Hepcidin and Iron Deficiency in Women One Year after Sleeve Gastrectomy

Thibaud Lefebvre (1, 2) , Muriel Coupaye (1, 3) , Marina Esposito-Farèse (4, 5) , Nathalie Gault (4, 5) , Neila Talbi (1, 2) , Caroline Quintin (5) , Caroline Schmitt (1, 2) , Soumeya Bekri (6) , André Bado (1) , Hervé Puy (1, 2) , Simon Msika (1, 5) , Carole Brasse-Lagnel (7) , Zoubida Karim (1, 8)

1 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
2 Hôpital Louis Mourier - AP-HP [Colombes]
3 CINFO - Centre Intégré Nord Francilien de l'Obésité
4 CIC 1425 - Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique
5 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
6 CHU Rouen
7 UNIROUEN - Université de Rouen Normandie
8 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires

Iron deficiency with or without anemia, needing continuous iron supplementation, is very common in obese patients, particularly those requiring bariatric surgery. The aim of this study was to address the impact of weight loss on the rescue of iron balance in patients who underwent sleeve gastrectomy (SG), a procedure that preserves the duodenum, the main site of iron absorption. The cohort included 88 obese women; sampling of blood and duodenal biopsies of 35 patients were performed before and one year after SG. An analysis of the 35 patients consisted in evaluating iron homeostasis including hepcidin, markers of erythroid iron deficiency (soluble transferrin receptor (sTfR) and erythrocyte protoporphyrin (PPIX)), expression of duodenal iron transporters (DMT1 and ferroportin) and inflammatory markers. After surgery, sTfR and PPIX were decreased. Serum hepcidin levels were increased despite the significant reduction in inflammation. DMT1 abundance was negatively correlated with higher level of serum hepcidin. Ferroportin abundance was not modified. This study shed a new light in effective iron recovery pathways after SG involving suppression of inflammation, improvement of iron absorption, iron supply and efficiency of erythropoiesis, and finally beneficial control of iron homeostasis by hepcidin. Thus, recommendations for iron supplementation of patients after SG should take into account these new parameters of iron status assessment.

Mots clés: hepcidin; inflammation; iron deficiency; iron metabolism; obesity; sleeve gastrectomy

Domaines: Sciences du Vivant [q-bio]

Thibaud Lefebvre, Muriel Coupaye, Marina Esposito-Farèse, Nathalie Gault, Neila Talbi, et al.. Hepcidin and Iron Deficiency in Women One Year after Sleeve Gastrectomy: A Prospective Cohort Study. Nutrients, 2021, 13 (8), pp.2516. ⟨10.3390/nu13082516⟩. ⟨hal-03448937⟩