Increased serum iron in preeclamptic women is likely due to low hepcidin levels

Brunacci, Fernanda; Rocha, Vivianne S.; Carli, Eduardo De; Espósito, Breno Pannia; Ruano, Rodrigo; Colli, Célia

doi:10.1016/j.nutres.2018.03.005

Cited by 24 publications

(33 citation statements)

References 26 publications

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“…Our results that there is a hyperferritinaemia in PE are similar to other studies [23][24][25] . Raman et al 26 showed higher mean ferritin levels in pregnant women with pregnancy induced hypertension and PE, concluding that hyperferritinaemia may mask iron deficiency.…”

Section: Discussionsupporting

confidence: 93%

Querying the value of indiscriminate iron supplementation in pre-eclampsia: a cross-sectional study

Dorsamy

Bagwandeen

Moodley

2021

Preprint

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Objective To determine the prevalence and type of anaemia and its association with pre-eclampsia (PE) in pregnant South Africans of African ancestry. Design Cross-sectional study design Setting A regional hospital in KwaZulu-Natal, South Africa. Sample 671 women seeking antenatal care. Methods Participants had haemoglobin(Hb), anthropometric measurements, HIV status, blood pressure levels(BP) and proteinuria measured to determine PE. Iron studies and transferrin receptor levels were assessed in a subset and chi-square tests of association between normotensive and pre-eclampsia sub-groups and blood parameters were conducted. Results No difference in Hb concentration amongst the 4 groups (F (3,621)=0.981, p< .001, η2=.014) was observed. A chi-square test of association (χ2(3)=6.674, p=.083) showed no associations between study groups and having anaemia. The severity of anaemia did not vary amongst study groups (χ2(12) =10.756, p=.550). Using ferritin, there was an association between the study groups having an iron deficiency, anaemia, both or neither (χ2(3)=12.559, p=.045) with a positive association between normotensive term and iron deficiency (adjusted residual(AR) 2.2) and positive association between early-onset PE(AR 2.4). Similar trends were found for transferrin and soluble transferrin receptor ferritin index. Twenty-two percent of the participants were not iron deficient. Conclusion Early-onset PE is associated with high iron status and not anaemia. Normotensive term pregnancies were associated with iron deficiency anaemia. Broad iron supplementation without adequate determination of iron deficiency in pregnant women needs to be revisited. Funding National Research Foundation (TTK170508230162), University of KwaZulu-Natal UCPD and Medical Research Council of South Africa(SIR Grant UNS14197). Keywords Anaemia, iron deficiency, pre-eclampsia

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Section: Discussionsupporting

confidence: 93%

Querying the value of indiscriminate iron supplementation in pre-eclampsia: a cross-sectional study

Dorsamy

Bagwandeen

Moodley

2021

Preprint

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“…Ferritin is considered an indicator of iron storage concentrations, but at the same time is an acute phase protein and its level increases in inflammation [28,29]. Correlations of iron concentrations with hepcidin levels have also been studied in recent years [1,30].…”

Section: Discussionmentioning

confidence: 99%

Can Serum Iron Concentrations in Early Healthy Pregnancy Be Risk Marker of Pregnancy-Induced Hypertension?

2019

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The aim of this study was to assess the relationship between serum iron concentrations in early healthy pregnancy and the risk of pregnancy-induced hypertension. The data comes from our prospective cohort study in which we recruited healthy women in week 10–14 of single pregnancy. We examined a study group (n = 121) consisting of women subsequently developing pregnancy-induced hypertension and a control group (n = 363) of matched women remaining normotensive. We measured iron concentrations in the serum collected in 10–14 gestational week, using the ICP-MS technique (mass spectrometry with inductively coupled plasma). The odds ratios of the disease (95% confidence intervals) for iron concentrations were assessed in multivariate logistic regression. We found that the mean microelement concentration was lower in the case group compared to normotensive controls (p = 0.011). Women in the lowest quartile of iron (≤801.20 µg/L) had a 2.19-fold increase in pregnancy-induced hypertension risk compared with women in the highest quartile (>1211.75 µg/L) (odds ratio (OR) = 2.19; 95% CI: 1.24–3.88; p = 0.007). This result was sustained after adjusted for all the accepted confounders. Women in the higher Q2 quartile (801.20–982.33 µg/L) had a 17% lower risk, compared with those in the highest quartile (OR = 0.83; 95% CI: 0.65–2.32; p = 0.519).

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“…Whether or not the increased serum iron in PE is due to low circulating hepcidin levels is unclear. Studies by Koenig et al [81] and by Brunacci et al [138] suggest that high serum iron and Tf saturation in PE women correlate with lower hepcidin levels. However, a study by Duvan et al found no significant correlation between prohepcidin concentrations and serum iron, ferritin, or Tf levels in women with PE [139].…”

Section: Molecular Basis For Dysregulated Iron Homeostasis In Preementioning

confidence: 99%

The Impact of Iron Overload and Ferroptosis on Reproductive Disorders in Humans: Implications for Preeclampsia

Norwitz

2019

IJMS

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Iron is an essential element for the survival of most organisms, including humans. Demand for iron increases significantly during pregnancy to support growth and development of the fetus. Paradoxically, epidemiologic studies have shown that excessive iron intake and/or high iron status can be detrimental to pregnancy and is associated with reproductive disorders ranging from endometriosis to preeclampsia. Reproductive complications resulting from iron deficiency have been reviewed elsewhere. Here, we focus on reproductive disorders associated with iron overload and the contribution of ferroptosis—programmed cell death mediated by iron-dependent lipid peroxidation within cell membranes—using preeclampsia as a model system. We propose that the clinical expressions of many reproductive disorders and pregnancy complications may be due to an underlying ferroptopathy (elemental iron-associated disease), characterized by a dysregulation in iron homeostasis leading to excessive ferroptosis.

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Increased serum iron in preeclamptic women is likely due to low hepcidin levels

Cited by 24 publications

References 26 publications

Querying the value of indiscriminate iron supplementation in pre-eclampsia: a cross-sectional study

Querying the value of indiscriminate iron supplementation in pre-eclampsia: a cross-sectional study

Can Serum Iron Concentrations in Early Healthy Pregnancy Be Risk Marker of Pregnancy-Induced Hypertension?

The Impact of Iron Overload and Ferroptosis on Reproductive Disorders in Humans: Implications for Preeclampsia

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