Decreased Serum Hepcidin and Improved Functional Iron Status 6 Months After Restrictive Bariatric Surgery
Decreased Serum Hepcidin and Improved Functional Iron Status 6 Months After Restrictive Bariatric Surgery
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DOI：
10.1038/oby.2009.490
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发表时间：
2010-10-01
期刊：
影响因子：
6.9
通讯作者：
Braunschweig, Carol
中科院分区：
文献类型：
--
作者：
Tussing-Humphreys, Lisa M.;Nemeth, Elizabeta;Braunschweig, Carol
过度肥胖与低度炎症和铁状态下降有关。肥胖中的铁缺乏被认为是由炎症诱导的体内铁稳态的主要调节剂铁调素的增加介导的。升高的铁调素可导致铁耗竭，因为它阻止吸收到肠细胞中的膳食铁的释放，限制身体铁损失的补充。体重减轻与炎症减少有关;然而，炎症减少对肥胖个体的铁状态和全身铁调素的影响仍然未知。我们前瞻性地研究了20名绝经前肥胖女性在限制性减肥手术后6个月体重减轻对铁状态参数、血清铁调素、炎症和膳食铁的影响。在基线时，铁缺乏的存在很高，45%的妇女血清转铁蛋白受体（sTfR）> 28.1 nmol/l。基线和术后6个月的BMI差异（47.56 vs. 39.55kg/m2; P < 0.0001），C反应蛋白（CRP）（10.83 vs. 5.71 mg/l; P < 0.0001），sTfR（29.97 vs. 23.08 nmol/l; P = 0.001），血清铁调素（111.25对31.35 ng/ml; P < 0.0001）显著降低，而血红蛋白（Hb）（12.10 vs. 13.30 g/dl; P < 0.0001）和红细胞压积（Hct）（36.58 vs. 38.78%; P = 0.001）显著较高。铁蛋白和转铁蛋白饱和度（Tsat）在随访时显示出最小的改善。在基线时，铁调素与sTfR不相关（r = 0.02）;然而，在随访时，发现了显著相关性（r = -0.58）。白细胞介素-6（IL-6）相对于基线的变化与血清铁调素对数降低略微相关（Δ IL-6：β = -0.22; P = 0.15），而BMI或体重的变化则无关。术后饮食铁无显著差异。肥胖绝经前妇女体重减轻与血清铁调素和炎症减少有关。炎症和铁调素的减少可能会增强膳食铁吸收，从而改善功能性铁分布。
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. 39.55kg/m(2); 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 (Delta IL-6: beta = -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.