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Catapano A, Cimmino F, Petrella L, Pizzella A, D'Angelo M, Ambrosio K, Marino F, Sabbatini A, Petrelli M, Paolini B, Lucchin L, Cavaliere G, Cristino L, Crispino M, Trinchese G, Mollica MP. Iron metabolism and ferroptosis in health and diseases: The crucial role of mitochondria in metabolically active tissues. J Nutr Biochem 2025; 140:109888. [PMID: 40057002 DOI: 10.1016/j.jnutbio.2025.109888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 11/15/2024] [Accepted: 02/27/2025] [Indexed: 03/30/2025]
Abstract
Iron is essential in various physiological processes, but its accumulation leads to oxidative stress and cell damage, thus iron homeostasis has to be tightly regulated. Ferroptosis is an iron-dependent non-apoptotic regulated cell death characterized by iron overload and reactive oxygen species accumulation. Mitochondria are organelles playing a crucial role in iron metabolism and involved in ferroptosis. MitoNEET, a protein of mitochondrial outer membrane, is a key element in this process. Ferroptosis, altering iron levels in several metabolically active organs, is linked to several non-communicable diseases. For example, iron overload in the liver leads to hepatic fibrosis and cirrhosis, accelerating non-alcholic fatty liver diseases progression, in the muscle cells contributes to oxidative damage leading to sarcopenia, and in the brain is associated to neurodegeneration. The aim of this review is to investigate the intricate balance of iron regulation focusing on the role of mitochondria and oxidative stress, and analyzing the ferroptosis implications in health and disease.
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Affiliation(s)
- Angela Catapano
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Fabiano Cimmino
- Department of Biology, University of Naples Federico II, Naples, Italy; Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lidia Petrella
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Amelia Pizzella
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Margherita D'Angelo
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Katia Ambrosio
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Francesca Marino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annarita Sabbatini
- Dietetic and Clinical Nutrition Unit, IEO European Institute of Oncology IRCSS, Milan, Italy
| | - Massimiliano Petrelli
- Department of Clinical and Molecular Sciences, Clinic of Endocrinology and Metabolic Diseases, Università Politecnica delle Marche, Ancona, Italy
| | - Barbara Paolini
- Department of Innovation, experimentation and clinical research, Unit of dietetics and clinical nutrition, S. Maria Alle Scotte Hospital, University of Siena, Siena, Italy
| | - Lucio Lucchin
- Dietetics and Clinical Nutrition, Bolzano Health District, Bolzano, Italy
| | - Gina Cavaliere
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Luigia Cristino
- Institute of Biomolecular Chemistry, National Research Council of Italy, Pozzuoli, Naples, Italy
| | - Marianna Crispino
- Department of Biology, University of Naples Federico II, Naples, Italy.
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Lupu A, Mihai CM, Dragan F, Tarnita I, Alecsa M, Chisnoiu T, Morariu ID, Cuciureanu M, Nedelcu AH, Salaru DL, Anton E, Danielescu C, Fotea S, Stoleriu G, Beser OF, Lupu VV. Antioxidant Supplementation in Childhood Obesity: A Path to Improved Metabolic Health? Antioxidants (Basel) 2025; 14:466. [PMID: 40298814 PMCID: PMC12024302 DOI: 10.3390/antiox14040466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Revised: 04/09/2025] [Accepted: 04/10/2025] [Indexed: 04/30/2025] Open
Abstract
Childhood obesity is linked to heightened oxidative stress, a key driver of endothelial dysfunction, inflammation, and metabolic complications. Antioxidants, including Vitamins C and E, are vital in neutralizing free radicals and mitigating oxidative damage. This non-systematic review examines the potential advantages of antioxidant supplementation in pediatric obesity, focusing on its effects on vascular health, insulin sensitivity, and inflammatory processes. Emerging data suggest that antioxidants may improve endothelial function, reduce blood pressure, and enhance metabolic homeostasis in obese children. However, the long-term efficacy and safety of antioxidant supplementation remain uncertain, necessitating further rigorous randomized controlled trials. A deeper understanding of antioxidants' role in pediatric obesity could unlock novel therapeutic approaches for managing obesity-related complications and improving children's overall health outcomes.
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Affiliation(s)
- Ancuta Lupu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.L.); (M.A.); (V.V.L.)
| | - Cristina Maria Mihai
- Pediatrics, Faculty of Medicine, “Ovidius” University, 900470 Constanta, Romania; (C.M.M.); (T.C.)
| | - Felicia Dragan
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Irina Tarnita
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.L.); (M.A.); (V.V.L.)
| | - Mirabela Alecsa
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.L.); (M.A.); (V.V.L.)
| | - Tatiana Chisnoiu
- Pediatrics, Faculty of Medicine, “Ovidius” University, 900470 Constanta, Romania; (C.M.M.); (T.C.)
| | - Ionela Daniela Morariu
- Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Magdalena Cuciureanu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.C.); (A.H.N.); (D.L.S.); (E.A.); (C.D.)
| | - Alin Horatiu Nedelcu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.C.); (A.H.N.); (D.L.S.); (E.A.); (C.D.)
| | - Delia Lidia Salaru
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.C.); (A.H.N.); (D.L.S.); (E.A.); (C.D.)
| | - Emil Anton
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.C.); (A.H.N.); (D.L.S.); (E.A.); (C.D.)
| | - Ciprian Danielescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.C.); (A.H.N.); (D.L.S.); (E.A.); (C.D.)
| | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (S.F.); (G.S.)
| | - Gabriela Stoleriu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (S.F.); (G.S.)
| | - Omer Faruk Beser
- Department of Pediatric Gastroenterology, Hepatology & Nutrition, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, 34776 Istanbul, Turkey;
| | - Vasile Valeriu Lupu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.L.); (M.A.); (V.V.L.)
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Calcaterra V, Cena H, Bolpagni F, Taranto S, Vincenti A, Madini N, Diotti M, Quatrale A, Zuccotti G. The Interplay Between Iron Metabolism and Insulin Resistance: A Key Factor in Optimizing Obesity Management in Children and Adolescents. Nutrients 2025; 17:1211. [PMID: 40218969 PMCID: PMC11990199 DOI: 10.3390/nu17071211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 03/20/2025] [Accepted: 03/27/2025] [Indexed: 04/14/2025] Open
Abstract
Iron plays a vital role in insulin signaling, regulating molecular mechanisms that influence cellular insulin responses. This review explores the link between iron metabolism and insulin resistance (IR) in children and adolescents with obesity. A connection between iron metabolism, iron deficiency (ID), and IR is well-documented, but further longitudinal studies are needed to better understand how iron metabolism influences insulin resistance during childhood and adolescence. This connection warrants attention due to its significant public health implications, as optimizing obesity management could help prevent both ID and metabolic complications in children. Current evidence does not suggest that dietary factors are primary contributors to ID in children. However, there is scientific evidence that weight reduction can restore iron homeostasis in people with obesity. Therefore, efforts should focus on improving dietary habits, increasing awareness of iron's importance, and implementing strategies to address both ID and obesity.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy;
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.T.); (N.M.); (M.D.); (A.Q.); (G.Z.)
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Clinical Nutrition and Dietetics Unit, ICS Maugeri IRCCS, 27100 Pavia, Italy; (F.B.); (A.V.)
| | - Federica Bolpagni
- Clinical Nutrition and Dietetics Unit, ICS Maugeri IRCCS, 27100 Pavia, Italy; (F.B.); (A.V.)
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.T.); (N.M.); (M.D.); (A.Q.); (G.Z.)
| | - Alessandra Vincenti
- Clinical Nutrition and Dietetics Unit, ICS Maugeri IRCCS, 27100 Pavia, Italy; (F.B.); (A.V.)
| | - Nagaia Madini
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.T.); (N.M.); (M.D.); (A.Q.); (G.Z.)
| | - Marianna Diotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.T.); (N.M.); (M.D.); (A.Q.); (G.Z.)
| | - Antonia Quatrale
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.T.); (N.M.); (M.D.); (A.Q.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.T.); (N.M.); (M.D.); (A.Q.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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Vlad RM, Istrate-Grigore OA, Pacurar D. Customizing Nutrients: Vitamin D and Iron Deficiencies in Overweight and Obese Children-Insights from a Romanian Study. Nutrients 2025; 17:1193. [PMID: 40218951 PMCID: PMC11990323 DOI: 10.3390/nu17071193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Revised: 03/22/2025] [Accepted: 03/27/2025] [Indexed: 04/14/2025] Open
Abstract
Background: Childhood obesity is a public health issue worldwide, recognized as a complex condition associated with multiple deficiencies in nutrients, such as vitamin D deficiency, iron-deficiency anemia, or abnormalities in serum calcium or phosphorus levels, despite an excess caloric intake. Objective: This study aims to investigate the prevalence of these deficiencies in overweight/obese children and to assess the correlation between vitamin D/serum iron levels and body mass index (BMI). Methods: The observational study was conducted on 69 Romanian overweight and obese children, aged 2 to 17, admitted to the Pediatrics Department of "Grigore Alexandrescu" Hospital in Bucharest over a 15-month period. The age- and gender-specific BMI percentiles were used to classify participants into three groups: overweight (≥85th and <95th BMI percentile), obese (≥95th BMI percentile), and severely obese (>120% of 95th BMI percentile). Data analysis focused on identifying the need for screening and targeted treatment in this pediatric population. Results: Hypovitaminosis D (defined as a serum level of 25(OH)D < 30 ng/mL) prevalence was significantly higher in the severe obesity category (71.5%) compared to the obesity (69%) and overweight (61.5%) groups. Iron deficiency and iron-deficiency anemia were both more prevalent in overweight children, with rates of 50% and 38.5%, respectively. Negative moderate correlations were found both between serum 25-hydroxyvitamin D levels and children's age (r = -0.444, p-value < 0.0001), as well as between serum 25(OH)D levels and BMI (r = -0.31, p = 0.015), with no statistically significant correlation between serum iron level and BMI in this cohort (r = -0.02, p > 0.05). Conclusions: Severe obesity could be regarded as an associated factor for vitamin D insufficiency as this is highly prevalent in severely obese children, with 25(OH)D levels decreasing with the increase in BMI. Overweight children demonstrated an increased prevalence of iron deficiency in the overweight category, suggesting that the adipose tissue contributes to chronic inflammation, disrupting iron homeostasis. Given the high prevalence of nutritional deficiencies in this population, implementing systematic screening and treatment programs would be beneficial to prevent long-term adverse outcomes.
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Affiliation(s)
- Raluca Maria Vlad
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.M.V.); (D.P.)
- “Grigore Alexandrescu” Emergency Children’s Hospital, Bld. Iancu de Hunedoara 30-32 Bucharest, 011743 Bucharest, Romania
| | - Oana-Andreea Istrate-Grigore
- “Grigore Alexandrescu” Emergency Children’s Hospital, Bld. Iancu de Hunedoara 30-32 Bucharest, 011743 Bucharest, Romania
| | - Daniela Pacurar
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.M.V.); (D.P.)
- “Grigore Alexandrescu” Emergency Children’s Hospital, Bld. Iancu de Hunedoara 30-32 Bucharest, 011743 Bucharest, Romania
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Broekaert IJ, Assa A, Borrelli O, Saccomani MD, Homan M, Martin‐de‐Carpi J, Mas E, Miele E, Misak Z, Sila S, Thomson M, Tzivinikos C, Dolinsek J. Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee. J Pediatr Gastroenterol Nutr 2025; 80:510-532. [PMID: 39783775 PMCID: PMC11874238 DOI: 10.1002/jpn3.12454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 10/31/2024] [Accepted: 12/10/2024] [Indexed: 01/12/2025]
Abstract
Anaemia is a frequent consequence of many gastrointestinal (GI) diseases in children and it can even be the initial presenting symptom of underlying chronic GI disease. The definition of anaemia is age and gender-dependent and it can be classified based on pathophysiology, red cell morphology, and clinical presentation. Although nutritional deficiencies, including GI malabsorption of nutrients and GI bleeding, play a major role, other pathophysiologic mechanisms seen in chronic GI diseases, whether inflammatory (e.g., inflammatory bowel disease) or not (e.g., coeliac disease and dysmotility), are causing anaemia. Drugs, such as proton pump inhibitors, mesalamine, methotrexate and sulfasalazine, are also a potential cause of anaemia. Not uncommonly, due to a combination of factors, such as iron deficiency and a chronic inflammatory state, the underlying pathophysiology may be difficult to decipher and a broad diagnostic work-up is required. The goal of treatment is correction of anaemia by supplementation of iron and vitamins. The first therapeutic step is to treat the underlying cause of anaemia including bleeding control, restoration of intestinal integrity and reduction of inflammatory burden. The route of iron and vitamin supplementation is guided by the severity of anaemia.
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Affiliation(s)
- Ilse Julia Broekaert
- Department of Paediatrics, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
| | - Amit Assa
- The Juliet Keidan Institute of Paediatric Gastroenterology and Nutrition, Shaare Zedek Medical CentreThe Hebrew UniversityJerusalemIsrael
| | - Osvaldo Borrelli
- Division of Neurogastroenterology & Motility, Department of Paediatric GastroenterologyGreat Ormond Street HospitalLondonUK
| | | | - Matjaž Homan
- Department of Gastroenterology, Hepatology and Nutrition, University Children's HospitalFaculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Javier Martin‐de‐Carpi
- Department of Paediatric Gastroenterology, Hepatology and NutritionHospital Sant Joan de DéuBarcelonaSpain
| | - Emmanuel Mas
- Service de Gastroentérologie, Hépatologie, Nutrition et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, and IRSDUniversité de Toulouse, INSERM, INRAE, ENVT, UPSToulouseFrance
| | - Erasmo Miele
- Department of Translational Medical Science, Section of PediatricsUniversity of Naples “Federico II”NaplesItaly
| | - Zrinjka Misak
- Referral Centre for Paediatric Gastroenterology and NutritionChildren's Hospital ZagrebZagrebCroatia
| | - Sara Sila
- Referral Centre for Paediatric Gastroenterology and NutritionChildren's Hospital ZagrebZagrebCroatia
| | - Mike Thomson
- Centre for Paediatric GastroenterologySheffield Children's Hospital NHS Foundation TrustSheffieldUK
| | - Christos Tzivinikos
- Paediatric Gastroenterology Department, Al Jalila Children's Specialty HospitalMohammed Bin Rashid University, Dubai Medical CollegeDubaiUnited Arab Emirates
| | - Jernej Dolinsek
- Department of PaediatricsUniversity Medical Centre MariborMariborSlovenia
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Prenzel F, Kaiser T, Willenberg A, Vom Hove M, Flemming G, Fischer L, Kratzsch J, Kiess W, Vogel M. Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents. Clin Chem Lab Med 2025; 63:184-192. [PMID: 38965083 DOI: 10.1515/cclm-2024-0369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVES Soluble transferrin receptor (sTfR) is a marker of both erythropoiesis and iron status and is considered useful for detecting iron deficiency, especially in inflammatory conditions, but reference intervals covering the entire pediatric age spectrum are lacking. METHODS We studied 1,064 (48.5 % female) healthy children of the entire pediatric age spectrum to determine reference values and percentiles for sTfR and the ratio of sTfR to log-ferritin (sTfR-F index) using a standard immunoturbidimetric assay. RESULTS Soluble TfR levels were highly age-specific, with a peak in infancy and a decline in adulthood, whereas the sTfR-F index was a rather constant parameter. There were positive linear relationships for sTfR with hemoglobin (Hb) (p=0.008) and transferrin (females p<0.001; males p=0.003). A negative association was observed between sTfR and ferritin in females (p<0.0001) and for transferrin saturation and mean corpuscular volume (MCV) in both sexes (both p<0.0001). We found a positive relationship between sTfR and body height, body mass index (BMI) and inflammatory markers (CrP p<0.0001; WBC p=0.0172), while sTfR-F index was not affected by inflammation. CONCLUSIONS Soluble TfR values appear to reflect the activity of infant erythropoiesis and to be modulated by inflammation and iron deficiency even in a healthy cohort.
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Affiliation(s)
- Freerk Prenzel
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), 70622 Leipzig University , Leipzig, Germany
| | - Thorsten Kaiser
- Institute for Laboratory Medicine, Microbiology and Pathobiochemistry, University Hospital Ostwestfalen-Lippe (UK-OWL) of Bielefeld University, Detmold, Germany
| | - Anja Willenberg
- 70622 Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig , Leipzig, Germany
| | - Maike Vom Hove
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), 70622 Leipzig University , Leipzig, Germany
| | - Gunter Flemming
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), 70622 Leipzig University , Leipzig, Germany
| | - Lars Fischer
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), 70622 Leipzig University , Leipzig, Germany
| | - Jürgen Kratzsch
- 70622 Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig , Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), 70622 Leipzig University , Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, 70622 University of Leipzig , Leipzig, Germany
| | - Mandy Vogel
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), 70622 Leipzig University , Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, 70622 University of Leipzig , Leipzig, Germany
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Qu Y, Xu W, Guo S, Wu H. Association of sociodemographic and lifestyle factors and dietary intake with overweight and obesity among U.S. children: findings from NHANES. BMC Public Health 2024; 24:2176. [PMID: 39135163 PMCID: PMC11318293 DOI: 10.1186/s12889-024-19637-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 07/30/2024] [Indexed: 08/16/2024] Open
Abstract
Childhood overweight/obesity is a serious problem that has not been adequately addressed. As a key factor affecting weight gain, the association between dietary intake with childhood overweight and obesity is still unclear. The objective of this study was to analyze the association between sociodemographic, lifestyle factors and dietary intake with overweight or obesity. We used data from a large cross-sectional National Health and Nutrition Examination Survey (NHANES). The U.S. children aged 6-15 years with both weight data and dietary data were included. For univariate analysis of sociodemographic data, t tests was performed for continuous variables and chi-square tests was performed for discrete variables. Dietary intakes were described by median and quartile, and differences in dietary intake between children with normal weight and children with overweight or obesity were compared by rank sum tests. A modern statistical shrinkage technique, LASSO regression was used to examine the association between dietary intake and childhood obesity. Our study confirms that Hispanic ethnicity, increasing age, passive exposure to smoking, higher protein intake, and higher caffeine intake were positively associated with child overweight or obesity. Additionally, non-Hispanic White race, higher physical activity levels, higher household income, and higher vitamin A intake were negatively associated with child overweight or obesity.
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Affiliation(s)
- Yangming Qu
- Department of Neonatology, the First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, Jilin, China
- School of Public Health, Jilin University, Changchun, China
| | - Wei Xu
- Department of Neonatology, the First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, Jilin, China
| | - Shijie Guo
- Department of Neonatology, the First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, Jilin, China
| | - Hui Wu
- Department of Neonatology, the First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, Jilin, China.
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8
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Dorsey AF, Roach J, Burten RB, Azcarate-Peril MA, Thompson AL. Intestinal microbiota composition and efficacy of iron supplementation in Peruvian children. Am J Hum Biol 2024; 36:e24058. [PMID: 38420749 DOI: 10.1002/ajhb.24058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Despite repeated public health interventions, anemia prevalence among children remains a concern. We use an evolutionary medicine perspective to examine the intestinal microbiome as a pathway underlying the efficacy of iron-sulfate treatment. This study explores whether gut microbiota composition differs between anemic children who respond and do not respond to treatment at baseline and posttreatment and if specific microbiota taxa remain associated with response to iron supplementation after controlling for relevant inflammatory and pathogenic variables. METHODS Data come from 49 pre-school-aged anemic children living in San Juan de Lurigancho, Lima, Peru. We tested for differences in alpha and beta diversity using QIIME 2 and performed differential abundance testing in DESeq2 in R. We ran multivariate regression models to assess associations between abundance of specific taxa and response while controlling for relevant variables in Stata 17. RESULTS While we found no evidence for gut microbiota diversity associated with child response to iron treatment, we observed several differential abundance patterns between responders and non-responders at both timepoints. Additionally, we present support for a nonzero relationship between lower relative abundance of Barnesiellaceae and response to iron supplementation in samples collected before and after treatment. CONCLUSION While larger studies and more specific approaches are needed to understand the relationship between microbes and anemia in an epidemiological context, this study suggests that investigating nutritional status and pathogen exposure is key to better understanding the gut microbiome and impact of iron fortification.
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Affiliation(s)
- Achsah F Dorsey
- Department of Anthropology, University of Massachusetts, Amherst, Massachusetts, USA
| | - Jeff Roach
- Center for Gastrointestinal Biology and Disease (CGIBD), Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, UNC Microbiome Core, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel B Burten
- Graduate Program in Organismic and Evolutionary Biology, University of Massachusetts, Amherst, Massachusetts, USA
| | - M Andrea Azcarate-Peril
- Center for Gastrointestinal Biology and Disease (CGIBD), Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, UNC Microbiome Core, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Amanda L Thompson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
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9
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Berton PF, Gambero A. Hepcidin and inflammation associated with iron deficiency in childhood obesity - A systematic review. J Pediatr (Rio J) 2024; 100:124-131. [PMID: 37541648 PMCID: PMC10943301 DOI: 10.1016/j.jped.2023.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVES This paper aims to review data on the association of obesity and iron deficiency in children and adolescents, exposing the possible involvement of hepcidin and interleukin-6 (IL-6), obesity's inflammation biomarkers. DATA SOURCE Articles from PUBMED and WEB OF SCIENCE database with no chronological limit were reviewed to write this systematic review. Keywords such as children, obesity, iron deficiency, and hepcidin were used. After deleting duplicated and review articles, 91 were screened, and 39 were selected as eligible. Sixteen articles were included because they involved serum hepcidin levels in obese children and adolescents as outcomes. SUMMARY OF FINDINGS Finally, those 16 articles were organized in two tables: one includes therapeutic interventions, and the other does not. As hepcidin was discovered in 2000, the first articles that presented serum hepcidin's quantification in obese children and adolescents, homeostasis iron markers, and their possible association with obesity's inflammatory environment began to be published in 2008. CONCLUSIONS Obesity's chronic inflammation state leads to the production of IL-6, which acts as a signaling molecule for hepcidin synthesis, resulting in iron deficiency, which is common in obese children and adolescents who respond inadequately to iron supplementation. On the other hand, that population responds adequately to therapeutic intervention programs that lead to weight loss, guaranteeing iron homeostasis improvement. Therefore, perhaps it is time to discuss serum hepcidin level quantification as part of evaluating children and adolescents with iron deficiency, which could guide clinical choices that might lead to better therapeutic outcomes.
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Affiliation(s)
- Pedro Ferro Berton
- Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Alessandra Gambero
- Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
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10
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Roth-Walter F, Berni Canani R, O'Mahony L, Peroni D, Sokolowska M, Vassilopoulou E, Venter C. Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients. Allergy 2024; 79:353-383. [PMID: 38084827 DOI: 10.1111/all.15972] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024]
Abstract
Nutritional Immunity is one of the most ancient innate immune responses, during which the body can restrict nutrients availability to pathogens and restricts their uptake by the gut mucosa (mucosal block). Though this can be a beneficial strategy during infection, it also is associated with non-communicable diseases-where the pathogen is missing; leading to increased morbidity and mortality as micronutritional uptake and distribution in the body is hindered. Here, we discuss the acute immune response in respect to nutrients, the opposing nutritional demands of regulatory and inflammatory cells and particularly focus on some nutrients linked with inflammation such as iron, vitamins A, Bs, C, and other antioxidants. We propose that while the absorption of certain micronutrients is hindered during inflammation, the dietary lymph path remains available. As such, several clinical trials investigated the role of the lymphatic system during protein absorption, following a ketogenic diet and an increased intake of antioxidants, vitamins, and minerals, in reducing inflammation and ameliorating disease.
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Affiliation(s)
- Franziska Roth-Walter
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Diego Peroni
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Emilia Vassilopoulou
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Carina Venter
- Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA
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11
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Zhang Y, Ding R, Zhang Y, Qi J, Cao W, Deng L, Zhou L, Ye Y, Xue Y, Liu E. Dysfunction of DMT1 and miR-135b in the gut-testis axis in high-fat diet male mice. GENES & NUTRITION 2024; 19:1. [PMID: 38243197 PMCID: PMC10797958 DOI: 10.1186/s12263-024-00737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Obese patients have been found to be susceptible to iron deficiency, and malabsorption of dietary iron is the cause of obesity-related iron deficiency (ORID). Divalent metal transporter 1 (DMT1) and ferroportin (FPN), are two transmembrane transporter proteins expressed in the duodenum that are closely associated with iron absorption. However, there have been few studies on the association between these two proteins and the increased susceptibility to iron deficiency in obese patients. Chronic inflammation is also thought to be a cause of obesity-related iron deficiency, and both conditions can have an impact on spermatogenesis and impair male reproductive function. Based on previous studies, transgenerational epigenetic inheritance through gametes was observed in obesity. RESULTS Our results showed that obese mice had decreased blood iron levels (p < 0.01), lower protein and mRNA expression for duodenal DMT1 (p < 0.05), but no statistically significant variation in mRNA expression for duodenal FPN (p > 0.05); there was an increase in sperm miR-135b expression (p < 0.05). Bioinformatics revealed ninety overlapping genes and further analysis showed that they were primarily responsible for epithelial cilium movement, fatty acid beta-oxidation, protein dephosphorylation, fertilization, and glutamine transport, which are closely related to spermatogenesis, sperm development, and sperm viability in mice. CONCLUSIONS In obese mice, we observed downregulation of DMT1 in the duodenum and upregulation of miR-135b in the spermatozoa.
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Affiliation(s)
- Yanru Zhang
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Ruike Ding
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Yulin Zhang
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Jia Qi
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Wenbin Cao
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Lijun Deng
- Spring Biological Technology Development Co., Ltd, Fangchenggang, Guangxi, 538000, China
| | - Lin Zhou
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China
| | - Yun Ye
- Central Laboratory, The First Affiliated Hospital of Xi'an Medical University, Xi'an, 710000, China
| | - Ying Xue
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China.
| | - Enqi Liu
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, 710061, China.
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education of China, Xi'an, 710049, China.
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12
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Jorgenson MC, Aguree S, Schalinske KL, Reddy MB. Effects of green tea polyphenols on inflammation and iron status. J Nutr Sci 2023; 12:e119. [PMID: 38155809 PMCID: PMC10753450 DOI: 10.1017/jns.2023.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 12/30/2023] Open
Abstract
Inflammation is an underlying problem for many disease states and has been implicated in iron deficiency (ID). This study aimed to determine whether iron status is improved by epigallocatechin-3-gallate (EGCG) through reducing inflammation. Thirty-two male Sprague-Dawley rats were fed an iron-deficient diet for 2 weeks and then randomly divided into four groups (n 8 each): positive controls, negative controls, lipopolysaccharide (LPS, 0⋅5 mg/kg body weight), and LPS + EGCG (LPS plus 600 mg EGCG/kg diet) for 3 additional weeks. The study involved testing two control groups, both treated with saline. One group (positive control) was fed a regular diet containing standard iron, while the negative control was fed an iron-deficient diet. Additionally, two treatment groups were tested. The first group was given LPS, while the second group was administered LPS and fed an EGCG diet. Iron status, hepcidin, C-reactive protein (CRP), serum amyloid A (SAA), and interleukin-6 (IL-6) were measured. There were no differences in treatment groups compared with control in CRP, hepcidin, and liver iron concentrations. Serum iron concentrations were significantly lower in the LPS (P = 0⋅02) and the LPS + EGCG (P = 0⋅01) than in the positive control group. Compared to the positive control group, spleen iron concentrations were significantly lower in the negative control (P < 0⋅001) but not with both LPS groups. SAA concentrations were significantly lower in the LPS + EGCG group compared to LPS alone group. EGCG reduced SAA concentrations but did not affect hepcidin or improve serum iron concentration or other iron markers.
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Affiliation(s)
| | - Sixtus Aguree
- Department of Applied Health Science, Indiana University School of Public Health—Bloomington, Bloomington, IN, USA
| | - Kevin L. Schalinske
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Manju B. Reddy
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
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13
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Alghadir AH, Gabr SA, Iqbal A. Mineral elements and adiposity-related consequences in adolescents with intellectual disabilities. BMC Mol Cell Biol 2023; 24:29. [PMID: 37730529 PMCID: PMC10512604 DOI: 10.1186/s12860-023-00490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Patients with intellectual disabilities are shown to have a limited capacity for cooperation, communication,and other biological consequences, which significantly require a specialized interest in healthcare professionals worldwide. AIM In this respect, the present study was designed to evaluate the levels mineral elements, and their correlation with oxidative stress markers and adiposity markers; leptin (L), adiponectin (A), and L/A ratio in adolescents with intellectual disabilities. METHODS A total of 350 schoolchildren aged (12-18 years) were randomly invited to participate in this prospective, observational study. Only 300 participants agreed to participate in this study. According to Intelligence quotients scores (IQ) measured by WISC-III, the participants were classified into two groups; the healthy control group (no = 180; IQ = 90-114); and the moderate intellectual disability (MID) group (no = 120; IQ = 35-49). Adiposity markers; body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), physical activity scores, adipokines biomarkers; leptin, adiponectin, L/A ratio, oxidative stress, and plasma mineral elements were evaluated by prevalidated questionnaires, inductively coupled plasma-mass spectrometry (ICP-MS), colorimetric, and immunoassay techniques. RESULTS Intellectual disability of moderate type was reported in 40% of the studied populations most of them are men aged 12-18 years (66.6% for men vs. 33.3 for females). Obesity was shown to be associated with the degree of intellectual disability of the students. There was a significant (P = 0.001) increase in the BMI, WHR, and WHtR scores as obesity markers with poor physical activity (P = 0.01) in students with poor disability compared to healthy controls (HC). The levels of leptin (P = 0.001), adiponectin (P = 0.01), and L/A ratio (P = 0.01) as adiposity biomarkers were significantly increased in students with MID compared to healthy controls. Also, oxidative stress measured by malondialdehyde (MDA) (P = 0.01) and total antioxidant capacity (TAC) (P = 0.01) were significantly increased in students with MID compared to healthy control subjects. In addition, mineral elements were shown to be linked with intellectual disability. The data showed that the levels of Fe, Mn, Zn, Hg, Pb, Ca, Cr, Mg, and Ni significantly (P = 0.001) increased, and the levels of Al, Na, K, Cu, and Zn/Cu ratio significantly (P = 0.001) decreased in subjects with MID compared to healthy controls. Correlation analysis concluded that changes in mineral elements significantly correlated with adiposity markers, oxidative stress, and the scores of intellectual disability (WISC III-IQ score). CONCLUSION The intellectual disability of moderate type (MID) was associated with abnormal changes in the levels of essential mineral elements and adipokines and increased levels of cellular oxidative stress. Thus, evaluating plasma mineral elements and adipokines levels could be a potential diagnostic parameter for diagnosing MID.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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14
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Verma M, Aditi A, Kapoor N, Sharma P, Kakkar M, Kakkar R, Kalra S. Childhood Obesity and Essential Micronutrients: Insights from India's Comprehensive National Nutrition Survey (2016-18). Diabetes Ther 2023; 14:1267-1283. [PMID: 37264296 PMCID: PMC10299976 DOI: 10.1007/s13300-023-01424-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/11/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Based on the long-term impact of childhood obesity, there is a compelling need to assess the burden of obesity and micronutrient deficiency and the interactions between the two. Thus, the aims of the study were to estimate the prevalence of overweight and obese children and adolescents to compare micro-nutrient levels in these children with normal and underweight categories and explore the factors affecting overweight and obesity in the presence of micronutrient deficiencies. METHODS Secondary data analysis of the Comprehensive National Nutrition Survey-India (2017-2018) was done. The survey recorded information from 112,245 preschool children (6-60 months), school age children (5-9 years), and adolescents (10-19 years). Half of these participants were invited for biochemical testing and were included in our analysis. The presence of overweight or obesity and micronutrient (serum erythrocyte folate; vitamin B12, A, and D; ferritin; zinc; and urinary iodine) deficiencies were the primary outcomes. The secondary outcome included the mean serum levels and predictors of overweight and obesity in the presence of micronutrient deficiencies. RESULTS Of the 38,060, 38,355, and 35,830 preschool, school-age, and adolescent study participants, about 2.69, 4.18, and 4.99% were overweight or obese. We observed significant variations in the mean folate and vitamin B12 levels among the overweight and obese preschool and school-age children compared to the normal weight group. School-age children exhibited significant differences in all micronutrient levels. In contrast, adolescents only showed substantial differences in vitamin D and A and serum ferritin levels. The predictors of overweight and obesity included geographical locations, wealth quintiles, and societal castes. Iron, folate, vitamin D, and zinc levels significantly affect the odds of developing childhood overweight and obesity. CONCLUSIONS It is vital to halt the growing burden of childhood overweight and obesity. Addressing micronutrient deficiencies can help us bring a sustainable and feasible approach to managing this menace.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.
| | - Aditi Aditi
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
| | - Nitin Kapoor
- Department of Endocrine, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India
- Non-Communicable Disease Unit, The Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
| | - Priyanka Sharma
- Department of Preventive Oncology, MPMMCC, and HBCH, TMC, Varanasi, Uttar Pradesh, India
| | - Monica Kakkar
- Department of Biochemistry, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, 151001, India
| | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
- University Centre for Research and Development, Chandigarh University, Mohali, Punjab, India.
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15
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Wang T, Gao Q, Yao Y, Luo G, Lv T, Xu G, Liu M, Xu J, Li X, Sun D, Cheng Z, Wang Y, Wu C, Wang R, Zou J, Yan M. Causal relationship between obesity and iron deficiency anemia: a two-sample Mendelian randomization study. Front Public Health 2023; 11:1188246. [PMID: 37397759 PMCID: PMC10313085 DOI: 10.3389/fpubh.2023.1188246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Background Observational studies have suggested an association between obesity and iron deficiency anemia, but such studies are susceptible to reverse causation and residual confounding. Here we used Mendelian randomization to assess whether the association might be causal. Methods Data on single-nucleotide polymorphisms that might be associated with various anthropometric indicators of obesity were extracted as instrumental variables from genome-wide association studies in the UK Biobank. Data on genetic variants in iron deficiency anemia were extracted from a genome-wide association study dataset within the Biobank. Heterogeneity in the data was assessed using inverse variance-weighted regression, Mendelian randomization Egger regression, and Cochran's Q statistic. Potential causality was assessed using inverse variance-weighted, Mendelian randomization Egger, weighted median, maximum likelihood and penalized weighted median methods. Outlier SNPs were identified using Mendelian randomization PRESSO analysis and "leave-one-out" analysis. Results Inverse variance-weighted regression associated iron deficiency anemia with body mass index, waist circumference, trunk fat mass, body fat mass, trunk fat percentage, and body fat percentage (all odds ratios 1.003-1.004, P ≤ 0.001). Heterogeneity was minimal and no evidence of horizontal pleiotropy was found. Conclusion Our Mendelian randomization analysis suggests that obesity can cause iron deficiency anemia.
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Affiliation(s)
- Tingting Wang
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Gao
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuanyuan Yao
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ge Luo
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Lv
- Department of Anesthesiology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Guangxin Xu
- Department of Anesthesiology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Mingxia Liu
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingpin Xu
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuejie Li
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dawei Sun
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenzhen Cheng
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Wang
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chaomin Wu
- Department of Anesthesiology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Ruiyu Wang
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingcheng Zou
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Yan
- Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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16
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Aguree S, Owora A, Hawkins M, Reddy MB. Iron Deficiency and Iron Deficiency Anemia in Women with and without Obesity: NHANES 2001-2006. Nutrients 2023; 15:nu15102272. [PMID: 37242155 DOI: 10.3390/nu15102272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Obesity has been linked to numerous health and nutritional problems, including impaired iron metabolism, a common cause of anemia. We aimed to determine the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among women aged 20-49 years based on body mass index (BMI) status. We used measures of iron status and body mass index from the 2001-2006 National Health and Nutrition Examination Survey (NHANES). Mean serum ferritin, erythrocyte protoporphyrin, and soluble transferrin receptor were higher, while those of serum iron, percent transferrin saturation, and mean cell volume (MCV) were lower in women with obesity than those with normal weight (all p < 0.016). ID based on the ferritin model was 12.5 ± 1.0% vs. 22.9 ± 1.6% (p < 0.001); 9.0 ± 0.9% vs. 20.0 ± 1.3% (p < 0.001) based on the MCV model; and 8.1 ± 1.0% vs. 10.5 ± 1.2% (p > 0.05) based on the BII model for women with normal weight and women with obesity, respectively. Anemia prevalence was 5.5 ± 0.8% (normal) vs. 9.3 ± 1.0% (obese) (p = 0.005). The IDA estimates based on the ferritin and MCV models were similar but higher than that from the BII model (p < 0.001). Generally, the prevalence rates of ID and anemia (and IDA) were higher for women with obesity, but the method used to define deficiency mattered. The choice of iron indices is important for estimating ID and IDA in populations with obesity.
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Affiliation(s)
- Sixtus Aguree
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA
| | - Arthur Owora
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN 47405, USA
| | - Misty Hawkins
- Department of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN 47405, USA
| | - Manju B Reddy
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA
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17
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Calcaterra V, Verduci E, Milanta C, Agostinelli M, Todisco CF, Bona F, Dolor J, La Mendola A, Tosi M, Zuccotti G. Micronutrient Deficiency in Children and Adolescents with Obesity-A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:695. [PMID: 37189944 PMCID: PMC10136772 DOI: 10.3390/children10040695] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023]
Abstract
Childhood obesity represents a serious public health burden. Despite excessive dietary consumption, children with obesity present high rates of micronutrient deficiencies, such as deficiencies in minerals and specific vitamins; micronutrient deficiencies may have a pathogenic role in obesity-related metabolic comorbidities. In this narrative review, we analyzed the main deficiencies associated with obesity, their clinical consequences, and the evidence about a possible supplementation. Iron; vitamins A, B, C, D, and E; folic acid; zinc; and copper deficiencies represent the most common deficient microelements. The relationship between obesity and multiple micronutrient deficiencies remains unclear, and different mechanisms have been proposed. The medical care plan for pediatric obesity should include food choices with high nutritional content as part of a crucial approach to obesity-related complications. Unfortunately, only a few studies are available regarding the efficacy of oral supplementation or weight loss for treating them; thus, continuous nutritional monitoring is necessary.
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Affiliation(s)
- Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Elvira Verduci
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Chiara Milanta
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | | | | | - Federica Bona
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Jonabel Dolor
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Alice La Mendola
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Martina Tosi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
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18
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Peroni DG, Hufnagl K, Comberiati P, Roth-Walter F. Lack of iron, zinc, and vitamins as a contributor to the etiology of atopic diseases. Front Nutr 2023; 9:1032481. [PMID: 36698466 PMCID: PMC9869175 DOI: 10.3389/fnut.2022.1032481] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
Micronutritional deficiencies are common in atopic children suffering from atopic dermatitis, food allergy, rhinitis, and asthma. A lack of iron, in particular, may impact immune activation with prolonged deficiencies of iron, zinc, vitamin A, and vitamin D associated with a Th2 signature, maturation of macrophages and dendritic cells (DCs), and the generation of IgE antibodies. In contrast, the sufficiency of these micronutrients establishes immune resilience, promotion of regulatory cells, and tolerance induction. As micronutritional deficiencies mimic an infection, the body's innate response is to limit access to these nutrients and also impede their dietary uptake. Here, we summarize our current understanding of the physiological function of iron, zinc, and vitamins A and D in relation to immune cells and the clinical consequences of deficiencies in these important nutrients, especially in the perinatal period. Improved dietary uptake of iron is achieved by vitamin C, vitamin A, and whey compounds, whereas zinc bioavailability improves through citrates and proteins. The addition of oil is essential for the dietary uptake of beta-carotene and vitamin D. As for vitamin D, the major source comes via sun exposure and only a small amount is consumed via diet, which should be factored into clinical nutritional studies. We summarize the prevalence of micronutritional deficiencies of iron, zinc, and vitamins in the pediatric population as well as nutritional intervention studies on atopic diseases with whole food, food components, and micronutrients. Dietary uptake via the lymphatic route seems promising and is associated with a lower atopy risk and symptom amelioration. This review provides useful information for clinical studies and concludes/emphasizes that a healthy, varied diet containing dairy products, fish, nuts, fruits, and vegetables as well as supplementing foods or supplementation with micronutrients as needed is essential to combat the atopic march.
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Affiliation(s)
- Diego G. Peroni
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Karin Hufnagl
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University of Vienna and University of Vienna, Vienna, Austria,Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Pasquale Comberiati
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Franziska Roth-Walter
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University of Vienna and University of Vienna, Vienna, Austria,Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria,*Correspondence: Franziska Roth-Walter, ;
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19
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Changes in obesity and iron deficiency between 4 and 9 years of age. Longitudinal study of childhood obesity (ELOIN). Int J Obes (Lond) 2022; 46:1992-1999. [PMID: 35931811 DOI: 10.1038/s41366-022-01196-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent studies revealed that children who are overweight have a higher risk of iron deficiency, although the etiology of this relationship remains unclear. The aim of the study was to evaluate the association between changes in obesity status between 4 and 9 years of age and iron deficiency. SUBJECTS This population-based cohort study included 1347 children from the ELOIN study, conducted in Madrid, Spain. Follow-up with physical examinations and a computer-assisted telephone interview were carried out at 4, 6 and 9 years of age, and a blood test was performed at 9 years. METHODS Changes in obesity were estimated based on body mass index and waist circumference, according to the persistence or variation in obesity rates at 4, 6 and 9 years and were classified as follows: (1) Stable without obesity; (2) Remitting obesity at 9 years; (3) Incident obesity or relapse at 9 years; and (4) Stable with obesity. Iron deficiency was defined as transferrin saturation value below 16%. Odds ratios (ORs) for iron deficiency were estimated according to obesity status using logistic regression and adjusted for confounding variables, including C-reactive protein (CRP). RESULTS The prevalence of iron deficiency in the stable general obesity (GO) and abdominal obesity (AO) groups was 38.2% and 41.2%, versus 23.6% and 23.4% in the stable without obesity groups, respectively. The ORs for iron deficiency were 1.85 (95% CI: 1.03-3.32) in the stable GO group and 2.34 (95% CI: 1.29-4.24) in the stable AO group. This association disappeared when CRP was included in the analysis. CONCLUSIONS An extended state of obesity during the first stages of life is associated with iron deficiency, and this association may be mediated by CRP. Prevention and early detection of obesity in children should be a priority to avoid a double burden of malnutrition.
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Li N, Liao Y, Huang H, Fu S. Co-regulation of hepatic steatosis by ferritinophagy and unsaturated fatty acid supply. Hepatol Commun 2022; 6:2640-2653. [PMID: 35861547 PMCID: PMC9512465 DOI: 10.1002/hep4.2040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 11/06/2022] Open
Abstract
Both iron overload and iron deficiency have been reported in obesity and metabolic syndromes. Due to the presence of multiple intracellular iron pools and the dynamic nature of iron mobilization and use, the actual status and contribution of free and metabolically active iron toward metabolic syndrome remain to be established. The discovery of nuclear receptor coactivator 4 (NCOA4) as a ferritinophagy receptor provides an opening to address the connection between iron and metabolic diseases. This study aims to specifically dissect the role of hepatic ferritinophagy in lipid metabolism and hepatic steatosis. We conducted a series of Ncoa4 gain- and loss-of-function experiments to examine how ferritinophagy affects lipid metabolism through phenotypic and lipidomic analyses both in vitro and in vivo. We show that ferritinophagy is required to release iron from ferritin cages for biological use, and is induced by lipid loading in vitro and during the development of obesity in vivo. Ncoa4 knockdown impairs mitochondrial morphology and reduces palmitate-induced lipid droplet formation in cultured cells and the development of hepatic steatosis in obese mice models. Importantly, the effect of Ncoa4 deficiency on mitochondrial morphology and lipid accumulation is specifically linked to lipidomic reductions in unsaturated fatty acid content in triglycerides and cardiolipins, and an external supply of unsaturated fatty acids reverses these phenotypes. Conclusion: This study shows that ferritinophagy-derived iron supports fatty acid desaturation and the synthesis of unsaturated fatty acid-rich lipids to reduce lipotoxicity. However, the continuous activation of ferritinophagy contributes to the development of hepatic steatosis and liver damage in obesity.
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Affiliation(s)
- Ning Li
- School of Life SciencesTsinghua UniversityBeijingChina
| | - Yilie Liao
- School of Life SciencesTsinghua UniversityBeijingChina
| | - Haipeng Huang
- School of Life SciencesTsinghua UniversityBeijingChina
| | - Suneng Fu
- Department of Basic ResearchGuangzhou LaboratoryGuangdongChina
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Skrypnik K, Olejnik-Schmidt A, Mikołajczyk-Stecyna J, Schmidt M, Suliburska J. Influence of supplementation of probiotic bacteria Lactobacillus plantarum and Lactobacillus curvatus on selected parameters of liver iron metabolism in rats on high-fat iron-deficient diet. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Malesza IJ, Bartkowiak-Wieczorek J, Winkler-Galicki J, Nowicka A, Dzięciołowska D, Błaszczyk M, Gajniak P, Słowińska K, Niepolski L, Walkowiak J, Mądry E. The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia—A Narrative Review. Nutrients 2022; 14:nu14173478. [PMID: 36079734 PMCID: PMC9458173 DOI: 10.3390/nu14173478] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 12/21/2022] Open
Abstract
Iron is an indispensable nutrient for life. A lack of it leads to iron deficiency anaemia (IDA), which currently affects about 1.2 billion people worldwide. The primary means of IDA treatment is oral or parenteral iron supplementation. This can be burdened with numerous side effects such as oxidative stress, systemic and local-intestinal inflammation, dysbiosis, carcinogenic processes and gastrointestinal adverse events. Therefore, this review aimed to provide insight into the physiological mechanisms of iron management and investigate the state of knowledge of the relationship between iron supplementation, inflammatory status and changes in gut microbiota milieu in diseases typically complicated with IDA and considered as having an inflammatory background such as in inflammatory bowel disease, colorectal cancer or obesity. Understanding the precise mechanisms critical to iron metabolism and the awareness of serious adverse effects associated with iron supplementation may lead to the provision of better IDA treatment. Well-planned research, specific to each patient category and disease, is needed to find measures and methods to optimise iron treatment and reduce adverse effects.
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Affiliation(s)
- Ida J. Malesza
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | | | - Jakub Winkler-Galicki
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Aleksandra Nowicka
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | | | - Marta Błaszczyk
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Paulina Gajniak
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Karolina Słowińska
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Leszek Niepolski
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Edyta Mądry
- Department of Physiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Correspondence:
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Adjusting Ferritin Concentrations for Nonclinical Inflammation in Adolescents with Overweight or Obesity. J Pediatr 2022; 244:125-132.e1. [PMID: 35074310 DOI: 10.1016/j.jpeds.2022.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/16/2021] [Accepted: 01/13/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare approaches for adjusting serum ferritin concentrations for inflammation in Chilean adolescents with overweight and obesity. STUDY DESIGN Cross-sectional data from 518 adolescents (aged 16-17 years; 48% females) from Santiago, Chile were analyzed. Several approaches were compared for estimating the prevalence of depleted iron stores (defined as serum ferritin <15 μg/L), including unadjusted prevalence and higher cutoffs for various subgroups (excluding participants with inflammation), correction factors, and regression corrections. A "reference" prevalence estimate was calculated as the prevalence of serum ferritin <15 μg/L in normal weight individuals without inflammation. Each adjustment approach was compared with this reference prevalence. RESULTS The sample comprised 61.2% normal weight, 23.7% overweight, and 15.1% obese individuals. The prevalence of inflammation (marked by C-reactive protein level >5.0 mg/L) was 6.3%, 8.1%, and 14.1% in the 3 groups, respectively. The correction factor approaches produced adjusted estimates closest to the reference estimate (24.1%-24.7% vs 22.9%), followed by the regression corrections (24.7%-25.1% vs 22.9%). Applying a higher serum ferritin cutoff (30 μg/L) to all participants or to participants with overweight/obesity produced adjusted estimates farthest from the reference (59.5% and 35.3%, respectively). CONCLUSIONS Adjusting serum ferritin concentration may be necessary when assessing iron status in populations with high rates of overweight/obesity. After reviewing 6 approaches for adjusting for the influence of inflammation, this study suggests that using correction factors may be the most appropriate approach for adjusting serum ferritin in Chilean adolescents. Further research is needed to determine the optimal approach for adjusting serum ferritin concentrations for weight-related inflammation in broader populations.
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Choy CC, Howe CJ, Soti-Ulberg C, Naseri T, Reupena MS, Duckham RL, Hawley NL. Is overweight or obesity associated with anemia in children? Follow-up of Samoans in the Ola Tuputupua'e "Growing Up" study. Obes Res Clin Pract 2022; 16:144-150. [PMID: 35256305 PMCID: PMC9636893 DOI: 10.1016/j.orcp.2022.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Globally, there is growing evidence of a double burden of malnutrition with obesity coexisting alongside micronutrient deficiencies across the life course. An emergent double burden poses a threat to health during childhood in Samoa: among 2-4-year-olds with overweight/obesity, 42.9% were anemic. Previous research suggests that obesity-related inflammation may increase the risk of iron deficiency or anemia in children. To test this hypothesis, we examined whether overweight/obesity at 2-4 is associated with anemia at 3.8-6 years old among Samoan children. METHODS Data were obtained from the Ola Tuputupua'e "Growing Up" cohort study. Overweight/obesity at 2-4 years old was classified by body mass index-for-age Z-score > +2 SD. Anemia was defined as hemoglobin < 110 g/L for under 5-year-olds and < 115 g/L for 5-6-year-olds. Prevalence ratios (PRs) for anemia at 3.8-6 years old were estimated by fitting modified Poisson regression models. RESULTS In our sample of 197 children, 16.24% (n = 32) were affected by overweight/obesity at 2-4 years old and 26.90% (n = 53) had anemia at 3.8-6 years old. After covariate adjustment, the prevalence of anemia was 18% lower among children with overweight/obesity at 2-4 years old compared to those without (PR:0.82; 95% CI:0.42-1.63); however, the corresponding confidence interval was imprecise and inclusive of a higher prevalence. CONCLUSIONS There was not strong evidence to support a relationship between overweight/obesity and anemia in Samoan children, suggesting that obesity-related inflammation may not be related to iron deficiency nor anemia in this setting. Further investigation of the antecedents of overweight/obesity and anemia is critical to inform integrated action to improve health in Samoa.
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Affiliation(s)
- Courtney C Choy
- Department of Epidemiology, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02906, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA
| | - Chanelle J Howe
- Department of Epidemiology, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02906, USA
| | | | - Take Naseri
- Ministry of Health, Ififi Street, Motootua, Apia, Samoa
| | | | - Rachel L Duckham
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC 3021, Australia
| | - Nicola L Hawley
- Department of Epidemiology, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02906, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.
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Associations between Serum Vitamin A and Metabolic Risk Factors among Eastern Chinese Children and Adolescents. Nutrients 2022; 14:nu14030610. [PMID: 35276969 PMCID: PMC8839095 DOI: 10.3390/nu14030610] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
Vitamin A, a fat-soluble essential vitamin, is implicated in a large range of physiological processes. Up to now, the associations between vitamin A and metabolic syndrome (MetS) or other metabolic risk factors are controversial in children and adolescents. Thus, we aimed to dig into the relationship of vitamin A with MetS and many other metabolic risk factors. This was a cross-sectional study derived from the China National Nutrition and Health Surveillance of Children and Lactating Mothers. A total of 3025 school-aged (7–17 years) children and adolescents were selected by applying multistage stratified cluster random sampling methods in the Jiangsu Province of eastern China. Through enquiry survey, anthropometric measurement and laboratory examination, relevant information and blood biochemical indexes of the participants were collected in this study. MetS was identified according to the modified criteria of the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III). Multivariate logistic analysis and the generalized additive model (GAM) were used to analyze the relationship between vitamin A and various metabolic risk factors. The overweight, obesity and MetS prevalence of children and adolescents in this study was 14.0%, 11.9% and 5.1%, respectively. The risk of prevalent MetS, general obesity, high low-density lipoprotein (LDL), high total cholesterol (TC) and hyperuricemia increased with vitamin A in a dose-dependent way. Logistic regression analysis showed that serum vitamin A Z scores were positively associated with MetS and central obesity, elevated blood pressure (BP) and elevated triglyceride (TG). Sex stratification analysis showed that both in male and female participants, the risk of prevalent MetS, general obesity, high LDL, high TC and hyperuricemia still increased with vitamin A levels. MetS was at a high prevalence level in children and adolescents in Jiangsu that were 7–17 years old. Vitamin A was positively associated with obesity, MetS, dyslipidemia and hyperuricemia. More public health measures and new visions should focus on the effects of retinol on children and adolescents.
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Giannini C, Polidori N, Saltarelli MA, Chiarelli F, Basilico R, Mohn A. Increased hepcidin levels and non-alcoholic fatty liver disease in obese prepubertal children: a further piece to the complex puzzle of metabolic derangements. J Pediatr Endocrinol Metab 2022; 35:39-47. [PMID: 34726357 DOI: 10.1515/jpem-2021-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/11/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Several studies on obese youths and adults have reported increased hepcidin levels, which seems to be related to metabolic and iron metabolism alterations. The complete mechanisms involved in hepcidin increase remain to be elucidated, and particularly its role in the development of other known complications such as Nonalcoholic Fatty Liver Disease (NAFLD). NAFLD in prepubertal children might be of special interest in understanding the underlying mechanisms. METHODS Anthropometric measurements, liver ultrasonography, lipid profile, liver function, oxidative stress, inflammatory state, and iron metabolism were studied in 42 obese prepubertal children and 33 healthy controls. We, therefore, evaluated the presence of possible correlations between Hepcidin and the other metabolic variables, and the possible association between NAFLD and iron metabolism. RESULTS Hepcidin levels were significantly increased in the obese prepubertal children (p=0.001) with significant differences between obese children with and without NAFLD (p=0.01). Blood iron was lower in obese children (p=0.009). In the obese group, a negative correlation between hepcidin and both blood iron levels (p=0.01) and LagPHASE (p=0.02) was found. In addition, a positive association between hepcidin and NAFLD (p=0.03) was detected. CONCLUSIONS We suggest that an increase in hepcidin levels may represent an early step in iron metabolism derangements and metabolic alterations, including NAFLD, in prepubertal obese children.
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Affiliation(s)
- Cosimo Giannini
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Clinical Research Center, "G. d'Annunzio" Foundation, University of Chieti, Chieti, Italy
| | - Nella Polidori
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | | | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Clinical Research Center, "G. d'Annunzio" Foundation, University of Chieti, Chieti, Italy
| | - Raffaella Basilico
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Angelika Mohn
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Clinical Research Center, "G. d'Annunzio" Foundation, University of Chieti, Chieti, Italy
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Dorsey A, Thompson AL. Child, caretaker, and community: Testing predictors of anemia and response to iron supplementation in Peruvian preschool-aged children. Am J Hum Biol 2021; 33:e23538. [PMID: 33200848 PMCID: PMC8126576 DOI: 10.1002/ajhb.23538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/02/2020] [Accepted: 11/03/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Despite repeated governmental and nongovernmental interventions, anemia remains a widespread public health concern in Peru. This article examines nutritional and disease factors associated with the prevalence of anemia and response to iron supplementation in Peruvian children, with the aim of understanding the lack of success of national programs. METHODS Data come from children, aged 2-5 years (n = 102), living in peri-urban Lima. Predictors of anemia and response to iron supplementation were explored at the individual, maternal, household, and environmental levels using logistic regression models, adjusted for clustering by household. RESULTS Half of the children in this sample were anemic and 50% of the anemic children responded to iron supplementation. We identified several factors that were associated with child anemia status and response to iron supplementation. Lower weight-for-age z-scores and the winter season were strong predictors of child anemia status and nonresponse to iron supplementation. Living with paternal grandparents was protective against anemia and elevated C-reactive protein at the time of the final interview was associated with a lack of response to iron supplementation. CONCLUSIONS The findings of this study document an association between children's anemia status and their nutritional and ecological environment, highlighting the importance of examining anemia within a specific context to better understand the factors driving this important health problem.
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Affiliation(s)
- Achsah Dorsey
- Department of Anthropology, University of Massachusetts, Amherst, USA
| | - Amanda L. Thompson
- Carolina Population Center, University of North Carolina, Chapel Hill, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
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Sun Y, Shen ZZ, Huang FL, Jiang Y, Wang YW, Zhang SH, Ma S, Liu JT, Zhan YL, Lin H, Chen YL, Shi YJ, Ma LK. Association of gestational anemia with pregnancy conditions and outcomes: A nested case-control study. World J Clin Cases 2021; 9:8008-8019. [PMID: 34621857 PMCID: PMC8462208 DOI: 10.12998/wjcc.v9.i27.8008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gestational anemia is a serious public health problem that affects pregnant women worldwide. Pregnancy conditions and outcomes might be associated with the presence of gestational anemia. This study investigated the association of pregnancy characteristics with anemia, exploring the potential etiology of the disease.
AIM To assess the association of pregnancy parameters with gestational anemia.
METHODS A nested case-control study was conducted based on the Chinese Pregnant Women Cohort Study-Peking Union Medical College Project (CPWCS-PUMC). A total of 3172 women were included. Patient characteristics and gestational anemia occurrence were extracted, and univariable and multivariable logistic regression models were used to analyze the association of pregnancy parameters with gestational anemia.
RESULTS Among the 3172 women, 14.0% were anemic, 46.4% were 25-30 years of age, 21.9% resided in eastern, 15.7% in middle, 12.4% in western 18.0% in southern and 32.0% in northern regions of China. Most women (65.0%) had a normal prepregnancy body mass index. Multivariable analysis found that the occurrence of gestational anemia was lower in the middle and western regions than that in the eastern region [odds ratio (OR) = 0.406, 95% confidence interval (CI): 0.309-0.533, P < 0.001)], higher in the northern than in the southern region (OR = 7.169, 95%CI: 5.139-10.003, P < 0.001), lower in full-term than in premature births (OR = 0.491, 95%CI: 0.316-0.763, P = 0.002), and higher in cases with premature membrane rupture (OR=1.404, 95%CI: 1.051-1.876, P = 0.02).
CONCLUSION Gestational anemia continues to be a health problem in China, and geographical factors may contribute to the situation. Premature birth and premature membrane rupture may be associated with gestational anemia. Therefore, we should vigorously promote local policy reformation to adapt to the demographic characteristics of at-risk pregnant women, which would potentially reduce the occurrence of gestational anemia.
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Affiliation(s)
- Yin Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Zhong-Zhou Shen
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Fei-Ling Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ya-Wen Wang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Su-Han Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Shuai Ma
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Tao Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Yong-Le Zhan
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hang Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Yun-Li Chen
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ying-Jie Shi
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Liang-Kun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
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Dorsey AF, Penny ME, Thompson AL. Adiposity and pathogen exposure: An investigation of response to iron supplementation and hypothesized predictors in anemic pre-school-aged children living in a dual burden environment. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 176:54-65. [PMID: 33852740 PMCID: PMC8376780 DOI: 10.1002/ajpa.24287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Peruvians are experiencing rapid dietary and lifestyle changes, resulting in a phenomenon known as the "dual burden of disease." A common manifestation of the dual burden in individuals is the co-occurrence of overweight and anemia. Despite recent initiatives introduced to address these concerns, rates continue to be public health concerns. This study investigates the relationship between immune activation and lack of response to iron supplementation after 1 month of treatment and explores variation in body fat stores as a potential moderator between immune function and response to treatment. METHODS Data come from children, aged 2-5 years (n = 50) from a peri-urban community in Lima, Peru. Multivariate logistic regression models were used to explore the associations between response to treatment (Hb > =11.0 g/dl) after 1 month of treatment), markers of immune activation (C-reactive protein [CRP] and reported morbidity symptoms), and measures of body fat (waist-to-height ratio, triceps skinfold thickness, and body mass index [BMI]). RESULTS We found that high CRP is associated with a lack of response to iron supplementation after 1 month of treatment and that BMI z-score may moderate this association. Generally, larger body size is associated with response to iron supplementation whether or not the children in this sample have high immune activation. However, the probability of anemic children responding to iron supplementation treatment differed across adiposity measures. CONCLUSIONS Our finding suggesting that adiposity and CRP influence response to iron supplementation, furthers our understanding of the relationship between inflammation and anemia treatment in children and has both theoretical and public health implications.
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Affiliation(s)
- Achsah F Dorsey
- Department of Anthropology, University of Massachusetts, Amherst, Massachusetts, USA
| | - Mary E Penny
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - Amanda L Thompson
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
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The Association between Hepcidin and Iron Status in Children and Adolescents with Obesity. J Nutr Metab 2021; 2021:9944035. [PMID: 34258058 PMCID: PMC8257374 DOI: 10.1155/2021/9944035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/27/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Iron deficiency (ID) is the most common nutritional deficiency found in pediatric practice. A higher prevalence of ID may be found in children with obesity. Obesity is a chronic low-grade inflammatory condition. It is postulated that inflammation increases hepcidin, a regulator of iron homeostasis. The aim of this study was to investigate the associations between iron status, hepcidin, and BMI-standard deviation score (BMI-SDS) in children with and without obesity. Methods A cross-sectional study of Thai children with obesity (5 to 15 years old) versus age- and sex-matched, nonobese controls was conducted. A total of 63 children with obesity and 27 controls were enrolled. Complete blood count, serum iron, ferritin, transferrin saturation, and total iron binding capacity were analyzed. Serum hepcidin-25 was assayed using a hepcidin ELISA Kit (Human Hepc25). Results There were 63 children with obesity, the median age (IQR) being 10 (9–13) years, and 27 controls. The median (IQR) BMI-SDS of the obese group was 2.3 (2.0–2.6) vs. −0.5 ((−1.3)−0.4) of the control group. ID was diagnosed in 27 children in the obese group (42.9%); 4 of the children with obesity and ID had anemia. Serum hepcidin-25 levels of the children with ID vs. without ID in the obese group were not significantly different (median (IQR) 25 (12.9–49.2) and 26.4 (12.6–43.6), respectively) but both of them were significantly higher than controls (19.7 (8.3–25.5) ng/ml, p = 0.04). BMI-SDS was positively correlated with hepcidin-25 (r = 0.28, p = 0.001). Conclusion Prevalence of iron deficiency in Thai children with obesity and serum hepcidin-25 was higher than controls. Further study in a larger population, preferably with interventions such as weight loss program, is warranted to clarify this association.
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Rodríguez-Mortera R, Caccavello R, Hermo R, Garay-Sevilla ME, Gugliucci A. Higher Hepcidin Levels in Adolescents with Obesity Are Associated with Metabolic Syndrome Dyslipidemia and Visceral Fat. Antioxidants (Basel) 2021; 10:antiox10050751. [PMID: 34065056 PMCID: PMC8150400 DOI: 10.3390/antiox10050751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/19/2022] Open
Abstract
Tightly regulated iron metabolism prevents oxidative stress. Hepcidin is a hormone that regulates iron flow in plasma; its production is induced by an iron overload and by inflammation. It inhibits iron entry into the circulation by blocking dietary absorption in the duodenum, the release of recycled iron from macrophages and the exit of stored iron from hepatocytes. Varied signals responding to iron stores, erythropoietic activity and host defense converge to regulate hepcidin production and thereby affect iron homeostasis. Although it is known that hepcidin increases when interleukin 6 (IL-6) increases, the relationship between hepcidin, dyslipidemia, insulin resistance (IR) and visceral adiposity index (VAI) in adolescents with obesity is unclear. In this cross-sectional study of 29 obese adolescents and 30 control subjects, we explored the difference of hepcidin, iron metabolism markers and IL-6 between obese and non-obese adolescents, and identified associations with inflammation, atherogenic dyslipidemia and IR. As compared to lean controls, obese participants showed 67% higher hepcidin: 14,070.8 ± 7213.5 vs. 8419.1 ± 4826.1 pg/mLc; 70% higher ferritin: 94.4 ± 82.4 vs. 55.1 ± 39.6 pg/mLa and 120% higher IL-6: 2.0 (1.1–4.9) vs. 0.9 (0.5–1.3) pg/mLd. Transferrin, soluble transferrin receptor and total body iron (as measured by sTFR/ferritin, log10 sTFR/ferritin ratio and sTFR/log ferritin ratios) were not different between the two cohorts. In the whole cohort, hepcidin correlated with VAI (r = 0.29a), sd-LDL (r = 0.31b), HOMA-IR (r = 0.29a) and IL-6 (r = 0.35c). In obese adolescents hepcidin correlated with TG (r = 0.47b), VLDL-C (r = 0.43b) and smaller LDL2 (r = 0.39a). Hepcidin elevation in adolescents with obesity is linked more to inflammation and metabolic alterations than to iron metabolism since the other markers of iron metabolism were not different between groups, except for ferritin. Studies addressing the long-term effects of higher hepcidin levels and their impact on subclinical anemia and iron status are warranted. a p < 0.05; b p < 0.01, c p < 0.001 dp < 0.0001.
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Affiliation(s)
- Reyna Rodríguez-Mortera
- Department of Medical Science, University of Guanajuato, Leon 37320, Mexico; (R.R.-M.); (M.E.G.-S.)
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA; (R.C.); (R.H.)
| | - Russell Caccavello
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA; (R.C.); (R.H.)
| | - Ricardo Hermo
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA; (R.C.); (R.H.)
| | | | - Alejandro Gugliucci
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA; (R.C.); (R.H.)
- Correspondence:
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Kerkadi A, Mohsen Ali R, A. H. Shehada A, Abdelnasser AbouHassanein E, Moawad J, Bawadi H, Shi Z. Association between central obesity indices and iron status indicators among Qatari adults. PLoS One 2021; 16:e0250759. [PMID: 33914792 PMCID: PMC8084168 DOI: 10.1371/journal.pone.0250759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Co-existence of iron deficiency and obesity in adults has been reported in many countries. However, little is known on the association between obesity and iron deficiency in Qatar. This study aimed to investigate the link between abdominal obesity indices and iron status among adults in Qatar. A random sample of 1000 healthy Qatari adults, aged 20-50 years, was obtained from Qatar Biobank study. Body weight, waist circumference, dual x-ray absorptiometry (DXA) parameters and iron status indicators were measured using standard techniques. Multiple regression analysis was used to examine the associations. The prevalence of iron deficiency and anaemia were 35.4 and 25%, respectively. Of the participants with a large waist circumference, 31.7% had anaemia. Ferritin significantly increased with the increase in the android fat to gynoid fat ratio and visceral fat in both genders. Serum iron and transferring saturation decreased significantly with the increase in waist circumference in women. In both genders, C-reactive protein increased with the increase in all obesity indices. Standardized values of waist circumference, android fat, gynoid fat ratio and visceral fat were significantly associated with log transformed ferritin in men and women. Waist circumference was inversely related to serum iron (β:-0.95, 95% CI:-1.50,-0.39) and transferrin saturation (β:-1.45, 95%CI:-2.46, -0.43) in women. In men, waist circumference was positively associated with haemoglobin level (β: 0.16, 95% CI:0.04, 0.29). Central obesity coexists with anaemia among the study population. Elevated central obesity indices were associated with an increase in ferritin concentration. The increased ferritin concentration may be attributed to the increase in inflammatory status as a result of an increase in c-reactive protein concentration associated with central obesity.
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Affiliation(s)
- Abdelhamid Kerkadi
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Reem Mohsen Ali
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Alaa A. H. Shehada
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | | | - Joyce Moawad
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Hiba Bawadi
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
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Anthropometric Markers and Iron Status of 6-12-Year-Old Thai Children: Associations and Predictors. J Nutr Metab 2021; 2021:9629718. [PMID: 33953979 PMCID: PMC8057914 DOI: 10.1155/2021/9629718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 02/03/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Obesity may be associated with poor iron status. The objective of this study was to investigate the association between different indices of iron status and anthropometric measurements in Thai children. Materials and Methods Anthropometry (weight, height, waist circumference (WC), and body composition assessed by bioelectrical impedance analysis) and iron indices were measured in 336 Thai children aged 6-12 years. Iron deficiency (ID) was defined using two or more of the following: (1) %transferrin saturation (%Tsat) < 16%; (2) serum ferritin (SF) < 15 μg/mL; and (3) soluble transferrin receptor (sTfR) > 5 mg/L. Iron deficiency anaemia (IDA) was defined as haemoglobin < WHO age cutoff combined with ID. Overweight and obesity were defined as body mass index (BMI) standard deviation score (SDS) ≥ +1 SDS or +2 SDS, respectively (WHO growth reference). Results BMI SDS was significantly positively correlated with sTfR and SF (sTfR, r: 0.209, p < 0.001; SF, r: 0.214, p < 0.001) and negatively correlated with %Tsat (r: -0.132, p = 0.013). Correlations between WC SDS and %fat mass and each iron marker were similar. The percentage with low SF was significantly lower than that using other individual markers. ID prevalence was not significantly different between normal-weight and overweight/obesity groups although a significantly higher proportion of overweight/obese children had sTfR >5 mg/L. Puberty and menarche were significant predictors of ID (puberty adjusted OR: 2.20, 95% CI: 0.43, 11.25; menarche adjusted OR: 6.11, 95% CI: 1.21, 30.94). Conclusion Greater adiposity was associated with poorer iron status. However, SF may not be a good indicator of iron status in Thai children, particularly in those who are overweight/obese, whereas sTfR merits further investigation.
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El-Mallah CA, Beyh YS, Obeid OA. Iron Fortification and Supplementation: Fighting Anemia of Chronic Diseases or Fueling Obesity? Curr Dev Nutr 2021; 5:nzab032. [PMID: 33959691 PMCID: PMC8085477 DOI: 10.1093/cdn/nzab032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/07/2021] [Accepted: 03/31/2021] [Indexed: 12/13/2022] Open
Abstract
The significant worldwide increase in obesity has become a major health problem. Excess adiposity has been extensively linked to inflammation. Recently, studies have shown that dietary intake and microbiota dysbiosis can affect the health of the gut and lead to low-grade systemic inflammation, worsening the state of obesity and further exacerbating inflammation. The latter is shown to decrease iron status and potentially increase the risk of anemia by inhibiting iron absorption. Hence, anemia of obesity is independent of iron intake and does not properly respond to increased iron ingestion. Therefore, countries with a high rate of obesity should assess the health impact of fortification and supplementation with iron due to their potential drawbacks. This review tries to elucidate the relation between inflammation and iron status to better understand the etiology of anemia of obesity and chronic diseases and wisely design any dietary or medical interventions for the management of anemia and/or obesity.
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Affiliation(s)
- Carla A El-Mallah
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Yara S Beyh
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Omar A Obeid
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
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Berger MM, Herter-Aeberli I, Zimmermann MB, Spieldenner J, Eggersdorfer M. Strengthening the immunity of the Swiss population with micronutrients: A narrative review and call for action. Clin Nutr ESPEN 2021; 43:39-48. [PMID: 34024545 PMCID: PMC7987506 DOI: 10.1016/j.clnesp.2021.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The enormous health impact of the COVID-19 pandemic has refocused attention on measures to optimize immune function and vaccine response. Dietary deficiencies of micronutrients can weaken adaptive immunity. The aim of this review was to examine links between micronutrients, immune function and COVID-19 infection, with a focus on nutritional risks in subgroups of the Swiss population. METHODS Scoping review on the associations between selected micronutrients (vitamins D and C, iron, selenium, zinc, and n-3 PUFAs) and immunity, with particular reference to the Swiss population. These nutrients were chosen because previous EFSA reviews have concluded they play a key role in immunity. RESULTS The review discusses the available knowledge on links between sufficient nutrient status, optimal immune function, and prevention of respiratory tract infections. Because of the rapid spread of the COVID-19 pandemic, controlled intervention studies of micronutrients in the context of COVID-19 infection are now underway, but evidence is not yet available to draw conclusions. The anti-inflammatory properties of n-3 PUFAs are well established. In Switzerland, several subgroups of the population are at clear risk of nutrient deficiencies; e.g., older adults, multiple comorbidities, obesity, pregnancy, and institutionalized. Low intakes of n-3 PUFA are present in a large proportion of the population. CONCLUSION There are clear and strong relationships between micronutrient and n-3 PUFA status and immune function, and subgroups of the Swiss population are at risk for deficient intakes. Therefore, during the COVID-19 pandemic, as a complement to a healthy and balanced diet, it may be prudent to consider supplementation with a combination of moderate doses of Vitamins C and D, as well as of Se, Zn and n-3 PUFA, in risk groups.
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Affiliation(s)
- Mette M Berger
- Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland.
| | | | | | - Manfred Eggersdorfer
- Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
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Zhang YX, Chen J, Liu XH. Profiles of anemia among school-aged children categorized by body mass index and waist circumference in Shandong, China. Pediatr Neonatol 2021; 62:165-171. [PMID: 33485821 DOI: 10.1016/j.pedneo.2020.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/29/2020] [Accepted: 11/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The prevalence of childhood obesity has been increasing worldwide. The connection between iron deficiency and obesity has received much research interest. The present study examined the profiles of anemia among school-aged children categorized by obesity-related index in Shandong, China. METHODS A total of 20,172 children aged 7, 9, 12, and 14 years participated in the study, whose hemoglobin (Hb) concentration was measured by laboratory technicians. The prevalence rates of anemia among children within each subgroup categorized by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) were determined. RESULTS On the whole, 3.99% of boys and 6.68% of girls suffer from anemia. Disparities in the prevalence of anemia were observed between different subgroups categorized by BMI, WC and WHtR. For both boys and girls, the prevalence of anemia increased with the severity of thinness and obesity, suggesting that both severe thinness and severe obesity are associated with an elevated prevalence of anemia. CONCLUSION In the era of the obesity pandemic, obesity could potentially add to the burden of anemia, suggesting that obese children should not be ignored when establishing strategies targeted at preventing anemia.
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Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China.
| | - Jian Chen
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Shandong, China.
| | - Xiao-Hui Liu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Shandong, China
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Oxidative Stress, Plant Natural Antioxidants, and Obesity. Int J Mol Sci 2021; 22:ijms22041786. [PMID: 33670130 PMCID: PMC7916866 DOI: 10.3390/ijms22041786] [Citation(s) in RCA: 217] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress is important in the pathophysiology of obesity, altering regulatory factors of mitochondrial activity, modifying the concentration of inflammation mediators associated with a large number and size of adipocytes, promoting lipogenesis, stimulating differentiation of preadipocytes to mature adipocytes, and regulating the energy balance in hypothalamic neurons that control appetite. This review discusses the participation of oxidative stress in obesity and the important groups of compounds found in plants with antioxidant properties, which include (a) polyphenols such as phenolic acids, stilbenes, flavonoids (flavonols, flavanols, anthocyanins, flavanones, flavones, flavanonols, and isoflavones), and curcuminoids (b) carotenoids, (c) capsaicinoids and casinoids, (d) isothiocyanates, (e) catechins, and (f) vitamins. Examples are analyzed, such as resveratrol, quercetin, curcumin, ferulic acid, phloretin, green tea, Hibiscus Sabdariffa, and garlic. The antioxidant activities of these compounds depend on their activities as reactive oxygen species (ROS) scavengers and on their capacity to prevent the activation of NF-κB (nuclear factor κ-light-chain-enhancer of activated B cells), and reduce the expression of target genes, including those participating in inflammation. We conclude that natural compounds have therapeutic potential for diseases mediated by oxidative stress, particularly obesity. Controlled and well-designed clinical trials are still necessary to better know the effects of these compounds.
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Yook JS, You M, Kim Y, Zhou M, Liu Z, Kim YC, Lee J, Chung S. The thermogenic characteristics of adipocytes are dependent on the regulation of iron homeostasis. J Biol Chem 2021; 296:100452. [PMID: 33631196 PMCID: PMC8010711 DOI: 10.1016/j.jbc.2021.100452] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/15/2022] Open
Abstract
The development of thermogenic adipocytes concurs with mitochondrial biogenesis, an iron-dependent pathway. Iron regulatory proteins (IRP) 1 and 2 are RNA-binding proteins that regulate intracellular iron homeostasis. IRPs bind to the iron-response element (IRE) of their target mRNAs, balancing iron uptake and deposition at the posttranscriptional levels. However, IRP/IRE-dependent iron regulation in adipocytes is largely unknown. We hypothesized that iron demands are higher in brown/beige adipocytes than white adipocytes to maintain the thermogenic mitochondrial capacity. To test this hypothesis, we investigated the IRP/IRE regulatory system in different depots of adipose tissue. Our results revealed that 1) IRP/IRE interaction was increased in proportional to the thermogenic function of the adipose depot, 2) adipose iron content was increased in adipose tissue browning upon β3-adrenoceptor stimulation, while decreased in thermoneutral conditions, and 3) modulation of iron content was linked with mitochondrial biogenesis. Moreover, the iron requirement was higher in HIB1B brown adipocytes than 3T3-L1 white adipocytes during differentiation. The reduction of the labile iron pool (LIP) suppressed the differentiation of brown/beige adipocytes and mitochondrial biogenesis. Using the 59Fe-Tf, we also demonstrated that thermogenic stimuli triggered cell-autonomous iron uptake and mitochondrial compartmentalization as well as enhanced mitochondrial respiration. Collectively, our work demonstrated that IRP/IRE signaling and subsequent adaptation in iron metabolism are a critical determinant for the thermogenic function of adipocytes.
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Affiliation(s)
- Jin-Seon Yook
- Department of Nutrition and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Mikyoung You
- Department of Nutrition and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Yongeun Kim
- Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, Nebraska, USA
| | - Mi Zhou
- Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, Nebraska, USA
| | - Zhenhua Liu
- Department of Nutrition and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Young-Cheul Kim
- Department of Nutrition and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Jaekwon Lee
- Department of Biochemistry, University of Nebraska, Lincoln, Nebraska, USA
| | - Soonkyu Chung
- Department of Nutrition and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA; Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, Nebraska, USA.
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Purdy JC, Shatzel JJ. The hematologic consequences of obesity. Eur J Haematol 2020; 106:306-319. [PMID: 33270290 DOI: 10.1111/ejh.13560] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
The prevalence of obesity is increasing and progressively influencing physician-patient interactions. While there is a sizable amount of data demonstrating that obesity is a state of low-grade inflammation, to our knowledge, there is no single review summarizing its effects on hematologic parameters and thrombotic risk. We performed a literature search which largely surfaced observational studies, with a few systematic reviews and meta-analyses of these studies. We took care to review the mechanisms driving an inflammatory state and obesity's effect on white blood cells, red blood cells, platelets, and thrombotic risk. There is an observed relative, and sometimes absolute leukocytosis driven by this inflammatory state. Obesity is also associated with increased platelet counts and an increased risk for venous thromboembolism (VTE). Lastly, the association between obesity, iron deficiency (ID), and red blood cell counts may be present but remains uncertain. Recognizing the above associations may provide clinicians with reassurance regarding otherwise unexplained hematologic abnormalities in obese individuals. We hope this review will prompt future studies to further understand the underlying mechanisms driving these abnormalities and identify modifiable risk factors and potential therapeutic targets to prevent the development of probable obesity-associated conditions with significant morbidity and mortality, such as ID and VTE.
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Affiliation(s)
- Johanna C Purdy
- Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR, USA
| | - Joseph J Shatzel
- Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA.,Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
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Vehapoglu A, Ozgurhan G, Ustabas Kahraman F, Cakın ZE, Sumbul B. Association between Consumption of Cow's Milk and Iron Deficiency Anemia in Children: Are There Roles for Hepcidin-25/Ferroportin? A Case-Control Study. Pediatr Hematol Oncol 2020; 37:676-686. [PMID: 32705943 DOI: 10.1080/08880018.2020.1782547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Systemic iron homeostasis is regulated by the interaction of the peptide hormone, hepcidin and the iron exporter, ferroportin. The objective was to investigate the relationship between the consumption of cow's milk and iron deficiency anemia in children 2-10 years old and its association with the hepcidin-25 and ferroportin concentrations. The study population consisted of 187 prepubescent children of similar ideal body weight (IBW:90-120%); 82 children with iron deficiency anemia (37girls and 45boys; 4.27 ± 0.28 years) and 105 (47girls and 58boys; 4.25 ± 0.34 years) healthy age-sex-matched controls. Serum fasting hepcidin-25/ferroportin concentrations were measured by enzyme immunoassay in all subjects. Mean cow's milk consumption in the anemic group (373 ± 248 mL/d) tended to be higher than that in the control group (320 ± 226 mL/d), but the result was not statistically significant (p = 0.063).The mean hepcidin-25 level was significantly higher in the anemic group (19.5 ± 18.4 ng/mL) than in the healthy controls (11.0 ± 10.7, p < 0.001). The mean ferroportin level was lower in the anemic group (21.04 ± 5.74 ng/mL) than in the healthy controls (22.68 ± 4.77 ng/ml, p = 0.037). Consuming cow's milk was not associated with IDA in prepubertal children, provided that it was adequately supplemented with iron-enriched foods. We observed a significant increase in hepcidin-25 levels and a decrease in ferroportin levels in children with iron deficiency anemia compared with healthy controls. Children who consumed more cow's milk had higher levels of hepcidin-25. Iron deficiency anemia is not a concern when cow's milk is given to children if the complementary foods are rich in iron.
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Affiliation(s)
- Aysel Vehapoglu
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Istanbul, Turkey
| | - Gamze Ozgurhan
- Department of Pediatrics, Süleymaniye Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Feyza Ustabas Kahraman
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Ebru Cakın
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Istanbul, Turkey
| | - Bilge Sumbul
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey
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Steenackers N, Mutwiri L, Schueren B, Matthys C. Do we need dietary reference values for people with obesity? NUTR BULL 2020. [DOI: 10.1111/nbu.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N. Steenackers
- Clinical and Experimental Endocrinology Department of Chronic Diseases and Metabolism KU Leuven Leuven Belgium
| | - L. Mutwiri
- Clinical and Experimental Endocrinology Department of Chronic Diseases and Metabolism KU Leuven Leuven Belgium
- School of Food and Nutrition Sciences Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya
| | - B. Schueren
- Clinical and Experimental Endocrinology Department of Chronic Diseases and Metabolism KU Leuven Leuven Belgium
- Department of Endocrinology University Hospitals Leuven Leuven Belgium
| | - C. Matthys
- Clinical and Experimental Endocrinology Department of Chronic Diseases and Metabolism KU Leuven Leuven Belgium
- Department of Endocrinology University Hospitals Leuven Leuven Belgium
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Holt RR, Zuelch ML, Charoenwoodhipong P, Al-Dashti YA, Hackman RM, Keen CL. Effects of short-term consumption of strawberry powder on select parameters of vascular health in adolescent males. Food Funct 2020; 11:32-44. [PMID: 31942892 DOI: 10.1039/c9fo01844a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cardiovascular disease is a leading cause of death in the United States and much of the developed world, costing billions of dollars in lost work time, lower productivity and high health care expenditures. Research on foods and bioactive food components that have cardioprotective benefits may provide new insights as to how modest changes in one's diet may result in a reduced risk of vascular disease. In intervention trials, the consumption of strawberries, either fresh or freeze-dried, has been reported to improve select markers of cardiovascular health, including improved lipid profiles, microvascular function, and platelet reactivity. Consistent with the above, epidemiological studies suggest beneficial effects of strawberries on vascular function. Preliminary studies on the effects of freeze-dried strawberry powder on vascular health are reviewed in the current paper.
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Affiliation(s)
- Roberta R Holt
- Department of Nutrition, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
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Ortíz Pérez M, Vázquez López MA, Ibáñez Alcalde M, Galera Martínez R, Martín González M, Lendínez Molinos F, Bonillo Perales A. Relationship between Obesity and Iron Deficiency in Healthy Adolescents. Child Obes 2020; 16:440-447. [PMID: 32877290 DOI: 10.1089/chi.2019.0276] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The relationship between overweight/obesity (excess of weight [EW]) and iron deficiency (ID) is not well defined. Objective: To analyze the relationship between EW and ID in healthy adolescents, assessing the contribution of new diagnostic measures of iron status and erythropoietic activity. Method: A cross-sectional study was made of 405 healthy adolescents, 12-16 years of age. A total of 289 were normal weight (NW) and 116 were otherwise healthy EW. Epidemiological, socioeconomic, diet, BMI Z-score, CRP (C-reactive protein), hematological, iron status, and erythropoietic activity parameters were measured. Statistical tests were Student's, analysis of variance (ANOVA), Chi-square, Pearson's correlation, and odds ratio. Results: ID prevalence in the EW group was 22.6% vs. 29.5% in the NW group (p: 0.3). Greater body weight was associated with lower reticulocyte hemoglobin content (CHr) (NW: 31.3 ± 1.7 pg vs. OW: 30.2 ± 1.7 pg, p: 0.007) and greater CRP (NW: 0.1 ± 0.2 mg/dL vs. OW: 0.2 ± 0.18 mg/dL, p < 0.001), leukocytes (NW: 6.69 ± 1.57 × 103/L vs. OW: 7.43 ± 1.63 × 103/L, p < 0.02), platelets (NW: 265.6 ± 58.9 × 103/L vs. OW: 291.8 ± 54.4 × 103/L, p < 0.002), ferritin (NW: 32.1 ± 17.9 ng/mL vs. OW: 42.8 ± 20.3 ng/mL, p: 0.01), serum transferrin receptor (sTfR) (NW: 1.39 ± 0.4 mg/L vs. OW: 1.73 ± 0.45 mg/L, p: 0.008), sTfR-F index (sTfR/log Ferritin) (NW: 1.06 ± 0.7 vs. OW: 1.33 ± 0.85, p: 0.036) and reticulocyte count (NW: 54.2 ± 18 × 103/L vs. OW: 65.4 ± 24.2 × 103/L, p: 0.003). A positive correlation was observed between the BMI Z-score and CRP, ferritin, sTfR, leukocytes, platelets, and reticulocyte count, and a negative one between the BMI Z-score and CHr and medium corpuscular volume. Conclusions: The prevalence of ID in otherwise healthy EW adolescents was no higher than in NW. The effect of obesity on iron status was low. The findings reveal the concomitant low-grade inflammation, and probably the effect of adiposity on erythropoietic activity. Specific cutoff values for ID in adolescents with OW need to be defined.
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Haidari F, Abiri B, Haghighizadeh MH, Kayedani GA, Birgani NK. Association of Hematological Parameters with Obesity- Induced Inflammation Among Young Females in Ahvaz, South-West of Iran. Int J Prev Med 2020; 11:55. [PMID: 32577185 PMCID: PMC7297432 DOI: 10.4103/ijpvm.ijpvm_35_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/31/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Iron deficiency is prevalent in overweight and obese individuals and may be induced by adiposity-related inflammation that affect iron metabolism. Objective: The objective of this study was to investigate the relationship between hematological parameters and obesity-induced inflammation among young females. Methods: A total of 170 young women (aged between 18-35 years) participated in this cross-sectional study. Obesity was assessed by BMI (body mass index), WHR (waist to hip ratio), and body fat percentage. Inflammatory and hematological parameters including hs-CRP (high-sensitivity C-reactive protein), serum Fe, hemoglobin, ferritin, transferrin, TIBC (total iron binding capacity) were measured. Dietary intakes of some nutrients (total iron, proteins, calcium, and vitamin C) were assessed according to BMI, WHR and fat mass categories. Results: Serum iron were negatively correlated with BMI (P = 0.045, r = −0.154) and hs-CRP (P = 0.032, r = −0.165). Hemoglobin were also negatively correlated with BMI (P = 0.043, r = −0.155). A significant correlation was also shown between WHR with transferrin (P = 0.034, r = 0.163) and TIBC levels (P = 0.035, r = 0.162), hs-CRP was positively correlated with BMI (P = 0.014, r = 0.183), WHR (P = 0.009, r = 0.202) and body fat percentage (P = 0.037, r = 0.353). Dietary intakes did not differ significantly among BMI, WHR and fat mass categories (P > 0.05). Conclusions: Obesity-induced inflammation, regardless of dietary intake of iron, can lead to iron deficiency. Therefore, weight control, especially in obese subjects is necessary to prevent iron deficiency and anemia.
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Affiliation(s)
- Fatemeh Haidari
- Department of Nutrition, Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad-Hossein Haghighizadeh
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholam A Kayedani
- Department of Laboratory Sciences, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Negar K Birgani
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Anaemia, iron deficiency, iron-deficiency anaemia and their associations with obesity among schoolchildren in Guangzhou, China. Public Health Nutr 2020; 23:1693-1702. [PMID: 31910936 DOI: 10.1017/s1368980019003604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The association of Fe metabolism with obesity in children remains unclear. The present study aimed to assess the status of Fe metabolism parameters, the prevalence of anaemia, Fe deficiency (ID) and Fe-deficiency anaemia (IDA), and the associations of these variables with obesity in Chinese schoolchildren. DESIGN A cross-sectional study conducted in 5295 schoolchildren aged 7-11 years in Guangzhou, China, 2014-2015. Full data of anthropometric and Fe metabolic parameters were collected to assess obesity, anaemia, ID and IDA. Logistic regression models were established to determine the possible associations of anaemia, ID and IDA with obesity. Two-tailed P values of <0·05 was considered statistically significant. SETTING Guangzhou City, China. PARTICIPANTS Schoolchildren aged 7-11 years (n 5295). RESULTS In this sample, mean Hb concentration was 128·1 g/l and the prevalence of anaemia, ID and IDA was 6·6, 6·2 and 0·6 %, respectively. Of the participants, 14·0 % were overweight and 8·8 % were obese. Importantly, obesity was associated with lower anaemia risk (adjusted OR = 0·553; 95 % CI 0·316, 0·968) but higher ID risk (adjusted OR = 1·808; 95 % CI 1·146, 2·853) after adjustment for confounders. No significant relationship was found between obesity and IDA. CONCLUSIONS Our results confirmed that anaemia and ID remain public health concerns among schoolchildren in Guangzhou, while IDA is remarkably less prevalent. Furthermore, obesity was associated with lower anaemia risk, but higher ID risk. More efforts should be made to prevent the onset of ID and obesity in the same individual, thus improving the health and fitness of children.
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Ahmed A. The significance of serum hepcidin on iron status in overweight and obese patients with iron-deficiency anemia. IRAQI JOURNAL OF HEMATOLOGY 2020. [DOI: 10.4103/ijh.ijh_23_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Çağlar Şimşek CE, Çelik N, Aygüneş U, Yavuz Dönmez A, Avcı E, Ekici M. Evaluation of Hematological Parameters and Iron Level in Obese Children and Adolescents. ANKARA MEDICAL JOURNAL 2019. [DOI: 10.17098/amj.624400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Muzzio ML, Lozano Chiappe ES, Kabakian L, Ferraro F, Landó I, Alonso E, Fernández J, Peredo S, Brovarone L, Pia Santucci M, Meroño T. Effects of Pubertal Status and Inflammation on the Use of Ferritin to Define Iron Deficiency in Children With Overweight or Obesity. Nutr Metab Insights 2019; 12:1178638819839064. [PMID: 31057325 PMCID: PMC6452423 DOI: 10.1177/1178638819839064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 01/22/2023] Open
Abstract
Background and aims: A worldwide increase in childhood overweight (OW) and obesity (OB) has been
reported. OB is an inflammatory state which affects iron metabolism and the
sensibility of the tests to detect iron deficiency (ID). Our aim was to
evaluate the adequacy of current ferritin cut-offs to define ID in children
with OW/OB. Methods: This cross-sectional study included 152 children (54% girls) aged (median
[Q1-Q3]) 11 (8-13) years with OW/OB. Complete blood count and iron
metabolism were evaluated. Low ferritin, transferrin saturation (TSat), and
anemia were defined by age- and sex-specific cut-offs recommended by
National Guidelines. Iron intake was assessed in a subgroup (n = 80) by a
24-hour dietary recall. Analyses were made according to pubertal development
and ferritin tertiles. Results: The overall prevalence of low ferritin, TSat, and anemia was 2.6%, 23.8%, and
5.2%, respectively. Among pre-pubertal children (n = 87), the frequency of
low TSat rose across ferritin tertiles (P < .05),
whereas it decreased among pubertal children (n = 65;
P < .005). Cases of anemia among pre-pubertal children
were found in the highest ferritin tertile, whereas 4/6 anemia cases in
pubertal children were found in the lowest ferritin tertile (<39 µg/L).
Pubertal children within the lowest ferritin tertile + low TSat (n = 11)
showed lower hemoglobin (–9%; P < .005) and hematocrit
(–8%, P < .01) than those in the same tertile + normal
TSat (n = 16). The overall prevalence of children with
ferritin < 39 µg/L + low TSat was 9.2%. Conclusions: Higher ferritin cut-off values are required to define ID in children with
OW/OB. Such cut-off remains to be validated in larger, multi-ethnic cohorts
of children with OW/OB.
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Affiliation(s)
- Maria Luz Muzzio
- Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.,Laboratorio Central, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Ezequiel S Lozano Chiappe
- Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Laura Kabakian
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Florencia Ferraro
- Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ines Landó
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Elizabeth Alonso
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Jorgelina Fernández
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Soledad Peredo
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Lucrecia Brovarone
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Maria Pia Santucci
- Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca Visca, Buenos Aires, Argentina
| | - Tomás Meroño
- Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.,Laboratorio Central, Complejo Médico Churruca Visca, Buenos Aires, Argentina
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Suárez-Ortegón MF, Echeverri I, Prats-Puig A, Bassols J, Carreras-Badosa G, López-Bermejo A, Fernández-Real JM. Iron Status and Metabolically Unhealthy Obesity in Prepubertal Children. Obesity (Silver Spring) 2019; 27:636-644. [PMID: 30821086 DOI: 10.1002/oby.22425] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/10/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association of metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) with iron status markers in prepubertal children. METHODS Three hundred twelve prepubertal children with overweight and obesity from a pediatric general Spanish population were evaluated. MHO and MUO were defined as obesity with the absence or presence of metabolic syndrome components. Phenotypes of metabolically healthy overweight including obesity (MHOV) and metabolically unhealthy overweight including obesity (MUOV) were also studied and defined using the same criteria. Serum ferritin, transferrin, and blood hemoglobin levels were evaluated. RESULTS Prevalence rates of MHOV and MHO were 35% (n = 111/312) and 27.1% (n = 42/155), respectively. Ferritin and hemoglobin levels were higher in children with MUOV versus MHOV (P < 0.05). MUO was positively associated with ferritin (beta [95% CI] = 0.43 [0.05 to 0.81]) and hemoglobin levels (0.43 [0.05 to 0.81]). These associations remained significant independently of age, sex, C-reactive protein, physical activity, and BMI/waist z scores in bivariate linear regression models. In multivariable models, transaminase levels attenuated the association of MUO with ferritin and hemoglobin levels (P > 0.05). CONCLUSIONS MUOV and MUO are associated with higher ferritin and hemoglobin levels in prepubertal children affected by overweight and obesity. Increased circulating ferritin in MUO might be influenced by liver injury.
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Affiliation(s)
- Milton Fabian Suárez-Ortegón
- Basic and Clinic Sciences Group-Department of Basic Sciences of Health, Pontificia Universidad Javeriana, Cali, Colombia
- Nutrition Group, University of Valle, Cali, Colombia
| | | | - Anna Prats-Puig
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
- Department of Physical Therapy, University School of Health and Sports, University of Girona, Girona, Spain
| | - Judit Bassols
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
| | - Gemma Carreras-Badosa
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
| | - Abel López-Bermejo
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
- TransLab Research Group, Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Jose Manuel Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Department of Medical Sciences, Faculty of Medicine, Girona Institute for Biomedical Research, Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition and National Institute of Health Carlos III, Girona, Spain
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Derderian SC, Le L, Xanthakos SA, Inge TH. Resolution of refractory iron deficiency anemia following sleeve gastrectomy in an adolescent with severe obesity. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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