The relationship between iron and lipid metabolism in overweight and obese children

Introduction and Objective: Obesity is a chronic, inflammatory disease characterized by an increase in body fat mass as a result of impaired energy balance. The incidence of obesity-related complications has also increased as the prevalence of obesity tends to increase and the age of its incidence is gradually decreasing. While obesity is an independent risk factor for cardiovascular disease, the presence of comorbidities such as dyslipidemia further increases the risk. It has also been shown that chronic inflammation due to obesity negatively affects lipid balance through iron metabolism. Hepcidin is one of the central regulators of iron metabolism. Increased hepcidin during chronic inflammation causes iron accumulation in reticuloendothelial system cells by preventing iron absorption from the intestinal endothelium. Increased iron load contributes to the development of atherosclerotic plaque by adversely affecting lipid metabolism through inflammation and oxidative stress. The aim of this study is to research the effect of chronic inflammation on iron and lipid metabolism in overweight and obese children and to determine the relationship between them. Material and Method: The study included 51 overweight, 61 obese and 50 healthy controls, aged 12-18 years, who are admitted to the Sakarya University Medical Faculty Education and Research Hospital Pediatric Endocrinology and Pediatrics Outpatient Clinic between 01.08.2019 and 03.11.2020. Sociodemographic and anthropometric characteristics, lipid profile, iron parameters, hsCRP, hepcidin and sTfR levels are analyzed among the groups. Results: Lower serum iron, iron / hepcidin ratio and higher TIBC values are found in the obese group compared to the other groups (p: 0.03, p: 0.014, p: 0.02). There is no significant difference between the groups in hepcidin and sTfR levels (p: 0.667, p:0.136). The hsCRP level is found to be significantly higher in the obese and overweight group compared to the control group (p <0.01). 25 (40%) patients in the obese group and 13 (25%) patients in the overweight group are found to be dyslipidemic. In the obese group, there is a positive correlation between hepcidin and total cholesterol and LDL cholesterol (r: 0.303 p: 0.019, r: 0.330 p: 0.010), and a negative correlation between iron and HDL (r: -0.258 p: 0.049). Conclusion: Serum iron levels are lower in obese children than healthy controls; this is considered to be due to chronic inflammation, not to iron deficiency. It can be said that chronic inflammation in childhood obesity does not increase serum hepcidin levels and thus does not adversely affect lipid metabolism.