Published in:

09-05-2024 | Sickle Cell Anemia | Original Contribution

Iron absorption in adults with sickle cell anemia: a stable-isotope approach

Authors: Juliana Omena¹, Flávia Fioruci Bezerra¹, Vanessa Monteiro Voll¹, Bernardo Ferreira Braz, Ricardo Erthal Santelli, Carmen Marino Donangelo, Gustavo Federico Jauregui, Andrea Soares Ribeiro, Cláudia dos Santos Cople Rodrigues, Marta Citelli

Published in: European Journal of Nutrition | Issue 6/2024

Abstract

Purpose

Iron absorption in sickle cell anemia (SCA) remains unclear and studies in adults with SCA are scarce. The aim of this study was to evaluate the iron absorption SCA adults and its association with iron status and hepcidin concentration.

Methods

SCA patients (n = 13; SCA_total) and control participants (n = 10) ingested an oral stable iron isotope (⁵⁷Fe). Iron absorption was measured by inductively coupled plasma mass spectrometry (ICP-MS) 14 days after isotope administration. Patients with ≥ 1000 ng/mL serum ferritin were considered to present iron overload (IO) (SCAio+; n = 3) and others classified without IO (SCAio-; n = 10).

Results

Iron absorption in the control group ranged from 0.3 to 26.5% (median = 0.9%), while it varied from 0.3 to 5.4% in SCAio+ (median = 0.5%) and from 0.3 to 64.2% in the SCAio- (median = 6.9%). Hepcidin median values were 14.1 ng/mL (3.0–31.9 ng/mL) in SCAio-, 6.2 ng/mL (3.3–7.8 ng/mL) in SCAio + and 6.2 ng/mL (0.6–9.3 ng/mL) in control. Iron absorption was associated with ferritin level (r = − 0.641; p = 0.018) and liver iron concentration (LIC; r = − 0.786; p = 0.036) in the SCA_total group.

Conclusion

Our data suggest that SCAio- individuals may be at risk of developing primary IO. Simultaneously, secondary IO may induce physiological adaptation, resulting in reduced iron absorption. Further studies evaluating intestinal iron absorption using larger sample sizes should be conducted to help establish a safe nutrition approach to be adopted and to ensure the security of food-fortifying public policies for these patients.

Trial registration

This trial was registered at www.ensaiosclinicos.gov.br (Identifier RBR-4b7v8pt).

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Title: Iron absorption in adults with sickle cell anemia: a stable-isotope approach
Authors: Juliana Omena¹
Flávia Fioruci Bezerra¹
Vanessa Monteiro Voll¹
Bernardo Ferreira Braz
Ricardo Erthal Santelli
Carmen Marino Donangelo
Gustavo Federico Jauregui
Andrea Soares Ribeiro
Cláudia dos Santos Cople Rodrigues
Marta Citelli
Publication date: 09-05-2024
Publisher: Springer Berlin Heidelberg
Keyword: Sickle Cell Anemia
Published in: European Journal of Nutrition / Issue 6/2024
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-024-03417-8

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Iron absorption in adults with sickle cell anemia: a stable-isotope approach

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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