Division of Pediatric Hematology/Oncology, Department of Pediatrics.
Department of Medical Biology.
Blood Coagul Fibrinolysis. 2021 Oct 1;32(7):451-457. doi: 10.1097/MBC.0000000000001060.
Oxidative stress is a potential mechanism involved in the pathogenesis of iron deficiency anaemia (IDA). Although a tendency for hypercoagulability has been reported in IDA, its underlying mechanism is yet to be elucidated. This study investigated the probable relationship between oxidative stress and hypercoagulability in children with IDA. This study included 57 children diagnosed with IDA (IDA group) between October 2016 and October 2017 in addition to 48 healthy children (control group). The maximum clot firmness (MCF) index, and clot formation time (CFT) index, which are indicators of hypercoagulability in rotational thromboelastometry assays [intrinsic TEM (INTEM) and extrinsic TEM (EXTEM)] derived from our previous study, were recorded. Total oxidant status (TOS), total antioxidant capacity (TAC) and oxidative stress index (OSI) were analysed from serum samples of the individuals. In IDA group, OSI and TOS levels were higher and TAC level was lower compared to the control group (P < 0.001, for all). The EXTEM and INTEM MCF in the IDA group was higher than in the control group, while the INTEM CFT was lower than in the control group (P < 0.001, P < 0.001, P < 0.05, published data).TOS and OSI had a negative correlation with INTEM CFT (r:-0.361, P < 0.001 and r:-0.333, P = 0.001) and a positive correlation with INTEM MCF (r:+0.420, P < 0.001 and r:+0.367, P < 0.001) and EXTEM MCF (r:+0.476, P < 0.001 and r:+0.403, P < 0.001). However, TAC demonstrated no correlation with CFT and MCF index. The oxidant-antioxidant balance is disrupted in favour of oxidative stress in children with IDA. In addition, TOS and OSI, which are parameters of oxidative stress, are correlated with CFT and MCF indices. Oxidative stress appears to be an important factor for the development of tendency to hypercoagulability in IDA.
氧化应激是缺铁性贫血 (IDA) 发病机制中的一个潜在机制。尽管已经报道 IDA 存在高凝倾向，但其潜在机制尚不清楚。本研究旨在探讨 IDA 患儿氧化应激与高凝状态之间的可能关系。
本研究纳入了 2016 年 10 月至 2017 年 10 月期间在我院诊断为 IDA 的 57 例患儿（IDA 组），并纳入了 48 例健康儿童（对照组）。记录了旋转血栓弹性测定（TEM）检测 [内源性 TEM（INTEM）和外源性 TEM（EXTEM）]的最大凝块硬度（MCF）指数和凝块形成时间（CFT）指数，这些指数是高凝状态的指标。分析了个体血清样本中的总氧化应激状态（TOS）、总抗氧化能力（TAC）和氧化应激指数（OSI）。
与对照组相比，IDA 组的 OSI 和 TOS 水平较高，TAC 水平较低（均 P<0.001）。IDA 组的 EXTEM 和 INTEM MCF 高于对照组，而 INTEM CFT 低于对照组（均 P<0.001，P<0.001，P<0.05，已发表数据）。TOS 和 OSI 与 INTEM CFT 呈负相关（r：-0.361，P<0.001 和 r：-0.333，P=0.001），与 INTEM MCF 呈正相关（r：+0.420，P<0.001 和 r：+0.367，P<0.001）和 EXTEM MCF 呈正相关（r：+0.476，P<0.001 和 r：+0.403，P<0.001）。然而，TAC 与 CFT 和 MCF 指数无相关性。IDA 患儿的氧化还原平衡向氧化应激倾斜。此外，氧化应激参数 TOS 和 OSI 与 CFT 和 MCF 指数相关。氧化应激似乎是 IDA 高凝倾向发展的一个重要因素。
