The impact of maternal obesity on iron status, placental transferrin receptor expression and hepcidin expression in human pregnancy
The impact of maternal obesity on iron status, placental transferrin receptor expression and hepcidin expression in human pregnancy
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DOI：
10.1038/ijo.2015.3
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发表时间：
2015-04-01
影响因子：
4.9
通讯作者：
McArdle, H. J.
中科院分区：
文献类型：
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作者：
Garcia-Valdes, L.;Campoy, C.;McArdle, H. J.
背景技术背景：肥胖与铁状态下降有关，可能是由于铁调素的升高，铁调素是一种已知会减少铁吸收的炎症蛋白。在动物实验中，我们发现母体铁缺乏通过胎盘转铁蛋白受体（pTFR 1）表达的增加而在胎儿中最小化，从而以母体铁储备为代价增加铁转移。目的：本研究探讨了妊娠期肥胖对人类队列中母体和新生儿铁营养状况的影响，以及胎盘是否可以通过增加pTFR 1来补偿母体铁储备的减少。受试者/方法：共有240名妇女被纳入本研究。分娩时收集了158个胎盘（正常：90个;超重：37个;肥胖：31个）。通过测定血清转铁蛋白受体（sTFR）和铁蛋白水平，在24和34周，并在分娩时测量母亲的铁状态。采用ELISA法检测孕妇和脐血中铁调素的含量，采用Western blotting和实时荧光定量RT-PCR法检测胎盘中pTFR 1的含量。妊娠结束时，肥胖妇女的铁调素水平（ng/ml）高于正常妇女（26.03 ± 12.95 vs 18.00 ± 10.77，P < 0.05）。母亲铁调素水平与母亲的铁状态（sTFR r = 0.2 P = 0.025），但与新生儿的值。pTFR 1的mRNA和蛋白水平均与母体铁状态呈负相关。对于mRNA和所有女性，sTFR r = 0.2 P = 0.044。铁蛋白mRNA水平仅在超重妇女相关r = -0.5 P = 0.039与铁调素（r = 0.1 P = 0.349），无论产妇体重指数（BMI）的结论：数据支持的假设，肥胖孕妇有更大的风险缺铁，铁调素可能是一个调节因素。此外，我们发现胎盘通过增加pTFR 1表达来响应母体铁状态的降低。
BACKGROUND: Obesity is associated with decreased iron status, possibly due to a rise in hepcidin, an inflammatory protein known to reduce iron absorption. In animals, we have shown that maternal iron deficiency is minimised in the foetus by increased expression of placental transferrin receptor (pTFR1), resulting in increased iron transfer at the expense of maternal iron stores.OBJECTIVE: This study examines the effect of obesity during pregnancy on maternal and neonatal iron status in human cohorts and whether the placenta can compensate for decreased maternal iron stores by increasing pTFR1 expression.SUBJECTS/METHODS: A total of 240 women were included in this study. One hundred and fifty-eight placentas (Normal: 90; Overweight: 37; Obese: 31) were collected at delivery. Maternal iron status was measured by determining serum transferrin receptor (sTFR) and ferritin levels at 24 and 34 weeks and at delivery. Hepcidin in maternal and cord blood was measured by ELISA and pTFR1 in placentas by western blotting and real-time RT-PCR.RESULTS: Low iron stores were more common in obese women. Hepcidin levels (ng ml(-1)) at the end of the pregnancy were higher in obese than normal women (26.03 +/- 12.95 vs 18.00 +/- 10.77, P < 0.05). Maternal hepcidin levels were correlated with maternal iron status (sTFR r = 0.2 P = 0.025), but not with neonatal values. mRNA and protein levels of pTFR1 were both inversely related to maternal iron status. For mRNA and all women, sTFR r = 0.2 P = 0.044. Ferritin mRNA levels correlated only in overweight women r = -0.5 P = 0.039 with hepcidin (r = 0.1 P = 0.349), irrespective of maternal body mass index (BMI).CONCLUSIONS: The data support the hypothesis that obese pregnant women have a greater risk of iron deficiency and that hepcidin may be a regulatory factor. Further, we show that the placenta responds to decreased maternal iron status by increasing pTFR1 expression.