CLINICAL AND BIOCHEMICAL CHARACTERISTICS OF IRON METABOLISM INDICATORS IN IRON DEFICIENCY ANEMIA

Iron deficiency anemia represents the most prevalent nutritional and hematological disorder globally, arising when systemic iron absorption and reticuloendothelial recycling fail to meet the physiological demands of erythropoiesis and cellular oxidative metabolism. Although routine clinical screening predominantly relies on isolated hemoglobin and mean corpuscular volume measurements, these conventional hematological parameters manifest only during the terminal stage of iron exhaustion, frequently overlooking pre-latent and latent phases of intracellular iron depletion. This comprehensive clinical-biochemical study investigates the diagnostic and pathophysiological characteristics of circulating and storage iron metabolism indicators in patients diagnosed with varying severities of iron deficiency anemia. A cohort of patients with clinically and hematologically confirmed microcytic hypochromic anemia was systematically evaluated alongside an age- and sex-matched healthy control group. Biochemical profiling encompassed the quantitative assessment of serum iron, total iron-binding capacity, unsaturated iron-binding capacity, transferrin saturation coefficient, serum transferrin, serum ferritin, soluble transferrin receptors, and the regulatory peptide hormone hepcidin-twenty-five, paired with complete erythrocyte morphometric indices. The findings demonstrate that individuals with iron deficiency anemia exhibit a profound, statistically significant depletion of serum ferritin, serum iron, transferrin saturation, and circulating hepcidin concentrations, accompanied by a marked compensatory upregulation of total iron-binding capacity, serum transferrin, and soluble transferrin receptor levels. Furthermore, the soluble transferrin receptor-to-log ferritin index correlated strongly and inversely with blood hemoglobin concentrations, mean corpuscular hemoglobin, and hepcidin levels across mild, moderate, and severe anemia subgroups. The study concludes that integrating comprehensive biochemical iron metabolism panels—particularly soluble transferrin receptors, ferritin, and hepcidin—into routine clinical diagnostics provides superior sensitivity for staging cellular iron depletion, differentiating true iron deficiency from inflammation-induced functional iron restriction, and guiding targeted ferrotherapy.