Serum Hepcidin and Soluble Transferrin Receptor in the Assessment of Iron Metabolism in Children on a Vegetarian Diet

Abstract

The aim of this study was to assess the effect of vegetarian diet on iron metabolism parameters paying special attention to serum hepcidin and soluble transferrin receptor (sTfR) concentrations in 43 prepubertal children (age range 4.5–9.0 years) on vegetarian and in 46 children on omnivorous diets. There were no significant differences according to age, weight, height, and body mass index (BMI) between vegetarian and omnivorous children. Vegetarians had similar intake of iron and vitamin B12 and a significantly higher intake of vitamin C (p < 0.05) compared with non-vegetarians. Hematologic parameters and serum iron concentrations were within the reference range in both groups of children. Serum transferrin levels were similar in all subjects; however, ferritin concentrations were significantly (p < 0.01) lower in vegetarians than in omnivores. In children on a vegetarian diet, median hepcidin levels were lower (p < 0.05) but sTfR concentrations significantly higher (p < 0.001) compared with omnivorous children. In the multivariate regression model, we observed associations between hepcidin level and ferritin concentration (β = 0.241, p = 0.05) in the whole group of children as well as between hepcidin concentration and CRP level (β = 0.419, p = 0.047) in vegetarians. We did not find significant associations with concentration of sTfR and selected biochemical, anthropometric, and dietary parameters in any of the studied groups of children. As hematologic parameters and iron concentrations in vegetarians and omnivores were comparable and ferritin level was lower in vegetarians, we suggest that inclusion of novel markers, in particular sTfR (not cofounded by inflammation) and hepcidin, can better detect subclinical iron deficiency in children following vegetarian diets.

Standardized serum hepcidin values in Dutch children: Set point relative to body iron changes during childhood

“…(d) evaluation of suspected iron overload disorders 13 ; (e) evaluation of ID, before the occurrence of iron deficiency anemia (IDA), for example in pregnant women, 14,15 in children, 16,17 and in children with cystic fibrosis. 18 Apart from diagnostic applications, multiple agents targeting the hepcidin/ferroportin axis are under development as novel therapeutics for iron disorders in adults.…”

“…[24][25][26] Available studies concern either small series with limited age groups or series including children with (anemia of) inflammation. 16,[27][28][29][30][31] As a first step to the implementation of serum hepcidin measurements in pediatric clinical practice, we established age-and sex-specific (Table 1).…”

Rationale for intake of vitamin-mineral complexes by children vegetarians

“…Кроме того, рацион вегетарианцев часто дефицитен по содержанию железа, цинка и йода [10][11][12]. Частота дефицита железа, выявляемая по уровню железа, и сниженного уровня ферритина и гепцидина в сыворотке крови среди детей-вегетарианцев 2-18 лет обнаруживается чаще, чем среди невегетарианцев того же возраста [13,14]. Низкий статус железа у детей-вегетарианцев может приводить к снижению уровня иммуноглобулинов IgA, IgM и IgG в сыворотке крови [15].…”

“…Это не вызывает удивления, поскольку обычно рацион вегетарианцев содержит значительное количество свежих овощей и фруктов. В результате потребление витамина С, как правило, превышает таковое у детей, получающих смешанный рацион [6,14].…”

Elevated hepcidin, ferroportin associated with glucose metabolism disorder in midpregnancy

“…sTfR is commonly used for the clinical determination of iron status, which is less affected by inflammation. Although recent data showed that serum ferritin levels were positively and independently associated with insulin resistance (IR) [13], Ambroszkiewicz J et al [15] found that soluble transferrin receptor, which was less affected by inflammation, was a better marker of iron status than other parameters.Many previous studies have shown that iron metabolism disorder may contribute to the pathogenesis of GDM. However, the correlation between iron metabolism and GDM is not well known.…”