Leumit Research Institute, Leumit Health Services, Tel Aviv-Yafo, Israel.
School of Public Health and Family Medicine Department, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
Front Immunol. 2023 Sep 11;14:1232560. doi: 10.3389/fimmu.2023.1232560. eCollection 2023.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked enzymatic disorder that is particularly prevalent in Africa, Asia, and the Middle East. This study aimed to assess the long-term health risks associated with G6PD deficiency.
A retrospective cohort study was conducted using data from a national healthcare provider in Israel (Leumit Health Services). A total of 7,473 G6PD-deficient individuals were matched with 29,892 control subjects in a 1:4 ratio, based on age, gender, socioeconomic status, and ethnic groups. The exposure of interest was recorded G6PD diagnosis or positive G6PD diagnostic test. The main outcomes and measures included rates of infectious diseases, allergic conditions, and autoimmune disorders between 2002 and 2022.
Significantly increased rates were observed for autoimmune disorders, infectious diseases, and allergic conditions in G6PD-deficient individuals compared to the control group. Specifically, notable increases were observed for rheumatoid arthritis (odds ratio [OR] 2.41, p<0.001), systemic lupus erythematosus (OR 4.56, p<0.001), scleroderma (OR 6.87, p<0.001), pernicious anemia (OR 18.70, p<0.001), fibromyalgia (OR 1.98, p<0.001), Graves' disease (OR 1.46, p=0.001), and Hashimoto's thyroiditis (OR 1.26, p=0.001). These findings were supported by elevated rates of positive autoimmune serology and higher utilization of medications commonly used to treat autoimmune conditions in the G6PD-deficient group.
In conclusion, individuals with G6PD deficiency are at a higher risk of developing autoimmune disorders, infectious diseases, and allergic conditions. This large-scale observational study provides valuable insights into the comprehensive association between G6PD deficiency and infectious and immune-related diseases. The findings emphasize the importance of considering G6PD deficiency as a potential risk factor in clinical practice and further research is warranted to better understand the underlying mechanisms of these associations.
葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症是一种 X 连锁的酶缺乏症，在非洲、亚洲和中东地区尤为普遍。本研究旨在评估 G6PD 缺乏症相关的长期健康风险。
采用以色列国家医疗服务提供者（Leumit 健康服务）的数据进行回顾性队列研究。根据年龄、性别、社会经济地位和种族，将 7473 名 G6PD 缺乏症个体与 29892 名对照个体以 1:4 的比例进行匹配。感兴趣的暴露是记录 G6PD 诊断或 G6PD 诊断性检测阳性。主要结局和测量指标包括 2002 年至 2022 年期间传染病、过敏和自身免疫性疾病的发生率。
与对照组相比，G6PD 缺乏症个体的自身免疫性疾病、传染病和过敏疾病发生率显著升高。具体而言，类风湿关节炎（比值比 [OR] 2.41，p<0.001）、系统性红斑狼疮（OR 4.56，p<0.001）、硬皮病（OR 6.87，p<0.001）、恶性贫血（OR 18.70，p<0.001）、纤维肌痛（OR 1.98，p<0.001）、格雷夫斯病（OR 1.46，p=0.001）和桥本甲状腺炎（OR 1.26，p=0.001）的发生率明显升高。这些发现得到了 G6PD 缺乏组自身免疫性血清学阳性率升高和用于治疗自身免疫性疾病的药物使用率升高的支持。
总之，G6PD 缺乏症个体患自身免疫性疾病、传染病和过敏疾病的风险较高。这项大规模观察性研究提供了 G6PD 缺乏症与感染和免疫相关疾病之间全面关联的有价值的见解。研究结果强调了在临床实践中考虑 G6PD 缺乏症作为潜在风险因素的重要性，进一步的研究是必要的，以更好地了解这些关联的潜在机制。
