Association between increased iron stores and impaired endothelial function in patients with hereditary hemochromatosis

Abstract

Impaired endothelial function and increased IMT are associated with iron overload, with subsequent induction of oxidative stress, and are not linked to a genetic disability in HH patients. Consequent iron-depletion therapy normalizes endothelial function and may thus reduce the increased risk of cardiovascular events. Female patients may be at a reduced risk, presumably due to continuous iron loss by menstruation.

Dysregulation of iron and copper homeostasis in nonalcoholic fatty liver

“…The incidence of diabetes, postprandial serum insulin and pancreatic insulin sensitivity, i.e., beta cell function were al improved in subjects with previous phlebotomy treatment [143] . Iron removal also improved coronary vascular dysfunction in patients with T2DM [144] and endothelial function in patients with known coronary artery disease and in subjects with primary iron overload [145,146] . Blood donations were linked to insulin sensitivity even in healthy subjects [46] .…”

Estrés oxidativo, prooxidantes y enfermedad de Crohn

“…Además, en estos pacientes se encuentran reducidos los niveles de un secuestrador de radicales libres como es el glutation. Concordantemente, se ha reportado que las TBARS disminuyen significativamente con la terapia de depleción de hierro 26 . En animales, una sobrecarga de hierro resulta en peroxidación lipídica hepática 27 , oxidación de proteínas hepáticas 28 y daño oxidativo asociado a otros tejidos, incluidos los eritrocitos 29 .…”

Stored Iron and Vascular Reactivity

“…Flowmediated dilation may increase inversely with endothelial iron but the relationship may not be linear. Some improvement in flow-mediated dilation has been documented in patients with hemochromatosis after partial phlebotomy treatment, 42 but the most prominent effects might be seen over a range of iron contents near iron deficiency. Interestingly, endothelium-independent dilation was unaffected by initial treatment in patients with hemochromatosis.…”

“…Interestingly, endothelium-independent dilation was unaffected by initial treatment in patients with hemochromatosis. 42 This suggests that iron impairs flow-mediated dilation largely by modulating endothelial function. 42 Serum ferritin level does not necessarily correlate well with maximal effects of iron loss near the lower end of the iron load spectrum.…”

“…42 This suggests that iron impairs flow-mediated dilation largely by modulating endothelial function. 42 Serum ferritin level does not necessarily correlate well with maximal effects of iron loss near the lower end of the iron load spectrum. For example, in hepatitis C, iron reduction therapy can lower the level of serum aminotransferases.…”