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22-06-2023 | Systematic Review

Factors Influencing the Hepcidin Response to Exercise: An Individual Participant Data Meta-analysis

Authors: Nikita C. Fensham, Andrew D. Govus, Peter Peeling, Louise M. Burke, Alannah K. A. McKay

Published in: Sports Medicine | Issue 10/2023

Abstract

Background

Hepcidin, the master iron regulatory hormone, has been shown to peak 3–6 h postexercise, and is likely a major contributor to the prevalence of iron deficiency in athletes. Although multiple studies have investigated the hepcidin response to exercise, small sample sizes preclude the generalizability of current research findings.

Objective

The aim of this individual participant data meta-analysis was to identify key factors influencing the hepcidin–exercise response.

Methods

Following a systematic review of the literature, a one-stage meta-analysis with mixed-effects linear regression, using a stepwise approach to select the best-fit model, was employed.

Results

We show that exercise is associated with a 1.5–2.5-fold increase in hepcidin concentrations, with pre-exercise hepcidin concentration accounting for ~ 44% of the variance in 3 h postexercise hepcidin concentration. Although collectively accounting for only a further ~ 3% of the variance, absolute 3 h postexercise hepcidin concentrations appear higher in males with lower cardiorespiratory fitness and higher pre-exercise ferritin levels. On the other hand, a greater magnitude of change between the pre- and 3 h postexercise hepcidin concentration was largely attributable to exercise duration (~ 44% variance) with a much smaller contribution from VO₂max, pre-exercise ferritin, sex, and postexercise interleukin-6 (~ 6% combined). Although females tended to have a lower absolute 3 h postexercise hepcidin concentration [1.4 nmol·L⁻¹, (95% CI [− 2.6, − 0.3]), p = 0.02] and 30% less change (95% CI [–54.4, – 5.1]), p = 0.02) than males, with different explanatory variables being significant between sexes, sample size discrepancies and individual study design biases preclude definitive conclusions.

Conclusion

Our analysis reveals the complex interplay of characteristics of both athlete and exercise session in the hepcidin response to exercise and highlights the need for further investigation into unaccounted-for mediating factors.

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Title: Factors Influencing the Hepcidin Response to Exercise: An Individual Participant Data Meta-analysis
Authors: Nikita C. Fensham
Andrew D. Govus
Peter Peeling
Louise M. Burke
Alannah K. A. McKay
Publication date: 22-06-2023
Publisher: Springer International Publishing
Published in: Sports Medicine / Issue 10/2023
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI: https://doi.org/10.1007/s40279-023-01874-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Factors Influencing the Hepcidin Response to Exercise: An Individual Participant Data Meta-analysis

Abstract

Background

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

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