The Effects Of Oral Iron Treatment On Reactive Oxygen Radicals, Protective Enzymes and Lipid Peroxidation In Women With Iron Deficiency Anemia

Iron deficiency anemia (IDA) is the commonest of deficiency disease in the world. In IDA, hemoglobin synthesis is impaired, nonetheless the production of iron (Fe²) containing proteins such as cytochrom, myoglobin, catalase (CAT), and peroxidase is affected. While oxidative stress can play an important role on the development of IDA, lipid peroxidation may be induced. The aim of the study is to investigate the effects of oral iron treatment on reactive oxygen radicals (ROR), protective enzymes from ROR, and lipid peroxidation in women with IDA. This prospective Phase-IV study was approved by ethical committees of university and the Ministry of Health. Sixty-seven women (mean age 34±11 years) with IDA were enrolled to the study. Inclusion criteria were hemoglobin level < 11 g/dl, serum ferritin level < 16 ng/ml, and iron saturation <15%. Twenty-seven helathy women (mean age 27±7 years) were accepted as control group. Exclusion criteria of control group were anemia, acute and chronic infection, acute and chronic bleeding, pregnancy, malignancy, chronic inflammatory, and renal diseases. In both group, whole blood counts, hydrogen peroxide (H₂0₂) as ROR, glutathione (GSH), superoxide dismutase, glutathione peroxidase, glutathione reductase, CAT for protective enzymes from ROR, and malondialdehyde (MDA) for lipid peroxidation were evaluated. Ferrous fumarate 200 mg/day were given to the patients for 4 weeks. At the end of 4 weeks, all parameters were repeated. All results were compared with SPSS 15.0 using independent and paired t-tests. P values <0.05 were accepted as significant. In women with IDA, the levels of GSH (p<0.001), H₂0₂ (p<0.001), and MDA (p<0.05) were significantly higher than controls, but other parameters were not different in both groups (p>0.05). At the end of treatment, GSH and H₂0₂ levels significantly decreased (p<0.001 for both), but other parameters did not changed (p>0.05). In women with IDA, while H₂0₂ increased, lipid peroxidation was induced. Compensation of oxidative stress were ensured by GSH. Iron treatment reduced oxidative stress, but it did not affect lipid peroxidation and protective enzymes from ROR.