Assessment of Oxidative Stress-Induced Anemia and Nutritional Deficiency in Various Arthritic Conditions: A Clinical Study

Abstract

Background: Arthritis encompasses a spectrum of chronic inflammatory disorders affecting joints and connective tissues, including conditions like rheumatoid arthritis (RA), osteoarthritis (OA), and Ankylosing spondylitis (AS). These disorders are frequently accompanied by systemic complications such as anemia and nutritional deficiencies. A growing body of evidence suggests that oxidative stress—an imbalance between reactive oxygen species (ROS) and antioxidant defenses—plays a pivotal role in the pathogenesis of arthritis and contributes to anemia by damaging erythrocytes and impairing erythropoiesis. Moreover, chronic inflammation in arthritis affects the absorption, metabolism, and utilization of essential micronutrients, leading to nutritional deficiency.
Objectives: The aim of this study was to assess the prevalence and severity of oxidative stress-induced anemia and nutritional deficiencies in patients with different arthritic conditions.
Materials and Methods: This hospital-based, observational clinical study included 120 diagnosed arthritis patients (40 each from RA, OA, and AS groups) attending the outpatient department of a tertiary care center. Patients were evaluated for hemoglobin (Hb), red cell indices, serum iron, ferritin, vitamin B12, folate, and oxidative stress biomarkers, including malondialdehyde (MDA), superoxide dismutase (SOD), and total antioxidant capacity (TAC). Standard biochemical methods and automated analyzers were used. Statistical analysis was performed using Microsoft Excel software, with p <0.05 considered statistically significant.
Results: Anemia was found in 76.6% of patients, with the highest prevalence in RA (85%), followed by AS (75%) and OA (70%). Mean MDA levels were significantly elevated in RA and AS compared to OA, indicating higher oxidative stress. Antioxidant enzymes like SOD and TAC were markedly decreased in all arthritis subgroups. Nutritional deficiencies, especially of iron and vitamin B12, were more common in RA patients. A significant inverse correlation was observed between MDA levels and hemoglobin concentration (r = -0.48, p < 0.01). Positive correlations were noted between antioxidant status and nutritional markers.
Conclusion: Oxidative stress-induced anemia and nutritional deficiencies are prevalent in various arthritic disorders, especially in RA and AS. Early screening for oxidative and nutritional markers in arthritic patients can improve clinical outcomes by guiding antioxidant and nutritional support strategies.