Decreased serum hepcidin and improved functional iron status 6 months after restrictive bariatric surgery
Open accessAbstract
Excess adiposity is associated with low‐grade inflammation and decreased iron status. Iron depletion in obesity is thought to be mediated by an inflammation‐induced increase in the body's main regulator of iron homeostasis, hepcidin. Elevated hepcidin can result in iron depletion as it prevents the release of dietary iron absorbed into the enterocytes, limiting replenishment of body iron losses. Weight reduction is associated with decreased inflammation; however, the impact of reduced inflammation on iron status and systemic hepcidin in obese individuals remains unknown. We determined prospectively the impact of weight loss on iron status parameters, serum hepcidin, inflammation, and dietary iron in 20 obese premenopausal females 6 months after restrictive bariatric surgery. At baseline, the presence of iron depletion was high with 45% of the women having serum transferrin receptor (sTfR) >28.1 nmol/l. Differences between baseline and 6 months after surgery for BMI (47.56 vs. 39.55 kg/m 2; P < 0.0001), C‐reactive protein (CRP) (10.83 vs. 5.71 mg/l; P < 0.0001), sTfR (29.97 vs. 23.08 nmol/l; P = 0.001), and serum hepcidin (111.25 vs. 31.35 ng/ml; P < 0.0001) were significantly lower, whereas hemoglobin (Hb) (12.10 vs. 13.30 g/dl; P < 0.0001) and hematocrit (Hct) (36.58 vs. 38.78%; P = 0.001) were significantly higher. Ferritin and transferrin saturation (Tsat) showed minimal improvement at follow‐up. At baseline, hepcidin was not correlated with sTfR (r = 0.02); however, at follow‐up, significant correlations were found (r = −0.58). Change in interleukin‐6 (IL‐6) from baseline was marginally associated with decreased log serum hepcidin (Δ IL‐6: β = −0.22; P = 0.15), whereas change in BMI or weight was not. No significant difference in dietary iron was noted after surgery. Weight loss in obese premenopausal women is associated with reduced serum hepcidin and inflammation. Reduction in inflammation and hepcidin likely allow for enhanced dietary iron absorption resulting in an improved functional iron profile.
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Given that obese patients have elevated serum hepcidin levels and signs of inflammation associated with obesity, it can be expected that a decrease in the amount of adipose tissue after bariatric surgery can activate Fe absorption.
“On the other hand, given that obese patients have elevated serum Hep levels and signs of inflammation associated with obesity, it can be expected that a decrease in the amount of adipose tissue after bariatric surgery can activate Fe absorption [125].”
From Iron Deficiency in Obesity and after Bariatric Surgery (2021) · cites this paper as [125]
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- Authors
- Tussing‐Humphreys, L. M., Nemeth, E., Fantuzzi, G., Freels, S., Holterman, A. L., Galvani, C., Ayloo, S., Vitello, J., & Braunschweig, C.
- Affiliations
- University of California, Los Angeles (US)
- University of Illinois Chicago (US)
- Rush University Medical Center (US)
- Corresponding author
- Braunschweig, Carol
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2010-10
- Volume
- 18
- Issue
- 10
- Pages
- 2010-2016
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2083773097
- Cited by
- 105
- References
- 40
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 4 · 2023: 5 · 2022: 2 · 2021: 7 · 2020: 5 · 2019: 3 · 2018: 7 · 2017: 6 · 2016: 8 · 2015: 8 · 2014: 11 · 2013: 14 · 2012: 5
- FWCI
- 6.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Rutgers University Community Repository (Rutgers University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Keywords
- hepcidin, iron status, restrictive bariatric surgery, weight loss, iron deficiency, inflammation, serum transferrin receptor, interleukin-6, C-reactive protein, iron homeostasis, iron intake, premenopausal women, ferritin, transferrin saturation, hemoglobin, hematocrit, BMI reduction
- MeSH terms
- Adult, C-Reactive Protein, Female, Ferritins, Follow-Up Studies, Hematocrit, Hemoglobins, Humans, Inflammation, Obesity, Prospective Studies, Receptors, Transferrin, Weight Loss, Interleukin-6, Body Mass Index, Prevalence, Premenopause, Anemia, Iron-Deficiency, Antimicrobial Cationic Peptides, Bariatric Surgery, Hepcidins
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