The research on the roles of irisin and FABP4 in iron deficiency anemia

Iron Deficiency Anemia (IDA) is a noteworthy health problem, frequently encountered in developing countries. Among its clinical presentations are growth retardation, developmental delay and disorder of thermoregulation. The irisin transforms the beige adipose tissue into the brown energy and heat dissipating adipose tissue. It is a myokine that exhibits positive correlation with the muscle mass of iris. The fatty acid-binding proteins (FABPs) play a role in facilitation of intracellular fatty acids. The fatty acid-binding protein 4 (FABP4) is found in mature adipose tissues. In the case of iron deficiency anemia, an increase in the FABP4 level can be expected due to the loss of muscle tissue together with a degradation of Ir level and increment of relative adipose tissue. By means of this study, we aim to conduct a research on Ir and FABP4 levels and thus evaluate the effects of the aforementioned on IDA and related symptoms. A total of 80 cases (DA: Empty iron store, n: 20], DE: Low serum iron, n: 20], DEA: Developing iron deficiency anemia, n: 20] and Control: Normal iron indicators, n: 20]) were included in the study. Blood and urine samples from the abovementioned cases, both the patient and control groups, were taken twice; first, prior to the commencement of the treatment and the latter, on the 3rd month of the ongoing treatment. Within the scope of our study, both groups exhibited an increase in post-treatment serum Ir levels. Symptoms of iron deficiency anemia such as fatigue and decline in physical activity may be connected with the low Ir levels. Symptoms such as disorder of thermoregulation and cold sensations event at normal body temperatures were also reported in relation with iron deficiency anemia. A possible reason for the disorder of thermoregulation can be the decreasing Ir level. This is due to the fact that Ir conduces to the generation of thermal energy rather than the synthesis of ATP by enhancing UCP-1 (Uncoupling protein 1) proteins. A difference between the serum and urine FABP4 ratios and pre- and post-treatment control ratios was not reported. Even though statistically insignificant, the serum and urine FABP4 ratios achieved higher levels in IDA compared to the control group. The growth retardation, encountered with in iron deficiency anemia, is related with the decreasing insulin levels. FABP4 increases the resistance of insulin. In consideration of IDA, the decrement in insulin levels and the insulin resistance caused by the increasing FABP4 level could explain the growth retardation. Key Words: Iron deficiency anemia, İrisin, FABP4