High on iron? It stops the anemia but has a downside

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21 June 2019

A global study examining the role that iron plays in 900 diseases has discovered the impact of both low and high iron levels – and the news is mixed.

People with high iron levels are not only protected against anemia but are also less likely to have high cholesterol, according to an international study conducted by Imperial College of London, the University of South Australia (UniSA) e University of Ioannina.

In a document published today at PLOS medicine, the researchers used genetic and clinical data from around 500,000 people in the British Biobank, examining the role of iron status and its impact on health.

Iron deficiency is well documented, with about 1.2 billion people worldwide living with anemia, leading to serious health problems if left untreated.

What is less known is the impact of excess iron in which the body stores too much iron, which can lead to liver disease, heart problems and diabetes in extreme cases.

About 25-65% of the differences between subjects in iron levels are due to genetic factors, according to the university geneticist Dr. Beben Benyamin (pictured left), first joint author of the article.

"We used a statistical method, called Mendelian randomization that uses genetic data to better estimate the causal effect of iron status on 900 diseases and conditions. Through this, we found a link between excess iron and reduced cholesterol risk high, "says Dr. Benyamin.

"This could be significant given that high cholesterol is an important factor in cardiovascular disease and heart attacks, causing about 2.6 million deaths each year according to the World Health Organization."

However, it is a double-edged sword: high iron levels could also lead to a greater risk of bacterial skin infections, such as cellulitis and abscesses.

Previous studies have found that bacteria need iron to survive and thrive, but the Biobank study is the first to use large-scale population data to support the link between iron overload and bacterial skin infections.

Cellulite hits around 21 million people every year, resulting in more than 17,000 deaths worldwide, making it a global health priority.

The main co-author of the document, dr. Dependent Gill of the Imperial College of London, states that a major strength of the study is its ability to "quickly and efficiently determine the effect of genetically elevated iron status on hundreds of clinically relevant findings using data that it already has been captured ".

"We identified the previously established protective effect of a higher iron status on anemia-related traits, and also showed protective effects related to the risk of high cholesterol levels and harmful effects on the risk of skin infections and soft tissue. "

Clinical studies have been conducted to manipulate iron status in anemic patients but, to date, no trials have targeted iron levels to prevent or treat skin infections or to regulate cholesterol. Test data is essential before recommending iron manipulation for these disorders.

"In this study, we provided population-based evidence that iron is associated with certain diseases. The next step is to investigate whether direct manipulation of iron levels improves health outcomes through clinical trials," says Dr. Benyamin.

Notes for editors

"Genetically determined associations of iron status through the phenomenon: a Mendelian randomization study" is published in PLOS Medicine. The research was conducted by dr. Dipender Gill and by Dr. Ioanna Tzoulaki of the Imperial College of London and by Dr. Beben Benyamin from Australian Center for Precision Health, University of South Australia.

The Bank of the United Kingdom is a large long-term study in the UK that studies the impact of genes and environmental exposure on the development of the disease.

The dott. Benyamin is funded by the National Health and Medical Research Council (NHMRC).

Dr Gill is funded by the Wellcome 4i Clinical PhD Program at Imperial College London.

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