Comparison of ferrous sulfate and ferrous glycinate chelate for the treatment of iron deficiency anemia in gastrectomized patients.
OBJECTIVE
Postgastrectomy iron deficiency anemia has a variable prevalence and occurs in 20-50% of patients. Food fortification reports examining ferrous glycinate chelate have shown that it can be 2.5-3.4 times more bioavailable than ferrous sulfate, with minimal gastrointestinal symptoms. The present study was designed as a controlled experimental study including 18 gastrectomized patients with iron deficiency anemia to compare the effects of ferrous sulfate and ferrous glycinate chelate in the treatment of anemia and to evaluate the presence of side effects.


METHODS
Patients were divided in two groups: group 1 received ferrous sulfate (200 mg twice a day, corresponding to 80 mg of elemental iron) and group 2 received ferrous glycinate chelate (250 mg/d, corresponding to 50 mg of elemental iron) for 4 mo. Laboratory measurements were performed at baseline and after 2 and 4 mo.


RESULTS
Group 1 showed an apparent recovery in laboratory parameters, with increases in medium corpuscular hemoglobin (P = 0.02), serum iron (P = 0.02), and ferritin (P = 0.04), and a decrease in transferrin (P = 0.002) after 4 mo. Individualized analysis showed that only one patient using ferrous sulfate had anemia at the end of the study in contrast to six patients using ferrous glycinate. In addition, ferritin levels increased above 20 microg/L at the end of the study in seven patients using ferrous sulfate in contrast to one patient using ferrous glycinate.


CONCLUSIONS
Patients with iron deficiency anemia after gastrectomy treated with ferrous sulfate had better results in hematologic laboratory parameters than those who used ferrous glycinate chelate.
Mimura
Erika C Mayumi
EC
Cancer Hospital of Londrina, Londrina, Paraná, Brazil.
Breganó
José Wander
JW
Dichi
Jane Bandeira
JB
Gregório
Emerson Pereira
EP
Dichi
Isaias
I
D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D001682:Biological Availability; D005260:Female; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005743:Gastrectomy / Q000009:adverse effects*; D005998:Glycine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007408:Intestinal Absorption; D007501:Iron / Q000097:blood; D007502:Iron Chelating Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016896:Treatment Outcome
D005296:Ferrous Compounds; D006454:Hemoglobins; D007502:Iron Chelating Agents; C073588:bis-glycino iron II; C020748:ferrous sulfate; D005293:Ferritins; D007501:Iron; D005998:Glycine