Hepatic Steatosis Is Associated with Elevated Serum Iron in Patients with Obesity and Improves after Laparoscopic Sleeve Gastrectomy

Abstract

<b><i>Background:</i></b> Iron is closely related to metabolism. However, the relationship between iron and hepatic steatosis has not been fully elucidated. <b><i>Objective:</i></b> We aimed to investigate the triangular relationship between iron and hepatic steatosis and laparoscopic sleeve gastrectomy (LSG) in patients with obesity. <b><i>Methods:</i></b> A total of 297 patients with obesity and 43 healthy individuals with a normal BMI were enrolled. Eighty-two patients underwent LSG. Anthropometrics, glucose-lipid metabolic markers, and hepatic steatosis assessed by FibroScan (CAP value and E value) were measured at baseline, and again at follow-up time intervals of 6 months and 1 year after surgery. <b><i>Results:</i></b> (1) Iron was significantly higher in patients with obesity or overweight than in the individuals with normal BMI (8.18 ± 1.47 vs. 7.46 ± 0.99 mmol/L, <i>p</i> = 0.002). Iron was also higher in subjects with high blood pressure, dyslipidemia, and hyperuricemia than non-corresponding disorders (all <i>p</i> < 0.05). Moreover, iron was significantly higher in the severe than mild or moderate non-alcoholic fatty liver disease (NAFLD) group (<i>p</i> = 0.046 and 0.018). (2) Iron was positively associated with body weight, BMI, waist-to-hip ratio, uric acid, liver enzymes, postprandial blood glucose, fasting insulin, HOMA-IR, triglycerides, free fatty acid, and hepatic steatosis (CAP value), and negatively associated with high-density lipoprotein cholesterol (all <i>p</i> < 0.05). Iron was also positively associated with the visceral adipose area in patients with obesity and negatively associated with the subcutaneous adipose area in patients with overweight (all <i>p</i> < 0.05). (3) Iron levels and CAP values were decreased gradually 6 months and 1 year after surgery (all <i>p</i> < 0.05). <b><i>Conclusions:</i></b> Overall, our results indicated that iron is associated with hepatic steatosis in obesity. The iron level was significantly higher in patients with severe NAFLD than with mild or moderate NAFLD. LSG may reduce iron levels while improving fat deposition in the liver.

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

“…For example, a cross-sectional study showed that the serum iron levels and the NAFLD prevalence had a negative correlation ( 16 ). Conversely, a recent study based on obese patients found that the severe NAFLD group had higher serum iron levels than the mild or moderate groups ( 39 ). Other studies suggested an irrelevant association between serum iron and NAFLD staging and liver fat content ( 17 , 18 ).…”

Relationship of Vitamin A and Thyroid Function in Individuals With Obesity and After Laparoscopic Sleeve Gastrectomy

“…Bariatric surgery is one of the most effective methods to reduce body weight as well as improve metabolism (13)(14)(15). However, findings regarding change in VA after bariatric surgery has been inconclusive.…”

“…Laparoscopic sleeve gastrectomy (LSG) is one of the most effective methods to treat obesity as it not only led to decreased bodyweight but also improved metabolism (13)(14)(15). The effects of LSG on VA levels are inconsistent.…”

Nonalcoholic Fatty Liver Disease and the Gut-Liver Axis: Exploring an Undernutrition Perspective

“…Beyond anemia, aberrant iron levels contribute to hepatic injury, lipid peroxidation, and NAFLD severity. 48,73 Ma et al 74 reported increased iron overload in obese/ overweight patients with more severe NAFLD compared with subjects with normal body mass index (BMI) or mild to moderate NAFLD. Iron levels were also significantly higher in patients with dyslipidemia, hypertension, and hyperuricemia.…”

“…The researchers reported significant positive correlations between iron and BMI, ALT, serum triglycerides, fasting insulin, postprandial glucose, serum-free fatty acids, and hepatic steatosis. 74 Both impaired iron and vitamin E (a-tocopherol) levels were linked to hepatic steatosis pathology within a genetic hemochromatosis murine model. 75 Intriguingly, a genetic model of anemia promoted earlyonset NAFLD, accompanied by elevated serum ALT and triglycerides, 76 suggesting a role for iron deficiencies and hepatic steatosis.…”