medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-17-144-148medsovet-441Research ArticleПрактикаPracticeОжирение как фактор риска нарушения обмена железаObesity is a risk factor for iron metabolism disorderДворецкийЛ. И.DvoretskiyL. I.noemail@neicon.ruИвлеваО. В.IvlevaO. V.noemail@neicon.ruПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian Federation201530122015017144148Copyright © Дворецкий Л.И., Ивлева О.В., 20152015Дворецкий Л.И., Ивлева О.В.Dvoretskiy L.I., Ivleva O.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/441

Приводятся данные о патогенетической связи между железодефицитом и наличием системного воспаления, ассоциированного с ожирением. В условиях хронического воспаления при ожирении запускается механизм секвестрации железа, преимущественно клетками макрофагальной системы и жировой ткани, снижается эффективность усвоения железа из пищи, поступление его в эритроидные клетки и синтез гема. Избыточно накопленное в клетках жировой ткани железо индуцирует оксида-тивный и эндоплазматический стресс, выработку провоспалительных цитокинов, т. е. воздействует на основные звенья патогенеза ожирения и усугубляет его. Имеются клинические данные об улучшении показателей обмена железа и снижении уровня сывороточного гепсидина у больных при снижении веса после бариатрических операций. Данные о частоте и патогенетическом варианте анемии (железодефицитная или анемия хронических заболеваний) после бариатрических операций неоднозначны.

There is data on the pathogenetic links between iron deficiency and systemic inflammation associated with obesity. In chronic inflammation in obese patients, a mechanism of iron sequestration becomes activated primarily by macrophage and adipose tissue cells. The efficiency of iron absorption from food, its uptake by erythroid cells and heme synthesis are decreased. Excessive accumulation of iron in fat cells induces oxidative and endoplasmic stress and production of proinflammatory cytokines, thus affecting the key pathogenetic links of obesity and exacerbating the condition. There is clinical evidence suggesting better iron metabolism parameters and decreased serum hepcidin in patients who lost weight after bariatric surgery. The findings related to the incidence and pathogenic form of anemia (iron deficiency or anemia of chronic disease) after bariatric surgery are heterogenous.

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The authors declare that there are no conflicts of interest present.