Iron Deficiency and Helicobacter pylori Infection in the United States

Abstract

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

cagA, cytotoxin-associated gene A, IDA, iron-deficiency anemia, NHANES, National Health and Nutrition Examination Survey