The effects of reducing chronic inflammation in overweight women on serum hepcidin and iron absorption with and without supplemental ascorbic acid

Abstract

Although hepcidin synthesis is stimulated by inflammation and inhibited by iron deficiency, the strength of their opposing effects on serum hepcidin in humans remain unclear. It was recently shown that an inflammatory stimulus in anemic women did not increase serum hepcidin or decrease iron absorption. The enhancing effect of ascorbic acid on iron absorption may not be effective during inflammation, because of increased serum hepcidin. Our study aim was to test whether reducing inflammation in iron-depleted overweight women with low-grade inflammation would lower serum hepcidin and improve iron absorption with and without ascorbic acid, compared to normal-weight women without inflammation. Before and after 14d of anti-inflammatory treatment (3x600mg ibuprofen daily) in overweight and normal-weight women (n=36; age 19-46 y), we measured serum hepcidin and fractional iron absorption (erythrocyte iron incorporation) from 57Fe- and 58Fe-labeled test meals with and without ascorbic acid. There were significant group effects on interleukin (IL)-6, C-reactive protein, serum ferritin, and SHep (for all, p<0.05). There was a significant treatment effect on SHep (p<0.05): in overweight women, treatment decreased IL-6 by ≍30% and SHep by ≍45%. However, there were no significant treatment or group effects on FIA. Body iron stores were a significant positive predictor of SHep before and after treatment (p<0.001), but IL-6 was not. Reducing chronic inflammation in overweight women halved SHep but did not affect iron absorption with or without ascorbic acid, and the main predictor of iron absorption was body iron stores.

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“…Hepcidin can cause a decrease in serum iron levels by reducing iron absorption in the gut and increasing iron storage in cells ( Imam et al, 2017 ). Anti-inflammatory agents can help reduce inflammation and therefore reduce hepcidin levels, which may increase serum iron levels ( Stoffel et al, 2021 ). Hepcidin is a protein consisting of 25 amino acids and is produced both by hepatocytes during inflammation and also by infected macrophages ( Tan et al, 2021 ).…”