Effect of Age and Weight Loss on Inflammation and Iron Homeostasis
| Status: | Completed |
|---|---|
| Conditions: | Healthy Studies, Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | March 2011 |
| End Date: | November 2013 |
Effect of Age and Weight Loss on Obesity-related Inflammation and Iron Homeostasis in Women
The purpose of this study is to evaluate the effect of aging and weight loss on iron status
and immune response in obese women. Iron deficiency and immune impairment are two of the
numerous complications of obesity. The central hypothesis is that obesity-induced
inflammation causes lower iron status through decreased iron absorption and availability in
young and older obese women. Furthermore, the investigators hypothesize that this can be
corrected with weight loss in both young and older obese women.
and immune response in obese women. Iron deficiency and immune impairment are two of the
numerous complications of obesity. The central hypothesis is that obesity-induced
inflammation causes lower iron status through decreased iron absorption and availability in
young and older obese women. Furthermore, the investigators hypothesize that this can be
corrected with weight loss in both young and older obese women.
Obese individuals have chronic inflammation, higher risk of iron deficiency, and impaired
immune response. These are conditions seen also with aging, but it is unknown to what extent
they may be further impacted by obesity in the elderly. With this study the investigators
aim to establish the mechanism by which weight loss may reduce inflammation and enhance iron
status in young and older obese adults through the peptide hormone hepcidin, which regulates
iron homeostasis. The investigators also aim to identify a possible link between iron
homeostasis and immune response through hepcidin, which has been implicated in T cell
mediated immunity. The investigators hypothesize that obesity-induced inflammation causes
dysregulation of hepcidin expression leading to lower iron status through decreased iron
absorption and availability in young and older adults. Furthermore, the investigators
hypothesize that hepcidin dysregulation, and thus iron status can be mitigated with weight
loss in both young and older obese adults. This hypothesis will be tested in obese young and
older women undergoing weight loss through calorie restriction. Change in iron status,
inflammation, and hepcidin will be determined before and after weight loss. Further, the
impact of inflammatory environment of obesity on peripheral blood mononuclear cell hepcidin,
ferroportin, intracellular iron, and T cell function in young and older adults will be
determined. This study will address two important public health problems, i.e. obesity and
iron deficiency and will be an important step toward the identification of strategies to
enhance health of obese young and older adults.
immune response. These are conditions seen also with aging, but it is unknown to what extent
they may be further impacted by obesity in the elderly. With this study the investigators
aim to establish the mechanism by which weight loss may reduce inflammation and enhance iron
status in young and older obese adults through the peptide hormone hepcidin, which regulates
iron homeostasis. The investigators also aim to identify a possible link between iron
homeostasis and immune response through hepcidin, which has been implicated in T cell
mediated immunity. The investigators hypothesize that obesity-induced inflammation causes
dysregulation of hepcidin expression leading to lower iron status through decreased iron
absorption and availability in young and older adults. Furthermore, the investigators
hypothesize that hepcidin dysregulation, and thus iron status can be mitigated with weight
loss in both young and older obese adults. This hypothesis will be tested in obese young and
older women undergoing weight loss through calorie restriction. Change in iron status,
inflammation, and hepcidin will be determined before and after weight loss. Further, the
impact of inflammatory environment of obesity on peripheral blood mononuclear cell hepcidin,
ferroportin, intracellular iron, and T cell function in young and older adults will be
determined. This study will address two important public health problems, i.e. obesity and
iron deficiency and will be an important step toward the identification of strategies to
enhance health of obese young and older adults.
Inclusion Criteria:
- Enrolling patients in the Weight and Wellness Center (WWC) at Tufts Medical Center,
part of their Tufts Employees, low calorie diet (LCD) or pre-surgical low calorie
diet (PS-LCD) program, or enrolling at WWC as individual patients.
- BMI in the range of 30 to 55 kg/m2.
- Either ages 18-45 or >60.
Exclusion Criteria:
- Pregnancy.
- Weight reduction greater than or equal to 3% in the past 3 months.
- Prior gastric restrictive surgery.
- Weight loss medications within the 4 weeks prior to screening.
- History of eating disorder.
- Renal disease (serum creatinine >2mg/dl).
- Hepatic disease, except for nonalcoholic steatohepatitis (NASH).
- Celiac disease, or any kind of intestinal malabsorption disorders.
- Gastrointestinal cancer.
- Hereditary hemochromatosis, or any blood disorders.
- Chronic infectious or inflammatory disease.
- Use of immunosuppressants.
- Severe iron deficiency anemia (hemoglobin<8 g/dl) or other conditions that would
prevent them from discontinuing iron supplement use.
- Unwilling to discontinue iron supplement intake. The dietary plan recommended by the
WWC will include daily intake of iron that meets the iron RDA for the subject's
gender and age group, therefore discontinuing iron supplement will not be harmful for
the participants. Intake of other supplements will not be an exclusion criteria, as
long as it stays constant throughout the study period.
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