Dynamic Thiol-Disulfide Homeostasis in Children with Newly Diagnosed Iron Deficiency Anemia

Abstract

Objective: Iron is an element, which is found in the structure of antioxidant enzymes and has an important role in the inactivation of reactive oxygen species. Disruption of oxidant-antioxidant balance may be playing a role in the pathogenesis of iron deficiency anemia (IDA). Dynamic thiol-disulfide homeostasis (DTDH) and serum ischemia-modified albumin (IMA) levels are important indicators of pro-oxidant/antioxidant status. In this study, we aimed to evaluate DTDH parameters and serum IMA levels in children with newly diagnosed IDA, who did not receive iron therapy. Material and Methods: Fifty patients diagnosed with IDA and 33 healthy age- and sex-matched control patients were included in the study. DTDH parameters and IMA levels of the patients and control groups were measured. The same parameters were also compared in patients with Hb<7 g/dl (profound IDA) (n:14/50, 28%) and Hb≥7 g/dl (mild-moderate IDA) (n: 36/50, 72%) in the IDA group. The relationship between DTDH parameters in these groups were investigated. Results: Native thiol, total thiol, native thiol/total thiol levels, constituting antioxidant capacity indicators, were found to be significantly lower in IDA patients; while oxidant disulfide, disulfide/native thiol, disulfide/total thiol, and IMA levels were found to be statistically higher compared to those in the control group (p<0.050). When DTDH parameters and IMA levels were examined; there was a positive correlation between antioxidant parameters and a negative correlation between oxidative parameters with hemoglobin and ferritin levels (p<0.050). Also, oxidative parameters were found to be much higher in profound IDA group than in the group with Hb>7 g/dl (p<0.050). Conclusion: In this study, increase in serum disulfide and IMA levels with the decrease in serum native thiol and total thiol levels indicated oxidative stress in IDA patients before treatment, compared to the control group. Evaluation of these indicators in children is important in predicting the toxicity due to IDA.