The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: a prospective 6-mo iron stable isotope study

Cepeda-Lopez, Ana C.; Labastida, Javier Allende; Melse‐Boonstra, Alida; Osendarp, Saskia; Herter-Aeberli, Isabelle; Moretti, Diego; Rodriguez-Lastra, Ramiro; González-Salazar, Francisco; Villalpando, Salvador; Zimmermann, Michael

doi:10.3945/ajcn.115.115592

Cited by 39 publications

(38 citation statements)

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“…In addition, a prospective study of SG patients in 38 patients found that fat loss after surgery resulted in reduced inflammation (reduced levels of IL‐6 and a fall in hepcidin levels). In patients who were iron deficient at baseline, iron absorption using labelled iron isotopes increased after weight loss at 8 months after surgery …”

Section: Obesity‐associated Modifications Of Iron Metabolismmentioning

confidence: 99%

“…This might reflect residual obesity and persistent inflammation in some patients, which will require further study to determine the best methodology for assessment of iron status in the presence of inflammation. The improvement in iron absorption and status in the first year postoperatively in some studies with the development of substantial levels of iron deficiency anaemia over longer periods suggests that compliance with nutritional supplementation recommendations and less intense clinical follow‐up may be potential factors to explain this anomaly.…”

Section: Postoperative Iron Nutritionmentioning

confidence: 99%

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Metabolic surgery and iron homeostasis

et al. 2018

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Iron deficiency and anaemia after metabolic surgery, potentially modifiable nutritional complications, are becoming an increasing cause for concern as prevalence increases with time and there is limited evidence supporting the effectiveness of the current guidelines for prophylactic oral iron supplementation and treatment for deficiency.Abnormalities in iron nutrition predisposing to deficiency are common in severely obese patients, and the low-grade systemic inflammation, also common to these patients, reduces the effectiveness of oral iron supplementation. The surgical procedures result in alterations of foregut anatomy and physiology, which limit iron absorptive capacity and daily food intake. These alterations and the limited effects of oral iron supplementation explain the high prevalence of postoperative iron deficiency and anaemia. This review outlines current mechanisms concerning the pathogenesis of disordered iron nutrition in patients with severe obesity, current gaps in knowledge, and opportunities for quality improvement.

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Section: Obesity‐associated Modifications Of Iron Metabolismmentioning

confidence: 99%

Section: Postoperative Iron Nutritionmentioning

confidence: 99%

Metabolic surgery and iron homeostasis

et al. 2018

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“…Gong et al (21) also reported that weight loss, achieved by overweight and obese children through a 1-year program, was associated with an improvement in iron status and inflammatory markers. Studies performed in adults also reported an association between fat loss, reduction in inflammation and hepcidin, and improvement in iron profile (35,36).…”

Section: Discussionmentioning

confidence: 93%

Physical exercise intervention at school improved hepcidin, inflammation, and iron metabolism in overweight and obese children and adolescents

et al. 2017

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BackgroundObesity is often associated with iron deficiency in children and adolescents. We aimed to study the effect of an 8-month physical exercise (PE) intervention on hepcidin and other markers of inflammation and on iron status in overweight/obese children and adolescents.MethodsSeventy-three overweight/obese children and adolescents participated in the 8-month-long longitudinal study. They were divided into two groups according to their participation in an after-school PE program: the PE group (n=44) and the control group (n=29). Hepcidin, interleukin (IL)-6, C-reactive protein (CRP), iron, ferritin, transferrin, and soluble transferrin receptor (sTfR) were evaluated.ResultsAt baseline, IL-6 correlated positively with hepcidin and negatively with iron and transferrin saturation, suggesting that increasing adiposity associates with increasing IL-6 and hepcidin synthesis, reducing iron availability. After 8 months, the PE group showed a decrease in BMI z-score (P=0.003), body fat mass (P=0.012), CRP (P=0.002), IL-6 (P=0.048), ferritin (P=0.013), hepcidin (P=0.040), and sTfR (P=0.010), and an increase in iron concentration (P=0.002). Moreover, the PE group, when compared with the control group, showed lower weight (P=0.026), BMI (P=0.040), waist circumference (P=0.010), and waist-to-height ratio (P=0.046).ConclusionWe showed that an 8-month-long intervention at school allowed a reduction in BMI z-score and an improvement in inflammation, reducing hepcidin levels and the disturbances in iron status.

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“…The key findings from this research were that overweight and obesity can result in: increased haemoglobin mass, which increases iron requirements; a reduction in iron absorption and blunting of the effect of vitamin C on iron absorption; a failure to downregulate hepcidin (an inhibitor of iron absorption) even if iron stores are low; and the dilution of iron levels due to increased blood volume which can affect interpretation of associated biomarkers (Cepeda‐Lopez et al . , , ). Given that, globally, 1.9 billion adults are overweight and 650 million are obese (WHO ), the use of stable isotopes to enable the assessment of the bioavailability of micronutrients (such as iron) is crucial and necessary to move forward in the development and assessment of nutrition interventions and programmes.…”

Section: Stable Isotopes and The Assessment Of Iron Metabolismmentioning

confidence: 99%

Highlights from the International Symposium on Understanding the Double Burden of Malnutrition for Effective Interventions: A focus on stable isotope techniques in nutrition

Nguo

2019

Nutrition Bulletin

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The International Symposium on Understanding the Double Burden of Malnutrition for Effective Interventions was held at the International Atomic Energy Agency (IAEA) headquarters in Vienna, Austria, from 10 to 13 December 2018. The Symposium was hosted by the IAEA in cooperation with the World Health Organization and United Nations Children's Fund. The double burden of malnutrition (DBM) is a complex situation characterised by the co‐existence of overweight/obesity, underweight and/or undernutrition, and can occur at the individual, household and population levels across the lifespan. Currently, one in three individuals worldwide suffer from at least one form of malnutrition. The objective of the meeting was to strengthen understanding of how to tackle the DBM by sharing research findings, ideas and issues with the implementation of relevant interventions, programmes and policies. In particular, the Symposium highlighted the crucial roles stable isotopes play in the assessment and monitoring of the DBM and in measuring the impact of programmes designed to address this issue. The range of stable isotope applications considered at the meeting is discussed in this paper and includes the assessment of body composition, total energy expenditure, breastfeeding practices and micronutrient bioavailability.

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The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: a prospective 6-mo iron stable isotope study

Cited by 39 publications

References 40 publications

Metabolic surgery and iron homeostasis

Metabolic surgery and iron homeostasis

Physical exercise intervention at school improved hepcidin, inflammation, and iron metabolism in overweight and obese children and adolescents

Highlights from the International Symposium on Understanding the Double Burden of Malnutrition for Effective Interventions: A focus on stable isotope techniques in nutrition

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