Decreased serum hepcidin and improved functional iron status 6 months after restrictive bariatric surgery

Lisa M. Tussing-Humphreys, Elizabeta Nemeth, Giamila Fantuzzi, Sally Freels, Ai Xuan L Holterman, Carlos A Galvani, Subhashini Ayloo, Joseph Vitello, Carol Braunschweig

Research output: Contribution to journalArticle

73 Citations (Scopus)

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) 28.1nmol/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. 5.71mg/l; P < 0.0001), sTfR (29.97 vs. 23.08nmol/l; P = 0.001), and serum hepcidin (111.25 vs. 31.35ng/ml; P < 0.0001) were significantly lower, whereas hemoglobin (Hb) (12.10 vs. 13.30g/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.

Original languageEnglish (US)
Pages (from-to)2010-2016
Number of pages7
JournalObesity
Volume18
Issue number10
DOIs
StatePublished - Oct 2010
Externally publishedYes

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Hepcidins
Bariatric Surgery
Iron
Dietary Iron
Inflammation
Serum
Transferrin Receptors
Weight Loss
Interleukin-6
Enterocytes
Adiposity
Transferrin
Ferritins
Hematocrit
C-Reactive Protein
Hemoglobins
Homeostasis
Obesity
Weights and Measures

ASJC Scopus subject areas

  • Endocrinology
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Tussing-Humphreys, L. M., Nemeth, E., Fantuzzi, G., Freels, S., Holterman, A. X. L., Galvani, C. A., ... Braunschweig, C. (2010). Decreased serum hepcidin and improved functional iron status 6 months after restrictive bariatric surgery. Obesity, 18(10), 2010-2016. https://doi.org/10.1038/oby.2009.490

Decreased serum hepcidin and improved functional iron status 6 months after restrictive bariatric surgery. / Tussing-Humphreys, Lisa M.; Nemeth, Elizabeta; Fantuzzi, Giamila; Freels, Sally; Holterman, Ai Xuan L; Galvani, Carlos A; Ayloo, Subhashini; Vitello, Joseph; Braunschweig, Carol.

In: Obesity, Vol. 18, No. 10, 10.2010, p. 2010-2016.

Research output: Contribution to journalArticle

Tussing-Humphreys, LM, Nemeth, E, Fantuzzi, G, Freels, S, Holterman, AXL, Galvani, CA, Ayloo, S, Vitello, J & Braunschweig, C 2010, 'Decreased serum hepcidin and improved functional iron status 6 months after restrictive bariatric surgery', Obesity, vol. 18, no. 10, pp. 2010-2016. https://doi.org/10.1038/oby.2009.490
Tussing-Humphreys, Lisa M. ; Nemeth, Elizabeta ; Fantuzzi, Giamila ; Freels, Sally ; Holterman, Ai Xuan L ; Galvani, Carlos A ; Ayloo, Subhashini ; Vitello, Joseph ; Braunschweig, Carol. / Decreased serum hepcidin and improved functional iron status 6 months after restrictive bariatric surgery. In: Obesity. 2010 ; Vol. 18, No. 10. pp. 2010-2016.
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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) 28.1nmol/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. 5.71mg/l; P < 0.0001), sTfR (29.97 vs. 23.08nmol/l; P = 0.001), and serum hepcidin (111.25 vs. 31.35ng/ml; P < 0.0001) were significantly lower, whereas hemoglobin (Hb) (12.10 vs. 13.30g/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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