Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China.
Nutrients. 2022 Jan 27;14(3):543. doi: 10.3390/nu14030543.
Ferrous sulfate is a commonly used iron supplement for the correction of iron-deficiency anemia but with frequent gastrointestinal side effects. Milk-derived iron-binding glycoprotein lactoferrin possesses well gastrointestinal tolerance and fewer side effects caused by the intake of high-dose iron. However, the underlying mechanism of the iron-enhancing effect of lactoferrin remains unclear. In addition, the comparative efficacies between lactoferrin and ferrous sulfate are also remained to be determined. We conducted a systematic review and meta-analysis on published intervention studies to investigate how lactoferrin modulate iron metabolism and evaluate the comparative effects between lactoferrin and ferrous sulfate supplementation on iron absorption, iron storage, erythropoiesis and inflammation. Lactoferrin supplementation had better effects on serum iron (WMD: 41.44 ug/dL; p < 0.00001), ferritin (WMD: 13.60 ng/mL; p = 0.003) and hemoglobin concentration (11.80 g/dL; p < 0.00001), but a reducing effect on fractional iron absorption (WMD: −2.08%; p = 0.02) and IL-6 levels (WMD: −45.59 pg/mL; p < 0.00001) compared with ferrous sulfate. In conclusion, this study supports lactoferrin as a superior supplement to ferrous sulfate regarding the improvement in serum iron parameters and hemoglobin levels. Considering the weak influence of lactoferrin on iron absorption, the anti-inflammation effect of lactoferrin may be the potential mechanism to explain its efficacy on iron status and erythropoiesis.
硫酸亚铁是一种常用的铁补充剂，用于纠正缺铁性贫血，但常伴有胃肠道副作用。乳源铁结合糖蛋白乳铁蛋白具有良好的胃肠道耐受性，且因摄入高剂量铁而产生的副作用较少。然而，乳铁蛋白增强铁的作用机制尚不清楚。此外，乳铁蛋白和硫酸亚铁之间的比较疗效也有待确定。我们对已发表的干预研究进行了系统评价和荟萃分析，以调查乳铁蛋白如何调节铁代谢，并评估乳铁蛋白和硫酸亚铁补充剂对铁吸收、铁储存、红细胞生成和炎症的比较效果。乳铁蛋白补充剂对血清铁（WMD：41.44ug/dL；p<0.00001）、铁蛋白（WMD：13.60ng/mL；p=0.003）和血红蛋白浓度（11.80g/dL；p<0.00001）的改善作用优于硫酸亚铁，但对铁的分数吸收（WMD：-2.08%；p=0.02）和白细胞介素-6 水平（WMD：-45.59pg/mL；p<0.00001）的降低作用优于硫酸亚铁。总之，这项研究支持乳铁蛋白作为硫酸亚铁的一种更好的补充剂，可改善血清铁参数和血红蛋白水平。考虑到乳铁蛋白对铁吸收的影响较弱，乳铁蛋白的抗炎作用可能是解释其对铁状态和红细胞生成作用的潜在机制。
