Does Fat Distribution Play a Role in Obesity-Associated Iron Deficiency Anemia? An Anthropometry-based Analysis in Young Women

Background and aim: High hepcidin levels in obesity reduce iron absorption, leading to iron deficiency anemia. Visceral fat is metabolically more active than subcutaneous fat. We wanted to assess if hemoglobin (Hb), serum iron, and serum ferritin levels correlated with surrogate markers of visceral fat and subcutaneous fat, i.e., waist circumference (WC) and the sum of three skinfold thicknesses (SFT3), respectively.
Material and methods: Thirty young women aged 17-20 years, BMI => 25.0 kg/m2, participated in the cross-sectional analytical study. Data collected: Anthropometry- weight and height for Body Mass Index (BMI) calculation, WC, and skinfold thickness at three sites – triceps, abdomen, and suprailiac regions for SFT3; Haematology parameters - Hb, serum ferritin, and serum iron levels. Data analysis: Pearson's Correlation coefficient (p< 0.05) was calculated for both WC and SFT3, with S. Iron, S. Ferritin, and Hemoglobin.
Results: Thirty percentage of the participants were anemic (Hb < 12.0 mg/dl). Their Iron stores and serum levels were poor (Serum Ferritin < 15.0 ng/ml and S. Iron < 60.0 µ/dl): 67.0% and 70.0%, respectively. WC and SFT3 correlated negatively with hemoglobin. SFT3 and BMI correlated positively with serum ferritin, but WC correlated negatively. Serum iron levels correlated negatively with WC and BMI but positively with SFT3. However, any positive or negative correlation was not found to be significant.
Conclusions: There was a positive association between obesity with iron deficiency anemia. However, whether visceral or subcutaneous fat is more associated with the same remained inconclusive.