Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake.
The relationship between dietary intake, circulating hepcidin and iron status in free-living premenopausal women has not been explored. This cross-sectional study aimed to identify dietary determinants of iron stores after accounting for blood loss and to determine whether iron intake predicts iron stores independently of hepcidin in a sample of Australian women. Three hundred thirty eight women aged 18-50 years were recruited. Total intake and food sources of iron were determined via food frequency questionnaire; the magnitude of menstrual losses was estimated by self-report; and blood donation volume was quantified using blood donation records and self-reported donation frequency. Serum samples were analysed for ferritin, hepcidin and C-reactive protein concentrations. Linear regression was used to investigate associations. Accounting for blood loss, each 1 mg/day increase in dietary iron was associated with a 3% increase in iron stores (p = 0.027); this association was not independent of hepcidin. Hepcidin was a more influential determinant of iron stores than blood loss and dietary factors combined (R² of model including hepcidin = 0.65; R² of model excluding hepcidin = 0.17, p for difference <0.001), and increased hepcidin diminished the positive association between iron intake and iron stores. Despite not being the biggest contributor to dietary iron intake, unprocessed meat was positively associated with iron stores, and each 10% increase in consumption was associated with a 1% increase in iron stores (p = 0.006). No other dietary factors were associated with iron stores. Interventions that reduce hepcidin production combined with dietary strategies to increase iron intake may be important means of improving iron status in women with depleted iron stores.
Institute for Physical Activity and Nutrition, Melbourne Burwood Campus, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. k.lim@deakin.edu.au.
Karen H C
KH
Lim
Institute for Physical Activity and Nutrition, Melbourne Burwood Campus, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. alison.booth@deakin.edu.au.
Alison O
AO
Booth
Institute for Physical Activity and Nutrition, Melbourne Burwood Campus, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. caryl.nowson@deakin.edu.au.
Caryl A
CA
Nowson
Institute for Physical Activity and Nutrition, Melbourne Burwood Campus, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. ewa.szymlekgay@deakin.edu.au.
Ewa A
EA
Szymlek-Gay
Australian Red Cross Blood Service, 17 O'Riordan Street, Alexandria, New South Wales 2015, Australia. dirving@redcrossblood.org.au.|Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, New South Wales 2007, Australia. dirving@redcrossblood.org.au.
David O
DO
Irving
Institute for Physical Activity and Nutrition, Melbourne Burwood Campus, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. lynn.riddell@deakin.edu.au.
Lynn J
LJ
Riddell
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001782:Blood Donors; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007501:Iron / Q000097:blood*; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000008:administration & dosage / Q000097:blood*; D008460:Meat; D008598:Menstruation / Q000097:blood*; D008875:Middle Aged; D009517:New South Wales; D011237:Predictive Value of Tests; D017697:Premenopause / Q000097:blood*; D015203:Reproducibility of Results; D014739:Victoria; D016387:Women's Health; D055815:Young Adult
D015415:Biomarkers; C578702:HAMP protein, human; D064451:Hepcidins; D019266:Iron, Dietary; D007501:Iron
blood donation; female; hepcidin; iron intake; iron status; menstrual loss