Serum Copper Homeostasis and Its Relationship with Iron Deficiency Anemia in Children

Abstract

Copper-dependent ferroxidases are required for cellular iron export, but local pediatric data on copper status in iron deficiency anemia (IDA) are limited. This comparative cross-sectional study evaluated serum copper homeostasis in 300 children aged 1-15 years at Civil Hospital, Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan. The study included 150 biochemically confirmed IDA cases and 150 age-matched healthy controls. Complete blood count, serum iron, ferritin, and copper were measured using validated hematological and biochemical procedures; serum copper was estimated by a bathocuproine-based method on the ADVIA 1800 Chemistry analyzer with trace-element-aware sample handling. Children with IDA showed significantly lower mean serum copper than controls (86.34 ± 0.83 vs 120.41 ± 1.02 µg/dL; P < 0.001). Serum iron (63.71 ± 1.54 vs 105.80 ± 1.52 µg/dL) and ferritin (8.57 ± 2.14 vs 35.68 ± 4.89 ng/mL) were also significantly reduced. Within the IDA group, serum copper correlated positively with serum iron (r = 0.52; P < 0.001) and ferritin (r = 0.49; P < 0.001). These findings indicate disturbed copper homeostasis accompanying pediatric IDA and support selective copper assessment in severe, recurrent, or treatment-resistant cases.