Peran Vitamin C dan Besi dalam Patogenesis Anemia Defisiensi Besi: Absorpsi, Metabolisme, dan Biomarker Klinis
Keywords:
anemia, besi, biomarkerAbstract
Anemia defisiensi besi (ADB) terjadi ketika ketersediaan besi tidak mencukupi sintesis hemoglobin dan eritropoiesis. Vitamin C dapat meningkatkan bioavailabilitas besi non-heme dengan mempertahankan besi dalam bentuk tereduksi yang lebih larut, tetapi manfaat klinis penambahan vitamin C secara rutin pada terapi besi oral masih diperdebatkan. Artikel review naratif ini menyintesis uji klinis, meta-analisis, dan tinjauan mekanistik yang disediakan mengenai absorpsi intestinal, regulasi metabolisme besi sistemik, dan pemeriksaan laboratorium. Besi non-heme diserap terutama di duodenum, diproses di enterosit, lalu diekspor melalui ferroportin; proses ini dikendalikan antara lain oleh hepcidin yang diproduksi hati. Uji acak terhadap 440 pasien dewasa menunjukkan pemulihan hemoglobin yang sebanding antara besi oral saja dan besi oral ditambah vitamin C. Sebaliknya, meta-analisis tahun 2024 menemukan peningkatan rerata hemoglobin dan ferritin yang kecil pada kelompok kombinasi. Perbedaan tersebut menunjukkan bahwa mekanisme biologis yang masuk akal tidak selalu menghasilkan manfaat klinis besar. Hemoglobin dan indeks eritrosit digunakan untuk menilai anemia, sedangkan ferritin, saturasi transferin, dan pada kondisi tertentu reseptor transferin terlarut membantu menilai status besi. Ferritin dapat meningkat akibat inflamasi sehingga hasilnya perlu ditafsirkan bersama saturasi transferin dan konteks klinis. Review ini menyimpulkan bahwa penggantian besi dan pencarian penyebab dasar tetap menjadi prioritas; suplementasi vitamin C rutin belum terbukti diperlukan untuk semua pasien, dan biomarker perlu dinilai secara terpadu.
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Copyright (c) 2026 Nursia Marsaulina Panjaitan, Manna Wa Salwa, Aulia Nurmala Sari, Meliana Meliana, Jihan Nur Asyfa Hanafi, Murniaty Simorangkir
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