Ferrous Sulfate (Fe2+) Had a Faster Effect Than Did Ferric Polymaltose (Fe3+) on Increased Oxidant Status in Children With Iron-deficiency Anemia

Objective: The purpose of this study was to compare the total oxidant and antioxidant effect of different oral iron preparations in children with iron-deficiency anemia (IDA). Methods: A total of 65 children with IDA were randomized to receive 5 mg Fe/kg/d iron (II) sulfate (Fe2+ group, n=33) or iron (III)-hydroxide polymaltose complex (Fe3+ group, n=32); healthy controls (n=28) were also included in the study. Serum total thiol (–SH), total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), and hematological profile were evaluated at the baseline and on day 8 and day 30 of the therapy. Results: Serum TOS and OSI levels were significantly higher and total –SH and total antioxidant capacity levels were significantly lower in the study groups at the beginning of therapy than in the controls (P>0.001). In multivariate analysis, after controlling for multiple confounding factors, on days 8 and 30, serum TOS and OSI levels were not different in the Fe3+ group, whereas they were significantly reduced in the Fe2+ group (P≤0.033). Conclusions: Serum total oxidant status was significantly increased in children with IDA, and Fe2+ was highly effective in correcting elevated oxidative status.