Inflammation and iron deficiency in the hypoferremia of obesity
Open Access
- 17 April 2007
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Obesity
- Vol. 31 (9), 1412-1419
- https://doi.org/10.1038/sj.ijo.0803625
Abstract
Context: Obesity is associated with hypoferremia, but it is unclear if this condition is caused by insufficient iron stores or diminished iron availability related to inflammation-induced iron sequestration. Objective: To examine the relationships between obesity, serum iron, measures of iron intake, iron stores and inflammation. We hypothesized that both inflammation-induced sequestration of iron and true iron deficiency were involved in the hypoferremia of obesity. Design: Cross-sectional analysis of factors anticipated to affect serum iron. Setting: Outpatient clinic visits. Patients: Convenience sample of 234 obese and 172 non-obese adults. Main outcome measures: Relationships between serum iron, adiposity, and serum transferrin receptor, C-reactive protein, ferritin, and iron intake analyzed by analysis of covariance and multiple linear regression. Results: Serum iron was lower (75.8±35.2 vs 86.5±34.2 g/dl, P=0.002), whereas transferrin receptor (22.6±7.1 vs 21.0±7.2 nmol/l, P=0.026), C-reactive protein (0.75±0.67 vs 0.34±0.67 mg/dl, Pμg/l, P=0.009) were higher in obese than non-obese subjects. Obese subjects had a higher prevalence of iron deficiency defined by serum iron (24.3%, confidence intervals (CI) 19.3–30.2 vs 15.7%, CI 11.0–21.9%, P=0.03) and transferrin receptor (26.9%, CI 21.6–33.0 vs 15.7%, CI 11.0–21.9%, P=0.0078) but not by ferritin (9.8%, CI 6.6–14.4 vs 9.3%, CI 5.7–14.7%, P=0.99). Transferrin receptor, ferritin and C-reactive protein contributed independently as predictors of serum iron. Conclusions: The hypoferremia of obesity appears to be explained both by true iron deficiency and by inflammatory-mediated functional iron deficiency.Keywords
This publication has 47 references indexed in Scilit:
- Lipocalin-2 Is an Inflammatory Marker Closely Associated with Obesity, Insulin Resistance, and Hyperglycemia in HumansClinical Chemistry, 2007
- Increased Adipose Tissue Expression of Hepcidin in Severe Obesity Is Independent From Diabetes and NASHGastroenterology, 2006
- Iron thieveryNature, 2004
- Overweight Children and Adolescents: A Risk Group for Iron DeficiencyPublished by American Academy of Pediatrics (AAP) ,2004
- Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase proteinBlood, 2003
- Inappropriate expression of hepcidin is associated with iron refractory anemia: implications for the anemia of chronic diseaseBlood, 2002
- Association of serum ferritin and indices of body fat distribution and obesity in Mexican American men—the Third National Health and Nutrition Examination SurveyInternational Journal of Obesity, 2001
- Hepcidin, a Urinary Antimicrobial Peptide Synthesized in the LiverJournal of Biological Chemistry, 2001
- Current issues in iron deficiencyCurrent Opinion in Hematology, 1996
- HYPOFERRÆMIA IN OBESE ADOLESCENTSThe Lancet, 1962