Monteiro Ana Margarida, Fernandes Vera, Matta-Coelho Cláudia, Paredes Sílvia, Pereira Maria Lopes, Marques Olinda, Alves Marta
Departamento de Endocrinologia. Hospital de Braga. Braga, Portugal.
Departamento de Endocrinologia. Hospital de Braga. Braga, Portugal; Consulta Multidisciplinar de Obesidade. Hospital de Braga. Braga. Portugal.
Acta Med Port. 2018 Sep 28;31(9):478-482. doi: 10.20344/amp.8916.
We aim to define the iron deficiency prevalence and eventual differences between obese patients with and without metabolic syndrome.
Analysis of patients evaluated at multidisciplinary consultation of obesity in our institution between 2013 and 2015 (n = 260). Iron deficiency: ferritin levels < 15 ng/mL.
prior bariatric surgery; lack of ferritin or hemoglobin determinations.
We analyzed data from 215 patients (84.2% female) with a mean age of 42.0 ± 10.3 years. The median body mass index was 42.5 (40.0 - 46.8) kg/m2 and 52.1% had metabolic syndrome. Iron deficiency was present in 7.0%, with no differences between genders or between patients with or without metabolic syndrome. Hypertension was associated with lower prevalence of iron deficiency. Type 2 diabetes and hypertension patients had higher levels of ferritin. The multivariate analysis showed that metabolic syndrome and increasing body mass index were predictive of higher risk of iron deficiency while hypertension predicted lower odds of iron deficiency.
The prevalence of iron deficiency was similar in other published studies. Iron deficiency may be underdiagnosed if based only on ferritin concentrations. In our study, diabetes and hypertension appear to contribute to the increase in ferritin levels described in obesity.
Ferritin may not be a reliable index for evaluating iron stores in obese patients, particularly when associated with comorbidities such as type 2 diabetes and hypertension. Further studies are needed to guide the diagnosis and iron supplementation in these patients.
我们旨在确定肥胖患者中缺铁的患病率以及有无代谢综合征的肥胖患者之间最终的差异。
对2013年至2015年在我们机构进行肥胖多学科会诊的患者（n = 260）进行分析。缺铁定义为铁蛋白水平<15 ng/mL。
既往接受过减肥手术；缺乏铁蛋白或血红蛋白测定。
我们分析了215例患者（84.2%为女性）的数据，平均年龄为42.0±10.3岁。中位体重指数为42.5（40.0 - 46.8）kg/m²，52.1%的患者患有代谢综合征。缺铁发生率为7.0%，性别之间以及有无代谢综合征的患者之间无差异。高血压与缺铁患病率较低相关。2型糖尿病和高血压患者的铁蛋白水平较高。多因素分析显示，代谢综合征和体重指数增加是缺铁风险较高的预测因素，而高血压则预测缺铁几率较低。
缺铁患病率与其他已发表研究相似。仅基于铁蛋白浓度可能会漏诊缺铁。在我们的研究中，糖尿病和高血压似乎导致了肥胖患者中铁蛋白水平升高。
铁蛋白可能不是评估肥胖患者铁储备的可靠指标，尤其是当与2型糖尿病和高血压等合并症相关时。需要进一步研究以指导这些患者的诊断和铁补充。
