The Potential Role of Iron and Copper in Pediatric Obesity and Nonalcoholic Fatty Liver Disease

Figure 1

Current understanding of molecular links between obesity and iron deficiency. Obese adipose tissue is characterized by an increased production of several proinflammatory cytokines and adipokines as opposed to healthy lean adipose tissue. These may directly impact iron absorption from the enterocyte. Additionally, proinflammatory cytokines such as interleukin 1 and interleukin 6 represent potent inducers of hepcidin production in the liver, which may further impair iron absorption. Both cytokines and hepcidin lead to iron retention in spleen, liver, or bone marrow macrophages, thereby lowering serum iron concentrations and iron availability for erythropoiesis.