肯尼亚医学研究所Sarah H. Atkinson和John Muthii Muriuki课题组合作发现疟疾是非洲儿童铁缺乏症（ID）原因。相关论文于2021年2月22日发表在《自然-医学》杂志上。
为了检验疟疾可能导致ID的假说，他们使用镰状细胞性状（HbAS，rs334）（孟德尔随机分析中的工具变量），该遗传变异赋予了针对疟疾的特异性保护。 在非洲疟疾流行国家的儿童中，HbAS与ID降低30％有关（n = 7,453），但在无疟疾地区的个体中却没有（n = 3,818）。遗传预测的疟疾风险与疟疾对数发病率每增加一个单位的ID比值比为2.65相关。 这表明，将疟疾发作风险降低一半的干预措施将使非洲儿童中ID的患病率降低49％。
据介绍，ID是非洲儿童中常见且相互关联的公共卫生问题。 观测数据表明，中断疟疾传播会降低ID的患病率。
附：英文原文
Title: Malaria is a cause of iron deficiency in African children
Author: John Muthii Muriuki, Alexander J. Mentzer, Ruth Mitchell, Emily L. Webb, Anthony O. Etyang, Catherine Kyobutungi, Alireza Morovat, Wandia Kimita, Francis M. Ndungu, Alex W. Macharia, Caroline J. Ngetsa, Johnstone Makale, Swaib A. Lule, Solomon K. Musani, Laura M. Raffield, Clare L. Cutland, Sodiomon B. Sirima, Amidou Diarra, Alfred B. Tiono, Michal Fried, Moses Gwamaka, Seth Adu-Afarwuah, James P. Wirth, Rita Wegmller, Shabir A. Madhi, Robert W. Snow, Adrian V. S. Hill, Kirk A. Rockett, Manjinder S. Sandhu, Dominic P. Kwiatkowski, Andrew M. Prentice, Kendra A. Byrd, Alex Ndjebayi, Christine P. Stewart, Reina Engle-Stone, Tim J. Green, Crystal D. Karakochuk, Parminder S. Suchdev, Philip Bejon, Patrick E. Duffy, George Davey Smith, Alison M. Elliott, Thomas N. Williams, Sarah H. Atkinson
Issue&Volume: 2021-02-22
Abstract: Malaria and iron deficiency (ID) are common and interrelated public health problems in African children. Observational data suggest that interrupting malaria transmission reduces the prevalence of ID1. To test the hypothesis that malaria might cause ID, we used sickle cell trait (HbAS, rs334), a genetic variant that confers specific protection against malaria2, as an instrumental variable in Mendelian randomization analyses. HbAS was associated with a 30% reduction in ID among children living in malaria-endemic countries in Africa (n=7,453), but not among individuals living in malaria-free areas (n=3,818). Genetically predicted malaria risk was associated with an odds ratio of 2.65 for ID per unit increase in the log incidence rate of malaria. This suggests that an intervention that halves the risk of malaria episodes would reduce the prevalence of ID in African children by 49%.
DOI: 10.1038/s41591-021-01238-4
Source: https://www.nature.com/articles/s41591-021-01238-4
Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：87.241
官方网址：https://www.nature.com/nm/
投稿链接：https://mts-nmed.nature.com/cgi-bin/main.plex
本期文章：《自然—医学》：Online/在线发表
