American Journal of Epidemiology Advance Access originally published online on November 23, 2005
American Journal of Epidemiology 2006 163(2):127-134; doi:10.1093/aje/kwj018
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Original Contribution |
Iron Deficiency and Helicobacter pylori Infection in the United States
1 Division of Epidemiology, University of Texas School of Public Health, El Paso, TX
2 Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, El Paso, TX
3 Division of Biostatistics, University of Texas School of Public Health, El Paso, TX
4 Gastroenterology Section, Baylor College of Medicine, Houston, TX
Reprint requests to Dr. Victor M. Cardenas, School of Public Health, University of Texas at Houston, 1100 Stanton Avenue, Suite 110F, El Paso, TX 79902 (e-mail: victor.cardenas{at}uth.tmc.edu).
Using data from the current National Health and Nutrition Examination Survey (1999–2000), the authors assessed whether Helicobacter pylori infection is associated with iron deficiency and iron-deficiency anemia (IDA) in the United States. Iron deficiency was defined as at least two abnormal results out of three biomarkers of iron stores. IDA was defined as a low hemoglobin level in the presence of iron deficiency. H. pylori infection was measured by serology. Complex survey estimators were used in the analysis. For 7,462 survey participants aged 
3 years, H. pylori infection was associated with decreased serum ferritin levels (percent change = –13.9%, 95% confidence interval (CI): –19.5, –8.0) but not with levels of free erythrocyte protoporphyrin, transferrin saturation, or hemoglobin (percent change = 1.5%, –2.8%, and –1.1%, respectively). Multinomial logistic regression analyses indicated that H. pylori infection was associated with the prevalence of IDA (prevalence odds ratio (POR) = 2.6, 95% CI: 1.5, 4.6) and, to a lesser degree, other types of anemia (POR = 1.3, 95% CI: 1.0, 1.7). H. pylori infection was associated with a 40% increase in the prevalence of iron deficiency (POR = 1.4, 95% CI: 0.9, 2.0) after controlling for relevant covariates. In the United States, H. pylori infection was associated with iron deficiency/IDA regardless of the presence or absence of peptic ulcer disease.
anemia; anemia, iron deficiency; Helicobacter pylori; iron; peptic ulcer
Abbreviations: cagA, cytotoxin-associated gene A; IDA, iron-deficiency anemia; NHANES, National Health and Nutrition Examination Survey
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