目前尚不清楚遗传性血色素沉着症患者和低或高血浆铁患者的感染风险是否增加。转铁蛋白饱和度,或者铁蛋白.因此,我们测试了高铁和低铁,转铁蛋白饱和度,和铁蛋白通过HFE基因型观察和遗传与感染风险相关。我们研究了142,188名丹麦普通人群。熨斗,转铁蛋白饱和度,和铁蛋白分别在136,656,136,599和38,020个人中进行了测量,分别。对132,542名个体的HFE进行了C282Y和H63D的基因分型。研究登记后的中位随访时间为8年(范围:0-38年),医院和急诊室住院感染(n=20,394人)使用国家患者登记册,覆盖所有丹麦医院。任何感染的危险比在血浆铁≤第5或≥第95百分位数的个体中分别为1.20(95CI:1.12-1.28)和1.14(1.07-1.22)。转铁蛋白饱和度的结果相似,而铁蛋白≤5百分位数或≥95百分位数的个体感染风险并未增加。对于任何感染,C282Y纯合子与非携带者的危险比为1.40(1.16-1.68),1.69(1.05-2.73)用于脓毒症,传染病死亡为2.34(1.41-3.90)。血浆铁正常的C282Y纯合子的感染风险增加,转铁蛋白饱和度,或者铁蛋白,在没有肝病的C282Y纯合子中,糖尿病,和/或心力衰竭。总之,低和高血浆铁和转铁蛋白饱和度与感染风险增加独立相关.C282Y纯合子感染的风险增加,脓毒症,和感染死亡。即使是具有正常铁的C282Y纯合子,转铁蛋白饱和度,或者铁蛋白,目前不推荐用于基因分型,增加了感染风险。
UNASSIGNED: It is unclear whether risk of infection is increased in individuals with hereditary hemochromatosis and in individuals with low or high plasma iron, transferrin saturation, or ferritin. Therefore, we tested whether high and low iron, transferrin saturation, and ferritin are associated with risk of infections observationally and genetically through HFE genotypes. We studied 142 188 Danish general population individuals. Iron, transferrin saturation, and ferritin were measured in 136 656, 136 599, and 38 020 individuals, respectively. HFE was genotyped for C282Y and H63D in 132 542 individuals. Median follow-up after
study enrollment was 8 years (range, 0-38) for hospital and emergency room admissions with infections (n = 20 394) using the National Patient Register, covering all Danish hospitals. Hazard ratios for any infection were 1.20 (95% confidence interval [CI], 1.12-1.28) and 1.14 (95% CI, 1.07-1.22) in individuals with plasma iron ≤5th or ≥95th percentile compared with individuals with iron from 26th to 74th percentiles. Findings for transferrin saturation were similar, whereas infection risk was not increased in individuals with ferritin ≤5th or ≥95th percentile. Hazard ratios in C282Y homozygotes vs noncarriers were 1.40 (95% CI, 1.16-1.68) for any infection, 1.69 (95% CI, 1.05-2.73) for sepsis, and 2.34 (95% CI, 1.41-3.90) for death from infectious disease. Risk of infection was increased in C282Y homozygotes with normal plasma iron, transferrin saturation, or ferritin, and in C282Y homozygotes without liver disease, diabetes, and/or heart failure. In summary, low and high plasma iron and transferrin saturation were independently associated with increased infection risk. C282Y homozygotes had increased risk of any infection, sepsis, and death from infections. Even C282Y homozygotes with normal iron, transferrin saturation, or ferritin, not currently recommended for genotyping, had increased infection risk.