Brøns Nanna, Kaspersen Kathrine Agergård, Bay Jakob Thaning, Dowsett Joseph, Erikstrup Christian, Hjalgrim Henrik, Aagaard Bitten, Mikkelsen Christina, Mikkelsen Susan, Pedersen Ole Birger, Rostgaard Klaus, Schwinn Michael, Sørensen Erik, Rigas Andreas Stribolt, Glenthøj Andreas, Ostrowski Sisse Rye
Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
Transfusion. 2025 Feb;65(2):286-296. doi: 10.1111/trf.18105. Epub 2025 Jan 14.
We aimed to investigate if iron deficiency was associated with infection susceptibility in a large cohort of healthy individuals.
The Danish Blood Donor Study is a national ongoing prospective study of blood donors. We included 94,628 donors with 338,290 ferritin measurements from March 2010 to October 2022. We performed sex-stratified multivariable Cox regression to estimate the risk of infection for iron-deficient donors compared with iron-replete donors. Infection was defined as either a filled prescription of antibiotics registered in the Danish National Prescription Registry (NPR), or a hospital contact with infection registered in the Danish National Patient Registry (DNPR).
Iron deficiency was associated with an overall increased risk of infection (defined as prescriptions of antibiotics) for women (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.02-1.15). Subgroup analyses showed an increased risk of respiratory tract infections (HR 1.16, 95% CI 1.05-1.28) and urinary tract infections (HR 1.16, 95% CI 1.04-1.29). Iron deficiency was not associated with overall risk of infection for men (HR 1.02, 95% CI 0.82-1.28). For both men and women, no association was found between iron deficiency and hospital contacts for infections.
Iron deficiency was associated with an increased risk of infection in female blood donors. However, effect sizes were small, and there was no association between iron deficiency and hospital contacts for infection. Consequently, risk of infection should not be considered an apprehension regarding blood donation. These findings support the role of iron in immune function and monitorization of iron stores in female blood donors.
我们旨在调查缺铁是否与一大群健康个体的感染易感性相关。
丹麦献血者研究是一项正在进行的全国性献血者前瞻性研究。我们纳入了2010年3月至2022年10月期间的94628名献血者，共进行了338290次铁蛋白测量。我们进行了按性别分层的多变量Cox回归，以估计缺铁献血者与铁充足献血者相比的感染风险。感染定义为丹麦国家处方登记处（NPR）登记的抗生素处方，或丹麦国家患者登记处（DNPR）登记的因感染而住院。
缺铁与女性总体感染风险（定义为抗生素处方）增加相关（风险比[HR]1.08，95%置信区间[CI]1.02 - 1.15）。亚组分析显示呼吸道感染风险增加（HR 1.16，95% CI 1.05 - 1.28）和尿路感染风险增加（HR 1.16，95% CI 1.04 - 1.29）。缺铁与男性总体感染风险无关（HR 1.02，95% CI 0.82 - 1.28）。对于男性和女性，缺铁与因感染而住院均无关联。
缺铁与女性献血者感染风险增加相关。然而，效应量较小，且缺铁与因感染而住院无关联。因此，感染风险不应被视为献血的顾虑。这些发现支持了铁在免疫功能中的作用以及对女性献血者铁储备的监测。
