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Satué K, Fazio E, Damiá E, Medica P, Cravana C. Correlation between erythrocyte parameters and iron status in cyclic Spanish Purebred mares. Vet Res Commun 2024:10.1007/s11259-024-10376-2. [PMID: 38635104 DOI: 10.1007/s11259-024-10376-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
The aim of this study was to evaluate the serum iron status and its relation to hematological indexes in cyclic mares. Blood samples were taken from 40 Spanish Purebred mares on days - 5, 0, + 5 and + 16 of their cycle. Concentration of transferrin (TRF) was significantly lower on day 0 than on days + 5 and + 16, transferrin saturation (TSAT) decreased significantly on days 0 and + 16 compared to day - 5, total iron-binding capacity (TIBC) on day + 16 was significantly higher than those on days - 5 and 0, and on day + 5 it was also significantly higher than that on day 0, unsaturated iron-binding capacity (UIBC) was reduced on day + 16 compared to days - 5 and 0, red blood cell (RBC) count on day + 16 was higher than that on days - 5 and 0 (p < 0.05), with no differences in the concentration of hemoglobin (HB) and packed cell volume (PCV). TRF and TIBC (r = 0.95), RBC and HB (r = 0.64), RBC and PCV (r = 0.78), and HB and PCV (r = 0.63) were positively and significantly correlated (P < 0.05). The estrous cycle in the Spanish Purebred mare is characterized by an increase in TRF and TIBC during the follicular phase and an increase in TSAT, UIBC and RBC in the luteal phase, without changes in other hematological parameters. The coordinated activity of these parameters guarantees an adequate iron (Fe) transfer and utilization during follicular development, ovulation, and the luteal period in the mare. Therefore, the estrous cycle must be considered in the evaluation of the mare's iron status, in light of significant changes observed both in early and at late luteal phases. The magnitude of these changes and the meaning to the physiology of the mares showed that in cyclic mares, hematological parameters and indicators of iron status evolve differently depending on the phase of the cycle, and their interpretation can help to veterinarians involved in equine practice.
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Affiliation(s)
- Katiuska Satué
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, CEU-Cardenal Herrera University, Tirant lo Blanc, 7, Alfara del Patriarca, Valencia, 46115, Spain.
| | - Esterina Fazio
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, Messina, 98168, Italy
| | - Elena Damiá
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, CEU-Cardenal Herrera University, Tirant lo Blanc, 7, Alfara del Patriarca, Valencia, 46115, Spain
| | - Pietro Medica
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, Messina, 98168, Italy
| | - Cristina Cravana
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, Messina, 98168, Italy
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Aguree S, Murray-Kolb LE, Diaz F, Gernand AD. Menstrual Cycle-Associated Changes in Micronutrient Biomarkers Concentration: A Prospective Cohort Study. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:339-348. [PMID: 35512771 DOI: 10.1080/07315724.2022.2040399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
To evaluate variations in micronutrient biomarker concentrations and deficiencies across the menstrual cycle in a cohort of healthy women. This prospective cohort study was conducted among healthy women of reproductive age living in the State College area, Pennsylvania, (n = 45). Data collection occurred at the early follicular phase, the late follicular phase, and the midluteal phase. Fasting blood samples were collected to measure micronutrient biomarkers. At the early follicular phase, the mean ± SD concentrations for zinc, copper, magnesium, and retinol were 81.8 ± 16.2 µg/dL, 80.1 ± 12.8 µg/dL, 17.9 ± 1.4 mg/L, and 39.4 ± 9.3 µg/dL, respectively. The geometric mean (95% CI) for manganese, iron and ferritin concentrations were 1.51 [1.21, 1.87] µg/L, 106.7 [90.8, 125.4] µg/dL, and 26.4 [20.5, 34.0] µg/L, respectively. Mean concentrations of zinc and magnesium declined by 6.6% (p = 0.009) and 4.6% (p < 0.001) from the early follicular phase to the midluteal phase, respectively. Other biomarkers remained relatively constant across the cycle. At the early follicular phase, the prevalence of low serum concentrations for zinc, copper, magnesium, manganese, iron, and ferritin was 22%, 7%, 29%, 13%, 14%, and 28%, respectively. Also, in early follicular phase, 36% had anemia, and 13% specifically had iron deficiency anemia. The prevalence of magnesium deficiency was significantly higher at the midluteal phase vs. the early follicular phase (p = 0.025). Our study suggests that while many micronutrient concentrations are relatively constant across the menstrual cycle in healthy women, zinc and magnesium decline, and the prevalence of magnesium deficiency increases. Supplemental data for this article is available online at.
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Affiliation(s)
- Sixtus Aguree
- Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa, USA
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Francisco Diaz
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
- Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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Satué K, Fazio E, La Fauci D, Medica P. Changes of Hepcidin, Ferritin and Iron Levels in Cycling Purebred Spanish Mares. Animals (Basel) 2023; 13:ani13071229. [PMID: 37048485 PMCID: PMC10093536 DOI: 10.3390/ani13071229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/21/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Several studies have demonstrated that in woman the sex hormones such as estrogen (E2) and progesterone (P4) influence iron (Fe) regulation, contributing to variations in Fe parameters along the menstrual cycle. These mechanisms based on the regulation of hepcidin (Hepc) which limits Fe availability during the cycle, remain poorly characterized in healthy mares. The objective of this study was to establish the relationship between Hepc, Fe, ferritin (Ferr), and the primary ovarian hormones E2 and P4 in cycling Purebred Spanish mares. Blood samples were taken from 31 Purebred Spanish mares day −5, on day 0, day +5 and day +16 of the cycle. Fe and Ferr significantly increased and Hepc decreased during pre- and ovulatory periods. The secretion peak of estradiol-17β (E2) was reached on day 0 and progesterone (P4) between days +5 and +16. Fe and Ferr were positively correlated (r = 0.57). Fe and Ferr were negatively correlated with Hepc (r = −0.72 and r = −0.02, respectively). E2 and P4 were negatively and positively correlated with Hepc (r = −0.753 and r = 0.54, respectively). In cycling Purebred Spanish mares there is a measurable relationship between steroid hormones and systemic Fe metabolism. Estrogenic dominance in the pre- and ovulatory period allows for a more effective iron status, mediated by hepcidin inhibition. However, P4 during the luteal phase substantially reduces serum Fe and iron stores, possibly related to Hepc stimulation. Future research is required to clarify the relationship between steroid hormones and iron metabolism at the molecular level in equids.
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Affiliation(s)
- Katiuska Satué
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, CEU-Cardenal Herrera University, 46115 Valencia, Spain
| | - Esterina Fazio
- Department of Veterinary Sciences, Veterinary Physiology Unit, Messina University, Viale Palatucci 13, 98168 Messina, Italy
| | - Deborah La Fauci
- Department of Veterinary Sciences, Veterinary Physiology Unit, Messina University, Viale Palatucci 13, 98168 Messina, Italy
| | - Pietro Medica
- Department of Veterinary Sciences, Veterinary Physiology Unit, Messina University, Viale Palatucci 13, 98168 Messina, Italy
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Benito PJ, Alfaro-Magallanes VM, Rael B, Castro EA, Romero-Parra N, Rojo-Tirado MA, Peinado AB. Effect of Menstrual Cycle Phase on the Recovery Process of High-Intensity Interval Exercise-A Cross-Sectional Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3266. [PMID: 36833959 PMCID: PMC9959793 DOI: 10.3390/ijerph20043266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Although the study of the menstrual cycle influence on endurance exercise has recently increased, there is a lack of literature studying its influence on females' cardiorespiratory recovery. Thus, the aim of the present work was to assess menstrual cycle influence on post-exercise recovery following a high intensity interval exercise in trained females. Thirteen eumenorrheic endurance-trained females performed an interval running protocol in three menstrual cycle phases: early follicular phase (EFP), late follicular phase (LFP), and mid-luteal phase (MLP). The protocol consisted of 8 × 3-min bouts at 85% of their maximal aerobic speed (vVO2peak) with a 90-s rest between bouts and a final 5-min active recovery at 30% vVO2peak. All variables were averaged every 15 s, obtaining 19 moments during recovery (time factor). To analyze the effects of the menstrual cycle on the final active cardiorespiratory recovery, an ANOVA for repeated measures was performed. ANOVA showed an effect on menstrual cycle phase on ventilation (EFP: 1.27 ± 0.35; LFP: 1.19 ± 0.36; MLP: 1.27 ± 0.37), breathing frequency (EFP: 35.14 ± 7.14; LFP: 36.32 ± 7.11; MLP: 37.62 ± 7.23), and carbon dioxide production (EFP: 1120.46 ± 137.62; LFP: 1079.50 ± 129.57; MLP: 1148.78 ± 107.91). Regarding the interaction results (phase x time), ventilation is higher at many of the recovery times during the MLP, with less frequent differences between EFP and LFP (F = 1.586; p = 0.019), while breathing reserve is lower at many of the recovery times during MLP, with less time differences between EFP and LFP (F = 1.643; p = 0.013). It seems that the menstrual cycle affects post-exercise recovery specially during the MLP, rising ventilation and lowering breathing reserve, giving rise to an impaired ventilatory efficiency.
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Affiliation(s)
- Pedro J. Benito
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Víctor M. Alfaro-Magallanes
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Beatriz Rael
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Eliane A. Castro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
- Department of Physical Education, São Paulo State University (UNESP), Bauru 17033-360, SP, Brazil
| | - Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
- Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de CC. de la Salud, Universidad Rey Juan Carlos, 28933 Madrid, Spain
| | - Miguel A. Rojo-Tirado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Ana B. Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
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Alfaro-Magallanes VM, Romero-Parra N, Barba-Moreno L, Rael B, Benito PJ, Díaz ÁE, Cupeiro R, Peinado AB. Serum iron availability, but not iron stores, is lower in naturally menstruating than in oral contraceptive athletes. Eur J Sport Sci 2023; 23:231-240. [PMID: 34904534 DOI: 10.1080/17461391.2021.2018503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study measured serum markers of iron status in naturally menstruating and oral contraceptive (OC) athletes during the main hormonal milieus of these two profiles to identify potential differences confounding the diagnosis of iron deficiency in female athletes. Resting blood samples were collected from 36 naturally menstruating athletes during the early-follicular phase (EFP), mid- late-follicular phase (MLFP) and mid-luteal phase (MLP) of the menstrual cycle. Simultaneously, blood samples were collected from 24 OC athletes during the withdrawal and active-pill phase of the OC cycle. Serum iron, ferritin, transferrin, transferrin saturation (TSAT), C-reactive protein (CRP), interleukin-6 and sex hormones were analyzed. Naturally menstruating athletes showed lower levels of TSAT, iron and transferrin than OC athletes when comparing the bleeding phase of both profiles (p<0.05) as well as when comparing all analyzed phases of the menstrual cycle to the active pill phase of the OC cycle (p<0.05). Interestingly, only lower transferrin was found during MLFP and MLP compared to the withdrawal phase of the OC cycle (p>0.05), with all other iron markers showing no differences (p>0.05). Intracycle variations were also found within both types of cycle, presenting reduced TSAT and iron during menstrual bleeding phases (p<0.05). In conclusion, in OC athletes, serum iron availability, but not serum ferritin, seems higher than in naturally menstruating ones. However, such differences are lost when comparing the MLFP and MLP of the menstrual cycle with the withdrawal phase of the OC cycle. This should be considered in the assessment of iron status in female athletes.Highlights Naturally menstruating athletes present lower TSAT, iron and transferrin in all analyzed phases of the menstrual cycle compared to OC athletes during their active pill phase. However, both the mid-late follicular and mid-luteal phases of the menstrual cycle do not differ from the withdrawal phase of the oral contraceptive cycle.Intracycle variations are found for TSAT and iron in both naturally menstruating and oral contraceptive athletes, which are mainly driven by a reduction in TSAT and iron during menstrual bleeding phases.As serum iron availability changes significantly as a function of the athlete's hormonal status, it should be considered in the assessment of the athlete's iron status as well as standardise the phase of the menstrual cycle in which to assess iron markers to avoid misdiagnosis or misleading results.In contrast, the assessment of iron stores through serum ferritin is substantially stable and the athlete's hormonal status does not seem to be of relevance for this purpose.
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Affiliation(s)
- Víctor M Alfaro-Magallanes
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Nuria Romero-Parra
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Laura Barba-Moreno
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Beatriz Rael
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Pedro J Benito
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Ángel E Díaz
- Clinical laboratory. National Center of Sport Medicine. Health and Sports Department, AEPSAD, Madrid, Spain
| | - Rocío Cupeiro
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Ana B Peinado
- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
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- LFE Research Group. Department of Health and Human Performance. Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
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Menstrual cycle affects iron homeostasis and hepcidin following interval running exercise in endurance-trained women. Eur J Appl Physiol 2022; 122:2683-2694. [PMID: 36129579 PMCID: PMC9613712 DOI: 10.1007/s00421-022-05048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Purpose Menstrual cycle phase affects resting hepcidin levels, but such effects on the hepcidin response to exercise are still unclear. Thus, we investigated the hepcidin response to running during three different menstrual cycle phases. Methods Twenty-one endurance-trained eumenorrheic women performed three identical interval running protocols during the early-follicular phase (EFP), late-follicular phase (LFP), and mid-luteal phase (MLP). The protocol consisted of 8 × 3 min bouts at 85% of the maximal aerobic speed, with 90-s recovery. Blood samples were collected pre-exercise and at 0 h, 3 h and 24 h post-exercise. Results Data presented as mean ± SD. Ferritin were lower in the EFP than the LFP (34.82 ± 16.44 vs 40.90 ± 23.91 ng/ml, p = 0.003), while iron and transferrin saturation were lower during the EFP (58.04 ± 19.70 µg/dl, 14.71 ± 5.47%) compared to the LFP (88.67 ± 36.38 µg/dl, 22.22 ± 9.54%; p < 0.001) and the MLP (80.20 ± 42.05 µg/dl, 19.87 ± 10.37%; p = 0.024 and p = 0.045, respectively). Hepcidin was not affected by menstrual cycle (p = 0.052) or menstrual cycle*time interaction (p = 0.075). However, when comparing hepcidin at 3 h post-exercise, a moderate and meaningful effect size showed that hepcidin was higher in the LFP compared to the EFP (3.01 ± 4.16 vs 1.26 ± 1.25 nMol/l; d = 0.57, CI = 0.07–1.08). No effect of time on hepcidin during the EFP was found either (p = 0.426). Conclusion The decrease in iron, ferritin and TSAT levels during the EFP may mislead the determination of iron status in eumenorrheic athletes. However, although the hepcidin response to exercise appears to be reduced in the EFP, it shows no clear differences between the phases of the menstrual cycle (clinicaltrials.gov: NCT04458662). Supplementary Information The online version contains supplementary material available at 10.1007/s00421-022-05048-5.
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Barney DE, Ippolito JR, Berryman CE, Hennigar SR. A Prolonged Bout of Running Increases Hepcidin and Decreases Dietary Iron Absorption in Trained Female and Male Runners. J Nutr 2022; 152:2039-2047. [PMID: 35661896 DOI: 10.1093/jn/nxac129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/22/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Declines in iron status are frequently reported in those who regularly engage in strenuous physical activity. A possible reason is increases in the iron regulatory hormone hepcidin, which functions to inhibit dietary iron absorption and can be induced by the inflammatory cytokine interleukin-6 (IL-6). OBJECTIVES The current study aimed to determine the impact of a prolonged bout of running on hepcidin and dietary iron absorption in trained female and male runners. METHODS Trained female and male collegiate cross country runners (n = 28, age: 19.7 ± 1.2 y, maximal oxygen uptake: 66.1 ± 6.1 mL $\cdot$ kg -1$\cdot$ min-2, serum ferritin: 21.9 ± 13.3 ng/mL) performed a prolonged run (98.8 ± 14.7 min, 21.2 ± 3.8 km, 4.7 ± 0.3 min/km) during a team practice. Participants consumed a stable iron isotope with a standardized meal 2 h postrun and blood was collected 1 h later. The protocol was repeated 2 wk later except participants abstained from exercise (rest). RBCs were collected 15 d after exercise and rest to determine isotope enrichment. Differences between exercise and rest were assessed by paired t tests and Wilcoxon matched-pairs signed rank tests. Data are means ± SDs. RESULTS Plasma hepcidin increased 51% after exercise (45.8 ± 34.4 ng/mL) compared with rest (30.3 ± 27.2 ng/mL, P = 0.0010). Fractional iron absorption was reduced by 36% after exercise (11.8 ± 14.6 %) compared with rest (18.5 ± 14.4 %, P = 0.025). Plasma IL-6 was greater after exercise (0.660 ± 0.354 pg/mL) than after rest (0.457 ± 0.212 pg/mL, P < 0.0001). Exploratory analyses revealed that the increase in hepcidin with exercise may be driven by a response in males but not females. CONCLUSIONS A prolonged bout of running increases hepcidin and decreases dietary iron absorption compared with rest in trained runners with low iron stores. The current study supports that IL-6 contributes to the increase in hepcidin with prolonged physical activity, although future studies should explore potential sex differences in the hepcidin response.This trial was registered at Clinicaltrials.gov as NCT04079322.
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Affiliation(s)
- David E Barney
- Department of Nutrition & Integrative Physiology, Florida State University, Tallahassee, FL, USA
| | - James R Ippolito
- Department of Nutrition & Integrative Physiology, Florida State University, Tallahassee, FL, USA
| | - Claire E Berryman
- Department of Nutrition & Integrative Physiology, Florida State University, Tallahassee, FL, USA
| | - Stephen R Hennigar
- Department of Nutrition & Integrative Physiology, Florida State University, Tallahassee, FL, USA
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Heat-Killed Lactococcus lactis subsp. cremoris H61 Altered the Iron Status of Young Women: A Randomized, Double-Blinded, Placebo-Controlled, Parallel-Group Comparative Study. Nutrients 2022; 14:nu14153144. [PMID: 35956320 PMCID: PMC9370818 DOI: 10.3390/nu14153144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023] Open
Abstract
Women are prone to iron deficiency because of increased iron excretion associated with menstruation. This is often treated by oral iron supplementation, although this treatment can cause side effects, such as stomach pain and nausea, with low absorption of ingested iron. Previously, a significant increase in serum iron was observed in association with the consumption of foods containing Lactococcus lactis subsp. cremoris H61 (H61). However, the causal relationship between H61 ingestion and elevated serum iron is still unclear. Therefore, in this study, we aimed to determine the effects of H61 ingestion on the iron status of young women. Healthy young Japanese women (18–25 years of age) ingested either heat-killed H61 or placebo for 4 weeks. Serum iron, transferrin saturation, and ferritin were significantly elevated in the H61 group but remained unchanged in the placebo group. Compared to before the intervention, iron intake remained unchanged during the intervention period, so the change in the iron status of the H61 group was not due to increased iron intake. These results suggest that heat-killed H61 may elevate iron status by enhancing iron absorption.
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Badenhorst CE, Forsyth AK, Govus AD. A contemporary understanding of iron metabolism in active premenopausal females. Front Sports Act Living 2022; 4:903937. [PMID: 35966107 PMCID: PMC9366739 DOI: 10.3389/fspor.2022.903937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Iron metabolism research in the past decade has identified menstrual blood loss as a key contributor to the prevalence of iron deficiency in premenopausal females. The reproductive hormones estrogen and progesterone influence iron regulation and contribute to variations in iron parameters throughout the menstrual cycle. Despite the high prevalence of iron deficiency in premenopausal females, scant research has investigated female-specific causes and treatments for iron deficiency. In this review, we provide a comprehensive discussion of factors that influence iron status in active premenopausal females, with a focus on the menstrual cycle. We also outline several practical guidelines for monitoring, diagnosing, and treating iron deficiency in premenopausal females. Finally, we highlight several areas for further research to enhance the understanding of iron metabolism in this at-risk population.
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Affiliation(s)
- Claire E. Badenhorst
- School of Sport, Exercise, and Nutrition, College of Health, Massey University, Auckland, New Zealand
- *Correspondence: Claire E. Badenhorst
| | - Adrienne K. Forsyth
- School of Behavioural and Health Science, Australian Catholic University, Fitzroy, VIC, Australia
| | - Andrew D. Govus
- Discipline of Sport and Exercise, Department of Sport, Exercise, and Nutrition Science, La Trobe University, Melbourne, VIC, Australia
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Hayashi N, Ishibashi A, Iwata A, Yatsutani H, Badenhorst C, Goto K. Influence of an energy deficient and low carbohydrate acute dietary manipulation on iron regulation in young females. Physiol Rep 2022; 10:e15351. [PMID: 35785528 PMCID: PMC9251860 DOI: 10.14814/phy2.15351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/10/2022] [Accepted: 05/21/2022] [Indexed: 11/24/2022] Open
Abstract
Hepcidin is a liver‐derived hormone that regulates iron metabolism. Recent studies suggest that an energy‐deficient diet or low carbohydrate (CHO) availability may increase hepcidin in the absence of inflammation. The purpose of the present study was to examine the impact of either an energy‐deficient diet or an ED diet with low CHO intake during three consecutive days on hepcidin responses, hematological variables, and energy metabolism in young Japanese women. Twenty‐two young females were divided into two different groups, either an energy‐deficient with low CHO intake group (ED + LCHO; 2.0 ± 0.3 g/kg/day CHO, 39%CHO, 1123 kcal/day) or an energy deficient with moderate CHO intake group (ED; 3.4 ± 0.3 g/kg/day CHO, 63%CHO, 1162 kcal/day). During the three consecutive days of the dietary intervention program, participants consumed only the prescribed diet and maintained their habitual physical activity levels. Body composition, substrate oxidation, iron metabolism, and inflammation were evaluated pre‐ and post‐intervention. Serum iron and ferritin levels were significantly elevated following the intervention (p < 0.001, p = 0.003, respectively). Plasma interleukin‐6 (IL‐6) levels did not change following the intervention. Serum hepcidin levels significantly increased after the intervention (p = 0.002). Relative change in hepcidin levels was significantly higher in the ED + LCHO (264.3 ± 87.2%) than in the ED group (68.9 ± 22.1%, p = 0.048). Three consecutive days of an energy‐deficient diet increased fasting hepcidin levels. Moreover, elevated hepcidin levels were further augmented when an energy‐deficient diet was combined with a lower CHO intake.
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Affiliation(s)
- Nanako Hayashi
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Aya Ishibashi
- Department of Life Science, The University of Tokyo, Meguro, Tokyo, Japan
| | - Ayame Iwata
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Haruka Yatsutani
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Claire Badenhorst
- School of Sports, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Kazushige Goto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
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Ameka M, Hasty AH. Paying the Iron Price: Liver Iron Homeostasis and Metabolic Disease. Compr Physiol 2022; 12:3641-3663. [PMID: 35766833 PMCID: PMC10155403 DOI: 10.1002/cphy.c210039] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Iron is an essential metal element whose bioavailability is tightly regulated. Under normal conditions, systemic and cellular iron homeostases are synchronized for optimal function, based on the needs of each system. During metabolic dysfunction, this synchrony is lost, and markers of systemic iron homeostasis are no longer coupled to the iron status of key metabolic organs such as the liver and adipose tissue. The effects of dysmetabolic iron overload syndrome in the liver have been tied to hepatic insulin resistance, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. While the existence of a relationship between iron dysregulation and metabolic dysfunction has long been acknowledged, identifying correlative relationships is complicated by the prognostic reliance on systemic measures of iron homeostasis. What is lacking and perhaps more informative is an understanding of how cellular iron homeostasis changes with metabolic dysfunction. This article explores bidirectional relationships between different proteins involved in iron homeostasis and metabolic dysfunction in the liver. © 2022 American Physiological Society. Compr Physiol 12:3641-3663, 2022.
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Affiliation(s)
- Magdalene Ameka
- Department of Molecular Physiology and Biophysics, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Alyssa H Hasty
- Department of Molecular Physiology and Biophysics, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.,VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA
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12
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Methodological Considerations for Investigating Iron Status and Regulation in Exercise and Sport Science Studies. Int J Sport Nutr Exerc Metab 2022; 32:359-370. [PMID: 35365588 DOI: 10.1123/ijsnem.2021-0343] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/10/2022] [Accepted: 03/01/2022] [Indexed: 11/18/2022]
Abstract
Iron deficiency is a common health issue in active and athlete populations. Accordingly, research into iron status, regulation, absorption, and iron deficiency treatment strategies is increasing at a rapid rate. However, despite the increase in the quantity of research, various methodological issues need to be addressed as we progress our knowledge in this area. The purpose of this review is to highlight specific considerations for conducting iron-related research in active and athlete populations. First, we discuss the methodological importance of assessment and interpretation of iron status, with reference to blood collection protocols, participant screening procedures, and biomarker selection. Next, we consider numerous variables that should be accounted for in the design of iron-related research studies, such as the iron regulatory hormone hepcidin and its interaction with exercise, in addition to an examination of female physiology and its impact on iron metabolism. Subsequently, we explore dietary iron and nutrient interactions that impact iron regulation and absorption, with recommendations made for optimal methodological control. Consideration is then given to key features of long-term study designs, such as the monitoring of training load, oral iron supplementation, dietary analysis, and general lifestyle factors. Finally, we conclude our recommendations with an exploration of stable iron isotope tracers as a methodology to measure iron absorption. Ultimately, it is our intention that this review can be used as a guide to improve study design, biomarker analysis, and reporting of findings, to maximize the quality of future research outputs in iron-related research focused on active and athlete populations.
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13
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Commentaries on Viewpoint: Consider iron status when making sex comparisons in human physiology. J Appl Physiol (1985) 2022; 132:703-709. [PMID: 35274549 DOI: 10.1152/japplphysiol.00016.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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14
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Moreillon B, Equey T, Astolfi T, Salamin O, Faiss R. Removal of the influence of plasma volume fluctuations for the athlete biological passport and stability of haematological variables in active women taking oral contraception. Drug Test Anal 2022; 14:1004-1016. [PMID: 34994063 PMCID: PMC9306693 DOI: 10.1002/dta.3218] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 01/06/2023]
Abstract
The haematological module of the athlete biological passport (ABP) monitors longitudinal haematological variations that could be indicative of blood manipulation. This study applied a multi‐parametric model previously validated in elite cyclists to compare inferred and actual PV variations, whereas the potential influence of the oral contraceptive pill (OCP) cycle on the ABP blood biomarkers and plasma volume (PV) in 14 physically active women taking OCPs was also investigated. Blood and serum samples were collected each week for 8 weeks, and the ABP haematological variables were determined according to the World Anti‐Doping Agency guidelines. Transferrin (sTFN), ferritin (FERR), albumin (ALB), calcium (Ca), creatinine (CRE), total protein (TP) and low‐density lipoprotein (LDL) were additionally computed as ‘volume‐sensitive’ variables in a multivariate analysis to determine individual estimations of PV variations. Actual PV variations were indirectly measured using a validated carbon monoxide rebreathing method. We hypothesised ABP markers to be stable during a standard OCP cycle and estimated PV variations similar to measured PV variations. Measured PV variations were in good agreement with the predictions and allowed to explain an atypical passport finding (ATPF). The ABP biomarkers, Hbmass and PV were stable over 8 weeks. Significant differences occurred only between Week 7 and Week 1, with lower levels of haemoglobin concentration ([Hb]), haematocrit (HCT) and red blood cell count (RBC)(−4.4%, p < 0.01; −5.1%, p < 0.01; −5.2%, p < 0.01) and higher levels of PV at week 7 (+9%, p = 0.05). We thus concluded that estimating PV variations may help interpret individual ABP haematological profiles in women.
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Affiliation(s)
- Basile Moreillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | | | - Tiffany Astolfi
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
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15
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Zeitoun T, Dehghan Noudeh N, Garcia-Bailo B, El-Sohemy A. Genetics of Iron Metabolism and Premenstrual Symptoms: A Mendelian Randomization Study. J Nutr 2021; 151:1747-1754. [PMID: 33758941 DOI: 10.1093/jn/nxab048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/16/2021] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many women of reproductive age experience adverse psychological and physiological premenstrual symptoms. These symptoms may last for most of the reproductive years and can negatively affect the quality of life of many women. Some studies have examined the role of micronutrients in premenstrual symptoms, but the research on iron has been limited. OBJECTIVES The objective of this study was to evaluate the effects of genetic predictors of iron overload and low iron status on premenstrual symptoms using Mendelian randomization. METHODS We examined 254 White females aged 20-29 y from the Toronto Nutrigenomics and Health Study. DNA was isolated from peripheral white blood cells and genotyped for the homeostatic regulatory iron gene (HFE; rs1800562 and rs1799945), transmembrane protease serine 6 (TMPRSS6; rs482026), transferrin receptor 2 (TFR2; rs3811647), and transferrin (TF; rs738584) polymorphisms. Risk of iron overload or low iron status was determined based on combined genotypes. Binomial logistic regressions were carried out to examine the association between genetic risk of iron overload or low iron status and the presence of premenstrual symptoms. RESULTS Compared with participants with typical risk of iron overload, those with an elevated risk of iron overload were less likely to experience premenstrual symptoms of confusion (OR: 0.13; 95% CI: 0.02, 1.00), headaches (OR: 0.28; 95% CI: 0.08, 0.98), and nausea (OR: 0.13; 95% CI: 0.02, 0.99) after adjusting for BMI, age, and vitamin C and calcium intake. No associations were seen with the other symptoms. There were also no associations between low iron status genotypes and premenstrual symptoms. CONCLUSIONS This Mendelian randomization study demonstrates that women with an elevated risk of iron overload may have a lower risk of experiencing some premenstrual symptoms (headache, confusion, and nausea), suggesting that iron status could impact the risk of certain premenstrual symptoms.
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Affiliation(s)
- Tara Zeitoun
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Negar Dehghan Noudeh
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bibiana Garcia-Bailo
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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16
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Badenhorst CE, Goto K, O'Brien WJ, Sims S. Iron status in athletic females, a shift in perspective on an old paradigm. J Sports Sci 2021; 39:1565-1575. [PMID: 33583330 DOI: 10.1080/02640414.2021.1885782] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Iron deficiency is a common nutrient deficiency within athletes, with sport scientists and medical professionals recognizing that athletes require regular monitoring of their iron status during intense training periods. Revised considerations for athlete iron screening and monitoring have suggested that males get screened biannually during heavy training periods and females require screening biannually or quarterly, depending on their previous history of iron deficiency. The prevalence of iron deficiency in female athletes is higher than their male counterparts and is often cited as being a result of the presence of a menstrual cycle in the premenopausal years. This review has sought to revise our current understanding of female physiology and the interaction between primary reproductive hormones (oestrogen and progesterone) and iron homoeostasis in females. The review highlights an apparent symbiotic relationship between iron metabolism and the menstrual cycle that requires additional research as well as identifying areas of the menstrual cycle that may be primed for nutritional iron supplementation.
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Affiliation(s)
- Claire E Badenhorst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Kazushige Goto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Wendy J O'Brien
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Stacy Sims
- Te Huataki Waiora - School of Health, the University of Waikato, Hamilton, New Zealand
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17
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Gibson-Smith E, Storey R, Ranchordas M. Dietary Intake, Body Composition and Iron Status in Experienced and Elite Climbers. Front Nutr 2020; 7:122. [PMID: 32850940 PMCID: PMC7419595 DOI: 10.3389/fnut.2020.00122] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/30/2020] [Indexed: 01/01/2023] Open
Abstract
Climbing has developed into a popular recreational and elite sport, evidenced by a growing number of licenced competition athletes, and the acceptance into the Olympic calendar for Tokyo 2020. A nutritional assessment, including the evaluation of anthropometric and biochemical data, has not been previously reported in climbing athletes. Therefore, the aim of this study was to assess the dietary intake, body composition, and iron status in experienced climbers, across a range of performance levels. Forty climbers (n = 20 male, n = 20 female; 8.8 ± 6.6 years' experience; BMI 21.6 ± 1.7) aged 18–46 (30.3 ± 6.7 years) participated in the study. Dietary intake was recorded in a 3-days diet diary. Body composition was assessed using a skinfold profile and iron status via blood markers. Mean energy intake was 2154.6 ± 450 kcal·day−1, with 30% of male climbers and 5% of female climbers failing to meet predicted resting metabolic rate. Furthermore, 77.5% of participants failed to meet a predicted energy requirement to support a “moderate” training programme. There were no significant correlations between daily energy intake and exercise volume. Mean intake of carbohydrate, protein and fat was 3.7 ± 0.9 g·kg−1·day−1, 1.6 ± 0.5 g·kg−1·day−1, and 1.4 ± 0.4 g·kg−1·day−1, respectively, with no significant difference between genders. Approximately 17% of males (n =3) and 45% of females (n = 9) had a sub-optimal iron status. Thirty percent of females met the classification criteria for iron deficiency. Mean serum ferritin was significantly greater in males, compared to females (102.7 ± 54.9 vs. 51.4 ± 24.2 μg·L−1; p ≤ 0.01) and significantly lower in vegan/vegetarians vs. omnivores, in female climbers only (33.2 ± 14.8 vs. 57.5 ± 24 μg·L−1; p = 0.05). No significant differences were observed between climbing ability groups (intermediate-advanced/elite-higher elite) for body composition, dietary intake, or iron status, for males or females. These findings suggest that experienced climbers are at risk of energy restriction and iron deficiency, therefore, routine assessment of nutritional status is warranted. Future research should consider iron status in relation to energy availability and investigate additional factors which may predispose this population to iron deficiency, as well as the risk of relative energy deficiency in sport (RED-S).
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Affiliation(s)
- Edward Gibson-Smith
- Centre for Sport and Exercise Science, College of Health, Wellbeing and Lifestyle, Sheffield Hallam University, Sheffield, United Kingdom
| | - Ryan Storey
- Sport Industry Research Centre, College of Health, Wellbeing and Lifestyle, Sheffield Hallam University, Sheffield, United Kingdom
| | - Mayur Ranchordas
- Academy of Sport and Physical Activity, College of Health, Wellbeing and Lifestyle, Sheffield Hallam University, Sheffield, United Kingdom
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18
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Hepcidin secretion was not directly proportional to intracellular iron-loading in recombinant-TfR1 HepG2 cells: short communication. Mol Cell Biochem 2020; 468:121-128. [PMID: 32185675 PMCID: PMC7145775 DOI: 10.1007/s11010-020-03716-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/06/2020] [Indexed: 02/08/2023]
Abstract
Hepcidin is the master regulator of systemic iron homeostasis and its dysregulation is observed in several chronic liver diseases. Unlike the extracellular iron-sensing mechanisms, the intracellular iron-sensing mechanisms in the hepatocytes that lead to hepcidin induction and secretion are incompletely understood. Here, we aimed to understand the direct role of intracellular iron-loading on hepcidin mRNA and peptide secretion using our previously characterised recombinant HepG2 cells that over-express the cell-surface iron-importer protein transferrin receptor-1. Gene expression of hepcidin (HAMP) was determined by real-time PCR. Intracellular iron levels and secreted hepcidin peptide levels were measured by ferrozine assay and immunoassay, respectively. These measurements were compared in the recombinant and wild-type HepG2 cells under basal conditions at 30 min, 2 h, 4 h and 24 h. Data showed that in the recombinant cells, intracellular iron content was higher than wild-type cells at 30 min (3.1-fold, p < 0.01), 2 h (4.6-fold, p < 0.01), 4 h (4.6-fold, p < 0.01) and 24 h (1.9-fold, p < 0.01). Hepcidin (HAMP) mRNA expression was higher than wild-type cells at 30 min (5.9-fold; p = 0.05) and 24 h (6.1-fold; p < 0.03), but at 4 h, the expression was lower than that in wild-type cells (p < 0.05). However, hepcidin secretion levels in the recombinant cells were similar to those in wild-type cells at all time-points, except at 4 h, when the level was lower than wild-type cells (p < 0.01). High intracellular iron in recombinant HepG2 cells did not proportionally increase hepcidin peptide secretion. This suggests a limited role of elevated intracellular iron in hepcidin secretion.
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19
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Lainé F, Laviolle B, Bardou-Jacquet E, Fatih N, Jezequel C, Collet N, Ropert M, Morcet J, Hamon C, Reymann JM, Loréal O. Curcuma decreases serum hepcidin levels in healthy volunteers: a placebo-controlled, randomized, double-blind, cross-over study. Fundam Clin Pharmacol 2017; 31:567-573. [DOI: 10.1111/fcp.12288] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 01/23/2017] [Accepted: 03/20/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Fabrice Lainé
- Inserm; Centre d'investigation Clinique 1414; CHU Rennes; F-35033 Rennes France
- Inserm; UMR 991; CHU Rennes; F-35033 Rennes France
| | - Bruno Laviolle
- Inserm; Centre d'investigation Clinique 1414; CHU Rennes; F-35033 Rennes France
- Universite de Rennes 1; F-35033 Rennes France
| | - Edouard Bardou-Jacquet
- Inserm; UMR 991; CHU Rennes; F-35033 Rennes France
- Universite de Rennes 1; F-35033 Rennes France
| | - Nadia Fatih
- Inserm; UMR 991; CHU Rennes; F-35033 Rennes France
- Universite de Rennes 1; F-35033 Rennes France
| | - Caroline Jezequel
- Inserm; Centre d'investigation Clinique 1414; CHU Rennes; F-35033 Rennes France
- Universite de Rennes 1; F-35033 Rennes France
| | - Nicolas Collet
- Laboratoire de Biochimie; CHU Rennes; F-35033 Rennes France
| | - Martine Ropert
- Inserm; UMR 991; CHU Rennes; F-35033 Rennes France
- Laboratoire de Biochimie; CHU Rennes; F-35033 Rennes France
| | - Jeff Morcet
- Inserm; Centre d'investigation Clinique 1414; CHU Rennes; F-35033 Rennes France
| | - Catherine Hamon
- Pôle Pharmaceutique; Secteur PCBU/essais cliniques; CHU Rennes; F-35033 Rennes France
| | - Jean-Michel Reymann
- Inserm; Centre d'investigation Clinique 1414; CHU Rennes; F-35033 Rennes France
- Universite de Rennes 1; F-35033 Rennes France
| | - Olivier Loréal
- Inserm; UMR 991; CHU Rennes; F-35033 Rennes France
- Universite de Rennes 1; F-35033 Rennes France
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20
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Iron deficiency or anemia of inflammation? : Differential diagnosis and mechanisms of anemia of inflammation. Wien Med Wochenschr 2016; 166:411-423. [PMID: 27557596 PMCID: PMC5065583 DOI: 10.1007/s10354-016-0505-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 05/30/2016] [Indexed: 02/08/2023]
Abstract
Iron deficiency and immune activation are the two most frequent causes of anemia, both of which are based on disturbances of iron homeostasis. Iron deficiency anemia results from a reduction of the body’s iron content due to blood loss, inadequate dietary iron intake, its malabsorption, or increased iron demand. Immune activation drives a diversion of iron fluxes from the erythropoietic bone marrow, where hemoglobinization takes place, to storage sites, particularly the mononuclear phagocytes system in liver and spleen. This results in iron-limited erythropoiesis and anemia. This review summarizes current diagnostic and pathophysiological concepts of iron deficiency anemia and anemia of inflammation, as well as combined conditions, and provides a brief outlook on novel therapeutic options.
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21
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Angeli A, Lainé F, Lavenu A, Ropert M, Lacut K, Gissot V, Sacher-Huvelin S, Jezequel C, Moignet A, Laviolle B, Comets E. Joint Model of Iron and Hepcidin During the Menstrual Cycle in Healthy Women. AAPS JOURNAL 2016; 18:490-504. [PMID: 26842695 DOI: 10.1208/s12248-016-9875-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
Abstract
Hepcidin regulates serum iron levels, and its dosage is used in differential diagnostic of iron-related pathologies. We used the data collected in the HEPMEN (named after HEPcidin during MENses) study to investigate the joint dynamics of serum hepcidin and iron during the menstrual cycle in healthy women. Ninety menstruating women were recruited after a screening visit. Six fasting blood samples for determination of iron-status variables were taken in the morning throughout the cycle, starting on the second day of the period. Non-linear mixed effect models were used to describe the evolution of iron and hepcidin. Demographic and medical covariates were tested for their effect on model parameters. Parameter estimation was performed using the SAEM algorithm implemented in the Monolix software. A general pattern was observed for both hepcidin and iron, consisting of an initial decrease during menstruation, followed by a rebound and stabilising during the second half of the cycle. We developed a joint model including a menstruation-induced decrease of both molecules at the beginning of the menses and a rebound effect after menses. Iron stimulated the release of hepcidin. Several covariates, including contraception, amount of blood loss and ferritin, were found to influence the parameters. The joint model of iron and hepcidin was able to describe the fluctuations induced by blood loss from menstruation in healthy non-menopausal women and the subsequent regulation. The HEPMEN study showed fluctuations of iron-status variables during the menstrual cycle, which should be considered when using hepcidin measurements for diagnostic purposes in women of child-bearing potential.
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Affiliation(s)
| | - Fabrice Lainé
- INSERM CIC 1414, Rennes, France.,INSERM U991, Rennes, France.,CHU, Rennes, France
| | - Audrey Lavenu
- INSERM CIC 1414, Rennes, France.,University Rennes 1, Rennes, France
| | | | | | | | | | | | - Aline Moignet
- INSERM CIC 1414, Rennes, France.,CHU, Rennes, France
| | - Bruno Laviolle
- INSERM CIC 1414, Rennes, France.,CHU, Rennes, France.,University Rennes 1, Rennes, France
| | - Emmanuelle Comets
- INSERM CIC 1414, Rennes, France. .,University Rennes 1, Rennes, France. .,INSERM IAME UMR 1137, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
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