Obesity Is Associated with Changes in Iron Nutrition Status and Its Homeostatic Regulation in Pregnancy.

Maria Eugenia Flores-Quijano,Rodrigo Vega-Sánchez,Ana Daniela López-Olvera,Mari Cruz Tolentino-Dolores,Mónica Crissel Flores-Urrutia,Mardia Guadalupe López-Alarcón,Juan O Talavera

doi:10.3390/nu11030693

Maria Eugenia Flores-Quijano, Rodrigo Vega-Sánchez + Show 5 more

Open Access

https://doi.org/10.3390/nu11030693

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Abstract

The influence of obesity on maternal iron homeostasis and nutrition status during pregnancy remains only partially clarified. Our study objectives were (1) to describe how obesity influences broad iron nutrition spectrum biomarkers such as available or circulating iron (serum transferrin receptor (sTfr) and serum iron), iron reserves (ferritin), and functional iron (hemoglobin); and (2) to depict the regulating role of hepcidin. The above was carried out while considering influential factors such as initial iron nutrition status, iron intake, and the presence of inflammation. Ninety three non-anemic pregnant adult women were included, 40 with obesity (Ob) and 53 with adequate weight (AW); all took ≈30 mg/day of supplementary iron. Information on iron intake and blood samples were obtained at gestational weeks 13, 20, 27, and 35. A series of repeated measure analyses were performed using General Linear Models to discern the effect of obesity on each iron indicator; iron intake, hepcidin, and C-reactive protein were successively introduced as covariates. Available and circulating iron was lower in obese women: sTfr was higher (p = 0.07) and serum iron was lower (p = 0.01); and ferritin and hemoglobin were not different between groups. Hepcidin was higher in the Ob group (p = 0.01) and was a significant predictor variable for all biomarkers. Obesity during pregnancy dysregulates iron homeostasis, resembling “obesity hypoferremia”.

Highlights

Iron deficiency during pregnancy may result in women experiencing a diminished capability to perform physical activity [1], a greater susceptibility to infections [2], depression [3], and a lower quality of interaction with their children during the postpartum period [4]
It is known that serum transferrin receptor (sTfr) concentration increases when tissues have a greater need for iron, which is driven by two reasons: there is less iron than necessary or the tissue is in a stage of increased erythropoiesis, as in the case of gestation
Concerning iron reserves, we found no difference in ferritin concentrations between the adequate weight (AW)

Summary

Introduction

Iron deficiency during pregnancy may result in women experiencing a diminished capability to perform physical activity [1], a greater susceptibility to infections [2], depression [3], and a lower quality of interaction with their children during the postpartum period [4]. Iron deficiency may progress to anemia, which is associated with prematurity and low birth weight [5]. In Mexico, as in many other countries, iron deficiency anemia is a public health problem among women of reproductive age. According to the latest Health and Nutrition Survey 2016 (Ensanut MC 2016), 18.5% of Mexican adult women are anemic [6], and for each of these women, presumably at least another is iron deficient [7,8]. In Mexico, the prevention of iron deficiency with anemia has long been a priority in health and nutrition programs for women of reproductive age [9]. Other factors that may influence the permanence of this public health problem have been overlooked, such as obesity, which is present in 38.6% [10] of women of reproductive age in our country

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