Iron and infection: An investigation of the optimal iron hypothesis in Lima, Peru

Dorsey, Achsah F.; Thompson, Amanda L.; Kleinman, Ronald E.; Duggan, Christopher; Penny, Mary E.

doi:10.1002/ajhb.23114

Cited by 5 publications

(4 citation statements)

References 11 publications

(12 reference statements)

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“…The use of endpoint CRP in statistical models assumes that this reflects higher levels of inflammation during the previous weeks. The allostatic nature of iron regulation is supported by additional analyses of this sample (Dorsey & Thompson, 2020) as well as in other studies (Dorsey et al, 2018; Hadley & DeCaro, 2015).…”

Section: Methodssupporting

confidence: 75%

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

Dorsey

Penny

Thompson

2021

American J Phys Anthropol

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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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Section: Methodssupporting

confidence: 75%

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

Dorsey

Penny

Thompson

2021

American J Phys Anthropol

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“…These results demonstrate an interesting relationship between levels of inflammation and anemia status. While earlier studies report opposing results on the association between morbidity and anemia (Dorsey et al 2018;Hadley and DeCaro 2015;Wander et al, 2009), here we see support for higher inflammation levels and lack of response to iron supplementation treatment. Additionally, in our pathogenic exposure models, season was always associated with efficacy of iron treatment.…”

Section: Discussioncontrasting

confidence: 52%

Intestinal microbiota composition and efficacy of iron supplementation in Peruvian children

Dorsey,

Roach,

Burten

et al. 2024

American J Hum Biol

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ObjectiveDespite 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.MethodsData 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.ResultsWhile 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.ConclusionWhile 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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“…These results demonstrate an interesting relationship between levels of inflammation and anemia status. While earlier studies report opposing results on the association between morbidity and anemia (Hadley & Decaro, 2015;Wander, Shell-Duncan, & McDade, 2009), a more recent study investigating the association between infection and anemia status within the San Juan de Lurigancho community found that while morbidity was not predictive of anemia status over a six-month interval period, it was shown to be associated with current morbidity symptoms (Dorsey et al, 2018). Our current results lend support investigating iron status as an allostatic system that responds to infection adaptively, rather than expecting an optimal preinfection value.…”

Section: Discussionmentioning

confidence: 93%

“…Immune activation also causes decreased iron absorption as well as a reduction in the amount of circulating iron in order to restrict pathogen growth and proliferation (Nemeth & Ganz, 2006). Recent investigations support interpreting anemia status as an allostatic system that responds to infection adaptively, rather than expecting an optimal preinfection value (Dorsey, Thompson, Kleinman, Duggan, & Penny, 2018;Hadley & Decaro, 2015).…”

Section: Introductionmentioning

confidence: 99%

Child, caretaker, and community: Testing predictors of anemia and response to iron supplementation in Peruvian preschool‐aged children

Dorsey

Thompson

2020

American J Hum Biol

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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 periurban 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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Iron and infection: An investigation of the optimal iron hypothesis in Lima, Peru

Cited by 5 publications

References 11 publications

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

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

Intestinal microbiota composition and efficacy of iron supplementation in Peruvian children

Child, caretaker, and community: Testing predictors of anemia and response to iron supplementation in Peruvian preschool‐aged children

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