title: Adolescent life-event stress in boys is associated with elevated IL-6 and hepcidin but not hypoferremia.
abstract: OBJECTIVE
  The link between stress-related increases in inflammatory markers, hepcidin, and iron status are poorly understood, especially in developing countries like India. The aim of the study was to examine the relationship between adolescent life-event stress (ALES), inflammatory markers, and its association with hepcidin and biomarkers of iron status among adolescent boys.
  
  
  METHODS
  Data pertaining to a subsample of 145 participants from a cross-sectional, school-based study recruiting 370 adolescent boys aged 15-19 years, from 5 schools in Hyderabad, India, were analyzed. Stress was assessed using the ALES scale, psychological distress by the General Health Questionnaire-2 (GHQ-12), and approach and avoidance coping using the Coping Strategies Scale. Biomarkers of iron and concentrations of other micronutrients, hepcidin, IL-6 and C-reactive protein (CRP) in plasma were analyzed. Data were subjected to regression, path analyses, and analysis of covariance (ANCOVA).
  
  
  RESULTS
  ALES was a significant predictor of interleukin (IL)-6 (β = 0.196, p = 0.012), CRP (β = 0.217, p = 0.010), and log hepcidin (β = 0.228, p = 0.006). Hepcidin correlated significantly (p < 0.001) with IL-6 (r = 0.344) and CRP (r = 0.370) but not with the biomarkers of iron status. Path analysis showed that the model had an acceptable fit, with a root mean square error of approximation of 0.019, 90% confidence interval (CI) of 0.00-0.074, comparative fit index of 0.988, chi-square p = 0.393, and chi-square/df of 1.053.
  
  
  CONCLUSIONS
  Adolescent life-event stress is associated with elevated IL-6 and hepcidin concentration but not hypoferremia. These findings may help in iron supplementation programs for tackling anemia.
authors.affiliation: a Division of Micronutrient Research , National Institute of Nutrition, Indian Council of Medical Research , Jamai-Osmania Hyderabad , Andhra Pradesh , INDIA.
authors.forename: Little Flower
authors.initials: LF
authors.lastname: Augustine
authors.forename: Krishnapillai Madhavan
authors.initials: KM
authors.lastname: Nair
authors.forename: Sylvia Fernandez
authors.initials: SF
authors.lastname: Rao
authors.forename: Mendu Vishnuvardhana
authors.initials: MV
authors.lastname: Rao
authors.forename: Punjal
authors.initials: P
authors.lastname: Ravinder
authors.forename: Nagalla
authors.initials: N
authors.lastname: Balakrishna
authors.forename: Avula
authors.initials: A
authors.lastname: Laxmaiah
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Vazir
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005293:Ferritins / Q000097:blood*; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007194:India; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D015850:Interleukin-6 / Q000097:blood*; D007501:Iron / Q000097:blood*; D008297:Male; D012574:Schools; D013315:Stress, Psychological / Q000097:blood / Q000150:complications*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D064451:Hepcidins; D015850:Interleukin-6; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron
keywords: IL-6; India; adolescents; hepcidin; inflammation; iron; path analysis; stress