Influence of inflammation as measured by α-1-acid glycoprotein on iron status indicators among HIV-positive postpartum Zimbabwean women

R. Rawat, R. J. Stoltzfus, R. Ntozini, K. Mutasa, P. J. Iliff, Jean Hawes Humphrey

Research output: Contribution to journalArticle

Abstract

Objectives: The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of α-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population. Subjects: We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women. Results: SF was significantly higher in APR-positive (AGP > 1 g/l) women (P <0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P <0.001). However, among anemic women (Hb <110 g/l), APR-positive women had marginally lower TfR concentrations (P = 0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women. Conclusions: AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoeisis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators.

Original languageEnglish (US)
Pages (from-to)787-793
Number of pages7
JournalEuropean Journal of Clinical Nutrition
Volume63
Issue number6
DOIs
StatePublished - 2009

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Acute-Phase Reaction
Postpartum Period
Glycoproteins
Iron
HIV
Inflammation
Transferrin Receptors
Acids
Hemoglobins
Ferritins
Centers for Disease Control and Prevention (U.S.)
Erythropoietin
Serum

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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Influence of inflammation as measured by α-1-acid glycoprotein on iron status indicators among HIV-positive postpartum Zimbabwean women. / Rawat, R.; Stoltzfus, R. J.; Ntozini, R.; Mutasa, K.; Iliff, P. J.; Humphrey, Jean Hawes.

In: European Journal of Clinical Nutrition, Vol. 63, No. 6, 2009, p. 787-793.

Research output: Contribution to journalArticle

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abstract = "Objectives: The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of α-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population. Subjects: We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women. Results: SF was significantly higher in APR-positive (AGP > 1 g/l) women (P <0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P <0.001). However, among anemic women (Hb <110 g/l), APR-positive women had marginally lower TfR concentrations (P = 0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women. Conclusions: AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoeisis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators.",
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T1 - Influence of inflammation as measured by α-1-acid glycoprotein on iron status indicators among HIV-positive postpartum Zimbabwean women

AU - Rawat, R.

AU - Stoltzfus, R. J.

AU - Ntozini, R.

AU - Mutasa, K.

AU - Iliff, P. J.

AU - Humphrey, Jean Hawes

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N2 - Objectives: The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of α-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population. Subjects: We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women. Results: SF was significantly higher in APR-positive (AGP > 1 g/l) women (P <0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P <0.001). However, among anemic women (Hb <110 g/l), APR-positive women had marginally lower TfR concentrations (P = 0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women. Conclusions: AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoeisis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators.

AB - Objectives: The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of α-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population. Subjects: We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women. Results: SF was significantly higher in APR-positive (AGP > 1 g/l) women (P <0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P <0.001). However, among anemic women (Hb <110 g/l), APR-positive women had marginally lower TfR concentrations (P = 0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women. Conclusions: AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoeisis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators.

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