The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: A prospective 6-mo iron stable isotope study

Ana C. Cepeda-Lopez, Javier Allende-Labastida, Alida Melse-Boonstra, Saskia J.M. Osendarp, Isabelle Herter-Aeberli, Diego Moretti, Ramiro Rodriguez-Lastra, Francisco Gonzalez-Salazar, Salvador Villalpando, Michael B. Zimmermann

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

© 2016 American Society for Nutrition. Background: Iron deficiency is common in obese subjects. This may be due to an increase in serum hepcidin and a decrease in iron absorption from adiposity-related inflammation. Objective: We evaluated whether weight and fat loss in obese subjects would decrease inflammation and serum hepcidin and thereby improve iron absorption. Design: We performed a 6-mo prospective study in obese [body mass index (in kg/m2) ≥ 35 and < 45] adults who had recently undergone laparoscopic sleeve gastrectomy. At 2 and 8 mo postsurgery, subjects consumed a test drink with 6 mg 57Fe as ferrous sulfate and were intravenously infused with 100 μg 58Fe as iron citrate. We then compared erythrocyte incorporation of iron isotopic labels, changes in body composition, iron status, hepcidin, and inflammation at each time point. Results: Forty-three subjects were studied at baseline, and 38 completed the protocol (32 women and 6 men). After 6 mo, total body fat, interleukin IL-6, and hepcidin were significantly lower (all P < 0.005). In iron-deficient subjects (n = 17), geometric mean (95% CI) iron absorption increased by 28% [from 9.7% (6.5%, 14.6%) to 12.4% (7.7%, 20.1%); P = 0.03], whereas in iron-sufficient subjects (n = 21), absorption did not change [5.9% (4.0%, 8.6%) and 5.6% (3.9%, 8.2%); P = 0.81]. Conclusion: Adiposity-related inflammation is associated with a reduction in the normal upregulation of iron absorption in iron-deficient obese subjects, and this adverse effect may be ameliorated by fat loss. This protocol was approved by the ethics committees of Wageningen University, ETH Zurich, the University of Monterrey, and the Federal Commission for the Protection against Sanitary Risks, and registered at clinicaltrials.gov as NCT01347905.
Original languageEnglish
Pages (from-to)1030-1038
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume194
Issue number4
DOIs
Publication statusPublished - 1 Oct 2016

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Iron Isotopes
Hepcidins
Bariatric Surgery
Iron
Fats
Inflammation
Serum
ferrous sulfate
Adiposity
Interleukin-6
Ethics Committees
Gastrectomy
Body Composition

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Cepeda-Lopez, Ana C. ; Allende-Labastida, Javier ; Melse-Boonstra, Alida ; Osendarp, Saskia J.M. ; Herter-Aeberli, Isabelle ; Moretti, Diego ; Rodriguez-Lastra, Ramiro ; Gonzalez-Salazar, Francisco ; Villalpando, Salvador ; Zimmermann, Michael B. / The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: A prospective 6-mo iron stable isotope study. In: American Journal of Clinical Nutrition. 2016 ; Vol. 194, No. 4. pp. 1030-1038.
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title = "The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: A prospective 6-mo iron stable isotope study",
abstract = "{\circledC} 2016 American Society for Nutrition. Background: Iron deficiency is common in obese subjects. This may be due to an increase in serum hepcidin and a decrease in iron absorption from adiposity-related inflammation. Objective: We evaluated whether weight and fat loss in obese subjects would decrease inflammation and serum hepcidin and thereby improve iron absorption. Design: We performed a 6-mo prospective study in obese [body mass index (in kg/m2) ≥ 35 and < 45] adults who had recently undergone laparoscopic sleeve gastrectomy. At 2 and 8 mo postsurgery, subjects consumed a test drink with 6 mg 57Fe as ferrous sulfate and were intravenously infused with 100 μg 58Fe as iron citrate. We then compared erythrocyte incorporation of iron isotopic labels, changes in body composition, iron status, hepcidin, and inflammation at each time point. Results: Forty-three subjects were studied at baseline, and 38 completed the protocol (32 women and 6 men). After 6 mo, total body fat, interleukin IL-6, and hepcidin were significantly lower (all P < 0.005). In iron-deficient subjects (n = 17), geometric mean (95{\%} CI) iron absorption increased by 28{\%} [from 9.7{\%} (6.5{\%}, 14.6{\%}) to 12.4{\%} (7.7{\%}, 20.1{\%}); P = 0.03], whereas in iron-sufficient subjects (n = 21), absorption did not change [5.9{\%} (4.0{\%}, 8.6{\%}) and 5.6{\%} (3.9{\%}, 8.2{\%}); P = 0.81]. Conclusion: Adiposity-related inflammation is associated with a reduction in the normal upregulation of iron absorption in iron-deficient obese subjects, and this adverse effect may be ameliorated by fat loss. This protocol was approved by the ethics committees of Wageningen University, ETH Zurich, the University of Monterrey, and the Federal Commission for the Protection against Sanitary Risks, and registered at clinicaltrials.gov as NCT01347905.",
author = "Cepeda-Lopez, {Ana C.} and Javier Allende-Labastida and Alida Melse-Boonstra and Osendarp, {Saskia J.M.} and Isabelle Herter-Aeberli and Diego Moretti and Ramiro Rodriguez-Lastra and Francisco Gonzalez-Salazar and Salvador Villalpando and Zimmermann, {Michael B.}",
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Cepeda-Lopez, AC, Allende-Labastida, J, Melse-Boonstra, A, Osendarp, SJM, Herter-Aeberli, I, Moretti, D, Rodriguez-Lastra, R, Gonzalez-Salazar, F, Villalpando, S & Zimmermann, MB 2016, 'The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: A prospective 6-mo iron stable isotope study', American Journal of Clinical Nutrition, vol. 194, no. 4, pp. 1030-1038. https://doi.org/10.3945/ajcn.115.115592

The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: A prospective 6-mo iron stable isotope study. / Cepeda-Lopez, Ana C.; Allende-Labastida, Javier; Melse-Boonstra, Alida; Osendarp, Saskia J.M.; Herter-Aeberli, Isabelle; Moretti, Diego; Rodriguez-Lastra, Ramiro; Gonzalez-Salazar, Francisco; Villalpando, Salvador; Zimmermann, Michael B.

In: American Journal of Clinical Nutrition, Vol. 194, No. 4, 01.10.2016, p. 1030-1038.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The effects of fat loss after bariatric surgery on inflammation, serum hepcidin, and iron absorption: A prospective 6-mo iron stable isotope study

AU - Cepeda-Lopez, Ana C.

AU - Allende-Labastida, Javier

AU - Melse-Boonstra, Alida

AU - Osendarp, Saskia J.M.

AU - Herter-Aeberli, Isabelle

AU - Moretti, Diego

AU - Rodriguez-Lastra, Ramiro

AU - Gonzalez-Salazar, Francisco

AU - Villalpando, Salvador

AU - Zimmermann, Michael B.

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N2 - © 2016 American Society for Nutrition. Background: Iron deficiency is common in obese subjects. This may be due to an increase in serum hepcidin and a decrease in iron absorption from adiposity-related inflammation. Objective: We evaluated whether weight and fat loss in obese subjects would decrease inflammation and serum hepcidin and thereby improve iron absorption. Design: We performed a 6-mo prospective study in obese [body mass index (in kg/m2) ≥ 35 and < 45] adults who had recently undergone laparoscopic sleeve gastrectomy. At 2 and 8 mo postsurgery, subjects consumed a test drink with 6 mg 57Fe as ferrous sulfate and were intravenously infused with 100 μg 58Fe as iron citrate. We then compared erythrocyte incorporation of iron isotopic labels, changes in body composition, iron status, hepcidin, and inflammation at each time point. Results: Forty-three subjects were studied at baseline, and 38 completed the protocol (32 women and 6 men). After 6 mo, total body fat, interleukin IL-6, and hepcidin were significantly lower (all P < 0.005). In iron-deficient subjects (n = 17), geometric mean (95% CI) iron absorption increased by 28% [from 9.7% (6.5%, 14.6%) to 12.4% (7.7%, 20.1%); P = 0.03], whereas in iron-sufficient subjects (n = 21), absorption did not change [5.9% (4.0%, 8.6%) and 5.6% (3.9%, 8.2%); P = 0.81]. Conclusion: Adiposity-related inflammation is associated with a reduction in the normal upregulation of iron absorption in iron-deficient obese subjects, and this adverse effect may be ameliorated by fat loss. This protocol was approved by the ethics committees of Wageningen University, ETH Zurich, the University of Monterrey, and the Federal Commission for the Protection against Sanitary Risks, and registered at clinicaltrials.gov as NCT01347905.

AB - © 2016 American Society for Nutrition. Background: Iron deficiency is common in obese subjects. This may be due to an increase in serum hepcidin and a decrease in iron absorption from adiposity-related inflammation. Objective: We evaluated whether weight and fat loss in obese subjects would decrease inflammation and serum hepcidin and thereby improve iron absorption. Design: We performed a 6-mo prospective study in obese [body mass index (in kg/m2) ≥ 35 and < 45] adults who had recently undergone laparoscopic sleeve gastrectomy. At 2 and 8 mo postsurgery, subjects consumed a test drink with 6 mg 57Fe as ferrous sulfate and were intravenously infused with 100 μg 58Fe as iron citrate. We then compared erythrocyte incorporation of iron isotopic labels, changes in body composition, iron status, hepcidin, and inflammation at each time point. Results: Forty-three subjects were studied at baseline, and 38 completed the protocol (32 women and 6 men). After 6 mo, total body fat, interleukin IL-6, and hepcidin were significantly lower (all P < 0.005). In iron-deficient subjects (n = 17), geometric mean (95% CI) iron absorption increased by 28% [from 9.7% (6.5%, 14.6%) to 12.4% (7.7%, 20.1%); P = 0.03], whereas in iron-sufficient subjects (n = 21), absorption did not change [5.9% (4.0%, 8.6%) and 5.6% (3.9%, 8.2%); P = 0.81]. Conclusion: Adiposity-related inflammation is associated with a reduction in the normal upregulation of iron absorption in iron-deficient obese subjects, and this adverse effect may be ameliorated by fat loss. This protocol was approved by the ethics committees of Wageningen University, ETH Zurich, the University of Monterrey, and the Federal Commission for the Protection against Sanitary Risks, and registered at clinicaltrials.gov as NCT01347905.

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JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

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