Iron deficiency and infection risk in Danish blood donors

Nanna Brøns; Kathrine Agergård Kaspersen; Jakob Thaning Bay; Joseph Dowsett; Christian Erikstrup; Henrik Hjalgrim; Bitten Aagaard; Christina Mikkelsen; Susan Mikkelsen; Ole Birger Pedersen; Klaus Rostgaard; Michael Schwinn; Erik Sørensen; Andreas Stribolt Rigas; Andreas Glenthøj; Sisse Rye Ostrowski

doi:10.1111/trf.18105

Iron deficiency and infection risk in Danish blood donors

Nanna Brøns, Kathrine Agergård Kaspersen, Jakob Thaning Bay, Joseph Dowsett, Christian Erikstrup, Henrik Hjalgrim, Bitten Aagaard, Christina Mikkelsen, Susan Mikkelsen, Ole Birger Pedersen, Klaus Rostgaard, Michael Schwinn, Erik Sørensen, Andreas Stribolt Rigas, Andreas Glenthøj, Sisse Rye Ostrowski

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: We aimed to investigate if iron deficiency was associated with infection susceptibility in a large cohort of healthy individuals.

STUDY DESIGN AND METHODS: 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).

RESULTS: 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.

CONCLUSION: 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.

Original language	English
Journal	Transfusion
Volume	65
Issue	2
Pages (from-to)	286-296
Number of pages	11
ISSN	0041-1132
DOIs	https://doi.org/10.1111/trf.18105
Publication status	Published - Feb 2025

Keywords

blood donors
ferritin
infection
iron deficiency

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10.1111/trf.18105

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@article{227f0d4f1ed64848a8a2ee12dcb1d62f,

title = "Iron deficiency and infection risk in Danish blood donors",

abstract = "BACKGROUND: We aimed to investigate if iron deficiency was associated with infection susceptibility in a large cohort of healthy individuals.STUDY DESIGN AND METHODS: 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).RESULTS: 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.CONCLUSION: 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.",

keywords = "blood donors, ferritin, infection, iron deficiency",

author = "Nanna Br{\o}ns and Kaspersen, {Kathrine Agerg{\aa}rd} and Bay, {Jakob Thaning} and Joseph Dowsett and Christian Erikstrup and Henrik Hjalgrim and Bitten Aagaard and Christina Mikkelsen and Susan Mikkelsen and Pedersen, {Ole Birger} and Klaus Rostgaard and Michael Schwinn and Erik S{\o}rensen and Rigas, {Andreas Stribolt} and Andreas Glenth{\o}j and Ostrowski, {Sisse Rye}",

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year = "2025",

month = feb,

doi = "10.1111/trf.18105",

language = "English",

volume = "65",

pages = "286--296",

journal = "Transfusion",

issn = "0041-1132",

publisher = "John Wiley & Sons Inc.",

number = "2",

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TY - JOUR

T1 - Iron deficiency and infection risk in Danish blood donors

AU - Brøns, Nanna

AU - Kaspersen, Kathrine Agergård

AU - Bay, Jakob Thaning

AU - Dowsett, Joseph

AU - Erikstrup, Christian

AU - Hjalgrim, Henrik

AU - Aagaard, Bitten

AU - Mikkelsen, Christina

AU - Mikkelsen, Susan

AU - Pedersen, Ole Birger

AU - Rostgaard, Klaus

AU - Schwinn, Michael

AU - Sørensen, Erik

AU - Rigas, Andreas Stribolt

AU - Glenthøj, Andreas

AU - Ostrowski, Sisse Rye

PY - 2025/2

Y1 - 2025/2

N2 - BACKGROUND: We aimed to investigate if iron deficiency was associated with infection susceptibility in a large cohort of healthy individuals.STUDY DESIGN AND METHODS: 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).RESULTS: 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.CONCLUSION: 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.

AB - BACKGROUND: We aimed to investigate if iron deficiency was associated with infection susceptibility in a large cohort of healthy individuals.STUDY DESIGN AND METHODS: 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).RESULTS: 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.CONCLUSION: 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.

KW - blood donors

KW - ferritin

KW - infection

KW - iron deficiency

UR - http://www.scopus.com/inward/record.url?scp=85214796780&partnerID=8YFLogxK

U2 - 10.1111/trf.18105

DO - 10.1111/trf.18105

M3 - Journal article

C2 - 39807019

SN - 0041-1132

VL - 65

SP - 286

EP - 296

JO - Transfusion

JF - Transfusion

IS - 2

ER -

Iron deficiency and infection risk in Danish blood donors

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