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Iron deficiency in patients with nonalcoholic Fatty liver disease is associated with obesity, female gender, and low serum hepcidin.

Publication ,  Journal Article
Siddique, A; Nelson, JE; Aouizerat, B; Yeh, MM; Kowdley, KV; NASH Clinical Research Network,
Published in: Clin Gastroenterol Hepatol
July 2014

BACKGROUND & AIMS: Iron deficiency is often observed in obese individuals. The iron regulatory hormone hepcidin is regulated by iron and cytokines interleukin (IL) 6 and IL1β. We examine the relationship between obesity, circulating levels of hepcidin, and IL6 and IL1β, and other risk factors in patients with nonalcoholic fatty liver disease (NAFLD) with iron deficiency. METHODS: We collected data on 675 adult subjects (>18 years old) enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network. Subjects with transferrin saturation <20% were categorized as iron deficient, whereas those with transferrin saturation ≥20% were classified as iron normal. We assessed clinical, demographic, anthropometric, laboratory, dietary, and histologic data from patients, and serum levels of hepcidin and cytokines IL6 and IL1β. Univariate and multivariate analysis were used to identify risk factors for iron deficiency. RESULTS: One-third of patients (231 of 675; 34%) were iron deficient. Obesity, diabetes, and metabolic syndrome were more common in subjects with iron deficiency (P < .01), compared with those that were iron normal. Serum levels of hepcidin were significantly lower in subjects with iron deficiency (61 ± 45 vs 81 ± 51 ng/mL; P < .0001). Iron deficiency was significantly associated with female gender, obesity, increased body mass index and waist circumference, presence of diabetes, lower alcohol consumption, black or American Indian/Alaska Native race (P ≤ .018), and increased levels of IL6 and IL1β (6.6 vs 4.8 for iron normal, P ≤ .0001; and 0.45 vs 0.32 for iron normal, P ≤ .005). CONCLUSIONS: Iron deficiency is prevalent in patients with NAFLD and associated with female gender, increased body mass index, and nonwhite race. Serum levels of hepcidin were lower in iron-deficient subjects, reflecting an appropriate physiologic response to decreased circulating levels of iron, rather than a primary cause of iron deficiency in the setting of obesity and NAFLD.

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Published In

Clin Gastroenterol Hepatol

DOI

EISSN

1542-7714

Publication Date

July 2014

Volume

12

Issue

7

Start / End Page

1170 / 1178

Location

United States

Related Subject Headings

  • Young Adult
  • Sex Factors
  • Serum
  • Risk Factors
  • Racial Groups
  • Obesity
  • Non-alcoholic Fatty Liver Disease
  • Middle Aged
  • Male
  • Iron Deficiencies
 

Citation

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Chicago
ICMJE
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Siddique, A., Nelson, J. E., Aouizerat, B., Yeh, M. M., Kowdley, K. V., & NASH Clinical Research Network, . (2014). Iron deficiency in patients with nonalcoholic Fatty liver disease is associated with obesity, female gender, and low serum hepcidin. Clin Gastroenterol Hepatol, 12(7), 1170–1178. https://doi.org/10.1016/j.cgh.2013.11.017
Siddique, Asma, James E. Nelson, Bradley Aouizerat, Matthew M. Yeh, Kris V. Kowdley, and Kris V. NASH Clinical Research Network. “Iron deficiency in patients with nonalcoholic Fatty liver disease is associated with obesity, female gender, and low serum hepcidin.Clin Gastroenterol Hepatol 12, no. 7 (July 2014): 1170–78. https://doi.org/10.1016/j.cgh.2013.11.017.
Siddique A, Nelson JE, Aouizerat B, Yeh MM, Kowdley KV, NASH Clinical Research Network. Iron deficiency in patients with nonalcoholic Fatty liver disease is associated with obesity, female gender, and low serum hepcidin. Clin Gastroenterol Hepatol. 2014 Jul;12(7):1170–8.
Siddique, Asma, et al. “Iron deficiency in patients with nonalcoholic Fatty liver disease is associated with obesity, female gender, and low serum hepcidin.Clin Gastroenterol Hepatol, vol. 12, no. 7, July 2014, pp. 1170–78. Pubmed, doi:10.1016/j.cgh.2013.11.017.
Siddique A, Nelson JE, Aouizerat B, Yeh MM, Kowdley KV, NASH Clinical Research Network. Iron deficiency in patients with nonalcoholic Fatty liver disease is associated with obesity, female gender, and low serum hepcidin. Clin Gastroenterol Hepatol. 2014 Jul;12(7):1170–1178.
Journal cover image

Published In

Clin Gastroenterol Hepatol

DOI

EISSN

1542-7714

Publication Date

July 2014

Volume

12

Issue

7

Start / End Page

1170 / 1178

Location

United States

Related Subject Headings

  • Young Adult
  • Sex Factors
  • Serum
  • Risk Factors
  • Racial Groups
  • Obesity
  • Non-alcoholic Fatty Liver Disease
  • Middle Aged
  • Male
  • Iron Deficiencies