title: Association between ischemic stroke and iron-deficiency anemia: a population-based study.
abstract: BACKGROUND
  Very little is known about the relationship between non-sickle cell anemia and stroke. The purpose of this study is to evaluate the association of iron-deficiency anemia (IDA) with stroke based on a nationwide coverage database in Taiwan.
  
  
  METHODS
  The case-control study subjects were obtained from the Taiwanese Longitudinal Health Insurance Database 2000. We included 51,093 subjects with stroke as cases and randomly selected 153,279 controls (3 controls per case) in this study.Separate conditional logistic regression analyses were used to calculate the odds ratio (OR) for having been previously diagnosed with IDA between cases and controls.We further analyzed the association between stroke and IDA by stroke subtype.
  
  
  RESULTS
  Results showed that 3,685 study subjects (1.81%) had been diagnosed with IDA prior to the index date; of those subjects, 1,268 (2.48%) were cases and 2,417 (1.58%) were controls (p<0.001). Conditional logistic regression shows that the OR of having previously received an IDA diagnosis among cases was 1.49 (95% CI: 1.39~1.60; p < 0.01) that of controls after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, atrial fibrillation, heart failure, hyperlipidemia, tobacco use disorder, and alcohol abuse/alcohol dependency syndrome. Furthermore, the adjusted OR of prior IDA for cases with ischemic stroke was found to be 1.45 (95% CI: 1.34~1.58) compared to controls. However, we did not find any significant relationship between IDA and subarachnoid/intracerebral hemorrhage even adjusting for other confounding factors (OR=1.17, 95% CI=0.97~1.40).
  
  
  CONCLUSIONS
  There is a significant association between prior IDA and ischemic stroke.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan ; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
authors.forename: Yen-Liang
authors.initials: YL
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Shih-Han
authors.initials: SH
authors.lastname: Hung
authors.affiliation: Department of Psychology, Saint Louis University, Saint Louis, Missouri, United States of America.
authors.forename: Wells
authors.initials: W
authors.lastname: Ling
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan ; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsien-Chang
authors.initials: HC
authors.lastname: Li
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan ; Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000453:epidemiology; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology