Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.
PLoS One. 2019 Aug 30;14(8):e0221908. doi: 10.1371/journal.pone.0221908. eCollection 2019.
Iron deficiency is associated with decreased cellular immunity, which may predispose patients with iron deficiency anemia (IDA) to increased risk of developing tuberculosis (TB). This study investigated the relationship between newly diagnosed IDA and TB infection in Taiwan.
The study included data on 21,946 patients with incident IDA and 87,555 non-IDA controls from a national database covering the period 2000-2012. IDA and non-IDA subjects were matched 1:4 on age, gender, and index year. The follow-up period was defined as the time from the initial IDA diagnosis to the date of developing TB or 31 December 2013. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals, with the control group as the reference.
The adjusted hazard ratio of TB for the IDA group was 1.99 (95% confidence interval, 1.77-2.25) compared with the control group. The subgroup analysis showed that for both genders, all age groups, and patients with diabetes mellitus, hyperlipidemia, hypertension, cancer, chronic obstructive pulmonary disease, and hepatitis B virus infection, the IDA group had significantly higher TB incidence. The association was significantly stronger within the 5 years after new IDA diagnosis for both genders and all age groups.
Higher TB incidence was discovered in the IDA group, especially for patients with comorbidities.
铁缺乏与细胞免疫功能下降有关，这可能使缺铁性贫血（IDA）患者更容易感染结核病（TB）。本研究调查了台湾地区新诊断的 IDA 与 TB 感染之间的关系。
该研究纳入了 2000 年至 2012 年期间一个全国性数据库中 21946 例新发 IDA 患者和 87555 例非 IDA 对照者的数据。IDA 和非 IDA 患者按年龄、性别和指数年份 1:4 匹配。随访期定义为从最初的 IDA 诊断到发生 TB 或 2013 年 12 月 31 日的时间。采用 Cox 比例风险模型估计风险比和 95%置信区间，以对照组为参照。
与对照组相比，IDA 组发生 TB 的调整后风险比为 1.99（95%置信区间，1.77-2.25）。亚组分析显示，对于男性和女性、所有年龄组以及患有糖尿病、高血脂、高血压、癌症、慢性阻塞性肺疾病和乙型肝炎病毒感染的患者，IDA 组的 TB 发病率均显著升高。在男女两性和所有年龄组中，IDA 诊断后 5 年内这种相关性更强。
IDA 组的 TB 发病率更高，特别是在合并症患者中。
