Özbilen Muhammet, Kaya Yasemin
Faculty of Medicine, Department of Internal Medicine, Ordu University, Cumhuriyet District, PO Box 52200, Ordu, Türkiye.
BMC Womens Health. 2025 Jul 28;25(1):376. doi: 10.1186/s12905-025-03906-w.
Iron deficiency, the most widespread micronutrient deficiency globally, is especially common among women and seriously impacts their health considerably. The symptom spectrum in non-anemic iron deficiency (NAID) is less well described than in anemic forms. The aim of this study was to demonstrate the diversity and frequency of symptoms in NAID and compare with anemic cases and explore the association of symptoms with biomarkers.
This retrospective and cross-sectional study was conducted on female patients at a university hospital. Patients admitted to the iron deficiency outpatient clinic between March 2021 and August 2022 were analyzed. Patients aged 18 years and older with iron deficiency (ferritin < 30 mcg/L) were included. Iron parameters, hemoglobin levels, and symptoms were included into the dataset, and these independent variables were compared between patient groups categorized as NAID and iron deficiency anemia (IDA).
The study sample consisted of 239 patients. The frequencies of IDA and NAID were 70.3% (n = 168) and 29.7% (n = 71), respectively. Forty-one distinct symptoms or symptom groups were documented, ranging from neuropsychiatric to gastrointestinal manifestations. The mean number of symptoms per person was 16.5 (7.03). The top ten most common symptoms were weakness (87.03%), fatigue (82.43%), easy fatigability (78.66%), amnesia (72.38%), feeling cold (71.55%), alopecia (70.29%), cold intolerance (69.04%), sleep problems (66.53%), nervosity (63.18%), and cold foot (59.83%). The IDA group had more diverse symptoms than the NAID group (P <.05). Most of the forty-one symptoms or symptom groups were similar in frequency in the IDA and NAID groups. Only palpitations, cold intolerance, easy fatigability, and unclassifiable group differed between the groups (P <.05). The highest correlation between iron parameters and symptom diversity was transferrin saturation (TSAT) (r=-.229, P <.001). All but three of the positive symptoms showed TSAT levels below 8%.
This study confirms that anemia is not a prerequisite for the majority of iron deficiency symptoms, which are common in non-anemic women. TSAT demonstrates a robust correlation, underscoring its potential as an early diagnostic biomarker. Clinicians must acknowledge various non-specific symptoms irrespective of anemia. Additional research is required to corroborate findings and investigate symptom mechanisms and treatments.
缺铁是全球最普遍的微量营养素缺乏症，在女性中尤为常见，并严重影响她们的健康。与贫血形式相比，非贫血性缺铁（NAID）的症状谱描述较少。本研究的目的是证明NAID症状的多样性和频率，并与贫血病例进行比较，探讨症状与生物标志物的关联。
本回顾性横断面研究在一家大学医院的女性患者中进行。分析了2021年3月至2022年8月期间缺铁门诊收治的患者。纳入年龄在18岁及以上的缺铁（铁蛋白<30 mcg/L）患者。将铁参数、血红蛋白水平和症状纳入数据集，并在分为NAID和缺铁性贫血（IDA）的患者组之间比较这些自变量。
研究样本包括239名患者。IDA和NAID的频率分别为70.3%（n = 168）和29.7%（n = 71）。记录了41种不同的症状或症状组，范围从神经精神症状到胃肠道表现。每人的平均症状数为16.5（7.03）。十大最常见症状为虚弱（87.03%）、疲劳（82.43%）、易疲劳（78.66%）、失忆（72.38%）、感觉寒冷（71.55%）、脱发（70.29%）、不耐寒（69.04%）、睡眠问题（66.53%）、紧张（63.18%）和脚冷（59.83%）。IDA组的症状比NAID组更多样化（P <.05）。41种症状或症状组中的大多数在IDA组和NAID组中的频率相似。两组之间仅心悸、不耐寒、易疲劳和无法分类的组存在差异（P <.05）。铁参数与症状多样性之间的最高相关性是转铁蛋白饱和度（TSAT）（r = -0.229，P <.001）。除三种症状外，所有阳性症状显示TSAT水平低于8%。
本研究证实，贫血并非大多数缺铁症状的先决条件，这些症状在非贫血女性中很常见。TSAT显示出很强的相关性，突出了其作为早期诊断生物标志物的潜力。临床医生必须认识到各种非特异性症状，无论是否存在贫血。需要进一步的研究来证实研究结果，并调查症状机制和治疗方法。
