A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials

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Background and purpose: Bioavailability studies and observational evidence suggest that heme iron (HI) may have greater impact on iron status indicators compared with non-heme iron (NHI). This systematic review and meta-analysis aimed to review the current evidence on the effect of the administratio...

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Detalles Bibliográficos
Autores: Gallo Ruelas, Mariano, Alvarado-Gamarra, Giancarlo, Aramburu, Adolfo, Dolores-Maldonado, Gandy, Cueva, Karen, Rojas-Limache, Gabriela, Diaz-Parra, Carmen del Pilar, Lanata, Claudio F.
Formato: artículo
Fecha de Publicación:2025
Institución:Universidad Peruana de Ciencias Aplicadas
Repositorio:UPC-Institucional
Lenguaje:inglés
OAI Identifier:oai:repositorioacademico.upc.edu.pe:10757/683816
Enlace del recurso:http://hdl.handle.net/10757/683816
Nivel de acceso:acceso abierto
Materia:Anemia
Heme iron
Humans
Iron administration (MeSH terms)
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dc.title.es_PE.fl_str_mv A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
title A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
spellingShingle A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
Gallo Ruelas, Mariano
Anemia
Heme iron
Humans
Iron administration (MeSH terms)
title_short A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
title_full A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
title_fullStr A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
title_sort A comparative analysis of heme vs non-heme iron administration: a systematic review and meta-analysis of randomized controlled trials
author Gallo Ruelas, Mariano
author_facet Gallo Ruelas, Mariano
Alvarado-Gamarra, Giancarlo
Aramburu, Adolfo
Dolores-Maldonado, Gandy
Cueva, Karen
Rojas-Limache, Gabriela
Diaz-Parra, Carmen del Pilar
Lanata, Claudio F.
author_role author
author2 Alvarado-Gamarra, Giancarlo
Aramburu, Adolfo
Dolores-Maldonado, Gandy
Cueva, Karen
Rojas-Limache, Gabriela
Diaz-Parra, Carmen del Pilar
Lanata, Claudio F.
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Gallo Ruelas, Mariano
Alvarado-Gamarra, Giancarlo
Aramburu, Adolfo
Dolores-Maldonado, Gandy
Cueva, Karen
Rojas-Limache, Gabriela
Diaz-Parra, Carmen del Pilar
Lanata, Claudio F.
dc.subject.es_PE.fl_str_mv Anemia
Heme iron
Humans
Iron administration (MeSH terms)
topic Anemia
Heme iron
Humans
Iron administration (MeSH terms)
description Background and purpose: Bioavailability studies and observational evidence suggest that heme iron (HI) may have greater impact on iron status indicators compared with non-heme iron (NHI). This systematic review and meta-analysis aimed to review the current evidence on the effect of the administration of HI compared with NHI for improving iron status in non-hospitalized population groups. Methods: We searched Pubmed, CENTRAL, Scopus, Web of Science, and LILACS from inception to July 2024. There was no language restriction or exclusion based on age or iron status. Only randomized controlled trials comparing HI with NHI were considered. A random-effects meta-analysis was performed to compare the effect of treatments for iron status indicators and total side effects (including gastrointestinal side effects). We measured the certainty of the evidence (CoE) using GRADE assessment. Results: After screening 3097 articles, 13 studies were included. Most of the interventions used HI in low doses combined with NHI. The meta-analysis showed higher hemoglobin increases in children with anemia or low iron stores receiving HI (MD 1.06 g/dL; 95% CI: 0.34; 1.78; CoE: very low). No statistically significant difference between interventions were found for any iron status indicator in the other population subgroups (CoE: very low). Participants receiving HI had a 38% relative risk reduction of total side effects compared to NHI (RR 0.62; 95% CI 0.40; 0.96; CoE: very low). Conclusion: The current evidence comparing HI with NHI is very limited, preliminary findings suggest that interventions using HI may result in fewer side effects and may be superior in children with iron deficiency or anemia. However, given the very low certainty of the evidence, these results need further investigation through high-quality clinical trials. Protocol registration: CRD42023483157.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-01-07T17:22:59Z
dc.date.available.none.fl_str_mv 2025-01-07T17:22:59Z
dc.date.issued.fl_str_mv 2025-02-01
dc.type.es_PE.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.issn.none.fl_str_mv 14366207
dc.identifier.doi.none.fl_str_mv 10.1007/s00394-024-03564-y
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10757/683816
dc.identifier.eissn.none.fl_str_mv 14366215
dc.identifier.journal.es_PE.fl_str_mv European Journal of Nutrition
dc.identifier.eid.none.fl_str_mv 2-s2.0-85212793341
dc.identifier.scopusid.none.fl_str_mv SCOPUS_ID:85212793341
dc.identifier.isni.none.fl_str_mv 0000 0001 2196 144X
dc.identifier.ror.none.fl_str_mv 047xrr705
identifier_str_mv 14366207
10.1007/s00394-024-03564-y
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European Journal of Nutrition
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url http://hdl.handle.net/10757/683816
dc.language.iso.es_PE.fl_str_mv eng
language eng
dc.rights.es_PE.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.es_PE.fl_str_mv application/pdf
dc.publisher.es_PE.fl_str_mv Springer Science and Business Media Deutschland GmbH
dc.source.es_PE.fl_str_mv Universidad Peruana de Ciencias Aplicadas (UPC)
Repositorio Academico - UPC
dc.source.none.fl_str_mv reponame:UPC-Institucional
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institution UPC
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collection UPC-Institucional
dc.source.journaltitle.none.fl_str_mv European Journal of Nutrition
dc.source.volume.none.fl_str_mv 64
dc.source.issue.none.fl_str_mv 1
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This systematic review and meta-analysis aimed to review the current evidence on the effect of the administration of HI compared with NHI for improving iron status in non-hospitalized population groups. Methods: We searched Pubmed, CENTRAL, Scopus, Web of Science, and LILACS from inception to July 2024. There was no language restriction or exclusion based on age or iron status. Only randomized controlled trials comparing HI with NHI were considered. A random-effects meta-analysis was performed to compare the effect of treatments for iron status indicators and total side effects (including gastrointestinal side effects). We measured the certainty of the evidence (CoE) using GRADE assessment. Results: After screening 3097 articles, 13 studies were included. Most of the interventions used HI in low doses combined with NHI. The meta-analysis showed higher hemoglobin increases in children with anemia or low iron stores receiving HI (MD 1.06 g/dL; 95% CI: 0.34; 1.78; CoE: very low). No statistically significant difference between interventions were found for any iron status indicator in the other population subgroups (CoE: very low). Participants receiving HI had a 38% relative risk reduction of total side effects compared to NHI (RR 0.62; 95% CI 0.40; 0.96; CoE: very low). Conclusion: The current evidence comparing HI with NHI is very limited, preliminary findings suggest that interventions using HI may result in fewer side effects and may be superior in children with iron deficiency or anemia. However, given the very low certainty of the evidence, these results need further investigation through high-quality clinical trials. 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