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Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake

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ABSTRACT

The relationship between dietary intake, circulating hepcidin and iron status in free-living premenopausal women has not been explored. This cross-sectional study aimed to identify dietary determinants of iron stores after accounting for blood loss and to determine whether iron intake predicts iron stores independently of hepcidin in a sample of Australian women. Three hundred thirty eight women aged 18–50 years were recruited. Total intake and food sources of iron were determined via food frequency questionnaire; the magnitude of menstrual losses was estimated by self-report; and blood donation volume was quantified using blood donation records and self-reported donation frequency. Serum samples were analysed for ferritin, hepcidin and C-reactive protein concentrations. Linear regression was used to investigate associations. Accounting for blood loss, each 1 mg/day increase in dietary iron was associated with a 3% increase in iron stores (p = 0.027); this association was not independent of hepcidin. Hepcidin was a more influential determinant of iron stores than blood loss and dietary factors combined (R2 of model including hepcidin = 0.65; R2 of model excluding hepcidin = 0.17, p for difference <0.001), and increased hepcidin diminished the positive association between iron intake and iron stores. Despite not being the biggest contributor to dietary iron intake, unprocessed meat was positively associated with iron stores, and each 10% increase in consumption was associated with a 1% increase in iron stores (p = 0.006). No other dietary factors were associated with iron stores. Interventions that reduce hepcidin production combined with dietary strategies to increase iron intake may be important means of improving iron status in women with depleted iron stores.

No MeSH data available.


Study flow diagram and inclusion of women in analyses.
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nutrients-08-00540-f001: Study flow diagram and inclusion of women in analyses.

Mentions: Women were eligible to participate if they had not been through menopause and if they were not currently pregnant or lactating and had not been in the previous 6 months. The presence of chronic disease was not an exclusion criterion. Participants were asked to complete a demographic and health background questionnaire, a food frequency questionnaire (FFQ) and to provide a blood sample. Of the 382 women who completed both questionnaires, 342 also provided a blood sample. Data from four women were excluded from analyses: three women reported energy intakes > 3 SD from the mean (>14,846 kJ/day), and one woman had recently received an intravenous iron infusion (serum ferritin = 461 µg/L). In total, 338 women were included in the present study, 313 in the analysis of dietary determinants of iron stores and 265 in the analysis of hepcidin as a determinant of iron stores (Figure 1).


Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake
Study flow diagram and inclusion of women in analyses.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037527&req=5

nutrients-08-00540-f001: Study flow diagram and inclusion of women in analyses.
Mentions: Women were eligible to participate if they had not been through menopause and if they were not currently pregnant or lactating and had not been in the previous 6 months. The presence of chronic disease was not an exclusion criterion. Participants were asked to complete a demographic and health background questionnaire, a food frequency questionnaire (FFQ) and to provide a blood sample. Of the 382 women who completed both questionnaires, 342 also provided a blood sample. Data from four women were excluded from analyses: three women reported energy intakes > 3 SD from the mean (>14,846 kJ/day), and one woman had recently received an intravenous iron infusion (serum ferritin = 461 µg/L). In total, 338 women were included in the present study, 313 in the analysis of dietary determinants of iron stores and 265 in the analysis of hepcidin as a determinant of iron stores (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

The relationship between dietary intake, circulating hepcidin and iron status in free-living premenopausal women has not been explored. This cross-sectional study aimed to identify dietary determinants of iron stores after accounting for blood loss and to determine whether iron intake predicts iron stores independently of hepcidin in a sample of Australian women. Three hundred thirty eight women aged 18–50 years were recruited. Total intake and food sources of iron were determined via food frequency questionnaire; the magnitude of menstrual losses was estimated by self-report; and blood donation volume was quantified using blood donation records and self-reported donation frequency. Serum samples were analysed for ferritin, hepcidin and C-reactive protein concentrations. Linear regression was used to investigate associations. Accounting for blood loss, each 1 mg/day increase in dietary iron was associated with a 3% increase in iron stores (p = 0.027); this association was not independent of hepcidin. Hepcidin was a more influential determinant of iron stores than blood loss and dietary factors combined (R2 of model including hepcidin = 0.65; R2 of model excluding hepcidin = 0.17, p for difference <0.001), and increased hepcidin diminished the positive association between iron intake and iron stores. Despite not being the biggest contributor to dietary iron intake, unprocessed meat was positively associated with iron stores, and each 10% increase in consumption was associated with a 1% increase in iron stores (p = 0.006). No other dietary factors were associated with iron stores. Interventions that reduce hepcidin production combined with dietary strategies to increase iron intake may be important means of improving iron status in women with depleted iron stores.

No MeSH data available.