1. Respiratory infections drive hepcidin-mediated blockade of iron absorption leading to iron deficiency anemia in African children
- Author
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Prentice, AM, Bah, A, Jallow, MW, Jallow, AT, Sanyang, S, Sise, EA, Ceesay, K, Danso, E, Armitage, AE, Pasricha, S-R, Drakesmith, H, Wathuo, M, Kessler, N, Cerami, C, Wegmuelleri, R, Prentice, AM, Bah, A, Jallow, MW, Jallow, AT, Sanyang, S, Sise, EA, Ceesay, K, Danso, E, Armitage, AE, Pasricha, S-R, Drakesmith, H, Wathuo, M, Kessler, N, Cerami, C, and Wegmuelleri, R
- Abstract
Iron deficiency anemia (IDA) is the most prevalent nutritional condition worldwide. We studied the contribution of hepcidin-mediated iron blockade to IDA in African children. We measured hepcidin and hemoglobin weekly, and hematological, inflammatory, and iron biomarkers at baseline, 7 weeks, and 12 weeks in 407 anemic (hemoglobin < 11 g/dl), otherwise healthy Gambian children (6 to 27 months). Each child maintained remarkably constant hepcidin levels (P < 0.0001 for between-child variance), with half consistently maintaining levels that indicate physiological blockade of iron absorption. Hepcidin was strongly predicted by nurse-ascribed adverse events with dominant signals from respiratory infections and fevers (all P < 0.0001). Diarrhea and fecal calprotectin were not associated with hepcidin. In multivariate analysis, C-reactive protein was the dominant predictor of hepcidin and contributed to iron blockade even at very low levels. We conclude that even low-grade inflammation, especially associated with respiratory infections, contributes to IDA in African children.
- Published
- 2019