Main Article Content
Iron deficiency anemia (IDA), a type of anemia with an increasing global frequency, is more common in women than men in the population. In IDA, the sensitivity of erythrocytes to oxidants is increased and their lifespan is shortened. Oxidative stress is an imbalance between free radicals and antioxidant molecules which is one of the potential biochemical mechanisms involved in the pathogenesis of IDA. In our study, we aimed to determine the levels of oxidant and antioxidant markers by assessing the levels of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase-1 (PON-1), and myeloperoxidase (MPO) in women with IDA.
This was a cross-sectional study involving 47 women with IDA aged ³40 years and 47 women volunteers. The levels of TAS, TOS, OSI, PON-1, and MPO were determined spectrophotometrically using appropriate kits. Non-parametric Mann Whitney-U tests were used to analyze the data.
The levels of antioxidants TAS (1.42 mmol Trolox equiv./L) and MPO (54.00 U/L) in the IDA group were significantly lower than in the control group [TAS (1.67 mmol Trolox equiv./L) and MPO (89.00 U/L)] (p=0.000 and p= 0.019, respectively). However, TOS (6.25 ìmol H2O2 equiv./L) level in the IDA group was significantly higher than in the control group (4.13 ìmol H2O2 equiv./L) (p=0.000), but PON-1 was not significantly different between the two groups (p=0.375).
In women with IDA, the oxidant-antioxidant balance is impaired, resulting in oxidative stress. Therefore, IDA in adult women must receive adequate attention in clinical practice.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.The journal allow the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
Paternostro R, Kapzan L, Mandorfer M, et al. Anemia and iron deficiency in compensated and decompensated cirrhosis: prevalence and impact on clinical outcomes. J Gastroenterol Hepatol 2020; 35: 1619-27. doi:10.1111/jgh.14988.
Owaidah T, Al-Numair, N, Al-Suliman A, et al. Iron deficiency and iron deficiency anemia are common epidemiological conditions in Saudi Arabia: report of the National Epidemiological Survey. Anemia 2020;Article ID 6642568. doi: 10.1155/2020/6642568.
Gardner W, Kassebaum N. Global, regional, and national prevalence of anemia and its causes in 204 countries and territories, 1990–2019. Curr Dev Nutr 2020;4:830. doi:10.1093/cdn/nzaa053_035.
Hall JE, Hall ME. Guyton & Hall Textbook of Medical Physiology_3rd SAE-E-book: Third South Asia Edition. Adaption Editor: Vaz M, Kurpad A, Raj T. New Delhi, India : Elsevier, Inc.; 2021.
Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci 2014;19:164–74.
Cronin SJF, Woolf CJ, Weiss G, Penninger JM. The role of iron regulation in immunometabolism and immune-related disease. Front Mol Biosci 2019;6:116. doi:10.3389/fmolb.2019.00116.
Alkadi H. A review on free radicals and antioxidants. Infect Disord Drug Targets 2020;20:16-26. doi: 10.2174/ 1871526518666180628124323.
Andries A, Rozenski J, Vermeersch P, Mekahli D, Van Schepdael A. Recent progress in the LC-MS/MS analysis of oxidative stress biomarkers. Electrophoresis 2021;42:402-28. doi: 10.1002/elps.202000208.
Dogru A, Nazýroglu M, Cig B. Modulator role of infliximab and methotrexate through the transient receptor potential melastatin 2 (TRPM2) channel in neutrophils of patients with rheumatoid arthritis: a pilot study. Arch Med Sci 2019;15:1415–24. doi:10.5114/aoms.2018.79485.
Gedik AH, Çakir E, Vehapoðlu Türkmen A, Özer OF, Kaygusuz SB. Total oxidant and antioxidant status and paraoxonase 1 levels of children with non-cystic fibrosis bronchiectasis. Turk J Med Sci 2020;50:1-7. doi:10.3906/sag1503-99.
Jansen E, Ruskovska T. Serum biomarkers of (anti)oxidant status for epidemiological studies. Int J Mol Sci 2015;16:27378–90. doi:10.3390/ijms161126032
Ndrepepa G. Myeloperoxidase - a bridge linking inflammation and oxidative stress with cardiovascular disease. Clinica Chimica Acta 2019;493:36-51. doi: 10.1016/j.cca.2019.02.022.
Hawkins CL, Davies MJ. Role of myeloperoxidase and oxidant formation in the extracellular environment in inflammation-induced tissue damage. Free Radical Biol Med 2021;172:633-51. doi: 10.1016/j.freeradbiomed.2021.07.007.
Davies MJ. Myeloperoxidase: mechanisms, reactions and inhibition as a therapeutic strategy in inflammatory diseases. Pharmacol Ther 2021;218:107685. doi:10.1016/j.pharmthera.2020. 107685.
Teiber JF, Kramer GL, Haley RW. Methods for measuring serum activity levels of the 192 Q and R isoenzymes of paraoxonase 1 in QR heterozygous individuals. Clin Chem 2013;59: 1251-9. doi: 10.1373/clinchem.2012. 99331.
Okuturlar Y, Gedikbasi A, Akalin N, et al. Serum paraoxonase 1 activity in patients with iron deficiency anemia. Arch Med Sci 2016;12:697-703. doi: 10.5114/aoms.2015.48730.
Sharma R, Nachane H. Oxidative stress in iron deficiency anemia- a gender-based analysis - a pilot study. J Evolution Med Dent Sci 2020;9:3739-42. doi:10.14260/jemds/2020/821.
Aslan M, Horoz M, Çelik H. Evaluation of oxidative status in iron deficiency anemia through total antioxidant capacity measured using an automated method. Turk J Hematol 2011;28:42-6. doi: 10.5152/tjh.2011.04.
Calim A, Kanat E, Mazi EE, Oygen S, Karabay U, Borlu F. Evaluation of in-patients with iron deficiency anemia in terms of etiology. Med Bull Sisli Etfal Hosp 2020;54:428-32. doi: 10.14744/SEMB.2018.47354.
Jimenez K, Lang M. Diagnostic approach to iron deficiency anemia. Wien Med Wochenschr 2016;166:402-10. doi: 10.1007/s10354-016-0495-5.
Chandyo RK, Henjum S, Ulak M, et al. Prevalence of anemia and iron deficiency is more common in breastfed infants than their mothers in Bhaktapur, Nepal. Eur J Clin Nutr 2016;70:456-62. doi: 10.1038/ejcn.2015.199.
Bayen S, Le Grand C, Bayen M, Richard F, Messaadi N. Anemia management in non-menopausal women in a primary care setting: a prospective evaluation of clinical practice. BMC Fam Pract 2020;21:13. doi: 10.1186/s12875-020-1086-5.
Kuyumcu F, Aycan. A. Evaluation of oxidative stress levels and antioxidant enzyme activities in burst fractures. Med Sci Monit 2018;24:225–34. doi: 10.12659/MSM.908312.
Maciejczyk M, Pliszka EH, Pietrucha B et al. Antioxidant defense, redox homeostasis, and oxidative damage in children with ataxia telangiectasia and Nijmegen breakage syndrome. Front. Immunol 2019;10:2322-33. doi:10.3389/fimmu.2019.02322.
Ayala A, Munoz MF, Argüelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev 2014;8:360438. doi: 10.1155/2014/360438.
Gürbüz DG, Ulaº T, Paksoy F, et al. The effect of intravenous iron therapy on total antioxidant capacity in patients with iron deficiency anemia. J Clin Exper Investig 2011;2:287-91. doi: 10.5799/ahinjs.01.2011.03.0056.
Zaka-Ur-Rab Z, Adnan M, Ahmad SM, Islam N. Effect of oral iron on markers of oxidative stress and antioxidant status in children with iron deficiency anaemia. J Clin Diagnost Res 2016;10:13-9. doi: 10.7860/JCDR/2016/23601.8761.
Jankowska EA, Rozentryt P, Witkowska A, et al. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J 2011;32:1054. doi:10.1093/eurheartj/ehq158.
Madhikarmi NL, Murthy KR. Antioxidant enzymes and oxidative stress in the erythrocytes of iron deficiency anemic patients supplemented with vitamins. Iran Biomed J 2014;18:82-7. doi: 10.6091/ibj.1228.2013.
Akarsu S, Demir H, Selek S, Oguzoncul F. Iron deficiency anemia and levels of oxidative stress induced by treatment modality. Pediatr Int 2013;55:289-95. doi: 10.1111/ped.12054.
El-Shimi MS, El-Farrash RA, Ismail EA, et al. Renal functional and structural integrity in infants with iron deficiency anemia: relation to oxidative stress and response to iron therapy. Pediatr Nephrol 2015;30:1835-42. doi: 10.1007/s00467-015-3122-6.
Meneses MJ, Silvestre R, Sousa-Lima I, Macedo MP. Paraoxonase-1 as a regulator of glucose and lipid homeostasis: impact on the onset and progression of metabolic disorders. Int J Mol Sci 2019;20:4049. doi: 10.3390/ijms20164049
Meroño T, Dauteuille C, Tetzlaff W, et al. Oxidative stress, HDL functionality and effects of intravenous iron administration in women with iron deficiency anemia. Clin Nutr 2017;36:552-8. doi: 10.1016/j.clnu.2016.02.003.
Asci D, Ekerbicer N, Guvenc Demiragci Y, Yilmaz R. Oxidative stress investigation in anemia. J Health Med Nur 2020;75:16-25. doi: 10.7176/JHMN/75-03.