Evaluation of serum hepcidin and its relationship to iron homeostasis in obese anemic patients

Abstract

Context Obesity is an increasingly recognized medical problem in both high-income and low-income countries owing to poor dietary habits and physical inactivity. This is frequently associated with dysregulated iron homeostasis. Iron deficiency in obese patients might be attributable to imbalanced diet or increased bodily demands. However, a role of enhanced hepcidin expression as a result of proinflammatory milieu in this setting has been contemplated in the recent years. Objectives First, we aimed at the measurement of serum hepcidin levels in obese anemic individuals. Second, we aimed at the assessment of the presence or absence of a relationship between its levels and deranged iron homeostatic profile. Patients and methods A total of 90 adult participants have been enrolled from the Clinical Hematology and Oncology Unit, Internal Medicine Department, Center ‘X,’ City ‘Z.’ Country ‘Y’. They have been divided into group I: 30 obese anemic patients, group II: 30 obese nonanemic patients, and group III: 30 healthy age-matched and sex-matched controls. Serum hepcidin levels were assayed using hepcidin ELISA kits. Results Group I enjoyed much higher serum hepcidin values as compared with either group II or III. Hepcidin level was associated with significantly lower mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, serum iron, and serum ferritin levels. However, it was remarkably associated with higher BMI, red cell distribution width, erythrocyte sedimentation rate, and high-sensitivity C-reactive protein levels. Conclusion There is a low state of chronic inflammation in obese anemic individuals associated with higher serum hepcidin levels. This results into repressed iron absorption and release by the liver and phagocytic system, contributing largely to obesity-associated iron deficiency.