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Guzel ER, Sarkaya NC, Kurtoglu AU, Karakus V, Kurtoglu E. Roles of ghrelin, hepcidin and HIF-2α in iron metabolism in iron deficiency anemia. Ir J Med Sci 2024; 193:1911-1916. [PMID: 38492151 DOI: 10.1007/s11845-024-03655-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES This study investigates the roles of HIF-2α, hepcidin, and ghrelin in iron deficiency anemia (IDA), the most widespread nutritional disorder globally. MATERIAL AND METHODS Fifty IDA patients (18-50 years, BMI 19-25) and 40 healthy volunteers were studied. Hemoglobin, ferritin, hepcidin, HIF-2α, and ghrelin levels were analyzed. RESULTS IDA patients showed lower hemoglobin, ferritin, hepcidin, and ghrelin levels than the control group, but HIF-2α levels were similar. Positive correlations were observed in both groups between hepcidin and HIF-2α (p < 0.001), hepcidin and ghrelin (p < 0.001), and HIF-2α and ghrelin (p < 0.001). Hemoglobin was correlated positively with HIF-2α, and ferritin was correlated positively with HIF-2α in the patient group. CONCLUSION The study suggests that the low hepcidin levels in IDA patients enhance iron absorption. The lack of significant HIF-2α level differences may be due to the absence of chronic hypoxia in current hemoglobin levels of IDA patients. Moreover, the low ghrelin levels in patients and the correlations between ghrelin, hepcidin, and HIF-2α in both groups indicate their involvement in iron metabolism.
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Affiliation(s)
- Esra Rizaogullari Guzel
- Antalya Training and Research Hospital, Internal Medicine Clinic, Antalya Eğitim ve Araştırma Hastanesi, Varlık Mh. Kazım Karabekir Cd. 07100, Antalya, Turkey.
| | | | | | - Volkan Karakus
- Antalya Training and Research Hospital, Hematology Clinic, Antalya, Turkey
| | - Erdal Kurtoglu
- Antalya Training and Research Hospital, Hematology Clinic, Antalya, Turkey
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Lueschow-Guijosa SR, Michels KR, Latta DE, Bermick JR. A Large Proportion of the Neonatal Iron Pool Is Acquired from the Gestational Diet in a Murine Model. J Nutr 2024; 154:2065-2075. [PMID: 38797484 PMCID: PMC11282491 DOI: 10.1016/j.tjnut.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/26/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Iron is crucial for growth and development, but excess iron is harmful. Neonatal mice have elevated concentrations of circulating iron, but the source of this iron is unclear. This lack of understanding makes it difficult to optimize early life iron balance. OBJECTIVES Identify the origins of neonatal tissue-specific iron pools using dietary manipulation and cross-fostering murine models. METHODS To determine whether tissue-specific neonatal iron was primarily acquired during gestation or after birth, pups born to iron-sufficient or iron-deficient dams were cross-fostered, and tissues were harvested at postnatal days 3-5 to measure iron content. A separate set of female mice were fed a diet enriched with the stable iron isotope 57 (57Fe) for 4 generations to replace naturally abundant liver iron isotope 56 (56Fe) stores with 57Fe. To quantify the proportions of neonatal iron acquired during gestation, pups born to dams with 56Fe or 57Fe stores were cross-fostered, and tissues were harvested at postnatal day 3-5 to determine 56Fe:57Fe ratios by inductively coupled plasma mass spectrometry. Finally, to quantify the proportion of neonatal iron acquired from the maternal diet, female mice with 56Fe or 57Fe stores switched diets upon mating, and pup tissues were harvested on P0 to determine 56Fe:57Fe ratios by inductively coupled plasma mass spectrometry. RESULTS Perinatal iron deficiency resulted in smaller pups, and gestational iron deficiency resulted in lower neonatal serum and liver iron. Cross-fostering between dams with 56Fe and 57Fe stores demonstrated that ≤70% of neonatal serum, liver, and brain iron were acquired during gestation. Dietary manipulation experiments using dams with 56Fe and 57Fe stores showed that over half of neonatal serum, liver, and brain iron were from the dam's gestational diet rather than preconception iron stores. CONCLUSIONS This study provides quantitative values for the sources of neonatal iron, which may inform approaches to optimize neonatal iron status.
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Affiliation(s)
- Shiloh R Lueschow-Guijosa
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, United States; Iowa Inflammation Program, University of Iowa, Iowa City, IA, United States
| | | | - Drew E Latta
- Department of Civil and Environmental Engineering, University of Iowa, Iowa City, IA, United States
| | - Jennifer R Bermick
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, United States; Iowa Inflammation Program, University of Iowa, Iowa City, IA, United States.
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Chen M, Chen Y, Li C. Serum iron concentration and leptin inversely relate, partially mediated by body mass index in American adults. Nutr Res 2024; 124:1-12. [PMID: 38342069 DOI: 10.1016/j.nutres.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 02/13/2024]
Abstract
Iron metabolism and leptin are interconnected, and both link with obesity. In this cross-sectional study, we hypothesized that serum iron markers associate with leptin, with body mass index (BMI) acting as a mediator, confounder, and effect modifier in this relationship. We analyzed data from the National Health and Nutrition Examination Survey III, with a focus on serum iron markers and leptin. The relationship between serum iron markers and leptin was determined by multiple linear regression. The bootstrap method was used to investigate the mediating effect of BMI on this association. Among 3888 American adults, serum iron and transferrin saturation showed a negative association with leptin (log2-transformed) (β: -0.010, 95% confidence interval [CI], -0.013 to -0.006, P < .001; β: -0.006, 95% CI, -0.008 to -0.004, P < .001). Total iron-binding capacity was positively associated with the serum concentration of leptin (log2-transformed) (β: 0.002, 95% CI, 0-0.004, P = .0292). Sex, BMI, and body fat percentage significantly influenced these associations. Notably, the association between the iron markers and leptin diminished in individuals with a BMI ≥30 kg/m2. There was no observable relationship between leptin and serum ferritin concentrations. BMI mediated 4.81% of the serum iron-leptin association, with no mediation of body fat percentage. Our study identified a link between serum iron and leptin, with BMI as a mediating factor. In clinical settings, it is vital to understand how treatments targeting iron metabolism can directly impact serum leptin concentration and the subsequent physiological changes.
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Affiliation(s)
- Mi Chen
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China; Department of Physical Medicine and Rehabilitation, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China
| | - Yuebai Chen
- Faculty of Science, McGill University, Montreal, Quebec, Canada
| | - Chao Li
- Department of Respiration, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
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Babić Leko M, Gunjača I, Pleić N, Zemunik T. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. Int J Mol Sci 2021; 22:6521. [PMID: 34204586 PMCID: PMC8234807 DOI: 10.3390/ijms22126521] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene-environment interactions underlying the pathology of thyroid diseases.
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Affiliation(s)
| | | | | | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (M.B.L.); (I.G.); (N.P.)
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Luo Q, Hu J, Yang G, Yuan X, Chen Z, Wang D, Lu Y, Zhu L, Wang G. Fasting Increases Iron Export by Modulating Ferroportin 1 Expression Through the Ghrelin/GHSR1α/MAPK Pathway in the Liver. Biol Trace Elem Res 2021; 199:267-277. [PMID: 32215811 DOI: 10.1007/s12011-020-02114-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/08/2020] [Indexed: 11/29/2022]
Abstract
The liver is contributed to maintaining body iron homeostasis and controlling of body adaptation to fasting. Although previous studies implied a negative relationship between iron and ghrelin in both mice and humans, it remains to be explored whether fasting or ghrelin has a functional effect on iron homeostasis in the liver. In this study, we examined the roles of fasting and ghrelin in modulating the protein expression of Fpn1, transferrin receptor 1 (TfR1), and ferritin light chain (Ft-L), as well as the mRNA expression of ghrelin, hepcidin, ghrelin O-acyltransferase (GOAT), and growth hormone secretagogue receptor 1 alpha (GHSR1α) in mouse liver and cultured hepatocytes. Our in vivo results suggested that fasting significantly upregulated the mRNA expression of ghrelin, GOAT, and GHSR1α, as well as the protein levels of ghrelin, Fpn1, and Ft-L, but not TfR1, in mouse liver. Interestingly, mRNA expression of hepcidin did not change significantly after fasting. Meanwhile, in cultured hepatocytes, ghrelin significantly increased the protein expression of Fpn1 but not Ft-L and TfR1 and significantly enhanced ERK phosphorylation. Furthermore, the pretreatment of cultured hepatocytes with either a pERK inhibitor or a GHSR1α antagonist abolished the effects of ghrelin on Fpn1 expression and ERK phosphorylation. Our findings confirmed that fasting increases iron export in the liver by upregulating Fpn1 expression through the ghrelin/GHSR1α/MAPK signaling pathway.
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Affiliation(s)
- Qianqian Luo
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China
| | - Jianan Hu
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China
| | - Guang Yang
- Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, Hubei, China
| | - Xiaoyu Yuan
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China
| | - Zhongping Chen
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China
| | - Dan Wang
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China
| | - Yapeng Lu
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China
| | - Li Zhu
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China.
| | - Guohua Wang
- Department of Physiology and Hypoxic Biomedicine, Institute of Special Environmental Medicine and Co-innovation Center of Neuroregeneration, Nantong University, 9 Seyuan Road, Chongchuan District, Nantong, 226019, Jiangsu, China.
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Zhao Q, Zhang M, Ji B, Chu Y, Pan H, Yan W, Ban B. Relationship between hemoglobin and insulin-like growth factor-1 in children and adolescents with idiopathic short stature. BMC Endocr Disord 2020; 20:119. [PMID: 32746834 PMCID: PMC7397650 DOI: 10.1186/s12902-020-00600-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/22/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis is critical for the regulation of children's growth and development. Serum IGF-1 concentrations are usually low in individuals with idiopathic short stature (ISS) despite normal endogenous GH levels, and the associated underlying factors are unknown. This study aimed to explore the relationship between IGF-1 and hemoglobin (Hb) in children with ISS. METHODS A cross-sectional analysis was performed including 178 children and adolescents with ISS who were enrolled from March 2013 to February 2019. The related clinical and biochemical parameters were evaluated for each patient. Univariate analysis, smooth curve fitting and multivariate piecewise linear regression were performed. RESULT The mean levels of IGF-1 standard deviation scores (SDS) and Hb were - 0.99 (- 1.60 - -0.09) and 131.81 ± 9.36 g/L, respectively. Univariate analysis displayed a significant positive association between Hb and IGF-1 SDS (P < 0.001). After adjusting for potential confounding factors, the positive relationship between Hb and IGF-1 SDS remained (P = 0.001). Furthermore, there was an inflection point for Hb in the curve. In a multivariate piecewise linear regression model, IGF-1 SDS was significantly positively associated with Hb when Hb concentrations were lower than 145 g/L (B 0.05; 95% CI 0.02, 0.07; P < 0.001). However, IGF-1 SDS decreased with increasing Hb levels when Hb concentrations were greater than 145 g/L (B -0.15; 95% CI -0.23, - 0.06; P = 0.001). CONCLUSION This study demonstrated that Hb is associated with IGF-1 in Chinese children and adolescents with ISS. The levels of IGF-1 increased with the elevation of Hb, but when the concentration of Hb exceeded a certain range, with the increase of Hb, IGF-1 decreased instead.
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Affiliation(s)
- Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
| | - Baolan Ji
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
| | - Yuntian Chu
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P.R. China
| | - Hui Pan
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, P.R. China
| | - Wenhua Yan
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China.
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China.
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China.
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China.
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Goldstein ER, Fukuda DH. Connecting Energy Availability and Iron Deficiency with Bone Health: Implications for the Female Athlete. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Irritability and Perceived Expressed Emotion in Adolescents With Iron Deficiency and Iron Deficiency Anemia: A Case-Control Study. J Pediatr Hematol Oncol 2020; 42:403-409. [PMID: 31725544 DOI: 10.1097/mph.0000000000001663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to assess the difference in irritability and perceived expressed emotion (EE) between adolescents with iron deficiency (ID) or iron deficiency anemia (IDA) and their healthy peers. In addition, we aimed to investigate the relationship between hemogram parameters, irritability, and perceived EE in adolescents with ID and IDA. The sample of this single-center cross-sectional case-control study consisted of 89 adolescents from 12 to 17 years of age. Of the participants, 19 had been diagnosed with ID, 31 had IDA, and 39 were healthy controls. Significant differences in the self-reported and parent-reported irritability scores were observed between the ID group and the control group and between the IDA group and the control group. There was also a significant difference in the subscale of irritability between the ID group and the control group. The difference between the IDA and control groups in the intrusiveness subscale was found to be significant as well. Adolescents with IDA and ID exhibited significantly perceived irritability compared with the control group. In terms of irritability, adolescents with IDA and ID revealed greater irritability than their healthy peers. The results of this study suggest that irritability and perceived EE should be investigated in cases of ID, whether with or without anemia. As chronic diseases may benefit substantially from psychiatric consultation, psychosocial evaluation and intervention should be considered a complementary treatment option in the management of ID and IDA.
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Ghrayeb H, Elias M, Nashashibi J, Youssef A, Manal M, Mahagna L, Refaat M, Schwartz N, Elias A. Appetite and ghrelin levels in iron deficiency anemia and the effect of parenteral iron therapy: A longitudinal study. PLoS One 2020; 15:e0234209. [PMID: 32497136 PMCID: PMC7272047 DOI: 10.1371/journal.pone.0234209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/20/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is associated with decreased appetite. The ghrelin hormone is one of the major regulators of appetite. OBJECTIVES To evaluate appetite and ghrelin levels in patients with IDA, and to investigate the change in appetite and ghrelin following intravenous iron therapy. METHODS A total of 56 IDA patients and 51 controls were included in the study. Both appetite and ghrelin were assessed at baseline and following intravenous iron therapy. These were assessed at corresponding time intervals in the control group. Appetite was assessed by the SNAQ score (Simplified Nutritional Appetite Questionnaire) and fasting ghrelin levels were assessed by acylated ghrelin (AG), unacylated ghrelin (UAG) and their respective ratio AG/UAG. RESULTS IDA patients had significantly lower SNAQ scores, yet higher AG levels and higher AG/UAG ratios compared to healthy controls; the mean SNAQ scores were 12.56 ± 3.45 and 16.1 ± 2, respectively (P<0.01); the median AG levels were 57.5 pg/ml and 43 pg/ml respectively (P = 0.007); and the median AG/UAG ratios were 0.48 and 0.25 respectively (P = 0.04). On multivariate linear regression analysis, IDA remained independently associated with decreased SNAQ score (β = -0.524, P<0.001) and increased acylated ghrelin (β = 0.289, P = 0.013). After IDA was treated, SNAQ scores increased significantly by a mean of 2 points. AG and AG/UAG ratios decreased significantly by a mean of -18.44 pg/ml and -0.2 respectively. The control group showed no significant change in SNAQ scores or ghrelin at corresponding time intervals. CONCLUSIONS IDA patients have a reduced appetite and paradoxically elevated ghrelin hormone activity compared to healthy controls. Treating IDA enhances appetite and lowers ghrelin levels. Future studies are needed to explore the mechanism of this paradoxical ghrelin activity.
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Affiliation(s)
- Hanin Ghrayeb
- Department of Internal Medicine C, Emek Medical Center, Afula, Israel
- Rapaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Mazen Elias
- Department of Internal Medicine C, Emek Medical Center, Afula, Israel
- Rapaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Jeries Nashashibi
- Department of Internal Medicine D, Rambam Health Care Campus, Haifa, Israel
| | - Awni Youssef
- Bar-Ilan University Faculty of Medicine, Azrieli Faculty of medicine, Safed, Israel
| | - Mari Manal
- Nazareth Tower Out Patients Clinic Ambulatory, Clalit, Nazareth, Israel
| | - Liala Mahagna
- Endocrine laboratory, HaEmek Medical Center, Afula, Israel
| | - Masalha Refaat
- Endocrine laboratory, HaEmek Medical Center, Afula, Israel
| | - Naama Schwartz
- Clinical Research Unit, HaEmek Medical Center, Afula, Israel
| | - Adi Elias
- Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel
- * E-mail:
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10
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The effect of iron replacement therapy on appetite in children with iron deficiency anemia. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/jcm.559567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kucuk N, Orbak Z, Karakelloglu C, Akcay F. The effect of therapy on plasma ghrelin and leptin levels, and appetite in children with iron deficiency anemia. J Pediatr Endocrinol Metab 2019; 32:275-280. [PMID: 30796846 DOI: 10.1515/jpem-2018-0352] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/01/2019] [Indexed: 12/13/2022]
Abstract
Background It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite, growth and plasma ghrelin and leptin levels in children aged between 12 and 24 months with isolated nutritional iron deficiency anemia. Methods Iron deficiency anemia was diagnosed by clinic and laboratory findings. All 19 cases were given 5 mg/kg/day iron therapy for 3 months. Results The mean plasma ghrelin level was 936.7±428.8 pg/mL before therapy and it increased to 1284.7±533.3 pg/mL (p<0.001) while the mean plasma leptin level decreased from 3.4±1.6 ng/mL to 1.9±1.0 ng/mL (p<0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p<0.001). Δ body weight was correlated with plasma ghrelin levels before and after therapy significantly. Conclusions In conclusion, the findings of this study indicate that plasma ghrelin level increases and leptin level decreases and growth accelerates because of an increase in appetite and daily calories, carbohydrate and protein amount in children with nutritional iron deficiency anemia after iron therapy. The increase in appetite and acceleration on growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels. The most important finding of this study is significantly increased plasma ghrelin levels after iron therapy, and this finding might be related to both the improved appetite and catch-up growth.
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Affiliation(s)
- Nuran Kucuk
- Faculty of Medicine, Department of Pediatrics, Atatürk University, Erzurum, Turkey
| | - Zerrin Orbak
- Faculty of Medicine, Department of Pediatrics, Atatürk University, Erzurum, Turkey
| | - Cahit Karakelloglu
- Faculty of Medicine, Department of Pediatrics, Atatürk University, Erzurum, Turkey
| | - Fatih Akcay
- Faculty of Medicine, Department of Biochemistry, Atatürk University, Erzurum, Turkey
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Handayani S, Purwanto B, Saputra K, Tamtomo DG. Laserpuncture Increases Serum Concentration of Insulin-Like Growth Factor-1 in Adolescent Rats. Med Acupunct 2018; 30:319-325. [PMID: 30671152 DOI: 10.1089/acu.2018.1279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: Previous studies have demonstrated that laserpuncture has a positive effect on longitudinal bone growth within varying parameters. The current authors hypothesized that laserpuncture affects serum concentration of insulinlike growth factor 1 (IGF-1), a growth factor that influences growth plates, and ghrelin, a growth hormone (GH) secretagogue. The goal of this research was to investigate if laserpuncture could increase serum concentrations of IGF-1 and ghrelin in adolescent rats. Materials and Methods: This was an experimental study with a post-test only and a controlled group design. The study was performed in a laboratory on 40 male Wistar rats, age ±3 weeks and weighing >40 g. The rats were divided randomly into 2 groups, A and B, each receiving laserpuncture for 10 days and 15 days, respectively. There were 4 subgroups in each group: control (C); GV 20; ST 36; and GV 20 + ST 36. The rats were stimulated by laserpuncture with a KX Laser GX-2000B (Kangxing), a semiconductor-based low-level laser therapy (LLLT) device emitting a cold red laser (635-680 nm/5 mW) for 60 seconds (0.3 J/cm2) The length of each rat's lower limb was measured using a caliper; IGF-1 and ghrelin concentrations were assessed using enzyme-linked immunosorbent assays. Results: A marked increase in IGF-1 concentration was observed in the ST 36 and GV 20 + ST 36 subgroups after 15 days, compared to the C subgroup (P = 0.001 and P = 0.002, respectively). The GV 20 subgroup had a lower IGF-1 concentration than the C subgroup (P = 0.06) at both 10 and 15 days. Laserpuncture did not influence ghrelin concentrations significantly, compared to the C subgroups. Conclusions: Laserpuncture administered to both the ST 36 and GV 20 + ST 36 subgroups with a power density of 0.3 J/cm2 increased serum concentrations of IGF-1 in adolescent rats.
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Affiliation(s)
- Selfi Handayani
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.,Doctoral Program in Medical Sciences, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Bambang Purwanto
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.,Department of Internal Medicine, Dr. Muwardi Hospital, Surakarta, Central Java, Indonesia
| | - Koosnadi Saputra
- Acupuncture Research Laboratory for Health Services, National Institute of Health of the Republic of Indonesia, Surabaya, Jawatimur, Indonesia.,Surabaya Acupuncture Academy, Surabaya, Jawatimur, Indonesia
| | - Didik G Tamtomo
- Department of Anatomy Faculty of Medicine Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
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13
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Petkus DL, Murray-Kolb LE, De Souza MJ. The Unexplored Crossroads of the Female Athlete Triad and Iron Deficiency: A Narrative Review. Sports Med 2018; 47:1721-1737. [PMID: 28290159 DOI: 10.1007/s40279-017-0706-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite the severity and prevalence of iron deficiency in exercising women, few published reports have explored how iron deficiency interacts with another prevalent and severe condition in exercising women: the 'female athlete triad.' This review aims to describe how iron deficiency may interact with each component of the female athlete triad, that is, energy status, reproductive function, and bone health. The effects of iron deficiency on energy status are discussed in regards to thyroid function, metabolic fuel availability, eating behaviors, and energy expenditure. The interactions between iron deficiency and reproductive function are explored by discussing the potentially impaired fertility and hyperprolactinemia due to iron deficiency and the alterations in iron metabolism due to menstrual blood loss and estrogen exposure. The interaction of iron deficiency with bone health may occur via dysregulation of the growth hormone/insulin-like growth factor-1 axis, hypoxia, and hypothyroidism. Based on these discussions, several future directions for research are presented.
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Affiliation(s)
- Dylan L Petkus
- Department of Kinesiology, The Pennsylvania State University, 104 Noll Laboratory, University Park, PA, 16802, USA
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Mary Jane De Souza
- Department of Kinesiology, The Pennsylvania State University, 104 Noll Laboratory, University Park, PA, 16802, USA.
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Luo QQ, Zhou G, Huang SN, Mu MD, Chen YJ, Qian ZM. Ghrelin is Negatively Correlated with Iron in the Serum in Human and Mice. ANNALS OF NUTRITION AND METABOLISM 2017; 72:37-42. [PMID: 29241202 DOI: 10.1159/000484698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/26/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND/AIMS The studies in the patients with iron deficiency anemia (IDA) implied the existence of the association of ghrelin with iron or hepcidin levels in the plasma under the pathophysiological conditions. We hypothesized that fasting may be able to affect iron metabolism via ghrelin under the physiological conditions. METHODS We investigated the effects of fasting on serum ghrelin and iron contents in healthy volunteers (23-31 years) and C57BL/6 male mice (8-week-olds) under the physiological conditions. RESULTS Fasting induced a significant elevation in both total ghrelin and acylated ghrelin and a reduction in iron levels in the serum of both human and mice. Correlation analysis demonstrated that total ghrelin or acylated ghrelin is negatively correlated with iron in the serum in human and mice. CONCLUSION Ghrelin has a role to reduce serum iron under the conditions of fasting.
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Affiliation(s)
- Qian-Qian Luo
- Department of Pharmacology and Laboratory of Prevention and Treatment of Neurodegenerative Diseases, Department of Biochemistry, Nantong University Medical School, Nantong, China
| | - Gan Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Su-Na Huang
- Department of Pharmacology and Laboratory of Prevention and Treatment of Neurodegenerative Diseases, Department of Biochemistry, Nantong University Medical School, Nantong, China
| | - Ming-Dao Mu
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yun-Jin Chen
- Department of Pharmacology and Laboratory of Prevention and Treatment of Neurodegenerative Diseases, Department of Biochemistry, Nantong University Medical School, Nantong, China
| | - Zhong-Ming Qian
- Department of Pharmacology and Laboratory of Prevention and Treatment of Neurodegenerative Diseases, Department of Biochemistry, Nantong University Medical School, Nantong, China
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15
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Luo QQ, Zhou YF, Chen MYJ, Liu L, Ma J, Zhang MW, Zhang FL, Ke Y, Qian ZM. Fasting up-regulates ferroportin 1 expression via a Ghrelin/GHSR/MAPK signaling pathway. J Cell Physiol 2017; 233:30-37. [PMID: 28338217 DOI: 10.1002/jcp.25931] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/22/2017] [Indexed: 01/18/2023]
Abstract
The significant positive correlation between ghrelin and iron and hepcidin levels in the plasma of children with iron deficiency anemia prompted us to hypothesize that ghrelin may affect iron metabolism. Here, we investigated the effects of fasting or ghrelin on the expression of hepcidin, ferroportin 1 (Fpn1), transferrin receptor 1 (TfR1), ferritin light chain (Ft-L) proteins, and ghrelin, and also hormone secretagogue receptor 1 alpha (GHSR1α) and ghrelin O-acyltransferase (GOAT) mRNAs in the spleen and/or macrophage. We demonstrated that fasting induces a significant increase in the expression of ghrelin, GHSR1α, GOAT, and hepcidin mRNAs, as well as Ft-L and Fpn1 but not TfR1 proteins in the spleens of mice in vivo. Similar to the effects of fasting on the spleen, ghrelin induced a significant increase in the expression of Ft-L and Fpn1 but not TfR1 proteins in macrophages in vitro. In addition, ghrelin was found to induce a significant enhancement in phosphorylation of ERK as well as translocation of pERK from the cytosol to nuclei. Furthermore, the increased pERK and Fpn1 induced by ghrelin was demonstrated to be preventable by pre-treatment with either GHSR1α antagonist or pERK inhibitor. Our findings support the hypothesis that fasting upregulates Fpn1 expression, probably via a ghrelin/GHSR/MAPK signaling pathway.
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Affiliation(s)
- Qian-Qian Luo
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China.,Pharmacological Evaluation and Research Center, Shanghai Institute of PharmaceuticalIndustry, Shanghai, China.,Department of Biochemistry, Institute for Nautical Medicine, Nantong University, Nantong, China
| | - Yu-Fu Zhou
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China
| | - Mesona Yung-Jin Chen
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China
| | - Li Liu
- Pharmacological Evaluation and Research Center, Shanghai Institute of PharmaceuticalIndustry, Shanghai, China
| | - Juan Ma
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China
| | - Meng-Wan Zhang
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China
| | - Fa-Li Zhang
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China
| | - Ya Ke
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Zhong-Ming Qian
- Laboratory of Neuropharmacology, Fudan University School of Pharmacy, Shanghai, China
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16
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Soliman AT, De Sanctis V, Yassin M, Adel A. Growth and Growth hormone - Insulin Like Growth Factor -I (GH-IGF-I) Axis in Chronic Anemias. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:101-111. [PMID: 28467344 PMCID: PMC6166184 DOI: 10.23750/abm.v88i1.5744] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 09/12/2016] [Indexed: 11/23/2022]
Abstract
Anaemia is a global public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. It occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children. Iron deficiency anaemia (IDA) was considered to be among the most important contributing factors to the global burden of disease. Prolonged and/or chronic anemia has a negative effect on linear growth especially during the rapid phases (infancy and puberty). Additionally infants with chronic IDA have delayed cognitive, motor, and affective development that may be long-lasting. In view of the significant impact of chronic anemias on growth, pediatricians endocrinologists and hematologists should advocate primary prevention and screening for growth disturbance in these forms of anemias. The extent of the negative effect of different forms of chronic anemias on linear growth and its possible reversibilty is addressed in this review. The possible mechanisms that may impair growth in the different forms of anemias are addressed with special attention to their effect on the growth hormone (GH) – insulin like growth factor -I (IGF-I). (www.actabiomedica.it)
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Affiliation(s)
- Ashraf T Soliman
- Department of Pediatrics, Alexandria University Children Hospital, Elchatby, Alexandria, Egypt.
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17
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Abstract
Iron-deficient individuals experience a loss of appetite that can be restored with iron supplementation. It has been proposed that iron influences the satiety hormone leptin; however, a direct link between iron and leptin has remained elusive. In this issue of the JCI, Gao and colleagues demonstrate an inverse relationship between adipocyte iron and leptin that is mediated by iron-dependent activation of cAMP-responsive element binding protein (CREB), the transcription factor that represses leptin transcription. Together, the results of this study provide a mechanistic connection between dietary iron and the appetite-regulating hormone leptin.
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Maggio M, De Vita F, Fisichella A, Lauretani F, Ticinesi A, Ceresini G, Cappola A, Ferrucci L, Ceda GP. The Role of the Multiple Hormonal Dysregulation in the Onset of "Anemia of Aging": Focus on Testosterone, IGF-1, and Thyroid Hormones. Int J Endocrinol 2015; 2015:292574. [PMID: 26779261 PMCID: PMC4686706 DOI: 10.1155/2015/292574] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 10/23/2015] [Accepted: 10/27/2015] [Indexed: 12/13/2022] Open
Abstract
Anemia is a multifactorial condition whose prevalence increases in both sexes after the fifth decade of life. It is a highly represented phenomenon in older adults and in one-third of cases is "unexplained." Ageing process is also characterized by a "multiple hormonal dysregulation" with disruption in gonadal, adrenal, and somatotropic axes. Experimental studies suggest that anabolic hormones such as testosterone, IGF-1, and thyroid hormones are able to increase erythroid mass, erythropoietin synthesis, and iron bioavailability, underlining a potential role of multiple hormonal changes in the anemia of aging. Epidemiological data more consistently support an association between lower testosterone and anemia in adult-older individuals. Low IGF-1 has been especially associated with anemia in the pediatric population and in a wide range of disorders. There is also evidence of an association between thyroid hormones and abnormalities in hematological parameters under overt thyroid and euthyroid conditions, with limited data on subclinical statuses. Although RCTs have shown beneficial effects, stronger for testosterone and the GH-IGF-1 axis and less evident for thyroid hormones, in improving different hematological parameters, there is no clear evidence for the usefulness of hormonal treatment in improving anemia in older subjects. Thus, more clinical and research efforts are needed to investigate the hormonal contribution to anemia in the older individuals.
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Affiliation(s)
- Marcello Maggio
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy
- Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy
- *Marcello Maggio:
| | - Francesca De Vita
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy
| | - Alberto Fisichella
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy
| | - Fulvio Lauretani
- Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy
| | - Andrea Ticinesi
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy
| | - Graziano Ceresini
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy
- Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy
| | - Anne Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health (NIH), Baltimore, MD 21201, USA
| | - Gian Paolo Ceda
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy
- Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy
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Affiliation(s)
| | | | - Sanjay Kalra
- Indian Journal Endocrinology and Metabolism, Journal of Social Health in Diabetes, Bharti Hospital and B.R.I.D.E., Karnal 132001, Haryana, India
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Insulin-like Growth Factor-1 (IGF-1): Demographic, Clinical and Laboratory Data in 120 Consecutive Adult Patients with Thalassaemia Major. Mediterr J Hematol Infect Dis 2014; 6:e2014074. [PMID: 25408860 PMCID: PMC4235482 DOI: 10.4084/mjhid.2014.074] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 10/18/2014] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION IGF-1 deficiency in TM patients in children and adolescents has been attributed to chronic anemia and hypoxia, chronic liver disease, iron overload and other associated endocrinopathies, e.g. growth hormone deficiency (GHD). Few data are available in the literature regarding adult TM patients and growth disorders. The aim of this study was to measure IGF-1 values and other clinical data in a large number of adult patients with TM to evaluate the possible relationships between them. PATIENTS AND METHODS A cohort of 120 adult patients with TM was studied for plasma levels of IGF-1. Plasma total IGF-1 was determined by chemiluminescent immunometric assay (CLIA) method. In eleven patients (3 females) the GH response during glucagon stimulation test (GST) was also evaluated. RESULTS Fifty percent of patients (33 males and 27 females) had IGF-1 levels <- 2 SDs below normative values for healthy subjects matched for age and sex. In these patients endocrine complications and elevations of aminotransferases (ALT) were more common compared to TM patients with IGF1 > -2SDs. In multivariate regression analyses, height, weight, BMI, serum ferritin, ALT, HCV serology and left ventricular ejection fraction (LVEF) were not significantly related to IGF-1, but a significant correlation was found in females between HCV-RNA positivity and IGF-1, ALT and serum ferritin. AGHD was diagnosed in 6 (4 males) out of 11 patients (54.5%) who had glucagon stimulation tests and in 5 out of 8 (62.5%) with IGF-1 <-2SD. The mean age of patients with GHD was 39.3 years (range: 25-49 years, median: 39 years) versus 35.8 years (range: 27-45 years, median: 37.5 years) in non-GHD patients. A positive correlation between GH peak after GST and IGF-1 level was found (r: 0.6409; p: < 0.05). CONCLUSIONS In 50% of TM patients the IGF-1 levels were 2SDs below average values for healthy individuals. IGF-1 deficiency was more common in TM patients with associated endocrine complications, and a significant correlation was found in HCV-RNA positive females among IGF-1, ALT, and serum ferritin. Further data in a larger group of patients are needed to confirm whether IGF-1 level <-2 SDs may be a potential criterion for additional studies in TM patients. This datum could avoid performing GH stimulation tests in the majority of them.
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Morales González E, Contreras I, Estrada J. Efecto de la deficiencia de hierro sobre la expresión de factor de crecimiento de insulina tipo II y su receptor en células neuronales y gliales. Neurologia 2014; 29:408-15. [DOI: 10.1016/j.nrl.2013.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 10/13/2013] [Indexed: 01/10/2023] Open
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Morales González E, Contreras I, Estrada J. Effect of iron deficiency on the expression of insulin-like growth factor-II and its receptor in neuronal and glial cells. NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2013.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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23
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Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, Chen TJ, Bai YM. Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study. BMC Psychiatry 2013; 13:161. [PMID: 23735056 PMCID: PMC3680022 DOI: 10.1186/1471-244x-13-161] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 05/28/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A great deal of evidence has shown that iron is an important component in cognitive, sensorimotor, and social-emotional development and functioning, because the development of central nervous system processes is highly dependent on iron-containing enzymes and proteins. Deficiency of iron in early life may increase the risk of psychiatric morbidity. METHODS Utilizing the National Health Insurance Database from 1996 to 2008, children and adolescents with a diagnosis of IDA were identified and compared with age and gender-matched controls (1:4) in an investigation of the increased risk of psychiatric disorders. RESULTS A total of 2957 patients with IDA, with an increased risk of unipolar depressive disorder (OR = 2.34, 95% CI = 1.58 ~ 3.46), bipolar disorder (OR = 5.78, 95% CI = 2.23 ~ 15.05), anxiety disorder (OR = 2.17, 95% CI = 1.49 ~ 3.16), autism spectrum disorder (OR = 3.08, 95% CI = 1.79 ~ 5.28), attention deficit hyperactivity disorder (OR = 1.67, 95% CI = 1.29 ~ 2.17), tic disorder (OR = 1.70, 95% CI = 1.03 ~ 2.78), developmental delay (OR = 2.45, 95% CI = 2.00 ~ 3.00), and mental retardation (OR = 2.70, 95% CI = 2.00 ~ 3.65), were identified. A gender effect was noted, in that only female patients with IDA had an increased OR of bipolar disorder (OR = 5.56, 95% CI = 1.98 ~ 15.70) and tic disorder (OR = 2.95, 95% CI = 1.27 ~ 6.86). CONCLUSION Iron deficiency increased the risk of psychiatric disorders, including mood disorders, autism spectrum disorder, attention deficit hyperactivity disorder, and developmental disorders. Further study is required to clarify the mechanism in the association between IDA and psychiatric disorder.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Sheue Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
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Dogan A, Alioglu B, Dindar N, Dallar Y. Increased serum hepcidin and ghrelin levels in children treated for iron deficiency anemia. J Clin Lab Anal 2013; 27:81-5. [PMID: 23292909 DOI: 10.1002/jcla.21566] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 11/19/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the relation between iron deficiency anemia (IDA) and serum leptin, hepcidin, and ghrelin levels. METHODS Thirty children with IDA and 28 healthy children between the ages of 6 months and 6 years admitted to our hospital were evaluated prospectively. IDA was diagnosed based on clinical and laboratory findings. All children with IDA were treated with iron II-glycine-sulphate complex for 3 months. Complete blood count; iron metabolism parameters; and serum leptin, hepcidin, and ghrelin levels were studied in all healthy children and in children with IDA before and after treatment. RESULTS In children with IDA, the decrease seen in serum leptin levels after the iron treatment was not statistically significant. However, the increase seen in serum hepcidin levels after the iron treatment was statistically significant (P = 0.038). Hepcidin levels were significantly higher in children with IDA who received iron treatment compared to healthy children (P = 0.008). After the iron treatment, serum ghrelin levels in children with IDA were also significantly higher compared to the levels before treatment and healthy children (P = 0.019 and 0.000, respectively). CONCLUSION Serum ghrelin and hepcidin levels increase with iron treatment in children with IDA. In view of the higher serum ghrelin and hepcidin levels after iron treatment when compared to pretreatment levels and the healthy children, we suggest that the iron treatment has an important role in serum hepcidin and ghrelin synthesis.
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Affiliation(s)
- Ayse Dogan
- Department of Pediatrics, Ankara Training and Research Hospital, Ankara, Turkey
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Miljuš G, Malenković V, Nedić O. The importance of metal ions for the formation and isolation of insulin-like growth factor-binding protein 3–transferrin (IGFBP-3–Tf) complexes, and the analysis of their physiological involvement. Metallomics 2013; 5:251-8. [DOI: 10.1039/c3mt20210k] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Tran PV, Fretham SJB, Wobken J, Miller BS, Georgieff MK. Gestational-neonatal iron deficiency suppresses and iron treatment reactivates IGF signaling in developing rat hippocampus. Am J Physiol Endocrinol Metab 2012; 302:E316-24. [PMID: 22068601 PMCID: PMC3287363 DOI: 10.1152/ajpendo.00369.2011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Gestational-neonatal iron deficiency, a common micronutrient deficiency affecting the offspring of more than 30% of pregnancies worldwide, leads to long-term cognitive and behavioral abnormalities. Preclinical models of gestational-neonatal iron deficiency result in reduced energy metabolism and expression of genes critical for neuronal plasticity and cognitive function, which are associated with a smaller hippocampal volume and abnormal neuronal dendrite growth. Because insulin-like growth factor (IGF) modulates early postnatal cellular growth, differentiation, and survival, we used a dietary-induced rat model to assess the effects of gestational iron deficiency on activity of the IGF system. We hypothesized that gestational iron deficiency attenuates postnatal hippocampal IGF signaling and results in downstream effects that contribute to hippocampal anatomic and functional deficits. At postnatal day (P) 15 untreated gestational-neonatal iron deficiency markedly suppressed hippocampal IGF activation and protein kinase B signaling, and reduced neurogenesis, while elevating extracellular signal-regulated kinase 1/2 signaling and hypoxia-inducible factor-1α expression. Iron treatment beginning at P7 restored IGF signaling, increased neurogenesis, and normalized all parameters by the end of rapid hippocampal differentiation (P30). Expression of the neuron-specific synaptogenesis marker, disc-large homolog 4 (PSD95), increased more rapidly than the glia-specific myelination marker, myelin basic protein, following iron treatment, suggesting a more robust response to iron therapy in IGF-I-dependent neurons than IGF-II-dependent glia. Collectively, our findings suggest that IGF dysfunction is in part responsible for hippocampal abnormalities in untreated iron deficiency. Early postnatal iron treatment of gestational iron deficiency reactivates the IGF system and promotes neurogenesis and differentiation in the hippocampus during a critical developmental period.
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MESH Headings
- Anemia, Iron-Deficiency/diet therapy
- Anemia, Iron-Deficiency/metabolism
- Anemia, Iron-Deficiency/pathology
- Animals
- Female
- Gene Expression Regulation, Developmental
- Hippocampus/metabolism
- Hippocampus/pathology
- Insulin-Like Growth Factor Binding Protein 3/genetics
- Insulin-Like Growth Factor Binding Protein 3/metabolism
- Insulin-Like Growth Factor I/genetics
- Insulin-Like Growth Factor I/metabolism
- Insulin-Like Growth Factor II/genetics
- Insulin-Like Growth Factor II/metabolism
- Iron, Dietary/administration & dosage
- Iron, Dietary/therapeutic use
- Lactation
- Male
- Maternal Nutritional Physiological Phenomena
- Neurogenesis
- Neurons/metabolism
- Pregnancy
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Receptor, IGF Type 1/genetics
- Receptor, IGF Type 1/metabolism
- Receptor, Insulin/genetics
- Receptor, Insulin/metabolism
- Signal Transduction
- Somatomedins/genetics
- Somatomedins/metabolism
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Affiliation(s)
- Phu V Tran
- Center for Neurobehavioral Development, University of Minnesota, Minneapolis MN, USA.
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Ndong M, Kazami M, Suzuki T, Uehara M, Katsumata SI, Inoue H, Kobayashi KI, Tadokoro T, Suzuki K, Yamamoto Y. Iron deficiency down-regulates the Akt/TSC1-TSC2/mammalian Target of Rapamycin signaling pathway in rats and in COS-1 cells. Nutr Res 2010; 29:640-7. [PMID: 19854379 DOI: 10.1016/j.nutres.2009.09.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 09/11/2009] [Accepted: 09/14/2009] [Indexed: 01/24/2023]
Abstract
Iron deficiency (ID) is one of the most commonly known forms of nutritional deficiencies. Low body iron is thought to induce neurologic defects but may also play a protective role against cancer development by cell growth arrest. Thus, ID may affect cellular pathways controlling cell growth and proliferation, the mechanism of which is still not fully understood. The serine/threonine protein kinase Akt and its downstream target, the mammalian Target of Rapamycin (mTOR), is known to play a crucial role in the regulation of cell growth and survival. Therefore, we hypothesized that Akt/mTOR pathway could be influenced by ID. Three-week-old male Wistar-strain rats were divided into 3 groups and the 2 groups had free access to a control diet (C group) or an iron-deficient diet (D group). The third group (PF group) were pair-fed the control diet to the mean intake of the D group. After 4 weeks, rats were killed and their brains were sampled. In separate experiments, COS-1 cells were cultured with or without the iron chelator deferoxamine. Western blots of brain samples and COS-1 lysates were used to analyze the expression and phosphorylation state of Akt, TSC2, mTOR, and S6 kinase proteins implicated in the Akt/mTOR pathway. Using 2 different ID models, we show for the first time that iron deficiency depresses Akt activity in rats and in COS-1 cells, leading to a decrease in mTOR activity.
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Affiliation(s)
- Moussa Ndong
- Department of Applied Biology and Chemistry, Tokyo University of Agriculture, Setagaya-ku, Tokyo 156-8502, Japan
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Katsumata SI, Katsumata-Tsuboi R, Uehara M, Suzuki K. Severe iron deficiency decreases both bone formation and bone resorption in rats. J Nutr 2009; 139:238-43. [PMID: 19106323 DOI: 10.3945/jn.108.093757] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The purpose of this study was to clarify the manner in which dietary iron deficiency decreased bone mineral density (BMD) in rats. Eighteen 3-wk-old male Wistar rats were divided into 3 groups of 6 rats each. The rats in 2 of the 3 groups had free access to a control diet (C group) or an iron-deficient diet (ID group) for 4 wk. The rats in the third group (PF group) were pair-fed the control diet to the mean intake of the ID group. Compared with the C and PF groups, hematocrit and hemoglobin concentrations were significantly reduced and bone mineral content and BMD of the femur were significantly lower in the ID group. Bone histomorphometric parameters showed that the bone formation rate and osteoclast surface in the lumbar vertebra were significantly reduced in the ID group compared with the C and PF groups. Furthermore, dietary iron deficiency decreased serum 1,25-dihydroxycholecalciferol, insulin-like growth factor-I, and osteocalcin concentrations and urinary excretion of deoxypyridinoline. These results suggest that severe iron deficiency decreases not only bone formation but also bone resorption.
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Affiliation(s)
- Shin-ichi Katsumata
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
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Kilic N, Aydin S, Barim AO. Hormonal alterations in prepubertal children with iron deficiency. Endocr J 2009; 56:309; author reply 311. [PMID: 19088400 DOI: 10.1507/endocrj.k08e-336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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