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Title: Iron metabolism in heterozygotes for hemoglobin E (HbE), α-thalassemia 1, or β-thalassemia and in compound heterozygotes for HbE/β-thalassemia
Authors: Michael B. Zimmermann
Suthat Fucharoen
Pattanee Winichagoon
Pornpan Sirankapracha
Christophe Zeder
Sueppong Gowachirapant
Kunchit Judprasong
Toshihiko Tanno
Jeffery L. Miller
Richard F. Hurrell
ETH Zurich
Mahidol University
The Institute of Science and Technology for Research and Development, Mahidol University
National Institute of Diabetes and Digestive and Kidney Diseases
Keywords: Medicine;Nursing
Issue Date: 1-Oct-2008
Citation: American Journal of Clinical Nutrition. Vol.88, No.4 (2008), 1026-1031
Abstract: Background: Despite large populations carrying traits for thalassemia in countries implementing universal iron fortification, there are few data on the absorption and utilization of iron in these persons. Objective: We aimed to determine whether iron absorption or utilization (or both) in women heterozygous for β-thalassemia, α-thalassemia 1, orhemoglobinE (HbE) differed from that in control subjects and compound HbE/β-thalassemia heterozygotes. Design: In Thai women (n = 103), red blood cell indexes, iron status, non-transferrin-bound iron, and growth differentiation factor 15 were measured, and body iron was calculated. Fractional iron absorption was measured from meals fortified with isotopically labeled (57Fe) Fe sulfate, and iron utilization was measured by the infusion of (58Fe) Fe citrate. Results: Iron utilization was ≈15% lower in α-thalassemia 1 or β-thalassemia heterozygotes than in controls. When corrected for differences in serum ferritin, absorption was significantly higher in the α- and β-thalassemia groups, but not the HbE heterozygotes, than in controls. HbE/β-thalassemia compound heterozygotes had lower iron utilization and higher iron absorption and body iron than did controls. Nontransferrin-bound iron and growth differentiation factor 15 were higher in the compound heterozygotes, but not in the other groups, than in the controls. Conclusions: In α-thalassemia 1 and β-thalassemia heterozygotes with ineffective erythropoesis, dietary iron absorption is not adequately down-regulated, despite a modest increase in body iron stores. In populations with a high prevalence of these traits, a program of iron fortification could include monitoring for possible iron excess and for iron deficiency. © 2008 American Society for Nutrition.
ISSN: 00029165
Appears in Collections:Scopus 2006-2010

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