Hafif Şişman ve Şişman Kadınlarda Demir Yetersizliği Anemisi, Beslenme Örüntüsü ile Kronik İnflamasyon Belirteçleri ve Diyet Tedavisinin Etkinliğinin Belirlenmesi

Abstract

Obesity is characterized by increased markers of inflammation, which in turn, has been associated with anemia. This study aimed to investigate iron deficiency anemia, the relationship between iron status, dietary intake pattern and markers of inflammation in overweight and obese women and the effect of dietary intervention. A total of 619 women, aged 20-49 years, in normal weight (BMI:18.5-24.9 kg/m2, n:170, 27.4%), overweight (BMI: 25.0-29.9 kg/m2, n:179, %28.9) and obese (BMI:≥30 kg/m2, n:270, %43.6) women admitted to İzmir Bozyaka Training and Research Hospital internal medicine, endocrinology and diet clinics outpatients were included to the cross-sectional part of the study. In the first part of the study, a general questionnaire was applied, biochemical parameters [whole blood count (WBC), anemia parameters, C-reactive protein (CRP), soluble transferrin receptor (sTfR)], 24-hour dietary intake for 3 consecutive days and physical activity levels were determined, anthropometric measurements were taken and bioelectrical impedance analysis was done. In the second part of the study (intervention part), 147 women were divided into two groups and dietary treatment was applied. First group was consisted of women with normal hemoglobin levels (n:101). Serum iron, hemoglobin levels and transferrin saturation of obese (65.4±33.7 mcg/dL, 12.6±1.3 g/dL, %17.4±10.0, respectively) and overweight (73.8±36.4 mcg/dL, 12.7±1.3 g/dL, %19.4±11.0, respectively) women were lower than the normal weight (85.6±37.5 mcg/dL, 13.0±1.2 g/dL, %23.8±11.0, respectively) women (p<0.05). White blood cell (WBC), CRP, high sensitive C- Reactive Protein (hsCRP) and sTfR levels of obese (7.3±1.6 mm3, 0.7±0.6 mg/dL, 13.6±16.8 mg/L, 1.9±0.7 mcg/mL, respectively) and overweight and (6.9±1.7 mm3 , 0.5±0.3 mg/dL, 2.4±2.6 mg/L, 1.7±0.9 mcg/mL, respectively) women were higher than the normal weight (6.4 ±1.5 mm3, 0.2±0.1 mg/dL, 1.5±0.9 mg/L, 1.5±0.8 mcg/mL, respectively) women (p<0.05). The prevalence of iron deficiency and iron deficiency anemia (IDA) in the obese, overweight and normal weight women were 45.6%, 27.4%; 41.9%, 24.0%, 23.5%, 12.4%, respectively. After three-month follow-up intervention, women with anemia had 10.1% weight loss, women without anemia had 10.7%. Statistically significant correlation between body weight loss and CRP levels was determined (p<0.05). Significant decreases were determined in the anthropometric variables (p<0.05) and also in the intakes of energy, total fat, saturated fatty acids and carbohydrate when compared to the initial intakes (p<0.05). Vitamin C, fiber, iron, calcium and zinc intakes increased compared to the initial intakes (p<0.05). In conclusion, it was determined that weight loss, by reducing the inflammation, had positive effects on iron parameters and on anthropometric measurements. It is obvious that obesity is an important public health problem and the precautions should be taken to prevent the occurrence of obesity. Preventive measures should cover life-long activities.