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Special Issue "Iron Deficiency: Development, Implications and Treatment"

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 July 2014)

Special Issue Editor

Guest Editor
Dr. Amanda Patterson

School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, 2308, Australia
Website | E-Mail
Interests: iron deficiency; nutrition in well-being, mental health and cognition; nutritional epidemiology; women`s health; diet quality; role of breakfast

Special Issue Information

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Keywords

  • iron deficiency
  • diet and iron status
  • predictors of iron deficiency
  • dietary Haem and non-haem iron
  • inhibitors and enhancers of iron absorption
  • iron deficiency and fatigue
  • iron deficiency and cognition
  • iron deficiency and general health
  • prevention of iron deficiency
  • dietary treatment of iron deficiency
  • iron supplementation

Published Papers (14 papers)

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Research

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Open AccessArticle Hepcidin-25, Mean Corpuscular Volume, and Ferritin as Predictors of Response to Oral Iron Supplementation in Hemodialysis Patients
Nutrients 2015, 7(1), 103-118; doi:10.3390/nu7010103
Received: 8 July 2014 / Accepted: 11 December 2014 / Published: 29 December 2014
Cited by 3 | PDF Full-text (313 KB) | HTML Full-text | XML Full-text
Abstract
The benefit of oral iron therapy (OIT) and factors predictive of OIT response are not established in hemodialysis (HD) patients with iron deficiency anemia (IDA). We examined the values of hepcidin-25, mean corpuscular volume (MCV), and ferritin as predictors of OIT response. Oral
[...] Read more.
The benefit of oral iron therapy (OIT) and factors predictive of OIT response are not established in hemodialysis (HD) patients with iron deficiency anemia (IDA). We examined the values of hepcidin-25, mean corpuscular volume (MCV), and ferritin as predictors of OIT response. Oral ferrous fumarate (50 mg/day, 8 weeks) was given to 51 HD patients with IDA (hemoglobin (Hb) < 12 g/dL, ferritin < 100 ng/mL) treated with an erythropoietin activator. Sixteen patients were responders (improvement of Hb (ΔHb) ≥ 2 g/dL) and 35 were non-responders (ΔHb < 2g/dL). Baseline Hb, MCV, serum hepcidin-25, ferritin, iron parameters, and C-reactive protein (CRP) before and ΔHb after OIT were compared between groups. Hepcidin-25, MCV, ferritin, and transferrin saturation were lower in the responders than in the non-responders. Hepcidin-25 positively correlated with ferritin. Hepcidin-25, MCV, and ferritin positively correlated with baseline Hb and negatively correlated with ΔHb. Despite normal CRP levels in all patients, CRP correlated positively with hepcidin-25 and ferritin. Stepwise multiple linear regression analysis and receiver operating characteristics curve analysis revealed that hepcidin-25, MCV, and ferritin could predict OIT response. We conclude that hepcidin-25, MCV, and ferritin could be useful markers of iron storage status and may help predict OIT response in HD patients. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessArticle Anemia and Feeding Practices among Infants in Rural Shaanxi Province in China
Nutrients 2014, 6(12), 5975-5991; doi:10.3390/nu6125975
Received: 29 August 2014 / Revised: 1 December 2014 / Accepted: 8 December 2014 / Published: 22 December 2014
Cited by 4 | PDF Full-text (451 KB) | HTML Full-text | XML Full-text
Abstract
Anemia is one of the most prevalent public health problems among infants and iron deficiency anemia has been related to many adverse consequences. The overall goal of this study is to examine the prevalence of anemia among infants in poor rural China and
[...] Read more.
Anemia is one of the most prevalent public health problems among infants and iron deficiency anemia has been related to many adverse consequences. The overall goal of this study is to examine the prevalence of anemia among infants in poor rural China and to identify correlates of anemia. In April 2013, we randomly sampled 948 infants aged 6–11 months living in 351 villages across 174 townships in nationally-designated poverty counties in rural areas of southern Shaanxi Province, China. Infants were administered a finger prick blood test for hemoglobin (Hb). Anthropometric measurement and household survey of demographic characteristics and feeding practices were conducted in the survey. We found that 54.3% of 6–11 month old infants in poor rural China are anemic, and 24.3% of sample infants suffer from moderate or severe anemia. We find that children still breastfed over 6 months of age had lower Hb concentrations and higher anemia prevalence than their non-breastfeeding counterparts (p < 0.01), and that children who had ever been formula-fed had significantly higher Hb concentrations and lower anemia prevalence than their non-formula-fed counterparts (p < 0.01). The results suggest the importance of iron supplementation or home fortification while breastfeeding. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessArticle Interactive Effects of Dietary Fat/Carbohydrate Ratio and Body Mass Index on Iron Deficiency Anemia among Taiwanese Women
Nutrients 2014, 6(9), 3929-3941; doi:10.3390/nu6093929
Received: 4 July 2014 / Revised: 25 August 2014 / Accepted: 1 September 2014 / Published: 24 September 2014
Cited by 5 | PDF Full-text (381 KB) | HTML Full-text | XML Full-text
Abstract
Whether being overweight or obese is associated with increased risk of iron deficiency anemia (IDA) remains controversial. We evaluated the dietary intakes and risk for IDA in relation to body mass index (BMI). One thousand two hundred and seventy-four females aged ≥19 years,
[...] Read more.
Whether being overweight or obese is associated with increased risk of iron deficiency anemia (IDA) remains controversial. We evaluated the dietary intakes and risk for IDA in relation to body mass index (BMI). One thousand two hundred and seventy-four females aged ≥19 years, enrolled in the third Nutrition and Health Survey in Taiwan (NAHSIT) 2005–2008, were selected. Half of the women were either overweight (24.0%) or obese (25.3%). The overall prevalence of anemia, iron deficiency and IDA among adult women was 19.5%, 8.6% and 6.2%. BMI showed a protective effect on IDA: overweight (odds ratio, OR: 0.365 (0.181–0.736)) and obese (OR: 0.480 (0.259–0.891)) when compared with normal weight. Univariate analysis identified increased IDA risk for overweight/obese women who consumed higher dietary fat but lower carbohydrate (CHO) (OR: 10.119 (1.267–80.79)). No such relationship was found in IDA women with normal weight (OR: 0.375 (0.036–4.022)). Analysis of interaction(s) showed individuals within the highest BMI tertile (T3) had the lowest risk for IDA and the risk increased with increasing tertile groups of fat/CHO ratio; OR 0.381 (0.144–1.008; p = 0.051), 0.370 (0.133–1.026; p = 0.056) and 0.748 (0.314–1.783; p = 0.513); for T1, T2 and T3, respectively. In conclusion, a protective effect of BMI on IDA may be attenuated in women who had increased fat/CHO ratio. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessArticle A Study of the Effects of Latent Iron Deficiency on Measures of Cognition: A Pilot Randomised Controlled Trial of Iron Supplementation in Young Women
Nutrients 2014, 6(6), 2419-2435; doi:10.3390/nu6062419
Received: 17 April 2014 / Revised: 6 June 2014 / Accepted: 16 June 2014 / Published: 23 June 2014
Cited by 5 | PDF Full-text (238 KB) | HTML Full-text | XML Full-text
Abstract
Rates of iron deficiency are high amongst healthy young women. Cognitive impairment occurs secondary to iron deficiency in infants and children, but evaluation of the impact on cognition among young women is inconsistent. The aim was to determine the suitability of the IntegNeuro
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Rates of iron deficiency are high amongst healthy young women. Cognitive impairment occurs secondary to iron deficiency in infants and children, but evaluation of the impact on cognition among young women is inconsistent. The aim was to determine the suitability of the IntegNeuro test battery for assessing cognitive function in iron-deficient and iron-sufficient young women. A pilot double-blinded, placebo-controlled intervention trial was conducted in iron-deficient (serum ferritin ≤ 20 μg/L and haemoglobin > 120 g/L) and iron-sufficient young women (18–35 years). Cognitive function and haematological markers of iron status were measured at baseline and follow-up. Iron-deficient participants (n = 24) were randomised to receive placebo, 60 mg or 80 mg elemental iron daily supplements for 16 weeks. A control group of iron-sufficient participants (n = 8) was allocated to placebo. Change scores for Impulsivity and Attention were significantly greater in plasma ferritin improvers than in non-improvers (p = 0.004, p = 0.026). IntegNeuro was easy to administer and acceptable to young women. Based on the differences in Memory and Attention scores between iron-deficient participants on iron treatment and those on placebo, it was decided that between 26 and 84 participants would be required in each iron treatment group for an adequately powered extension of this pilot RCT. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessArticle Comparison of Two Doses of Elemental Iron in the Treatment of Latent Iron Deficiency: Efficacy, Side Effects and Blinding Capabilities
Nutrients 2014, 6(4), 1394-1405; doi:10.3390/nu6041394
Received: 9 January 2014 / Revised: 24 March 2014 / Accepted: 26 March 2014 / Published: 4 April 2014
Cited by 2 | PDF Full-text (218 KB) | HTML Full-text | XML Full-text
Abstract
Adherence to iron supplementation can be compromised due to side effects, and these limit blinding in studies of iron deficiency. No studies have reported an efficacious iron dose that allows participants to remain blinded. This pilot study aimed to determine a ferrous sulfate
[...] Read more.
Adherence to iron supplementation can be compromised due to side effects, and these limit blinding in studies of iron deficiency. No studies have reported an efficacious iron dose that allows participants to remain blinded. This pilot study aimed to determine a ferrous sulfate dose that improves iron stores, while minimising side effects and enabling blinding. A double-blinded RCT was conducted in 32 women (18–35 years): 24 with latent iron deficiency (serum ferritin < 20 µg/L) and 8 iron sufficient controls. Participants with latent iron deficiency were randomised to 60 mg or 80 mg elemental iron or to placebo, for 16 weeks. The iron sufficient control group took placebo. Treatment groups (60 mg n = 7 and 80 mg n = 6) had significantly higher ferritin change scores than placebo groups (iron deficient n = 5 and iron sufficient n = 6), F(1, 23) = 8.46, p ≤ 0.01. Of the 24 who completed the trial, 10 participants (77%) on iron reported side effects, compared with 5 (45%) on placebo, but there were no differences in side effects (p = 0.29), or compliance (p = 0.60) between iron groups. Nine (69%) participants on iron, and 11 (56%) on placebo correctly guessed their treatment allocation. Both iron doses were equally effective in normalising ferritin levels. Although reported side-effects were similar for both groups, a majority of participants correctly guessed their treatment group. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)

Review

Jump to: Research

Open AccessReview Duodenal Cytochrome b (DCYTB) in Iron Metabolism: An Update on Function and Regulation
Nutrients 2015, 7(4), 2274-2296; doi:10.3390/nu7042274
Received: 25 October 2014 / Revised: 3 March 2015 / Accepted: 5 March 2015 / Published: 31 March 2015
Cited by 7 | PDF Full-text (341 KB) | HTML Full-text | XML Full-text
Abstract
Iron and ascorbate are vital cellular constituents in mammalian systems. The bulk-requirement for iron is during erythropoiesis leading to the generation of hemoglobin-containing erythrocytes. Additionally; both iron and ascorbate are required as co-factors in numerous metabolic reactions. Iron homeostasis is controlled at the
[...] Read more.
Iron and ascorbate are vital cellular constituents in mammalian systems. The bulk-requirement for iron is during erythropoiesis leading to the generation of hemoglobin-containing erythrocytes. Additionally; both iron and ascorbate are required as co-factors in numerous metabolic reactions. Iron homeostasis is controlled at the level of uptake; rather than excretion. Accumulating evidence strongly suggests that in addition to the known ability of dietary ascorbate to enhance non-heme iron absorption in the gut; ascorbate regulates iron homeostasis. The involvement of ascorbate in dietary iron absorption extends beyond the direct chemical reduction of non-heme iron by dietary ascorbate. Among other activities; intra-enterocyte ascorbate appears to be involved in the provision of electrons to a family of trans-membrane redox enzymes; namely those of the cytochrome b561 class. These hemoproteins oxidize a pool of ascorbate on one side of the membrane in order to reduce an electron acceptor (e.g., non-heme iron) on the opposite side of the membrane. One member of this family; duodenal cytochrome b (DCYTB); may play an important role in ascorbate-dependent reduction of non-heme iron in the gut prior to uptake by ferrous-iron transporters. This review discusses the emerging relationship between cellular iron homeostasis; the emergent “IRP1-HIF2α axis”; DCYTB and ascorbate in relation to iron metabolism. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Figures

Open AccessReview Plant Ferritin—A Source of Iron to Prevent Its Deficiency
Nutrients 2015, 7(2), 1184-1201; doi:10.3390/nu7021184
Received: 31 July 2014 / Accepted: 3 February 2015 / Published: 12 February 2015
Cited by 6 | PDF Full-text (174 KB) | HTML Full-text | XML Full-text
Abstract
Iron deficiency anemia affects a significant part of the human population. Due to the unique properties of plant ferritin, food enrichment with ferritin iron seems to be a promising strategy to prevent this malnutrition problem. This protein captures huge amounts of iron ions
[...] Read more.
Iron deficiency anemia affects a significant part of the human population. Due to the unique properties of plant ferritin, food enrichment with ferritin iron seems to be a promising strategy to prevent this malnutrition problem. This protein captures huge amounts of iron ions inside the apoferritin shell and isolates them from the environment. Thus, this iron form does not induce oxidative change in food and reduces the risk of gastric problems in consumers. Bioavailability of ferritin in human and animal studies is high and the mechanism of absorption via endocytosis has been confirmed in cultured cells. Legume seeds are a traditional source of plant ferritin. However, even if the percentage of ferritin iron in these seeds is high, its concentration is not sufficient for food fortification. Thus, edible plants have been biofortified in iron for many years. Plants overexpressing ferritin may find applications in the development of bioactive food. A crucial achievement would be to develop technologies warranting stability of ferritin in food and the digestive tract. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview The Impact of Anemia on Child Mortality: An Updated Review
Nutrients 2014, 6(12), 5915-5932; doi:10.3390/nu6125915
Received: 1 August 2014 / Revised: 21 November 2014 / Accepted: 2 December 2014 / Published: 22 December 2014
Cited by 6 | PDF Full-text (262 KB) | HTML Full-text | XML Full-text
Abstract
Iron deficiency anemia and child mortality are public health problems requiring urgent attention. However, the degree to which iron deficiency anemia contributes to child mortality is unknown. Here, we utilized an exhaustive article search and screening process to identify articles containing both anemia
[...] Read more.
Iron deficiency anemia and child mortality are public health problems requiring urgent attention. However, the degree to which iron deficiency anemia contributes to child mortality is unknown. Here, we utilized an exhaustive article search and screening process to identify articles containing both anemia and mortality data for children aged 28 days to 12 years. We then estimated the reduction in risk of mortality associated with a 1-g/dL increase in hemoglobin (Hb). Our meta-analysis of nearly 12,000 children from six African countries revealed a combined odds ratio of 0.76 (0.62–0.93), indicating that for each 1-g/dL increase in Hb, the risk of death falls by 24%. The feasibility of a 1-g/dL increase in Hb has been demonstrated via simple iron supplementation strategies. Our finding suggests that ~1.8 million deaths in children aged 28 days to five years could be avoided each year by increasing Hb in these children by 1 g/dL. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview Increasing Iron and Zinc in Pre-Menopausal Women and Its Effects on Mood and Cognition: A Systematic Review
Nutrients 2014, 6(11), 5117-5141; doi:10.3390/nu6115117
Received: 11 July 2014 / Revised: 15 October 2014 / Accepted: 16 October 2014 / Published: 14 November 2014
Cited by 2 | PDF Full-text (248 KB) | HTML Full-text | XML Full-text
Abstract
Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or
[...] Read more.
Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or zinc supplementation and its impact on mood or cognition in pre-menopausal women. Searches included MEDLINE complete, Excerpta Medica Database (EMBASE), psychINFO, psychARTICLES, pubMED, ProQuest Health and Medical Complete Academic Search complete, Scopus and ScienceDirect. Ten randomized controlled trials and one non-randomized controlled trial were found to meet the inclusion criteria. Seven studies found improvements in aspects of mood and cognition after iron supplementation. Iron supplementation appeared to improve memory and intellectual ability in participants aged between 12 and 55 years in seven studies, regardless of whether the participant was initially iron insufficient or iron-deficient with anaemia. The review also found three controlled studies providing evidence to suggest a role for zinc supplementation as a treatment for depressive symptoms, as both an adjunct to traditional antidepressant therapy for individuals with a diagnosis of major depressive disorder and as a therapy in its own right in pre-menopausal women with zinc deficiency. Overall, the current literature indicates a positive effect of improving zinc status on enhanced cognitive and emotional functioning. However, further study involving well-designed randomized controlled trials is needed to identify the impact of improving iron and zinc status on mood and cognition. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview Identification, Prevention and Treatment of Iron Deficiency during the First 1000 Days
Nutrients 2014, 6(10), 4093-4114; doi:10.3390/nu6104093
Received: 11 August 2014 / Revised: 9 September 2014 / Accepted: 16 September 2014 / Published: 10 October 2014
Cited by 10 | PDF Full-text (456 KB) | HTML Full-text | XML Full-text
Abstract
Iron deficiency is a global problem across the life course, but infants and their mothers are especially vulnerable to both the development and the consequences of iron deficiency. Maternal iron deficiency during pregnancy can predispose offspring to the development of iron deficiency during
[...] Read more.
Iron deficiency is a global problem across the life course, but infants and their mothers are especially vulnerable to both the development and the consequences of iron deficiency. Maternal iron deficiency during pregnancy can predispose offspring to the development of iron deficiency during infancy, with potentially lifelong sequelae. This review explores iron status throughout these “first 1000 days” from pregnancy through two years of age, covering the role of iron and the epidemiology of iron deficiency, as well as its consequences, identification, interventions and remaining research gaps. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview Iron, Oxidative Stress and Gestational Diabetes
Nutrients 2014, 6(9), 3968-3980; doi:10.3390/nu6093968
Received: 31 July 2014 / Revised: 27 August 2014 / Accepted: 9 September 2014 / Published: 25 September 2014
Cited by 13 | PDF Full-text (136 KB) | HTML Full-text | XML Full-text
Abstract
Both iron deficiency and hyperglycemia are highly prevalent globally for pregnant women. Iron supplementation is recommended during pregnancy to control iron deficiency. The purposes of the review are to assess the oxidative effects of iron supplementation and the potential relationship between iron nutrition
[...] Read more.
Both iron deficiency and hyperglycemia are highly prevalent globally for pregnant women. Iron supplementation is recommended during pregnancy to control iron deficiency. The purposes of the review are to assess the oxidative effects of iron supplementation and the potential relationship between iron nutrition and gestational diabetes. High doses of iron (~relative to 60 mg or more daily for adult humans) can induce lipid peroxidation in vitro and in animal studies. Pharmaceutical doses of iron supplements (e.g., 10× RDA or more for oral supplements or direct iron supplementation via injection or addition to the cell culture medium) for a short or long duration will induce DNA damage. Higher heme-iron intake or iron status measured by various biomarkers, especially serum ferritin, might contribute to greater risk of gestational diabetes, which may be mediated by iron oxidative stress though lipid oxidation and/or DNA damage. However, information is lacking about the effect of low dose iron supplementation (≤60 mg daily) on lipid peroxidation, DNA damage and gestational diabetes. Randomized trials of low-dose iron supplementation (≤60 mg daily) for pregnant women are warranted to test the relationship between iron oxidative stress and insulin resistance/gestational diabetes, especially for iron-replete women. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview Dietary Determinants of and Possible Solutions to Iron Deficiency for Young Women Living in Industrialized Countries: A Review
Nutrients 2014, 6(9), 3747-3776; doi:10.3390/nu6093747
Received: 31 July 2014 / Revised: 22 August 2014 / Accepted: 25 August 2014 / Published: 19 September 2014
Cited by 13 | PDF Full-text (456 KB) | HTML Full-text | XML Full-text
Abstract
Iron deficiency is a concern in both developing and developed (industrialized) countries; and young women are particularly vulnerable. This review investigates dietary determinants of and possible solutions to iron deficiency in young women living in industrialized countries. Dietary factors including ascorbic acid and
[...] Read more.
Iron deficiency is a concern in both developing and developed (industrialized) countries; and young women are particularly vulnerable. This review investigates dietary determinants of and possible solutions to iron deficiency in young women living in industrialized countries. Dietary factors including ascorbic acid and an elusive factor in animal protein foods (meat; fish and poultry) enhance iron absorption; while phytic acid; soy protein; calcium and polyphenols inhibit iron absorption. However; the effects of these dietary factors on iron absorption do not necessarily translate into an association with iron status and iron stores (serum ferritin concentration). In cross-sectional studies; only meat intake has consistently (positively) been associated with higher serum ferritin concentrations. The enhancing effects of ascorbic acid and meat on iron absorption may be negated by the simultaneous consumption of foods and nutrients which are inhibitory. Recent cross-sectional studies have considered the combination and timing of foods consumed; with mixed results. Dietary interventions using a range of focused dietary measures to improve iron status appear to be more effective than dietary approaches that focus on single nutrients or foods. Further research is needed to determine optimal dietary recommendations for both the prevention and treatment of iron deficiency. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview Obesity as an Emerging Risk Factor for Iron Deficiency
Nutrients 2014, 6(9), 3587-3600; doi:10.3390/nu6093587
Received: 28 July 2014 / Revised: 29 August 2014 / Accepted: 3 September 2014 / Published: 11 September 2014
Cited by 21 | PDF Full-text (489 KB) | HTML Full-text | XML Full-text
Abstract
Iron homeostasis is affected by obesity and obesity-related insulin resistance in a many-facetted fashion. On one hand, iron deficiency and anemia are frequent findings in subjects with progressed stages of obesity. This phenomenon has been well studied in obese adolescents, women and subjects
[...] Read more.
Iron homeostasis is affected by obesity and obesity-related insulin resistance in a many-facetted fashion. On one hand, iron deficiency and anemia are frequent findings in subjects with progressed stages of obesity. This phenomenon has been well studied in obese adolescents, women and subjects undergoing bariatric surgery. On the other hand, hyperferritinemia with normal or mildly elevated transferrin saturation is observed in approximately one-third of patients with metabolic syndrome (MetS) or nonalcoholic fatty liver disease (NAFLD). This constellation has been named the “dysmetabolic iron overload syndrome (DIOS)”. Both elevated body iron stores and iron deficiency are detrimental to health and to the course of obesity-related conditions. Iron deficiency and anemia may impair mitochondrial and cellular energy homeostasis and further increase inactivity and fatigue of obese subjects. Obesity-associated inflammation is tightly linked to iron deficiency and involves impaired duodenal iron absorption associated with low expression of duodenal ferroportin (FPN) along with elevated hepcidin concentrations. This review summarizes the current understanding of the dysregulation of iron homeostasis in obesity. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Open AccessReview Hepcidin and Iron Homeostasis during Pregnancy
Nutrients 2014, 6(8), 3062-3083; doi:10.3390/nu6083062
Received: 15 May 2014 / Revised: 2 July 2014 / Accepted: 8 July 2014 / Published: 4 August 2014
Cited by 12 | PDF Full-text (712 KB) | HTML Full-text | XML Full-text
Abstract
Hepcidin is the master regulator of systemic iron bioavailability in humans. This review examines primary research articles that assessed hepcidin during pregnancy and postpartum and report its relationship to maternal and infant iron status and birth outcomes; areas for future research are also
[...] Read more.
Hepcidin is the master regulator of systemic iron bioavailability in humans. This review examines primary research articles that assessed hepcidin during pregnancy and postpartum and report its relationship to maternal and infant iron status and birth outcomes; areas for future research are also discussed. A systematic search of the databases Medline and Cumulative Index to Nursing and Allied Health returned 16 primary research articles including 10 human and six animal studies. Collectively, the results indicate that hepcidin is lower during pregnancy than in a non-pregnant state, presumably to ensure greater iron bioavailability to the mother and fetus. Pregnant women with undetectable serum hepcidin transferred a greater quantity of maternally ingested iron to their fetus compared to women with detectable hepcidin, indicating that maternal hepcidin in part determines the iron bioavailability to the fetus. However, inflammatory states, including preeclampsia, malaria infection, and obesity were associated with higher hepcidin during pregnancy compared to healthy controls, suggesting that maternal and fetal iron bioavailability could be compromised in such conditions. Future studies should examine the relative contribution of maternal versus fetal hepcidin to the control of placental iron transfer as well as optimizing maternal and fetal iron bioavailability in pregnancies complicated by inflammation. Full article
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)

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