Iron Deficiency and Obesity – Are we Diagnosing with Appropriate Indicators?

Abstract

Introduction: We aim to define the iron deficiency prevalence and eventual differences between obese patients with and without metabolic syndrome. Material and Methods: Analysis of patients evaluated at multidisciplinary consultation of obesity in our institution between 2013 and 2015 (n = 260). Iron deficiency: ferritin levels < 15 ng/mL. Exclusion criteria: prior bariatric surgery; lack of ferritin or hemoglobin determinations. Results: We analyzed data from 215 patients (84.2% female) with a mean age of 42.0 ± 10.3 years. The median body mass index was 42.5 (40.0 -46.8) kg/m 2 and 52.1% had metabolic syndrome. Iron deficiency was present in 7.0%, with no differences between genders or between patients with or without metabolic syndrome. Hypertension was associated with lower prevalence of iron deficiency. Type 2 diabetes and hypertension patients had higher levels of ferritin. The multivariate analysis showed that metabolic syndrome and increasing body mass index were predictive of higher risk of iron deficiency while hypertension predicted lower odds of iron deficiency. Discussion: The prevalence of iron deficiency was similar in other published studies. Iron deficiency may be underdiagnosed if based only on ferritin concentrations. In our study, diabetes and hypertension appear to contribute to the increase in ferritin levels described in obesity. Conclusion: Ferritin may not be a reliable index for evaluating iron stores in obese patients, particularly when associated with comorbidities such as type 2 diabetes and hypertension. Further studies are needed to guide the diagnosis and iron supplementation in these patients.

Anthropometric Markers and Iron Status of 6–12-Year-Old Thai Children: Associations and Predictors

“…No correlation between ID and obesity was found in eight studies which used a ferritin-based diagnosis (OR: 1.04, 95% CI: 0.69-1.56), whereas using nonferritin-based diagnosis, overweight and obese children were at 49% more risk of ID (OR: 1.49, 95% CI: 1.19, 1.85) [6]. ese findings are consistent with previous studies in adults which showed that ferritin-based diagnosis may have limitations for the diagnosis of ID in obese patients [33,34]. Similarly, in our study, which defined ID by using multiple markers including SF, we did not find any correlation between ID and overweight/ obesity.…”

Can Serum Iron Concentrations in Early Healthy Pregnancy Be Risk Marker of Pregnancy-Induced Hypertension?

“…In the literature, obesity increases the risk of pregnancy-induced hypertension [9,32]. Obesity and smoking reduce iron concentrations [20,21].…”

“…Clinical risk factors of pregnancy-induced hypertension [9,11] and influencing factors related to the concentration of iron [20,21] have been identified based on literature data.…”

The hematologic consequences of obesity

“…Additional studies in non‐pregnant adults (or a mean age ≥18), not included in either Zhao et al (2015) or Cheng et al (2012), have conflicting results. Some studies suggest an association between obesity and ID, 71,74‐78 while multiple others note no difference 79‐82 …”

“…Additional studies in non-pregnant adults (or a mean age ≥18), not included in either Zhao et al (2015) or Cheng et al (2012), have conflicting results. Some studies suggest an association between obesity and ID, 71,[74][75][76][77][78] while multiple others note no difference. [79][80][81][82] Given the literature, a relationship between obesity and ID likely exists in children and adolescents but remains unclear in adults.…”