JUNIPER PUBLISHERS-Current Research in Diabetes & Obesity Journal
Dysmetabolic Iron Overload and Cardiometabolic Diseases. Cause-Effect Relationship or Indirect Association?
Authored by M Pilar Vaquero*
The prevalence
of cardiometabolic diseases is increasing all over the world. Insulin
resistance has been proposed as one major factor of the Metabolic syndrome
(MetS) that ultimately leads to type 2 Diabetes Mellitus (T2DM). The
relationship between iron status and MetS has been scarcely described. This
mini-review presents on one hand the existing knowledge on the effects of
excess body iron (iron overload) on insulin resistance and on the other the
link between hyperglycemia and alterations in iron metabolism. When the binding
capacity of serum transferrin exceeds normal levels, free-iron induces the
formation of reactive oxygen species (ROS) which may increase oxidative stress
and cause tissue damage. In addition, ROS have been linked to insulin
resistance, reduction in adiponectin release, and non-alcoholic fatty liver,
among others. It is also discussed that as a consequence of glucose excess,
transferrin, as other proteins, becomes glycated decreasing its iron binding
capacity resulting in elevated free-iron levels and the consequent deleterious
effects. As in both, T2DM and hemochromatosis patients, a significant high
ferritin-dyslipemia relationship has been reported, present review hypothesizes
that iron stored as “ferritin” partially escapes to plasma contributing to the
vicious circle. Increases in liver free fatty acids availability and
gluconeogenesis aggravate insulin resistance, giving rise to adyslipemic
profile. Nonetheless, several points and action mechanisms are still poorly
understood and require more studies to elucidate the role of iron in the
etiology of cardiometabolic diseases. Finally, it is suggested that subjects
predisposed to cardiometabolic diseases and/or to accumulate iron should limit
the prolonged consumption of iron supplements or iron fortified foods.
Strategies to decrease the bioavailability of iron in such vulnerable
population groups, such as recommending high vegetable diets, deserve future
investigation.
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