Assessment of Oral Iron Absorption in Patients with Pulmonary Arterial Hypertension: A Clinical Study

L Repsold; A Florea; S Harutyunova; P Xanthouli; B Egenlauf; E Grünig; N Benjamin; C Eichstaedt; M Muckenthaler; R Sparla; C Mertens

doi:10.1055/s-0045-1804807

Pneumologie, Inhaltsverzeichnis

Pneumologie 2025; 79(S 01): S118-S119
DOI: 10.1055/s-0045-1804807

Abstracts

E1 – Kardiorespiratorische Interaktion und Pulmonale Hypertonie

Assessment of Oral Iron Absorption in Patients with Pulmonary Arterial Hypertension: A Clinical Study

Authors

L Repsold

¹Thoraxklinik Heidelberg; Zentrum für Pulmonale Hypertonie
A Florea

¹Thoraxklinik Heidelberg; Zentrum für Pulmonale Hypertonie
S Harutyunova

²Zentrum für Pulmonale Hypertonie, Thoraxklinik am Universitätsklinikum Heidelberg; Center for Pulmonary Hypertension, Thoraxklinik at Heidelberg University Hospital, Translational Lung Research Center Heidelberg (Tlrc), German Center for Lung Research (Dzl), Heidelberg; Pulmonale Hypertonie
P Xanthouli

³Universitätsklinikum Heidelberg; Medizinische Klinik V; Rheumatologie
B Egenlauf

⁴Thoraxklinik Universitätsklinik Heidelberg; Zentrum für Pulmonale Hypertonie; Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg
E Grünig

⁵Zentrum für Pulmonale Hypertonie; Thoraxklinik am Universitätsklinikum Heidelberg; Universitätsklinikum
N Benjamin

⁶Zentrum für Pulmonale Hypertonie; Thoraxklinik am Universitätsklinikum Heidelberg; Translational Lung Research Centre Heidelberg (Tlrc), German Centre for Lung Research (Dzl)
C Eichstaedt

⁷Translational Lung Research Centre Heidelberg (Tlrc), German Centre for Lung Research (Dzl); Institut für Humangenetik, Universität Heidelberg
M Muckenthaler

⁸Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Molecular; Translational Lung Research Center Heidelberg (Tlrc), German Center for Lung Research (Dzl), Heidelberg
R Sparla

⁹Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Molecular Medicine Partnership Unit (Mmpu), University Hospital Heidelberg; Translational Lung Research Centre Heidelberg (Tlrc), German Center for Lung Research (Dzl), Heidelberg
C Mertens

¹⁰Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Molecular Medicine Partnership Unit (Mmpu), University Hospital Heidelberg

Abstract

Volltext

Background: Iron deficiency (ID) is common in patients with pulmonary arterial hypertension (PAH). It is associated with worse clinical outcomes, including decreased exercise capacity and increased mortality. Previous studies have suggested that impaired gastrointestinal iron absorption may contribute to the high prevalence of ID in PAH patients.

Objective: The aim of this study was to determine in a standardized manner whether differences in oral iron absorption exist between PAH patients with and without ID and healthy controls.

Methods: This single-center prospective, cross-sectional cohort study involved 45 participants, divided into three groups: 15 PAH patients with ID in the past, 15 PAH patients without ID in the past and 15 healthy controls, who were age and sex matched to non-ID PAH patients. ID was defined by either recorded ID anemia in the past 3 years or clinical indication for i.v. iron supplementation. A standardized iron absorption test with 200 mg iron (II) glycine sulfate was performed by all participants after an overnight fast. Plasma iron levels and transferrin saturation (TSAT) were measured before oral iron intake and after 3 h and compared with the Mann-Whitney-U test.

Results: Patients with and without ID showed a similar increase of plasma iron and TSAT after 3 h. The increase in plasma iron and TSAT both patient groups was significantly lower (with ID: 95.5±70.6 µg/dl; 28.9±20.3%; without ID: 83.8±57.1 µg/dl; 26.7±16.1%) compared to healthy controls (151.9±62.4 µg/dl; 44.8±17.7%), p=0,004, [Fig. 1].

Conclusion: The standardized iron absorption test revealed a functioning but reduced iron uptake in PAH patients compared to controls. Thus, factors such as chronic inflammation may reduce the iron uptake in patients. Hence, this study supports the hypothesis of reduced iron absorption in PAH patients.

Fig. 1 Differences in iron absorption in PAH patients and healthy controls after 3 hours

Abbildungen

Fig. 1 Differences in iron absorption in PAH patients and healthy controls after 3 hours