kaspersen Kathrine, Rigas Andreas S, Hjalgrim Henrik, Rostgaard Klaus, Edgren Gustaf, Ullum Henrik, Erikstrup Christian
Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark.
Transfusion. 2017 Mar;57(3):571-577. doi: 10.1111/trf.13931. Epub 2016 Nov 29.
Low hemoglobin (Hb) is associated with poor general health and adverse outcomes in a wide range of diseases. However, a link between Hb levels and the risk of infection among healthy individuals has yet to be investigated.
Using data from the Scandinavian Donations and Transfusions database, 497,390 donors were followed after 5,458,499 donations in health registers. With 1,339,362 person-years of follow-up, Andersen-Gill Cox regression was used to study the association of Hb levels below deferral thresholds, very low Hb levels (in the lowest 0.1 percentile), and declining Hb levels with the risk of infection as measured by hospital or outpatient contact for infection and filling of prescription for antimicrobials, respectively, within 3 months of donation. Analyses were stratified by sex, menopausal status, and frequency of donation.
Hb levels below deferral thresholds were not associated with a risk of hospital contact for infection among premenopausal women (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.95-1.14), postmenopausal women (HR, 0.77; 95% CI, 0.54-1.11), or men (HR, 0.97; 95% CI, 0.81-1.16), nor was there any association with hospital contact for very low Hb levels or patterns of declining Hb levels. However, subthreshold Hb levels were associated with a reduced risk of antimicrobial prescriptions among premenopausal women (HR, 0.92; 95% CI, 0.91-0.93), postmenopausal women (HR, 0.93; 95% CI, 0.89-0.97), and men (HR, 0.91; 95% CI, 0.88-0.94).
Neither Hb levels below deferral thresholds nor very low or declining Hb levels were associated with an increased risk of infection. This is reassuring, because blood donation can lead to lower Hb levels.
低血红蛋白（Hb）与多种疾病的总体健康状况不佳及不良结局相关。然而，Hb水平与健康个体感染风险之间的联系尚未得到研究。
利用斯堪的纳维亚捐赠与输血数据库的数据，在健康登记册中对497,390名捐赠者进行了5,458,499次捐赠后的随访。随访时间为1,339,362人年，采用Andersen-Gill Cox回归分析，研究低于延期阈值的Hb水平、极低Hb水平（最低0.1百分位数）以及Hb水平下降与感染风险之间的关联，感染风险分别通过捐赠后3个月内因感染的住院或门诊接触以及抗菌药物处方的开具来衡量。分析按性别、绝经状态和捐赠频率进行分层。
低于延期阈值的Hb水平与绝经前女性（风险比[HR]，1.04；95%置信区间[CI]，0.95 - 1.14）、绝经后女性（HR，0.77；95% CI，0.54 - 1.11）或男性（HR，0.97；95% CI，0.81 - 1.16）因感染的住院接触风险无关，极低Hb水平或Hb水平下降模式与住院接触也无关联。然而，低于阈值的Hb水平与绝经前女性（HR，0.92；95% CI，0.91 - 0.93）、绝经后女性（HR，0.93；95% CI，0.89 - 0.97）和男性（HR，0.91；95% CI，0.88 - 0.94）抗菌药物处方风险降低相关。
低于延期阈值的Hb水平、极低或下降的Hb水平均与感染风险增加无关。这令人安心，因为献血会导致Hb水平降低。
