The effects of oral iron treatment on free oxygen radicals, protective enzymes and lipid peroxidation in iron deficiency anemia

Aim The production of Fe+2 containing proteins such as cytochrome, myoglobin, catalase and peroxidase are affected along with hemoglobin synthesis in iron defficiency anemia (IDA). Moreover while oxidative stress plays an important role in the pathogenesis of IDA, lipid peroxidation can be triggered. The effects of free oxygen radicals, protective enzymes, and lipid peroxidation in the patients receiving oral iron treatment with IDA were investigated in this study. Material and Methods Seventy patients (67 females and 3 males, mean age of 34 ± 11 years) with IDA (hemoglobin levels < 11 g/dl, serum ferritin level <16 ng/ml, iron saturation <15%) were enrolled in this prospective Phase IV study. The control group comprised of 30 healthy subjects (27 women and 3 men, mean age of 26 ± 7 years) not receiving any vitamin/mineral supplement, without anemia, chronic infection, inflammatory, liver, kidney, and malignant diseases, acute blood loss, and pregnancy. For each group, whole blood counts, hydrogen peroxide (H2O2), glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (Grx), superoxide dismutase (SOD), and catalase to examine the free radical metabolism, and malondialdehyde levels as an indicator of lipid peroxidation levels were determined by spectrophotometric methods. 200 mg/day ferrous fumarate was given to the patients for 4 weeks and these tests were repeated at the end of the 4 weeks. The resulte were compared with independent sample and two-paired-t test usingbSPSS 15.0 program.The values of P <0.05 were accepted as significantly. Results While the levels of GSH (p<0.001), MDA (p=0.012), Grx (p=0.035) and H2O2 (p=0.001) levels in the patients with IDA were higher than those of the control group, SOD, Gpx and CAT levels were not different (p>0.05). After 4 weeks treatment, the levels of GSH (p=0.045) and H2O2 (p<0.001) with IDA significantly decreased, however there was no significant difference for other parameters (p>0.05). Conclusions In IDA, free radicals increase and lipid peroxidation is induced. It is compansated by GSH and Grx. While oral iron treatment reduces oxidative stres, its role on protective enzymes was not determined. However as oxidative stress decreases, the compensation of GSH decreases. Keywords: Oral iron treatment, free oxygen radicals, iron defficiency anemia, lipid peroxidation