RESUMO
Iron is important general well being, to prevent or treat anemia, and is a cofactor of many enzymes in the anti-oxidant process. Effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA) and ferrous sulfate on iron bioavailability and oxidative stress in anemic pregnant women was evaluated. A 2-month randomized controlled trial was conducted on 153 anemic pregnant women, with 80 <= Hb <110 g/L. They were randomly allocated to three groups: group C (n=51) was the placebo control group, group I (n=51) was supplemented daily with 60 mg iron as ferrous sulfate, and group IE (n=51) with 60 mg iron as NaFeEDTA. Blood samples were collected before and at the end of the intervention for measurements of hematological indices and oxidative stress parameters. Considerable increases of hematologic indicators were observed: 20.5 and 21.8 g/L for Hb (both p values <0.001); 4.81 and 7.19 µmol/L for plasma iron (both p values <0.001), 2.63 and 8.99 µg /L for ferritin (both p values <0.05) in I and IE groups, respectively, compared with the control group. Glutathione peroxidase (GSH-Px) activities increased by 32.6 and 75.3 IU/ml, and malondialdehyde (MDA) levels decreased by 0.70 and 1.12 µmol/L in I and IE groups, compared with the C group (p values <0.05). Moreover, differences of plasma iron, ferritin and GSH-Px activity were 2.38 µmol/L, 6.36 µg /L and 42.7 IU/ml were also significantly greater in the IE group than in the I group. Moderate iron supplementation may be beneficial to improving iron deficiency and oxidative stress, and NaFeEDTA is better than ferrous sulfate.
Assuntos
Anemia Ferropriva/dietoterapia , Suplementos Nutricionais , Compostos Férricos/administração & dosagem , Compostos Ferrosos/administração & dosagem , Complicações Hematológicas na Gravidez/dietoterapia , Adulto , Anemia Ferropriva/sangue , Método Duplo-Cego , Ácido Edético/administração & dosagem , Feminino , Glutationa Peroxidase/sangue , Humanos , Ferro/sangue , Malondialdeído/sangue , Gravidez , Complicações Hematológicas na Gravidez/sangue , Resultado do TratamentoRESUMO
BACKGROUND: Iron and vitamin A deficiencies impact anemia and the immune system. OBJECTIVE: to investigate the effect of iron combined with retinol supplementation on iron status, IL-2 level and lymphocyte proliferation. METHODS: a double-blind randomized trial conducted over 2 months. We randomly allocated 186 anemic pregnant women with 80 ≤ Hb 0 < 110 g/L into four groups. Group I (n=47) was supplemented daily with 60 mg iron as ferrous sulfate, IF (n=46) with 60 mg iron and 0.4 mg folic acid, IR (n=46) with 60 mg iron, 2.0 mg retinol and 0.4 mg folic acid and C (n=47) was the placebo group,. RESULTS: after the 2 months trial, there were considerable increases of iron status in Hb, plasma iron and ferritin in the I, IF and IR groups compared with Group C. Increases in plasma iron and ferritin in the IR group were also significantly greater than in Groups I and IF. Compared with group C, increases of IL-2 levels were 119, 184 and 206 ng/L; and lymphocyte proliferation increased by 0.095, 0.112 and 0.219 in Groups I, IF and IR, respectively. Increases of IL-2 were 65.3 ng/L and 87.5 ng/L in Groups IF and IR, greater than in Group I (both p values <0.01); and lymphocyte proliferation in Group IR were 0.124 and 0.107, also greater than in Groups I and IF, respectively. CONCLUSION: iron combined retinol supplementation was more beneficial to improving iron status and lymphocyte proliferation during pregnancy than iron alone.
Assuntos
Anemia/tratamento farmacológico , Interleucina-2/sangue , Ferro da Dieta/uso terapêutico , Ferro/sangue , Linfócitos/efeitos dos fármacos , Vitamina A/uso terapêutico , Adulto , Anemia/sangue , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Ferritinas/sangue , Ferritinas/efeitos dos fármacos , Compostos Ferrosos/administração & dosagem , Compostos Ferrosos/sangue , Ácido Fólico/administração & dosagem , Ácido Fólico/sangue , Humanos , Estado Nutricional/efeitos dos fármacos , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/tratamento farmacológico , Vitaminas/uso terapêuticoRESUMO
In rural China, many pregnant women in their third trimester suffer from anemia (48%) and iron deficiency (ID; 42%), often with coexisting deficiencies of retinol and riboflavin. We investigated the effect of retinol and riboflavin supplementation in addition to iron plus folic acid on anemia and subjective well-being in pregnant women. The study was a 2-mo, double-blind, randomized trial. Subjects (n = 366) with anemia [hemoglobin (Hb) = 105 g/L] were randomly assigned to 4 groups, all receiving 60 mg/d iron and 400 mug/d folic acid. The iron+folic acid (IF) group (n = 93) served as reference, the iron+folic acid+retinol group (IFA) (n = 91) was treated with 2000 mug retinol, the iron+folic acid+riboflavin group (IFB) (n = 91) with 1.0 mg riboflavin, and the iron+folic acid+retinol+riboflavin group (IFAB) (n = 91) with retinol and riboflavin. After the 2-mo intervention, the Hb concentration increased in all 4 groups (P < 0.001). The increase in the IFAB group was 5.4 +/- 1.1 g/L greater than in the IF group (P < 0.001). The reduced prevalence of anemia (Hb < 110g/L) and ID anemia were significantly greater in the groups supplemented with retinol and /or riboflavin than in the IF group. Moreover, gastrointestinal symptoms were less prevalent in the IFA group than in the IF group (P < 0.05) and improved well-being was more prevalent in the groups receiving additional retinol and/or riboflavin than in the IF group (P < 0.05). Thus, a combination of iron, folic acid, retinol, and riboflavin was more effective than iron plus folic acid alone. Multimicronutrient supplementation may be worthwhile for pregnant women in rural China.