Fernandez-Jimenez M Cristina, Moreno Gemma, Wright Ione, Shih Pei-Chun, Vaquero M Pilar, Remacha Angel F
Hematology Department, Complejo Hospitalario de Toledo, Toledo, Spain.
Hematology Department, Hospital Ramón y Cajal, Madrid, Spain.
Womens Health Rep (New Rochelle). 2020 Jan 29;1(1):26-35. doi: 10.1089/whr.2019.0011. eCollection 2020.
Iron deficiency anemia (IDA) is highly prevalent in women of child-bearing age. However, their nonhematological symptoms have been overlooked. This study aims to analyze the nonhematological features and symptoms of IDA in a group of women of reproductive age and the changes occurred during iron therapy. IDA women underwent dietary, physical activity, menstrual blood loss, and cognitive function assessment at baseline. Hematological and biochemical parameters were analyzed. Executive attention was tested by the flanker task and working memory by the 2-back task. Oral iron therapy (ferrous sulfate) was given to 35 women for 8 weeks and the changes in iron status, biochemical markers, cognitive function, and nonhematological symptoms were evaluated. Patients presented nonhematological symptoms: pica, 32.4%; cheilitis, 20.6%; restless legs syndrome (RLS), 20.6%; diffuse hair loss, 55.9%; and ungual alterations, 38.2%. Two or more symptoms were present in 58.8% of women. Serum iron and working memory were correlated at baseline. Multivariate analyses show associations (odds ratio [OR], 95% confidence interval [CI]) between pica and reaction time in the working memory test (OR 2.14, 95% CI 1.19-3.87, = 0.012); RLS with total serum protein (OR 0.08, 95% CI 0.06-0.92, = 0.043); and cheilitis with mean corpuscular hemoglobin (OR 0.388, 95% CI 0.189-0.799, = 0.01). Pica, cheilitis, and RLS completely resolved with iron therapy, and ungual alterations and hair loss improved in 92.3% and 84.2% of women, respectively. Better performance in executive attention and working memory was observed after iron therapy. More attention should be given to the nonhematological manifestations of IDA to improve the quality of life of menstruating women.
缺铁性贫血（IDA）在育龄女性中极为普遍。然而，她们的非血液学症状一直被忽视。本研究旨在分析一组育龄女性缺铁性贫血的非血液学特征和症状，以及铁剂治疗期间发生的变化。缺铁性贫血女性在基线时接受了饮食、身体活动、月经失血和认知功能评估。分析了血液学和生化参数。通过侧翼任务测试执行注意力，通过2-back任务测试工作记忆。对35名女性给予口服铁剂治疗（硫酸亚铁）8周，并评估铁状态、生化标志物、认知功能和非血液学症状的变化。患者出现的非血液学症状有：异食癖，32.4%；唇炎，20.6%；不安腿综合征（RLS），20.6%；弥漫性脱发，55.9%；以及指甲改变，38.2%。58.8%的女性存在两种或更多症状。基线时血清铁与工作记忆相关。多变量分析显示，异食癖与工作记忆测试中的反应时间之间存在关联（优势比[OR]，95%置信区间[CI]）（OR 2.14，95%CI 1.19 - 3.87，P = 0.012）；不安腿综合征与总血清蛋白之间存在关联（OR 0.08，95%CI 0.06 - 0.92，P = 0.043）；唇炎与平均红细胞血红蛋白之间存在关联（OR 0.388, 95%CI 0.189 - 0.799，P = 0.01）。铁剂治疗后，异食癖、唇炎和不安腿综合征完全缓解，指甲改变和脱发分别在92.3%和84.2%的女性中得到改善。铁剂治疗后观察到执行注意力和工作记忆有更好的表现。应更多关注缺铁性贫血的非血液学表现，以提高经期女性的生活质量。
