Greater blood volume and Hb mass in obese women quantified by the carbon monoxide-rebreathing method affects interpretation of iron biomarkers and iron requirements

被引:32
作者
Cepeda-Lopez, Ana C. [1 ,2 ]
Zimmermann, Michael B. [3 ]
Wussler, Sophia [3 ]
Melse-Boonstra, Alida [1 ]
Naef, Nicole [4 ]
Mueller, Sandro Manuel [5 ,6 ]
Toigo, Marco [6 ,7 ]
Herter-Aeberli, Isabelle [3 ]
机构
[1] Wageningen Univ, Div Human Nutr, Wageningen, Netherlands
[2] Univ Monterrey UDEM, Hlth Sci Div, Monterrey, Mexico
[3] Swiss Fed Inst Technol, Lab Human Nutr, Zurich, Switzerland
[4] Univ Hosp Balgrist, Balgrist Move Med, Zurich, Switzerland
[5] Univ Hosp Zurich, Dept Neurol, Zurich, Switzerland
[6] Swiss Fed Inst Technol, Inst Human Movement Sci, Zurich, Switzerland
[7] Univ Hosp Balgrist, Lab Muscle Plast, Zurich, Switzerland
关键词
TOTAL HEMOGLOBIN MASS; RED-CELL; PLASMA HEMODILUTION; PHYSICAL-ACTIVITY; UNITED-STATES; DEFICIENCY; CHILDREN; INFLAMMATION; OVERWEIGHT; MEN;
D O I
10.1038/s41366-018-0127-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/objective Iron deficiency (ID) is common in overweight and obese individuals (OW/OB) but the mechanism is uncertain. Greater blood volume (BV) in OW/OB may increase hemoglobin (Hb) mass and iron requirements, and confound iron biomarkers by hemodilution. Quantification of BV/PV changes in OW/OB is challenging and a formula to estimate BV/PV based on anthropometric indices would be valuable. In normal weight (NW) and OW/OB women, we aimed at: (1) measure BV and assess whether differences in BV affect concentrations and total circulating mass of Hb and iron biomarkers; (2) develop an algorithm describing BV in OW/OB. Subjects/methods In a cross-sectional study, we measured BV in NW, OW, and OB non-anemic women (n = 62) by using the carbon monoxide-rebreathing method, body composition by dual energy X-ray absorptiometry, and iron and inflammatory status. Results OW and OB women had 11 and 16% higher mean BV and PV compared to NW (P < 0.05), respectively. In OW/OB compared to NW, total circulating masses of IL-6, hepcidin, Hb, and sTfR were higher, while total mass of serum iron was lower (for all, P < 0.05). An equation including height, body mass and lean mass to estimate BV in all BMI groups (R-2 = 0.76). Conclusion An equation based on anthropometric indices provides a good estimate of increased BV in OW/OB women. In OW/OB women, there is an increase in Hb mass that likely increases iron requirements for erythropoiesis and circulating TfR mass. At the same time, higher hepcidin concentrations may lower serum iron mass. Both these mechanisms may increase risk for ID in OW/OB women.
引用
收藏
页码:999 / 1008
页数:10
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