Decreased Serum Hepcidin and Improved Functional Iron Status 6 Months After Restrictive Bariatric Surgery |
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| Authors: | Lisa M Tussing‐Humphreys Elizabeta Nemeth Giamila Fantuzzi Sally Freels Ai‐Xuan L Holterman Carlos Galvani Subhashini Ayloo Joseph Vitello Carol Braunschweig |
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| Institution: | 1. United States Department of Agriculture‐Agricultural Research Service, Southern Regional Research Center, Baton Rouge, Louisiana, USA;2. Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, California, USA;3. Department of Kinesiology and Nutrition, Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA;4. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA;5. Department of Pediatric Surgery, College of Medicine, Rush University Medical Center, Chicago, Illinois, USA;6. Department of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA |
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| Abstract: | Excess adiposity is associated with low‐grade inflammation and decreased iron status. Iron depletion in obesity is thought to be mediated by an inflammation‐induced increase in the body's main regulator of iron homeostasis, hepcidin. Elevated hepcidin can result in iron depletion as it prevents the release of dietary iron absorbed into the enterocytes, limiting replenishment of body iron losses. Weight reduction is associated with decreased inflammation; however, the impact of reduced inflammation on iron status and systemic hepcidin in obese individuals remains unknown. We determined prospectively the impact of weight loss on iron status parameters, serum hepcidin, inflammation, and dietary iron in 20 obese premenopausal females 6 months after restrictive bariatric surgery. At baseline, the presence of iron depletion was high with 45% of the women having serum transferrin receptor (sTfR) >28.1 nmol/l. Differences between baseline and 6 months after surgery for BMI (47.56 vs. 39.55 kg/m2; P < 0.0001), C‐reactive protein (CRP) (10.83 vs. 5.71 mg/l; P < 0.0001), sTfR (29.97 vs. 23.08 nmol/l; P = 0.001), and serum hepcidin (111.25 vs. 31.35 ng/ml; P < 0.0001) were significantly lower, whereas hemoglobin (Hb) (12.10 vs. 13.30 g/dl; P < 0.0001) and hematocrit (Hct) (36.58 vs. 38.78%; P = 0.001) were significantly higher. Ferritin and transferrin saturation (Tsat) showed minimal improvement at follow‐up. At baseline, hepcidin was not correlated with sTfR (r = 0.02); however, at follow‐up, significant correlations were found (r = ?0.58). Change in interleukin‐6 (IL‐6) from baseline was marginally associated with decreased log serum hepcidin (Δ IL‐6: β = ?0.22; P = 0.15), whereas change in BMI or weight was not. No significant difference in dietary iron was noted after surgery. Weight loss in obese premenopausal women is associated with reduced serum hepcidin and inflammation. Reduction in inflammation and hepcidin likely allow for enhanced dietary iron absorption resulting in an improved functional iron profile. |
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