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Updated: Nov 1, 2025
Setup of Capillary Electrophoresis-Inductively Coupled Plasma Mass Spectrometry CE-ICP-MS for Quantification of Iron Redox Species FeII, FeIII
Published on: May 4, 2020
Relationship between oxidant-antioxidant status and hypercoagulobility indices in children with iron deficiency
Zeynep Canan Özdemir1, Emine Çolak2, Yeter Düzenli Kar1
1Division of Pediatric Hematology/Oncology, Department of Pediatrics.
Insights
Oxidative stress is linked to hypercoagulability in children with iron deficiency anaemia (IDA). Increased oxidative stress markers (TOS, OSI) correlated with higher clot firmness (MCF) and lower clot formation time (CFT), suggesting a role in IDA
Area of Science:
- Hematology
- Pediatrics
- Biochemistry
Background:
- Iron deficiency anaemia (IDA) is associated with a potential tendency towards hypercoagulability.
- The underlying mechanisms linking IDA and hypercoagulability, particularly the role of oxidative stress, remain incompletely understood.
Purpose of the Study:
- To investigate the relationship between oxidative stress and hypercoagulability in children diagnosed with IDA.
- To determine if oxidative stress markers correlate with indicators of hypercoagulability in pediatric IDA.
Main Methods:
- Rotational thromboelastometry (ROTEM) was used to assess hypercoagulability, measuring maximum clot firmness (MCF) and clot formation time (CFT) using INTEM and EXTEM assays.
- Serum levels of total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) were analyzed.
- A cohort of 57 children with IDA was compared to 48 healthy children.
Main Results:
- Children with IDA exhibited significantly higher OSI and TOS levels, and lower TAC levels compared to controls (P < 0.001).
- IDA group showed increased INTEM and EXTEM MCF and decreased INTEM CFT compared to controls (P < 0.001, P < 0.05).
- TOS and OSI positively correlated with INTEM/EXTEM MCF and negatively correlated with INTEM CFT (P < 0.001).
Conclusions:
- The oxidant-antioxidant balance is disrupted in favor of oxidative stress in children with IDA.
- Oxidative stress markers (TOS, OSI) are significantly correlated with hypercoagulability indices (CFT, MCF).
- Oxidative stress appears to be a key factor contributing to the hypercoagulable state observed in pediatric IDA.
Abstract:
Oxidative stress is a potential mechanism involved in the pathogenesis of iron deficiency anaemia (IDA). Although a tendency for hypercoagulability has been reported in IDA, its underlying mechanism is yet to be elucidated. This study investigated the probable relationship between oxidative stress and hypercoagulability in children with IDA. This study included 57 children diagnosed with IDA (IDA group) between October 2016 and October 2017 in addition to 48 healthy children (control group). The maximum clot firmness (MCF) index, and clot formation time (CFT) index, which are indicators of hypercoagulability in rotational thromboelastometry assays [intrinsic TEM (INTEM) and extrinsic TEM (EXTEM)] derived from our previous study, were recorded. Total oxidant status (TOS), total antioxidant capacity (TAC) and oxidative stress index (OSI) were analysed from serum samples of the individuals. In IDA group, OSI and TOS levels were higher and TAC level was lower compared to the control group (P < 0.001, for all). The EXTEM and INTEM MCF in the IDA group was higher than in the control group, while the INTEM CFT was lower than in the control group (P < 0.001, P < 0.001, P < 0.05, published data).TOS and OSI had a negative correlation with INTEM CFT (r:-0.361, P < 0.001 and r:-0.333, P = 0.001) and a positive correlation with INTEM MCF (r:+0.420, P < 0.001 and r:+0.367, P < 0.001) and EXTEM MCF (r:+0.476, P < 0.001 and r:+0.403, P < 0.001). However, TAC demonstrated no correlation with CFT and MCF index. The oxidant-antioxidant balance is disrupted in favour of oxidative stress in children with IDA. In addition, TOS and OSI, which are parameters of oxidative stress, are correlated with CFT and MCF indices. Oxidative stress appears to be an important factor for the development of tendency to hypercoagulability in IDA.
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