The relationship between obesity and hypoferraemia in adults: a systematic review

Obes Rev. 2012 Feb;13(2):150-61. doi: 10.1111/j.1467-789X.2011.00938.x. Epub 2011 Oct 10.


A growing number of studies suggest a potential link between obesity and altered iron metabolism. The purpose of this systematic review was to examine existing literature on iron status in obese populations. A comprehensive literature search was conducted. Included studies recruited participants ≥ 18 years with a body mass index ≥ 30 kg m(-2) and provided descriptive statistics for haemoglobin or ferritin at a minimum. There were 25 studies meeting all eligibility criteria, of these 10 examined iron status in free-living obese individuals and 15 reported baseline iron biomarkers from bariatric surgery candidates. Non-obese comparison groups were used by 10 (40%) articles. In these, seven obese groups reported higher mean haemoglobin concentration; six reported significantly higher ferritin concentration; and four significantly lower transferrin saturation. Due to insufficient data, it was not possible to make conclusions regarding mean differences for soluble transferrin receptor (sTfR), hepcidin or C-reactive protein. Existing evidence suggests a tendency for higher haemoglobin and ferritin concentration and lower transferrin saturation in obesity. Alternation of iron biomarkers in obese populations may be a result of obesity-related inflammation and/or related comorbidities. Further research incorporating measurement of inflammatory cytokines, sTfR and hepcidin is required to confirm the impact of obesity on iron status.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Body Mass Index
  • Body Weight / physiology*
  • C-Reactive Protein / metabolism
  • Ferritins / blood
  • Hemoglobins / metabolism
  • Humans
  • Iron / blood
  • Iron / metabolism*
  • Iron Deficiencies*
  • Obesity / blood*
  • Obesity / physiopathology*
  • Receptors, Transferrin / metabolism
  • Transferrin / metabolism


  • Hemoglobins
  • Receptors, Transferrin
  • Transferrin
  • C-Reactive Protein
  • Ferritins
  • Iron