Iron Deficiency Research Articles

Iron deficiency anemia among infants: a retrospective cohort study

Postnatal iron deficiency, especially from ages 6 to 24 months, has long-term consequences lasting into adolescence and adulthood. We aimed to characterize iron deficiency anemia among infants from one central Israeli district by demographic and laboratory parameters. A retrospective chart review was performed on all infants from a single district who had undergone a complete blood count as part of a routine survey for iron deficiency anemia during 2010–2021. Data retrieved included hemoglobin levels, mean corpuscular volume, and demographic features: sex, sector (non-ultraorthodox Jew, ultraorthodox Jew, and Arab), socioeconomic status, and type of residence. The study group comprised 101,650 infants, aged 9 to 18 months. Iron deficiency anemia, defined as a hemoglobin level <11 g/dL and mean corpuscular volume <70 fl was observed in 4296 (4.2%) of the study infants. Iron deficiency anemia was more prevalent among Arab and ultraorthodox Jewish infants, than non-ultraorthodox Jewish infants (6.6% vs. 6% vs. 3%, respectively). It was also more prevalent among infants of low socioeconomic status, and relatively common among infants of rural residence. We identified two specific sub-populations at risk of developing iron deficiency anemia: Arab and ultraorthodox Jewish infants. We recommend enhancing the nationwide intervention program for both clinicians and parents, thereby treating iron deficiency anemia promptly to avoid short- and long-term deleterious health consequences.

A Study on the of Nutrition, Health and Hygiene Counselling impact on Iron Deficiency Anaemia

Iron deficiency anemia (IDA) is a prevalent nutritional disorder, especially among women and children in developing countries. This study investigates the impact of nutrition, health, and hygiene counseling on the prevalence and management of iron deficiency anemia. Through a combination of dietary modifications, health education, and hygiene practices, the study aims to evaluate improvements in hemoglobin levels and overall health outcomes. Participants included women of reproductive age and children from a rural community, who were provided with structured counseling sessions over six months. Baseline and post-intervention data on hemoglobin levels, dietary intake, and hygiene practices were collected and analyzed. The results demonstrate significant improvements in hemoglobin levels and a reduction in the incidence of IDA, highlighting the effectiveness of comprehensive counseling as a sustainable intervention strategy.

Comparison of the efficacy and adverse effects of oral ferrous succinate tablets and intravenous iron sucrose: a retrospective study

ObjectiveTo analyse the clinical efficacy and adverse drug reactions (ADRs) of iron preparations.MethodsA total of 374 patients with iron deficiency anaemia admitted to our hospital between 1 January and 31 December 2020 were included in this study. They were divided into 2 groups based on their medication regimens: Group A (n = 187) took oral ferrous succinate tablets, and Group B (n = 187) received intravenous iron sucrose. The remission of major symptoms, laboratory test results, ADRs and other related data were collected after 4 weeks of treatment.ResultsCompared with the pre-treatment baseline, haemoglobin (Hb), serum iron (SI), serum ferritin (SF) and the mean corpuscular volume (MCV) increased in both groups at 4 weeks of treatment (P < 0.05). After treatment, Group A had lower levels of Hb (108.41 ± 8.39 vs. 122.31 ± 6.04 g/L, t = 6.293, P < 0.001), SI (9.72 ± 4.24 vs. 15.62 ± 5.41 µmol/L, t = 5.482, P < 0.001) and SF (27.1 ± 10.82 vs. 39.82 ± 10.44 ug/L, t = 6.793, P < 0.001) compared with Group B. In contrast, there was no significant difference in the post‐treatment level of MCV (P > 0.05). The overall response rate significantly differed between the 2 groups (78.61% vs. 90.91%, χ2 = 10.949, P < 0.001). The incidence of ADRs of both groups were similar, and the difference was not statistically significant (χ2 = 0.035, P = 0.851).ConclusionIron sucrose demonstrates favourable efficacy and safety in treating iron deficiency anaemia.

The impact of different doses of oral iron supplementation during pregnancy: a pilot randomized trial

AbstractThe burden of iron deficiency anemia remains significant during pregnancy. Oral iron is the first-line medication, but there is uncertainty about a range of factors including adherence and the side effects of different doses. We conducted a pilot randomized trial to investigate the impact of different doses of oral iron supplementation started early in pregnancy on women without anemia for 4 main outcomes, namely recruitment and protocol compliance, adherence, maintenance of maternal hemoglobin, and side effects. At antenatal clinic visits, participants were allocated to 1 of the 3 following trial arms in a 1:1:1 ratio: 200 mg ferrous sulfate daily, alternate days, or 3 times per week. The participants were followed up to delivery. The baseline characteristics of 300 recruited participants were well matched between trial arms. The mean proportion of tablets taken as expected per participant was 82.5% overall (72.3%, 89.6%, and 84.5% for the daily, alternate days, and 3 times a week arm, respectively). There was a lower overall adherence rate in the daily arm (47%) than in the alternate days (62%) and the 3 times per week (61%) arms. A reduction in hemoglobin between randomization and 28 weeks’ gestation seemed smaller for the daily arm. A range of side effects were commonly reported at baseline before starting interventions and at later antenatal visits. Many side effects of iron overlapped with normal pregnancy symptoms. A daily iron dosing schedule might give the best opportunity for delivering an adequate iron load during pregnancy in women without anemia. Further randomized trials powered on clinical outcomes are needed to establish the clinical effectiveness of oral iron supplementation to prevent iron deficiency anemia. This study was registered in the ISRCTN registry as #ISRCTN12911644.

Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing of blood donors by Australian Red Cross Lifeblood.

Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing of blood donors by Australian Red Cross Lifeblood.

Dietary patterns and association with Iron deficiency among children and adolescents aged 9-17 years in rural Guangzhou, China: a cross-sectional study.

Iron deficiency and iron deficiency anemia cause a huge disease burden worldwide. Diet is an important factor affecting the iron levels. This study aims to explore the dietary patterns of school-aged children in rural areas of Guangzhou and their association with iron deficiency. Data on dietary surveys, lifestyle, demographic and laboratory tests were gathered from rural school-age children in Guangzhou. Factor analysis was applied to derive dietary patterns. Robust Poisson regression and subgroup analysis were used to analyze the association between dietary patterns and iron deficiency. A total of 2,530 children and adolescents aged 9-17 years were enrolled. The prevalence of iron deficiency was 13.36%. Four dietary patterns were identified including snack and fast-food pattern, fruit and vegetable pattern, cereal and tuber pattern and meat and offal pattern. Both children and adolescents in the Q4 group (the highest propensity) of snack and fast-food pattern and cereal and tuber pattern had a higher risk of iron deficiency than the Q1 group (the lowest propensity). Both children and adolescents in the Q4 group of meat and offal pattern and fruit and vegetable pattern had a lower risk of iron deficiency than the Q1 group. The results of stratified analysis showed the negative effect of snack and fast-food pattern and the protective benefits of meat and offal pattern are more obvious for boys, and the negative effect of cereal and tuber pattern were obvious for girls. The negative effect or protective benefits of the four dietary patterns were obvious for children aged 9-13. Females, older children, and those with shorter sleep duration are at higher risk of iron deficiency. Snack and fast-food pattern and cereal and tuber pattern are risk factors for iron deficiency, and fruit and vegetable pattern and meat and offal pattern are protective factors for iron deficiency. The impact of diet on body iron levels is more obvious in boys and younger children. The findings of this study can provide evidence for formulating prevention and control measures on children and adolescents iron deficiency and iron deficiency anemia.

Association of FGF23 Levels and Development of Anemia in Patients with Non Dialysis Chronic Kidney Disease

Background: Anemia is one of the common complication of Chronic Kidney Disease that intensifies in grade and severity as eGFR decline which also increases the risks for cardiovascular mortality. The development of anemia and elevated fibroblast growth factor 23 levels are the earliest changes observed in chronic kidney disease. Objective: This study aims to understand the association of FGF23 levels development of anemia in chronic kidney disease patients prior to renal replacement therapy. Methods: This is an analytical type of cross sectional study carried out among 95 respondent'1ged between 18 and 75 years with CKD stage 1-5 before dialysis, divided into two groups- Group I­ comprised of 68 patients and Group 11- included 27 age and sex matched respondents not having CKD, enrolled from two te1tiary-care hospitals, namely- Sir Salimullah Medical College &amp; Mitford Hospital and National Institute of Kidney Diseases &amp; Urology (NIKDU). Socio-demographic status, disease profile and laboratory findings including serum iron, iron binding capacity, ferritin, transferrin saturation, calcium, phosphorus, intact parathormone, vitamin D, eGFR and FGF-23 levels were studied. Result: Mean age of the respondents was 50.1±10.74 (SD) years, mean estimated glomerular filtration rate was 35.92± 22.61 in group I and 91.66± 14.2 in group II. The mean FGF23 level in group I and II were 85.76± 207.54, 21.99± 12.12 pg/mL respectively, serum iron level was 81.61± 39.24 mcg/dL and 95.0± 32.38 mcg/dL in group I and II respectively, serum ferritin level was 225.59± 2 I 2.5 ng/mL and 157.85± 220.89 ng/ml. TIBC was 312.65± 95.83 mcg/dL and 418.85± 118.25 mcg/dL in group I and II respectively. In Group I and II, iron deficiency was found in 23% and 25%respectively when stratified according to serum ferritin level and 26.5% and 22.22% respectively, when stratified according to serum transferrin saturation level. This difference was significant among the group. Serum iron, ferritin, TIBC and TSAT were significantly associated with serum FGF23 levels. Conclusion: Disrupted iron metabolism and high FGF23 levels is commonly found in chronic kidney disease. Clinical laboratory findings have revealed the relation between FGF23 and anemia in no dialysis chronic kidney disease patients.

Iron chelation capacity and prediction of peptide binding modes identified in California red worm hydrolysates and effects on iron bioavailability in differentiated Caco-2 cells

Metal-chelating peptides represent an alternative for overcoming iron deficiencies, a common nutritional disease affecting populations worldwide. This study explored the iron-chelating activity of California red worm hydrolysates (WH) and its fractions. WH was obtained by hydrolysis with Alcalase 2.4 L and fractionated using a ceramic membrane with molecular weight cutoff 3 kDa. Both the complete hydrolysate and its fractions were assessed for their in-vitro iron-chelating activity and their ability to improve iron bioavailability through ferritin formation by differentiated Caco-2 cells assay. Finally, peptides in the fraction with the highest activity were sequenced by LC-MS/MS analysis and molecular docking was performed to elucidate the chelation mechanism. The findings reveal that the smallest fraction (F < 3 kDa) exhibits the most potent iron-chelating activity with IC50 value like carnosine. Moreover, in intestinal-like differentiated Caco-2 cells, this fraction enhances iron bioavailability in a remarkable 77.9% in comparison to FeSO4 alone. On the other hand, the peptide SLLDDRLDEK identified in this fraction presents the lowest value of affinity energy (−1.5 kcal/mol) and exhibits specific interactions with iron, allowing iron ions to be trapped within its structure. These results underscore the potential of F < 3 kDa fractions from WH as promising candidates for increasing iron bioavailability and addressing iron deficiency and related health concerns.

Effects of Different Doses of Oral Iron on Hepcidin and Treatment Response in Iron Deficiency Anemia

Effects of Different Doses of Oral Iron on Hepcidin and Treatment Response in Iron Deficiency Anemia

From the marrow to the blood: Optimising the diagnosis of iron deficiency in the setting of inflammation

Iron deficiency (ID) is a common condition with readily available treatment but can be challenging to diagnose. Traditional biomarkers of ID are acute phase reactants, which complicates diagnosis in patients with co-existent inflammation. This study aimed to establish optimal biomarker diagnostic thresholds for ID diagnosis using bone marrow (BM) iron stores as the gold standard and the C-reactive protein (CRP) as an inflammatory marker.A cross-sectional study was carried out in the haematology department of a tertiary academic hospital. Patients undergoing BM biopsies for any reason were recruited for inclusion. Retrospective case finding was used to enrich the data for cases with confirmed BM ID. Laboratory markers including red cell indices, reticulocyte haemoglobin and iron studies were evaluated to establish optimal cut-offs for ID diagnosis. A CRP of >5 mg/L was used as a marker of inflammation.The study included 139 patients. Forty-two had BM ID with a median serum ferritin (SF) of 48.5 μg/L. 96/134 (72%) had inflammation with a CRP >5mg/L. A SF of <80 μg/L had optimal sensitivity (69%) and specificity (94%) for ID diagnosis in the whole group (OR 23.5; CI 4.3-129). In patients without inflammation, a SF 80 μg/L cut-off had high sensitivity (93%) and specificity (96%). A SF <200 μg/L indicated ID in those with inflammation (sensitivity 78%, specificity 74%). A transferrin saturation of <13% in those with inflammation increased the diagnostic specificity (92%). The reticulocyte haemoglobin was unhelpful in diagnosing ID in this setting.In this hospital population, SF was the best parameter to diagnose ID, even in the presence of inflammation. The CRP was useful to identify populations with inflammation in whom higher SF thresholds could be used together with the transferrin saturation to accurately diagnose ID.

Association between Adiposity and Iron Status in Women of Reproductive Age: Data from the UK National Diet and Nutrition Survey (NDNS) 2008–2019

BackgroundOverweight/obesity and iron deficiency (ID) are highly prevalent in women of reproductive age (WRA), impacting on women’s health. Obesity is a risk factor for nutritional deficiencies but its association with ID is unclear. ObjectivesTo determine the association between adiposity and markers of iron status and ID prevalence in WRA. MethodsThis cross-sectional study analyzed the National Diet and Nutrition Survey (2008–2019) data, focusing on women aged 18–49 y with body mass index (BMI) ≥18.5 kg/m2. Prevalence of anemia, iron deficiency anemia (IDA), and ID were analyzed. Ferritin was adjusted for C-reactive protein. Iron status was assessed across high and low BMI, waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR). χ2, linear and logistic regressions were performed adjusting for covariates. ResultsAmong 1098 WRA, 496 normal weight and 602 overweight/obesity, prevalence rates were: anemia 9.2% and IDA 6.8%. Anemia was more prevalent in those with higher WHtR and WHR (11.9% compared with 5.9% and 16.7% compared with 6.5%, both P < 0.001). WRA with increased WC, WHtR, and WHR had higher IDA prevalence than those with lower adiposity (8.5% compared with 4.3%, P = 0.005; 9.4% compared with 3.3%, P < 0.001; 12.1% compared with 4.9%, P < 0.001). ID prevalence was 49.7% (ferritin cutoff 30 μg/L) and 19.6% (ferritin cutoff 15 μg/L), showing similar rates across adiposity groups. ID prevalence defined by soluble transferrin receptor (sTfR) was higher in women with increased WHR (P = 0.001). Higher WHR predicted ID categorized by sTfR (adjusted odds ratio [aOR]: 2.104, P = 0.004), and WHtR and WHR predicted anemia and IDA (anemia: WHtR aOR: 2.006, P = 0.036; WHR aOR: 4.489, P < 0.001 and IDA: WHtR aOR: 2.942, P = 0.012; WHR aOR: 4.142, P < 0.001). ConclusionsAt least 1 in 5 WRA in the UK are iron deficient, highlighting the need to revise current policies. Greater central adiposity was strongly associated with impaired iron status and the development of anemia, IDA, and ID.

Association of dietary iron intake with diabetic kidney disease among individuals with diabetes.

The current study investigated the correlation between dietary iron intake and diabetic kidney disease among diabetic adults. This cross-sectional study enrolled 8118 participants who suffered from diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Dietary iron intake was obtained from 24 h recall interviews, and diabetic kidney disease was defined as eGFR < 60 mL/min per 1.73 m2 or albumin creatinine ratio (ACR) ≥ 30 mg/g. Three weighted logistic regression models were utilized to investigate odd ratio (OR) and 95% CIs for diabetic kidney disease. Stratified analyses were performed by gender, age, BMI, HbA1c, hypertension status, and smoking status, and diabetes types. Among 8118 participants (51.6% male, mean age 61.3 years), 40.7% of participants suffered from diabetic kidney disease. With the adjustment of potential covariates, we found that ≥ 12.59 mg of dietary iron was related to a lower risk of diabetic kidney disease (OR = 0.78, 95% CI: 0.63 to 0.96; OR = 0.79, 95% CI: 0.63 to 0.98). In stratified analyses, higher iron intake was negatively related to diabetic kidney disease, especially among those who were male, < 60 years, those with hypertension, those with HbA1c < 7.0%, and those who were ex-smokers. The result remained robust in sensitivity analyses. We found that ≥ 12.59 mg of dietary iron is associated with a lower risk of diabetic kidney disease, especially in those who were male, younger, heavier weight, have better blood sugar control, and those who were ex-smokers.

Associations between dietary iron intake from different sources and non-alcoholic fatty liver disease in adults.

Non-alcoholic fatty liver disease (NAFLD) has become a worldwide public health problem. Current evidence on the association between dietary iron intake and the risk of NAFLD is limited. The present study aimed to investigate the associations of animal-derived dietary iron (ADDI) intake, plant-derived dietary iron (PDDI) intake, and the ratio of PDDI:ADDI with NAFLD risk among U.S. adult population. This was a repeated cross-sectional study. Data were collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. NAFLD was defined as a United States Fatty Lives Index ≥30, and dietary iron intake was assessed through two 24-h dietary recall in-terviews. Logistic regression and restricted cubic spline models were applied to examine the associations between dietary iron intake from different sources and NAFLD risk. A total of 9478 participants aged ≥20 years were enrolled in the present study. After adjustment for multiple confounding factors, relative to the lowest quartile, the odds ratio (OR) and 95% confidence interval (CI) of NAFLD for the highest quartile was 1.01(95% CI, 0.82-1.24) for ADDI intake, 0.82 (95% CI, 0.64-0.99) for PDDI intake, and 1.00 (95% CI, 0.81-1.24) for the PDDI: ADDI intake ratio. In stratified analysis by sex and age, the significantly negative associations of PDDI intake with NAFLD was observed in women and participants older than 45 years. Dose-response analyses indicated that NAFLD was negatively associated with PDDI intake in a non-linear manner. PDDI intake was negatively associated with NAFLD in U.S. adults.

Micronutrient deficiencies and the double burden of malnutrition in Vietnamese female adolescents: a national cross-sectional study in 2020

Vietnam is facing a double burden of malnutrition, with increasing prevalence of overweight coexisting with undernutrition (stunting and/or thinness) and micronutrient deficiencies (MNDs). Although malnutrition during female adolescence leads to poor health outcomes with potential intergenerational effects on offspring, no studies have comprehensively investigated MNDs and nutritional status among contemporary Vietnamese female adolescents. Data from 10- to 18-year-old female participants (n=1471) in the nationally-representative Vietnam General Nutrition Survey 2020 were analysed. Blood nutritional biomarkers, anthropometric measurements, and sociodemographic data were collected, and associations between nutrition status and MNDs were analysed; with anaemia, iron deficiency (ID), iron deficiency anaemia, low serum zinc, low serum retinol, and any MNDs as specified outcomes. Prevalence of overweight, stunting, and thinness was 27.2%, 14.3%, and 6.9%, respectively. Low serum zinc was common (39.8%), as was ID (13.4%). Bivariate analyses showed that older age (16-18 years old), ethnic minority status, lower wealth index, and inflammation were associated with MNDs. In adjusted logistic regressions, stunting was associated with increased odds ratio and [95% confidence intervals] of low serum retinol (8.92 [2.26, 35.15], p<0.01), as was thinness (12.25 [3.47, 43.33], p<0.01). Stunting was also associated with increased odds of having any MND (2.06 [1.31, 3.25], p<0.01). More female adolescents were overweight than undernourished in Vietnam in 2020. However, undernutrition, low serum zinc, and ID remain prevalent. Food systems approaches should be considered to stem the stark increase in the double burden of malnutrition in young people living in Vietnam. UK BBSRCBB/T008989/1.

Supplemental Iron and Recombinant Erythropoietin for Anemia in Infants Born Very Preterm: A Survey of Clinical Practice in Europe

To survey practices of iron and recombinant human erythropoietin (rhEpo) administration to infants born preterm across Europe. Over a three-month period, we conducted an online survey in 597 neonatal intensive care units (NICUs) of 18 European countries treating infants born with a gestational age (GA) <32 weeks. 343 NICUs (response rate 56·3%) completed the survey. Almost all (97·7%) NICUs routinely supplement enteral iron, and 74·3% of respondents to all infants born <32 weeks' GA. 65·3% of NICUs routinely evaluate erythropoiesis and iron parameters beyond day 28 after birth. Most NICUs initiate iron supplementation at postnatal age of two weeks and stop after 6 (34·3%) or 12 months (34·3%). Routine use of rhEpo was reported in 22·2% of NICUs, and in individual cases in 6·9%. RhEpo was mostly administered subcutaneously (70·1%) and most frequently at a dose of 250 U/kg 3 times a week (44·3%), but the dose varied greatly between centers. This survey highlights wide heterogeneity in evaluating erythropoietic activity and iron deficiency in infants born preterm. Variation in iron supplementation during infancy likely reflects an inadequate evidence base. Current evidence on the efficacy and safety profile of rhEpo is only poorly translated into clinical practice. This survey demonstrates a need for standards to optimize patient blood management in anemia of prematurity.

A síndrome das pernas inquietas

Restless legs syndrome is a disorder of unknown cause that causes an irresistible urge to move the lower limbs, worsening at night, greatly disturbing sleep, with a consequent poor quality of life. It may begin in childhood, but diagnosis is usually late. It is also known as Willis-Ekbom Disease. It affects between 10% and 15% of the population. Iron deficiency is a frequently mentioned cause, which is why the study of iron metabolism is recommended. Clinical evaluation is normal, and it helps to identify possible secondary causes. The criteria for diagnosis were developed by the International Restless Legs Syndrome Study Group (IRLSG). In treatment, it is necessary to correct iron deficits and prescribe dopamine agonists. Many patients experience worsening of symptoms as they age.

408. IS DYSPNOEA IN PARAOESOPHAGEAL HERNIA ONLY POST PRANDIAL? RELEVANCE TO THE POST TOOL DEVELOPMENT

Abstract Background Paraoesophageal hernia (POH) presents with a unique symptomatology that may mimic respiratory and cardiovascular disease. Dyspnoea is increasingly recognised as a predominant symptom of POH. Post-prandial dyspnoea was included in a POH specific symptom reporting tool (POST). We have prospectively recorded the type of dyspnoea among patients with POH, and whether surgery improves dyspnoea. Methods Consecutive patients with POH managed in our service from 2009 to 2022 were identified. Preoperative dyspnoea was documented as 'post prandial' or 'with ordinary physical activity' on a symptom recording proforma. Post operative improvement in dyspnoea was evaluated. Results A total of 520 consecutive patients were diagnosed with POH between January 2009 to November 2022. 514 patients were included in the analysis; there were 383 females (75%) and mean age was 70. Improvement in dyspnoea was reported in 308 out of 355 (95%) patients. Pre-operative dyspnoea was categorised into activity induced (89%) and post-prandial (3%) or both (8%). Patients with both activity induced and post-prandial dyspnoea were 0.26 times less likely to report improvement in dyspnoea postoperatively than those with only activity induced dyspnoea (OR=0.26, 95% CI 0.07-0.94, P=0.041). Conclusion Symptom assessment of POH should include both post-prandial and activity induced dyspnoea, as both type of dyspnoea are associated with the presence of POH and is improved following surgical repair. There are multiple possible causes for dyspnoea including post prandial cardiac inflow obstruction, pulmonary aspiration, as well as anaemia (with or without iron deficiency) associated with the hernia. Any dyspnoea should be considered related to POH and therefore both post-prandial and activity induced dyspnoea should be included in diagnostic algorithm designed to evaluate POH.

Hepcidin: A missing link at the interface of malaria and hypertension

Malaria and hypertension are seemingly unrelated communicable and non-communicable diseases, both highly pervasive in the global south. There is a debate about the potential connection between these two disorders beyond any obvious factors. The emerging evidence suggests an emerging genetic selection pressure for hypertension in malaria-endemic regions. Furthermore, the impact of the liver hormone hepcidin, which has been overlooked, is significant in the development of hypertension due to malaria. Malaria exposure leads to changes in iron metabolism through the regulation of hepcidin, resulting in iron deficiency and consequently the development of hypertension.

241.5: Erythropoietin-stimulating agent resistance index in kidney transplant recipients without iron deficiency.

241.5: Erythropoietin-stimulating agent resistance index in kidney transplant recipients without iron deficiency.

High Iron Consumption Modifies the Hepatic Transcriptome Related to Cholesterol Metabolism.

Iron supplementation is a common method for alleviating symptoms of iron deficiency, but excessive iron intake may lead to systemic copper deficiencies and hypercholesterolemia. In our study, we explored the intricate relationship between dietary iron and copper levels and their impact on cholesterol metabolism. Using a rat model, we conducted dietary interventions with varying iron and copper concentrations and analyzed hepatic transcriptomes. High iron intake coupled with low copper intake induced hypercholesterolemia and altered the expression of genes associated with cholesterol and lipid metabolism, thereby, exacerbating cardiovascular disease risks. Conversely, copper supplementation mitigated these hepatic gene expression alterations, suggesting that dietary copper plays a role in cholesterol regulation. Transcriptomic analysis revealed significant upregulation of genes involved in cholesterol synthesis and antioxidative pathways in response to high iron intake, while genes involved in cholesterol elimination were downregulated. Furthermore, high iron consumption was associated with cellular apoptosis and the activation of cholesterol synthesis. Our findings underscore the importance of balanced iron and copper intake in cholesterol homeostasis and highlight the potential of copper supplementation for mitigating iron-induced hypercholesterolemia.