The hematologic consequences of obesity

Purdy, Julie; Shatzel, Joseph J.

doi:10.1111/ejh.13560

Cited by 108 publications

(95 citation statements)

References 181 publications

(303 reference statements)

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“…Obesity-related conditions such as non-alcoholic steatohepatitis (NASH) and low-grade inflammation might affect iron absorption and the frequency of iron deficiency and anemia prior to bariatric surgery ( 40 ). Obesity is also associated with hematologic changes other than iron deficiency and anemia ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity

et al. 2021

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Iron deficiency with or without anemia is a well-known long-term complication after Roux-en-Y, gastric bypass (RYGB) as the procedure alters the gastrointestinal absorption of iron. Iron is essential for hemoglobin synthesis and a number of cellular processes in muscles, neurons, and other organs. Ferritin is the best marker of iron status, and in a patient without inflammation, iron deficiency occurs when ferritin levels are below 15 µg/L, while iron insufficiency occurs when ferritin levels are below 50 µg/L. Lifelong regular blood tests are recommended after RYGB, but the clinical relevance of iron deficiency and iron insufficiency might be misjudged as long as the hemoglobin levels are normal. The aim of this study was to explore the frequency of iron deficiency and iron deficiency anemia one decade or more after RYGB, the use of per oral iron supplements, and the frequency of intravenous iron treatment. Nine hundred and thirty patients who underwent RYGB for severe obesity at three public hospitals in Norway in the period 2003–2009 were invited to a follow-up visit 10–15 years later. Results from blood tests and survey data on the use of oral iron supplements and intravenous iron treatment were analyzed. Ferritin and hemoglobin levels more than 10 years after RYGB were available on 530 patients [423 (79.8%) women]. Median (IQR) ferritin was 33 (16–63) µg/L, and mean (SD) hemoglobin was 13.4 (1.3) g/dl. Iron deficiency (ferritin ≤ 15 µg/L) was seen in 125 (23.6%) patients; in addition, iron insufficiency (ferritin 16–50 µg/L) occurred in 233 (44%) patients. Mean (SD) hemoglobin levels were 12.5 (1.4) g/dl in patients with iron deficiency, 13.5 (1.2) g/dl in patients with iron insufficiency, 13.8 (1.3) g/dl in the 111 (21%) patients with ferritin 51–100 µg/L, and 13.8 (1.2) g/dl in the 55 (10%) patients with ferritin >100 µg/L. Two hundred and seventy-five (56%) patients reported taking oral iron supplements, and 138 (27.5%) had received intravenous iron treatment after the RYGB procedure. Iron deficiency or iron insufficiency occurred in two-thirds of the patients 10 years after RYGB, although more than half of them reported taking oral iron supplements.

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Section: Discussionmentioning

confidence: 99%

Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity

et al. 2021

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“…Obesity is now regarded as a state of low-grade systemic inflammation where larger adipocytes secrete proinflammatory mediators and recruit leukocytes 14,15 . Obese individuals have altered peripheral blood cell counts with increased risks of leukocytosis, and modulations in the phenotype of lymphocyte subpopulations 16,17 . In breastmilk, obesity impacts the macro-and micro-nutrients 18 .…”

Section: Introductionmentioning

confidence: 99%

Insights into the trafficking of human leukocytes to colostrum evidences a modulation of the B lymphocyte compartment in obesity

ntildeeiro-Salvador

Vázquez‐Garza

Cruz-Cardenas

et al. 2021

Preprint

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Breastmilk is a dynamic fluid which initial goal is to provide the most adapted nutrition to the neonate. Additional functions have been recently attributed to breastmilk, with the evidence of a specific microbiota and the presence of a variety of components of the immune system, such as cytokines and leukocytes. The composition of breastmilk varies through time, according to the health status of mother and child, and altogether contributes to future health of the infant. Obesity is a rising condition worldwide, that creates a state of systemic, chronic inflammation including leukocytosis. Here, we asked whether colostrum, the milk produced within the first 48 h post-partum, would contain a distinct leukocyte composition depending on the body mass index (BMI) of the mother. We applied a panel of 6 antibodies plus viability marker to the peripheral blood and colostrum obtained from obese (BMI > 30) and lean (BMI < 25) mothers to characterize 10 major leukocyte subpopulations using flow cytometry. While lymphoid cells were otherwise unaffected by their tissue of origin, the phenotypes of granulocyte and monocyte populations significantly contrasted between blood and colostrum, including variations in morphology and surface expression of CD45 and CD16. These differences recapitulated across groups, which suggests a generalized cell-specific phenotype alteration caused by trafficking to colostrum. The B lymphocyte compartment was significantly reduced in obese colostrum and these cells did not exhibit enhanced CD16 shedding in this tissue, unlike B lymphocytes from lean mothers’ colostrum. This is the first exhaustive characterization of major leukocyte subsets in obese mothers’ colostrum, and the first report of leukocyte subpopulations from Latin-American women’s colostrum. This pioneering study is a steppingstone to further investigate active immunity in human breastmilk.

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“…Obesity differs in different genders and seems to interact with platelets and also with coffee. 9,10 Several studies confirm the efficacy of coffee extract's application for weight loss and treatment of some metabolic disorders (diabetes, obesity, etc.). The differences in lifestyle between the genders can also influence the effects of coffee on platelet activity.…”

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confidence: 98%

“…The effects of food components on biological function are influenced by hormones and metabolism. [8][9][10] Obesity is an important cardiovascular risk factor in women, especially visceral obesity that develops during menopause and is associated with high levels of inflammation. Obesity differs in different genders and seems to interact with platelets and also with coffee.…”

mentioning

confidence: 99%