Effects of phlebotomy-induced reduction of body iron stores on metabolic syndrome: results from a randomized clinical trial

BMC Medicine

Research Article

Rainer Lüdtke¹  Martina Broecker-Preuss²  Thomas Rampp³  Gustav J Dobos³  Khosrow S Houschyar³  Benno Brinkhaus⁴  Andreas Michalsen⁵  Ulrich Kalus⁶ 

[1] Department of Biometry, Karl und Veronica Carstens-Foundation, Essen, Germany;Department of Endocrinology and Division of Laboratory Research, University Hospital Essen, Essen, Germany;Department of Internal Medicine, Kliniken Essen-Mitte, University Duisburg-Essen, Essen, Germany;Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre, Berlin, Germany;Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre, Berlin, Germany;Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Königstrasse 63, 14109, Berlin, Germany;Institute of Transfusion Medicine, Charité- University Medical Centre, Berlin, Germany;

关键词: Insulin Sensitivity;    Ferritin;    Iron Overload;    Ferritin Level;    Iron Store;   

DOI  :  10.1186/1741-7015-10-54

 received in 2011-12-07, accepted in 2012-05-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMetabolic syndrome (METS) is an increasingly prevalent but poorly understood clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity. Increased oxidative stress catalyzed by accumulation of iron in excess of physiologic requirements has been implicated in the pathogenesis of METS, but the relationships between cause and effect remain uncertain. We tested the hypothesis that phlebotomy-induced reduction of body iron stores would alter the clinical presentation of METS, using a randomized trial.MethodsIn a randomized, controlled, single-blind clinical trial, 64 patients with METS were randomly assigned to iron reduction by phlebotomy (n = 33) or to a control group (n = 31), which was offered phlebotomy at the end of the study (waiting-list design). The iron-reduction patients had 300 ml of blood removed at entry and between 250 and 500 ml removed after 4 weeks, depending on ferritin levels at study entry. Primary outcomes were change in systolic blood pressure (SBP) and insulin sensitivity as measured by Homeostatic Model Assessment (HOMA) index after 6 weeks. Secondary outcomes included HbA1c, plasma glucose, blood lipids, and heart rate (HR).ResultsSBP decreased from 148.5 ± 12.3 mmHg to 130.5 ± 11.8 mmHg in the phlebotomy group, and from 144.7 ± 14.4 mmHg to 143.8 ± 11.9 mmHg in the control group (difference -16.6 mmHg; 95% CI -20.7 to -12.5; P < 0.001). No significant effect on HOMA index was seen. With regard to secondary outcomes, blood glucose, HbA1c, low-density lipoprotein/high-density lipoprotein ratio, and HR were significantly decreased by phlebotomy. Changes in BP and HOMA index correlated with ferritin reduction.ConclusionsIn patients with METS, phlebotomy, with consecutive reduction of body iron stores, lowered BP and resulted in improvements in markers of cardiovascular risk and glycemic control. Blood donation may have beneficial effects for blood donors with METS.Trial registrationClinicalTrials.gov: NCT01328210Please see related article: http://www.biomedcentral.com/1741-7015/10/53

【 授权许可】

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© Houschyar et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.