Evaluation of the efficacy of iron deficiency anemia treatment in women: an observational study

Background: Iron deficiency anemia (IDA) is one of the most common anemia forms worldwide, particularly among women of reproductive age and pregnant women.

Aim: This study aimed to evaluate changes in cytokine levels and iron metabolism profile in women of reproductive age with mild IDA before and after treatment, and to develop an integrative scale for evaluating the treatment efficacy.

Methods: The study included 120 women between the ages of 18 and 49 years with mild IDA. All participants received iron sulfate at 200 mg once daily for 60 days. The participants were scheduled to five visits throughout the study, with hematology and blood chemistry tests performed at each visit. Prior to treatment initiation and at day 90, a comprehensive biomarker panel was assessed, including cytokines, iron metabolism, and concentrations of copper, zinc, pepsinogens I and II, C-reactive protein, and erythropoietin.

Results: The analysis of laboratory markers showed a significant decrease in the unsaturated iron binding capacity, transferrin and soluble transferrin receptor levels, and the concentration of zinc and copper. Increased levels of hepcidin and serum interleukin-8 (IL-8) and a significant decrease in erythropoietin were noted, which may suggest the restoration of erythropoiesis and a decrease in hypoxic stimulus. Serum IL-1b, IL-6, IL-10, IFN-γ, pepsinogens I and II, and C-reactive protein remained unchanged throughout the treatment period. The collected data allowed for the development of a scale for evaluating the efficacy of IDA treatment, including five laboratory values: unsaturated iron binding capacity, transferrin, hepcidin, soluble transferrin receptors, and erythropoietin.

Conclusion: An increase in IL-8 levels may be indicative of an inflammatory process, probably associated with colonic microbiota changes following oral iron supplementation. The observed decrease in zinc and copper concentrations underscores the importance of monitoring the micronutrient status and implementing appropriate interventions. The developed scale for evaluating the efficacy of IDA treatment offers a standardized assessment of the therapeutic response and facilitates continuous monitoring of the treatment outcome.