Hirosawa Takanobu, Hayashi Arisa, Harada Yukinori, Shimizu Taro
Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan.
Int J Gen Med. 2022 Aug 23;15:6765-6773. doi: 10.2147/IJGM.S376405. eCollection 2022.
The clinical presentation of iron deficiency is not well understood. We aimed to identify the clinical manifestations of iron deficiency without anemia in women.
We conducted a retrospective cohort study of women who visited the general internal medicine outpatient department of a university hospital in Japan between 2016 and 2022. Women who were prescribed iron supplements were included in the study. Anemia was defined as hemoglobin levels below 12 g/dl. Iron deficiency was defined as serum ferritin levels < 30.0 μg/l. The primary outcome was the difference in symptoms between patients with iron deficiency with and without anemia. The secondary outcome was the ratio of symptom, hemoglobin, and serum ferritin improvement (levels > 30.0 μg/l after treatment), comparing the measurements at the beginning and after supplementation.
A total of 147 women were included in the final analysis. There were no significant differences in the initial symptoms and the ratio of symptom improvement between the groups. Compared to patients with iron deficiency anemia, patients with iron deficiency without anemia had high initial serum ferritin levels (14.8 vs 7.1 μg/l, p<0.001), and hemoglobin (13.2 vs 9.9 g/dl, p<0.001). Iron supplements significantly improved the serum ferritin level in two groups and the hemoglobin in iron deficiency anemia. After treatment, iron deficiency without anemia still had high serum ferritin levels (37.7 vs 28.2 μg/l, p=0.017) and hemoglobin (13.3 vs 12.3 g/dl, p < 0.001).
There were no differences in any of the investigated symptoms and the ratio of the symptom improvement depending on the anemic state in iron deficiency. After iron supplementation, the serum ferritin levels in the iron deficiency without anemia group improved. Hemoglobin and serum ferritin in iron deficiency without anemia were still highly comparable to that of iron deficiency anemia.
缺铁的临床表现尚未得到充分了解。我们旨在确定女性缺铁但无贫血的临床表现。
我们对2016年至2022年间就诊于日本一家大学医院普通内科门诊的女性进行了一项回顾性队列研究。研究纳入了接受铁补充剂治疗的女性。贫血定义为血红蛋白水平低于12 g/dl。缺铁定义为血清铁蛋白水平<30.0 μg/l。主要结局是缺铁伴贫血和不伴贫血患者的症状差异。次要结局是比较补充铁剂前后症状、血红蛋白和血清铁蛋白改善情况（治疗后水平>30.0 μg/l）的比例。
共有147名女性纳入最终分析。两组在初始症状和症状改善比例方面无显著差异。与缺铁性贫血患者相比，缺铁但无贫血的患者初始血清铁蛋白水平较高（14.8 vs 7.1 μg/l，p<0.001），血红蛋白水平也较高（13.2 vs 9.9 g/dl，p<0.001）。铁补充剂显著提高了两组的血清铁蛋白水平，以及缺铁性贫血组的血红蛋白水平。治疗后，缺铁但无贫血的患者血清铁蛋白水平仍较高（37.7 vs 28.2 μg/l，p=0.017），血红蛋白水平也较高（13.3 vs 12.3 g/dl，p<0.001）。
缺铁患者的任何被调查症状及症状改善比例在有无贫血状态下均无差异。补充铁剂后，缺铁但无贫血组的血清铁蛋白水平有所改善。缺铁但无贫血患者的血红蛋白和血清铁蛋白水平仍与缺铁性贫血患者高度可比。
