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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

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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; SCAtotal) 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 SCAtotal 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).
Literature
25.
29.
go back to reference van den Heuvel EG, Muys T, Pellegrom H, Bruyntjes JP, van Dokkum W, Spanhaak S, Schaafsma G (1998) A new method to measure iron absorption from the enrichment of 57Fe and 58Fe in young erythroid cells. Clin Chem 44(3):649–654CrossRefPubMed van den Heuvel EG, Muys T, Pellegrom H, Bruyntjes JP, van Dokkum W, Spanhaak S, Schaafsma G (1998) A new method to measure iron absorption from the enrichment of 57Fe and 58Fe in young erythroid cells. Clin Chem 44(3):649–654CrossRefPubMed
32.
go back to reference International Atomic Energy Agency (IAEA) (2012) Assessment of iron bioavailability in humans using stable iron isotope techniques. Vienna: International Atomic Energy Agency 77 p. No.: 21 International Atomic Energy Agency (IAEA) (2012) Assessment of iron bioavailability in humans using stable iron isotope techniques. Vienna: International Atomic Energy Agency 77 p. No.: 21
39.
go back to reference Institute of Medicine (US) Panel on Micronutrients (2001) Dietary reference intakes for. In: Vitamin A, Vitamin K (eds) Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academies Press (US) Institute of Medicine (US) Panel on Micronutrients (2001) Dietary reference intakes for. In: Vitamin A, Vitamin K (eds) Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academies Press (US)
45.
go back to reference Lynch SR, Skikne BS, Cook JD (1989) Food iron absorption in idiopathic hemochromatosis. Blood 74(6):2187–2193CrossRefPubMed Lynch SR, Skikne BS, Cook JD (1989) Food iron absorption in idiopathic hemochromatosis. Blood 74(6):2187–2193CrossRefPubMed
47.
48.
go back to reference Erlandson ME, Walden B, Stern G, Hilgartner MW, Wehman J, Smith CH (1962) Studies on congenital hemolytic syndromes, IV. Gastrointestinal absorption of iron. Blood 19:359–378CrossRefPubMed Erlandson ME, Walden B, Stern G, Hilgartner MW, Wehman J, Smith CH (1962) Studies on congenital hemolytic syndromes, IV. Gastrointestinal absorption of iron. Blood 19:359–378CrossRefPubMed
Metadata
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
Published in
European Journal of Nutrition
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-024-03417-8
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