Serum hepcidin levels and iron metabolism in obese children with and without fatty liver: case–control study

Demircioğlu, Fatih; Görünmez, Gökhan; Dağıstan, Emine; Göksügür, Sevil Bilir; Bekdaş, Mervan; Tosun, Mehmet; Kızıldağ, Betül; Kısmet, Erol

doi:10.1007/s00431-014-2268-8

Cited by 37 publications

(28 citation statements)

References 26 publications

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“…The expression of hepcidin, for example, is also stimulated by adipokines [40, 42]. Hepcidin levels were significantly higher in obese children with NAFLD than in those without NAFLD [43]. According to the present study, therefore, changes in the hepcidin regulation would be possible but should be the focus of future investigations.…”

Section: Discussionmentioning

confidence: 74%

Fat content, fatty acid pattern and iron content in livers of turkeys with hepatic lipidosis

Visscher

Middendorf

Gunther³

et al. 2017

Lipids Health Dis

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BackgroundThe so-called “hepatic lipidosis” in turkeys is an acute progressive disease associated with a high mortality rate in a very short time. Dead animals show a massive fatty degeneration of the liver. The cause is still unclear. Previous findings suggest that there may be parallels to human non-alcoholic fatty liver disease. The object of the study was to examine the changes in the fat contents, the fatty acid composition and the iron content in livers of animals, which have died from hepatic lipidosis.MethodsThe conspicuous livers (n = 85) were collected from 20 flocks where the phenomenon of massive increased animal losses accompanied by marked macroscopically visible pathological liver steatosis suddenly occurred. For comparison and as a reference, livers (n = 16) of two healthy flocks were taken. Healthy and diseased flocks were fed identical diets concerning official nutrient recommendations and were operating under standardized, comparable conventional conditions.ResultsCompared to livers of healthy animals, in the livers of turkeys died from hepatic lipidosis there were found massively increased fat levels (130 ± 33.2 vs. 324 ± 101 g/kg dry matter-DM). In all fatty livers, different fatty acids concentrations were present in significantly increased concentrations compared to controls (palmitic acid: 104 g/kg DM, +345%; palmitoleic acid: 18.0 g/kg DM, + 570%; oleic acid: 115 g/kg DM, +437%). Fatty acids concentrations relevant for liver metabolism and inflammation were significantly reduced (arachidonic acid: 2.92 g/kg DM, −66.6%; eicosapentaenoic acid: 0.141 g/kg DM, −78.3%; docosahexaenoic acid: 0.227 g/kg DM, −90.4%). The ratio of certain fatty acids to one another between control and case livers changed analogously to liver diseases in humans (e.g.: C18:0/C16:0 – 0.913 against 0.311; C16:1n7/C16:0 – 0.090 against 0.165; C18:1/C18:0 – 0.938 against 4.03). The iron content in the liver tissue also increased massively (271 ± 51.5 vs 712 ± 214 mg/kg DM).ConclusionThe hepatic lipidosis has a massive impact on the lipid content, the lipid composition and the iron content in the liver. The character of the metabolic disorder includes parallels to the non-alcoholic steatohepatitis in humans.

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Section: Discussionmentioning

confidence: 74%

Fat content, fatty acid pattern and iron content in livers of turkeys with hepatic lipidosis

Visscher

Middendorf

Gunther³

et al. 2017

Lipids Health Dis

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“…Several human studies have elucidated the role of hepcidin in iron overload and chronic liver disease [21,22], but its effect on NAFLD is controversial. In the study by Auguet et al [11], the plasma levels of hepcidin among women with morbidly obesity were not significantly different between NAFLD patients and those with normal liver; however, Demircioğlu et al [16] reported that among children with obesity, hepcidin levels were significantly higher in NAFLD patients than in controls. In the present study, we found that serum hepcidin levels were not associated with NAFLD risk, but may have augmented the risk effect of central obesity on NAFLD (p = 0.04).…”

Section: Discussion/conclusionmentioning

confidence: 92%

“…Hepcidin is the principal regulator of systemic iron homeostasis, secreted mainly by hepatocytes in response to iron perturbations, inflammation, and hypoxia [15]. However, the role of hepcidin in the pathogenesis of NAFLD is controversial [11,16,17]. The reasons for these inconsistent results are unclear, but may relate to patient selection/study design, or competing factors that may influence serum levels of ferritin and hepcidin.…”

Section: Introductionmentioning

confidence: 99%

Circulating Iron Levels Interaction with Central Obesity on the Risk of Nonalcoholic Fatty Liver Disease: A Case–Control Study in Southeast China

et al. 2019

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Objectives: We aimed to evaluate the associations between body iron stores and the risk of nonalcoholic fatty liver disease (NAFLD) in a Chinese population and explore whether this effect may be modified by other factors. Methods: A 1: 1 frequency-matched case–control study was conducted, including 482 NAFLD cases and 490 gender- and age-matched controls. Serum levels of ferritin, hepcidin, and C-reactive protein were measured. Results: Multivariate logistic regression analysis showed that hepcidin was not associated with NAFLD risk; however, elevated serum ferritin was significantly associated with increased risk of NAFLD (adjusted OR 1.619, 95% CI 1.158–2.267), and hepcidin:ferritin ratio was significantly associated with decreased risk of NAFLD (OR_adjusted 0.702, 95% CI 0.501–0.984). When stratified by gender, a significant association was found between elevated serum ferritin and hepcidin:ferritin ratio and NAFLD only for women (OR_adjusted 2.131, 95% CI 1.151–3.944 and OR_adjusted 0.414, 95% CI 0.219–0.781, respectively). A significant multiplicative interaction between central obesity and elevated serum hepcidin was observed (p < 0.05). Conclusions: Elevated serum ferritin and hepcidin:ferritin ratio are associated with NAFLD in a Chinese population. Although serum hepcidin is not associated with NAFLD, it may augment the risk effect of central obesity on NAFLD.

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“…After applying the inclusion and exclusion criteria, a total of 26 original studies were ultimately included in the meta‐analysis (Fig. ), including 21 cross‐sectional studies and 5 case–control studies ; no cohort studies were include in the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 13,393 overweight and/or obese subjects and 26,621 non‐overweight subjects were included in these 26 studies. Fifteen studies reported serum iron levels , 10 reported TS% , 15 reported serum ferritin and 4 reported sTfR . Fifteen studies evaluated the risk of developing ID among overweight/obese populations , and four studies evaluated the risk of developing IDA .…”

Section: Resultsmentioning

confidence: 99%

Obesity and iron deficiency: a quantitative meta‐analysis

et al. 2015

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Hypoferraemia (i.e. iron deficiency) was initially reported among obese individuals several decades ago; however, whether obesity and iron deficiency are correlated remains unclear. Here, we evaluated the putative association between obesity and iron deficiency by assessing the concentration of haematological iron markers and the risks associated with iron deficiency in both obese (including overweight) subjects and non-overweight participants. We performed a systematic search in the databases PubMed and Embase for relevant research articles published through December 2014. A total of 26 cross-sectional and case-control studies were analysed, comprising 13,393 overweight/obese individuals and 26,621 non-overweight participants. Weighted or standardized mean differences of blood iron markers and odds ratio (OR) of iron deficiency were compared between the overweight/obese participants and the non-overweight participants using a random-effects model. Compared with the non-overweight participants, the overweight/obese participants had lower serum iron concentrations (weighted mean difference [WMD]: -8.37 μg dL(-1) ; 95% confidence interval [CI]: -11.38 to -5.36 μg dL(-1) ) and lower transferrin saturation percentages (WMD: 2.34%, 95% CI: -3.29% to -1.40%). Consistent with this finding, the overweight/obese participants had a significantly increased risk of iron deficiency (OR: 1.31; 95% CI: 1.01-1.68). Moreover, subgroup analyses revealed that the method used to diagnose iron deficiency can have a critical effect on the results of the association test; specifically, we found a significant correlation between iron deficiency and obesity in studies without a ferritin-based diagnosis, but not in studies that used a ferritin-based diagnosis. Based upon these findings, we concluded that obesity is significantly associated with iron deficiency, and we recommend early monitoring and treatment of iron deficiency in overweight and obese individuals. Future longitudinal studies will help to test whether causal relationship exists between obesity and iron deficiency.

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Serum hepcidin levels and iron metabolism in obese children with and without fatty liver: case–control study

Abstract: Hepcidin levels were significantly higher in obese children with NAFLD than those without NAFLD. Obese children with NAFLD should receive attention regarding iron metabolism disorders. Serum hepcidin could be a marker of iron metabolism status and NAFLD in these groups of patients.

Cited by 37 publications

References 26 publications

Fat content, fatty acid pattern and iron content in livers of turkeys with hepatic lipidosis

Fat content, fatty acid pattern and iron content in livers of turkeys with hepatic lipidosis

Circulating Iron Levels Interaction with Central Obesity on the Risk of Nonalcoholic Fatty Liver Disease: A Case–Control Study in Southeast China

Obesity and iron deficiency: a quantitative meta‐analysis

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