Greater blood volume and Hb mass in obese women quantified by the carbon monoxide-rebreathing method affects interpretation of iron biomarkers and iron requirements
Greater blood volume and Hb mass in obese women quantified by the carbon monoxide-rebreathing method affects interpretation of iron biomarkers and iron requirements
复制标题
DOI：
10.1038/s41366-018-0127-9
复制
发表时间：
2019-05-01
影响因子：
4.9
通讯作者：
Herter-Aeberli, Isabelle
中科院分区：
文献类型：
--
作者：
Cepeda-Lopez, Ana C.;Zimmermann, Michael B.;Herter-Aeberli, Isabelle
背景/目的 缺铁（ID）在超重和肥胖个体（OW/OB）中很常见，但其机制尚不确定。 OW/OB 中较大的血容量 (BV) 可能会增加血红蛋白 (Hb) 质量和铁需求，并通过血液稀释混淆铁生物标志物。 OW/OB 中 BV/PV 变化的量化具有挑战性，基于人体测量指数来估计 BV/PV 的公式将很有价值。在正常体重 (NW) 和 OW/OB 女性中，我们的目标是：(1) 测量 BV 并评估 BV 差异是否影响 Hb 和铁生物标志物的浓度和总循环质量； (2) 开发一种描述 OW/OB 中 BV 的算法。受试者/方法在一项横断面研究中，我们使用一氧化碳再呼吸法测量了 NW、OW 和 OB 非贫血女性 (n = 62) 的 BV，通过双能 X 射线吸收测定法测量了身体成分，以及铁和炎症状态。结果 OW 和 OB 女性的平均 BV 和 PV 比 NW 分别高 11% 和 16% （P<0.05），分别。与 NW 相比，OW/OB 中 IL-6、铁调素、Hb 和 sTfR 的总循环质量较高，而血清铁的总质量较低（全部 P < 0.05）。包含身高、体重和瘦体重的方程，用于估计所有 BMI 组的 BV (R-2 = 0.76)。结论 基于人体测量指数的方程可以很好地估计 OW/OB 女性 BV 的增加。在 OW/OB 女性中，Hb 量增加可能会增加红细胞生成和循环 TfR 量的铁需求。同时，较高的铁调素浓度可能会降低血清铁量。这两种机制都可能增加 OW/OB 女性患 ID 的风险。
Background/objective Iron deficiency (ID) is common in overweight and obese individuals (OW/OB) but the mechanism is uncertain. Greater blood volume (BV) in OW/OB may increase hemoglobin (Hb) mass and iron requirements, and confound iron biomarkers by hemodilution. Quantification of BV/PV changes in OW/OB is challenging and a formula to estimate BV/PV based on anthropometric indices would be valuable. In normal weight (NW) and OW/OB women, we aimed at: (1) measure BV and assess whether differences in BV affect concentrations and total circulating mass of Hb and iron biomarkers; (2) develop an algorithm describing BV in OW/OB.Subjects/methods In a cross-sectional study, we measured BV in NW, OW, and OB non-anemic women (n = 62) by using the carbon monoxide-rebreathing method, body composition by dual energy X-ray absorptiometry, and iron and inflammatory status.Results OW and OB women had 11 and 16% higher mean BV and PV compared to NW (P < 0.05), respectively. In OW/OB compared to NW, total circulating masses of IL-6, hepcidin, Hb, and sTfR were higher, while total mass of serum iron was lower (for all, P < 0.05). An equation including height, body mass and lean mass to estimate BV in all BMI groups (R-2 = 0.76).Conclusion An equation based on anthropometric indices provides a good estimate of increased BV in OW/OB women. In OW/OB women, there is an increase in Hb mass that likely increases iron requirements for erythropoiesis and circulating TfR mass. At the same time, higher hepcidin concentrations may lower serum iron mass. Both these mechanisms may increase risk for ID in OW/OB women.