Abstract
Markers of iron metabolism are altered in new-onset diabetes, but their relationship with metabolic signals involved in the maintenance of energy balance is poorly understood. The primary aim was to explore the associations between markers of iron metabolism (hepcidin and ferritin) and markers of energy balance (leptin, ghrelin, and the leptin/ghrelin ratio) in both the fasted and postprandial states. These associations were also studied in the sub-groups stratified by diabetes status. This was a cross-sectional study of individuals without disorders of iron metabolism who were investigated after an overnight fast and, in addition, some of these individuals underwent a mixed meal test to determine postprandial responses of metabolic signals. The associations between hepcidin, ferritin, and leptin, ghrelin, leptin/ghrelin ratio were studied using several multiple linear regression models. A total of 76 individuals in the fasted state and 34 individuals in the postprandial state were included. In the overall cohort, hepcidin was significantly inversely associated with leptin (in the most adjusted model, the β coefficient ± SE was −883.45 ± 400.94; p = 0.031) and the leptin/ghrelin ratio (in the most adjusted model, the β coefficient ± SE was −148.26 ± 61.20; p = 0.018) in the fasted state. The same associations were not statistically significant in the postprandial state. In individuals with new-onset prediabetes or diabetes (but not in those with normoglycaemia or longstanding prediabetes or diabetes), hepcidin was significantly inversely associated with leptin (in the most adjusted model, the β coefficient ± SE was −806.09 ± 395.44; p = 0.050) and the leptin/ghrelin ratio (in the most adjusted model, the β coefficient ± SE was −129.40 ± 59.14; p = 0.037). Leptin appears to be a mediator in the link between iron metabolism and new-onset diabetes mellitus. These findings add to the growing understanding of mechanisms underlying the derangements of glucose metabolism.
Highlights
The central nervous system integrates metabolic signals from peripheral tissues to maintain energy balance
There were no significant associations between ferritin and leptin, ghrelin, and the leptin/ghrelin ratio, in both the unadjusted and adjusted models (Table 4)
To the best of our knowledge, this is the first study in people with no diseases of iron metabolism reporting the associations between markers of iron metabolism and metabolic signals involved in the maintenance of energy balance
Summary
The central nervous system integrates metabolic signals from peripheral tissues to maintain energy balance. Leptin and ghrelin are key metabolic signals in this regard. Leptin is a hormone secreted primarily from the adipose tissue to relay the status of the energy stores to the central nervous system [1,2]. Leptin acts by stimulating the anorexigenic pathways in the appetite-regulating nucleus of the human hypothalamus, transmitting this information as peripheral signals that cause appetite suppression, limit food intake/energy consumption, and regulate energy expenditure [3,4]. Ghrelin primarily stimulates orexigenic pathways that trigger the feeling of hunger and increase appetite by affecting the same hypothalamic arcuate neurons engaged by leptin [7,8,9]. Ghrelin and leptin are antagonistic signals, and the leptin/ghrelin ratio is deemed a biomarker of metabolic adaptation to energy balance [10,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
