Hacibekiroglu T, Basturk A, Akinci S, Bakanay S M, Ulas T, Guney T, Dilek I
Department of Hematology, Edirne Public Hospital, Edirne, Turkey.
Eur Rev Med Pharmacol Sci. 2015 Dec;19(24):4835-40.
Iron deficiency anemia (IDA) is the most common form of anemia. Impaired intake absorption and blood loss are the main factors in the etiology. Impaired absorption can be caused by a decrease in trace elements such as copper and zinc, which are found in the structure of enzymes that coordinate iron metabolism or act as a catalyst for them, and the existence of Helicobacter pylori (H. pylori), which inhibits iron absorption in the stomach. Serum levels of zinc, copper, and H. pylori antibodies were measured in IDA cases, and correlations with IDA were evaluated.
The study group was composed of 115 IDA cases who were followed at hematology outpatient clinics, and the control group was composed of 92 gender- and age-matched healthy individuals. Patients were diagnosed with iron deficiency anemia according to hemoglobin, serum ferritin, and iron levels and total iron-binding capacity. Serum zinc, copper, H. pylori immunoglobulin A (HpIgA) and immunoglobulin G (HpIgG), vitamin B12, and folic acid levels were examined in the blood specimens collected.
No statistically significant difference in zinc and copper serum levels between the study and control groups was observed (p > 0.05 for both groups). Although no difference was observed between the HpIgG levels of the two groups, patients with IDA had a statistically significant increase in HpIgA levels (p < 0.05). Pearson's correlation analysis showed that the zinc levels of the IDA group did not have a correlation with any parameters (p < 0.05 for all). Copper levels had a positive correlation with only the HpIgA level in the IDA group (r = 0.222, p = 0.017).
Trace elements and H. pylori infection did not have a correlation with IDA. Elevated levels of HpIgA and positive correlation of HpIgA with copper levels were observed. The literature review clearly suggests that several points require further explanation, and extensive research with larger samples is required.
缺铁性贫血（IDA）是最常见的贫血形式。摄入吸收受损和失血是病因中的主要因素。吸收受损可能由铜和锌等微量元素减少引起，这些元素存在于协调铁代谢的酶结构中或作为其催化剂，还可能由幽门螺杆菌（H. pylori）的存在引起，幽门螺杆菌会抑制胃内铁的吸收。对IDA患者测定血清锌、铜和幽门螺杆菌抗体水平，并评估其与IDA的相关性。
研究组由115例在血液科门诊随访的IDA患者组成，对照组由92例性别和年龄匹配的健康个体组成。根据血红蛋白、血清铁蛋白、铁水平和总铁结合力对患者进行缺铁性贫血诊断。检测采集的血液标本中的血清锌、铜、幽门螺杆菌免疫球蛋白A（HpIgA）和免疫球蛋白G（HpIgG）、维生素B12和叶酸水平。
研究组和对照组血清锌和铜水平无统计学显著差异（两组p均>0.05）。虽然两组的HpIgG水平无差异，但IDA患者的HpIgA水平有统计学显著升高（p<0.05）。Pearson相关分析显示，IDA组的锌水平与任何参数均无相关性（所有p<0.05）。铜水平仅与IDA组的HpIgA水平呈正相关（r = 0.222，p = 0.017）。
微量元素和幽门螺杆菌感染与IDA无相关性。观察到HpIgA水平升高以及HpIgA与铜水平呈正相关。文献综述明确表明，有几点需要进一步解释，需要进行更大样本量的广泛研究。
