缺铁女性隔日低剂量口服铁补充治疗：一项随机对照试验。
完整摘要 · 中文译文
目的：口服铁补充常受到胃肠道副作用以及与铁调素介导的调控相关的吸收减少的限制。这项随机、平行组、阳性对照研究评估了减剂量隔日口服铁补充策略是否能改善缺铁女性的铁状态。 方法：66名缺铁育龄女性（18-50岁；血清铁蛋白 < 30 ng/mL）被随机分配接受为期42天的治疗：微粉化、可分散焦磷酸铁每48小时提供21 mg元素铁并联合每日肠道菌群调节剂，或蔗糖体焦磷酸铁每日提供30 mg元素铁。主要终点为血清铁蛋白，次要终点包括血清铁、转铁蛋白、转铁蛋白饱和度（TSAT）、总铁结合力（TIBC）、血红蛋白和红细胞计数。 结果：两组血清铁蛋白随时间显著增加（p < 0.001），治疗间无显著差异。血清铁、转铁蛋白、TSAT和TIBC观察到相当的改善，而血红蛋白在整个研究期间保持稳定。两种干预通常耐受良好，仅出现轻度一过性胃肠道不良事件，炎症标志物无临床相关变化。 结论：减剂量隔日口服铁补充策略在累积铁暴露较低的情况下，实现了与标准每日补充相当的铁状态改善。这些发现支持潜在的 在铁缺乏女性中，基于生理学信息指导的低剂量铁补充策略的初步临床相关性。
完整摘要 · 英文原文
PURPOSE: Oral iron supplementation is frequently limited by gastrointestinal side effects and reduced absorption associated with hepcidin-mediated regulation. This randomized, parallel-group, active-controlled study evaluated whether a reduced-dose alternate-day oral iron supplementation strategy could improve iron status in women with iron deficiency. METHODS: Sixty-six iron-deficient women of reproductive age (18-50 years; serum ferritin < 30 ng/mL) were randomized to receive, for 42 days, either micronized, dispersible ferric pyrophosphate providing 21 mg of elemental iron every 48 h combined with a daily gut microbiota modulator, or sucrosomial ferric pyrophosphate providing 30 mg of elemental iron per day. The primary endpoint was serum ferritin, while secondary endpoints included serum iron, transferrin, transferrin saturation (TSAT), total iron-binding capacity (TIBC), hemoglobin, and red blood cell count. RESULTS: Serum ferritin increased significantly over time in both groups (p < 0.001), with no significant differences between treatments. Comparable improvements were observed for serum iron, transferrin, TSAT, and TIBC, while hemoglobin remained stable throughout the study. Both interventions were generally well tolerated, with only mild transient gastrointestinal adverse events and no clinically relevant changes in inflammatory markers. CONCLUSION: A reduced-dose alternate-day oral iron supplementation strategy achieved improvements in iron status comparable to standard daily supplementation despite lower cumulative iron exposure. These findings support the potential clinical relevance of physiologically informed low-dose iron supplementation strategies in women with iron deficiency.