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Open AccessReview

Obesity as an Emerging Risk Factor for Iron Deficiency

First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
Department of Internal Medicine, General Hospital, Paracelsusstrasse 37, 5110 Oberndorf, Austria
Authors to whom correspondence should be addressed.
Nutrients 2014, 6(9), 3587-3600;
Received: 28 July 2014 / Revised: 29 August 2014 / Accepted: 3 September 2014 / Published: 11 September 2014
(This article belongs to the Special Issue Iron Deficiency: Development, Implications and Treatment)
Iron homeostasis is affected by obesity and obesity-related insulin resistance in a many-facetted fashion. On one hand, iron deficiency and anemia are frequent findings in subjects with progressed stages of obesity. This phenomenon has been well studied in obese adolescents, women and subjects undergoing bariatric surgery. On the other hand, hyperferritinemia with normal or mildly elevated transferrin saturation is observed in approximately one-third of patients with metabolic syndrome (MetS) or nonalcoholic fatty liver disease (NAFLD). This constellation has been named the “dysmetabolic iron overload syndrome (DIOS)”. Both elevated body iron stores and iron deficiency are detrimental to health and to the course of obesity-related conditions. Iron deficiency and anemia may impair mitochondrial and cellular energy homeostasis and further increase inactivity and fatigue of obese subjects. Obesity-associated inflammation is tightly linked to iron deficiency and involves impaired duodenal iron absorption associated with low expression of duodenal ferroportin (FPN) along with elevated hepcidin concentrations. This review summarizes the current understanding of the dysregulation of iron homeostasis in obesity. View Full-Text
Keywords: iron deficiency; obesity; insulin resistance; hepcidin iron deficiency; obesity; insulin resistance; hepcidin
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Aigner, E.; Feldman, A.; Datz, C. Obesity as an Emerging Risk Factor for Iron Deficiency. Nutrients 2014, 6, 3587-3600.

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