The Relationship Between Iron Deficiency Anemia and Lipid Metabolism in Premenopausal Women

Iron deficiency and lipid metabolism disorders are common health problems. We investigated the relationship between iron deficiency anemia and lipid metabolism in premenopausal women, in whom iron deficiency anemia is not uncommon. This prospective cohort study was carried out in 64 premenopausal women (median age of 40 years, ranging from 15 to 52) with iron deficiency anemia and 21 non-anemic control women (median age of 38 years, ranging from 28 to 50). Serum ferritin values less than 11 ng/mL and transferrin saturation below 15% were accepted as indicators of iron deficiency. All anemic patients were treated with oral iron replacement. The mean levels of total and low density lipoprotein cholesterol of anemic women were lower than those of non-anemic control patients (173.6 ± 39.3 vs 205.7 ± 36.0, P=0.001, 105.3 ± 32.7 vs 135.6 ± 31.3mg/dL, P < 0.001, respectively). Despite increasing significantly after treatment of anemia (from 173.6 ± 39.3 to 181.6 ± 35.2, P=0.018, from 105.3 ± 32.7 to 111.3 ± 29.4mg/dL, P=0.029, respectively), their levels were still lower than in the control subjects (181.6 ± 35.2 vs 205.7 ± 36.0mg/dL, P=0.008, 111.3 ± 29.4 vs 135.6 ± 31.3mg/dL, P=0.002, respectively). In anemic patients, statistically significant positive correlations were found between the pre-treatment total cholesterol levels and hemoglobin (r=0.336, P=0.007), hematocrit (r=0.326, P=0.009), serum iron (r=0.404, P=0.001), serum ferritin (r=280, P=0.026), and transferrin saturation (r=0.314, P=0.012). The only significant factor affecting pre-treatment total cholesterol levels was serum iron. We hypothesize that low iron states in premenopausal women may exert an additional protective effect against atherosclerotic heart disease via lipid metabolism.