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  • Original Article
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Inflammation and iron deficiency in the hypoferremia of obesity

International Journal of Obesity volume 31, pages 1412–1419 (2007)Cite this article

Abstract

Context:

Obesity is associated with hypoferremia, but it is unclear if this condition is caused by insufficient iron stores or diminished iron availability related to inflammation-induced iron sequestration.

Objective:

To examine the relationships between obesity, serum iron, measures of iron intake, iron stores and inflammation. We hypothesized that both inflammation-induced sequestration of iron and true iron deficiency were involved in the hypoferremia of obesity.

Design:

Cross-sectional analysis of factors anticipated to affect serum iron.

Setting:

Outpatient clinic visits.

Patients:

Convenience sample of 234 obese and 172 non-obese adults.

Main outcome measures:

Relationships between serum iron, adiposity, and serum transferrin receptor, C-reactive protein, ferritin, and iron intake analyzed by analysis of covariance and multiple linear regression.

Results:

Serum iron was lower (75.8±35.2 vs 86.5±34.2 g/dl, P=0.002), whereas transferrin receptor (22.6±7.1 vs 21.0±7.2 nmol/l, P=0.026), C-reactive protein (0.75±0.67 vs 0.34±0.67 mg/dl, P<0.0001) and ferritin (81.1±88.8 vs 57.6±88.7 μg/l, P=0.009) were higher in obese than non-obese subjects. Obese subjects had a higher prevalence of iron deficiency defined by serum iron (24.3%, confidence intervals (CI) 19.3–30.2 vs 15.7%, CI 11.0–21.9%, P=0.03) and transferrin receptor (26.9%, CI 21.6–33.0 vs 15.7%, CI 11.0–21.9%, P=0.0078) but not by ferritin (9.8%, CI 6.6–14.4 vs 9.3%, CI 5.7–14.7%, P=0.99). Transferrin receptor, ferritin and C-reactive protein contributed independently as predictors of serum iron.

Conclusions:

The hypoferremia of obesity appears to be explained both by true iron deficiency and by inflammatory-mediated functional iron deficiency.

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Acknowledgements

This work is supported by ZO1 HD-00641 (to JAY) from the National Institute of Child Health and Human Development and by Y2-OD-2067 (to JAY) from the Office of Dietary Supplements, National Institutes of Health, DHHS.

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Author notes

  1. B Denkinger, N G Sebring, A T Remaley and J A Yanovski: These authors are Commissioned Officers in the United States Public Health Service, DHHS.

Authors and Affiliations

  1. Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD, USA

    L B Yanoff, C M Menzie & J A Yanovski

  2. Nutrition Department, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD, USA

    B Denkinger & N G Sebring

  3. Nursing Department, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD, USA

    T McHugh

  4. Department of Laboratory Medicine, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD, USA

    A T Remaley

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Correspondence to J A Yanovski.

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Yanoff, L., Menzie, C., Denkinger, B. et al. Inflammation and iron deficiency in the hypoferremia of obesity. Int J Obes 31, 1412–1419 (2007). https://doi.org/10.1038/sj.ijo.0803625

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