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Tissue iron deficiency and adiposity-related inflammation in disadvantaged preschoolers from NE Brazil
R S Gibson1, K B Bailey1, S Williams2
1Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Insights
Overweight Brazilian preschoolers showed higher rates of iron deficiency and inflammation. Adiposity-related inflammation may contribute to iron deficiency, even in populations with low overweight prevalence.
Area of Science:
- Pediatric Nutrition
- Biochemistry
- Public Health
Background:
- Previous research indicated a link between iron deficiency and overweight status in Brazilian preschoolers.
- This study aimed to explore the potential role of adipose-tissue-related inflammation in this association.
Purpose of the Study:
- To investigate the relationship between overweight, iron deficiency, and inflammation markers in Brazilian preschoolers.
- To determine if inflammation associated with excess body fat contributes to iron deficiency in this population.
Main Methods:
- Measured serum biomarkers including C-reactive protein, α-1-acid glycoprotein (AGP), hepcidin, interleukin-6 (IL-6), leptin, serum ferritin, and transferrin receptor (sTfR) in 364 preschoolers.
- Assessed genetic hemoglobin disorders, intestinal parasites, and calculated dietary iron intake.
- Utilized Body Mass Index Z-score (BMIZ) to categorize children as overweight (BMIZ >1) or normal-weight.
Main Results:
- Overweight children (13%) exhibited higher prevalence of tissue iron deficiency (sTfR) and chronic inflammation (AGP).
- Higher BMIZ correlated positively with sTfR, ferritin, and leptin levels.
- Interleukin-6 (IL-6) and elevated AGP were significant predictors of hepcidin, suggesting inflammation drives iron regulation.
Conclusions:
- Adiposity-related inflammation plays a role in tissue iron deficiency among Brazilian preschoolers.
- This association should be considered even in populations with a relatively low prevalence of overweight children.
Background/Objectives:
Earlier we reported an association between iron deficiency and overweight in Brazilian preschoolers. Here, we investigate whether this is the result of adipose-related inflammation.
Subjects/Methods:
Fasting serum C-reactive protein, α-1-acid glycoprotein (AGP), hepcidin, interleukin-6 (IL-6) and leptin, together with two iron biomarkers (serum ferritin and transferrin receptor (sTfR)), were measured in 364 disadvantaged preschoolers with a mean BMIZ (standardised Z-score for BMI) of 0.015, aged 3-6 years and attending day care in Salvador, Brazil. The role of genetic haemoglobin (Hb) disorders, intestinal parasites and dietary iron supply (calculated from serving sizes of 20 weekday menus) were also examined.
Results:
Forty-eight children (13%) were overweight (BMIZ >1). Prevalence of tissue iron deficiency (sTfR >113.3 nmol/l; 30.6 vs 12.5%; P=0.002) and chronic inflammation (AGP >25 μmol/l; 19 vs 10%; P=0.025) were higher in overweight than in normal-weight children. From multiple regression, BMIZ was a positive predictor of log serum sTfR, ferritin and leptin, but not of log hepcidin or IL-6. Instead, major positive predictors of log hepcidin were log IL-6, followed by an elevated AGP and sex (male), whereas for log IL-6 elevated AGP was the only significant predictor. Besides BMIZ, sex (female) was also a major positive predictor of leptin. Heterozygous variant of sickle cell Hb (n=20), but not helminths, was also a positive predictor of log sTfR. Median dietary iron supply (mg/day) was above the WHO Recommended Nutrient Intake assuming moderate bioavailability and appeared adequate.
Conclusions:
The role of adiposity-related inflammation in tissue iron deficiency should be considered even when the prevalence of overweight is relatively low.
