Abstract
Background and AimsEvidence suggests obesity-related inflammation alters iron metabolism potentially increasing the risk of iron deficiency. This cross-sectional study aimed to investigate iron, hepcidin and inflammatory status in young, healthy overweight and obese women.Methods114 young (18–25 years), healthy comorbidity-free women with a body mass index (BMI) ≥27.5 kg/m2 were recruited. Biochemical data were analysed using mean ± standard deviation or median (interquartile range) and multivariate modelling. Biochemical markers were also stratified according to varying degrees of overweight and obesity.ResultsAnaemia (haemoglobin <120 g/l) and iron deficiency (serum ferritin <15.0 µg/l) were prevalent in 10% and 17% of participants respectively. Mean/median soluble transferrin receptor was 1.61±0.44 mg/l; hepcidin 6.40 (7.85) ng/ml and C-reactive protein (CRP) 3.58 (5.81) mg/l. Multivariate modelling showed that BMI was a significant predictor of serum iron (coefficient = -0.379; standard error = 0.139; p = 0.008), transferrin saturation (coefficient = -0.588; standard error = 0.222; p = 0.009) and CRP (coefficient = 0.127; standard error = 0.024; p<0.001). Stratification of participants according to BMI showed those with ≥35.0 kg/m2 had significantly higher CRP (p<0.001) than those in lower BMI categories.ConclusionsIncreasing obesity was associated with minor disturbances in iron metabolism. However, overall outcomes indicated simple iron deficiency (hypoferritinaemia) was the primary iron-related abnormality with no apparent contribution of inflammation or hepcidin, even in those with BMI >35.0 kg/m2. This indicates that obesity alone may not be sufficient to induce clinically significant disturbances to iron metabolism as previously described. This may be attributed to the lack of comorbidity in this cohort.
Highlights
Obesity is regarded as a pro-inflammatory condition characterised by the presence of chronic, low grade systemic inflammation. [1,2] In the past decade, a growing number of studies have suggested that obesity-related inflammation can lead to an iron handling defect similar to anaemia of inflammation (AI), [1] with hepcidin proposed as a key mediator.[2,3,4]
[6] In addition to regular menstrual iron loss, [7] low iron intake and restrictive dietary practices for weight loss in overweight women can increase the risk of iron deficiency. [8,9] Overweight and obese young women may have a combination of age, dietary and inflammatory-associated factors perturbing iron status
dual-energy x-ray absorptiometry (DXA) body composition information was obtained from a subset (n = 69) of participants (Table 1)
Summary
Premenopausal women are at higher risk of iron deficiency. [6] In addition to regular menstrual iron loss, [7] low iron intake (which is often reported in this group) and restrictive dietary practices for weight loss in overweight women can increase the risk of iron deficiency. [8,9] Overweight and obese young women may have a combination of age, dietary and inflammatory-associated factors perturbing iron status. Evidence suggests obesity-related inflammation alters iron metabolism potentially increasing the risk of iron deficiency. This cross-sectional study aimed to investigate iron, hepcidin and inflammatory status in young, healthy overweight and obese women
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