Ferrous sulfate (Fe2+) had a faster effect than did ferric polymaltose (Fe3+) on increased oxidant status in children with iron-deficiency anemia.

Objective: The purpose of this study was to compare the total oxidant and antioxidant effect of different oral iron preparations in children with iron-deficiency anemia (IDA). Methods: A total of 65 children with IDA were randomized to receive 5mg Fe/kg/d iron (II) sulfate (Fe2+ group, n = 33) or iron (III)-hydroxide polymaltose complex (Fe3+ group, n = 32); healthy controls (n = 28) were also included in the study. Serum total thiol (-SH), total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), and hematological profile were evaluated at the baseline and on day 8 and day 30 of the therapy. Results: Serum TOS and OSI levels were significantly higher and total -SH and total antioxidant capacity levels were significantly lower in the study groups at the beginning of therapy than in the controls (P > 0.001). In multivariate analysis, after controlling for multiple confounding factors, on days 8 and 30, serum TOS and OSI levels were not different in the Fe3+ group, whereas they were significantly reduced in the Fe2+ group (P <= 0.033). Conclusions: Serum total oxidant status was significantly increased in children with IDA, and Fe2+ was highly effective in correcting elevated oxidative status.