(P44-28-26) Lipoprotein(a) Concentration Is Associated With Iron Status Indicators Before and After 8-Weeks of Iron Supplementation Among Women of Reproductive Age With Low Iron Stores

Objectives: Higher lipoprotein(a) [Lp(a)] concentration is associated with increased risk of deficiency anemias, but it is unclear if this includes iron deficiency anemia. The objective of this study was to examine relationships between baseline Lp(a) concentration and indicators of iron status and their response to iron supplementation.

Methods: A secondary analysis was conducted using samples from a completed randomized two-arm parallel trial. Fifty-two non-pregnant women of reproductive age (age 18-40 y, BMI 18.5-29.9 kg/m2) with low serum ferritin concentrations ( < 25 µg/L) were given 32 mg iron (as ferrous sulfate) and a lunch meal containing beef (n = 27) or a plant-based meat alternative (n = 25) daily for 8 weeks. Indicators of iron status (ferritin, body iron, hepcidin, total iron binding capacity, serum iron [SFe], transferrin saturation [TSat], transferrin, and soluble transferrin receptor), anemia (hemoglobin [Hgb] and hematocrit) and Lp(a) concentrations were measured at baseline and post-intervention. Associations between baseline Lp(a) concentrations (independent variable) and indicators of iron status and anemia were tested with linear regression. A Fisher’s Exact test was used to assess the likelihood of iron deficiency (ID; ferritin < 25 µg/L) or iron deficiency anemia (IDA; ferritin < 25 µg/L and a Hgb < 12 g/dL) pre- and post-intervention among those with a baseline Lp(a) category < 30 mg/dL versus ≥30 mg/dL which reflects a low or elevated risk of cardiovascular disease.

Results: Baseline Lp(a) concentrations were inversely associated with baseline ferritin (-0.12 µg/L [95%CI: -0.22, -0.02]) and baseline body iron (-0.04 mg/kg [-0.8, -0.01]). Baseline Lp(a) concentration was negatively associated with the change in TSat (-0.25% [-0.45, -0.05]) and the change in SFe (-0.86 µg/dL [-1.59, -0.13]). No other associations were observed between Lp(a) and indicators of iron status or ID/IDA.

Conclusions: In women of reproductive age with low iron stores, higher baseline Lp(a) concentrations were associated with lower baseline iron stores (i.e., ferritin and body iron), as well as a blunted response in the change in circulating iron (TSat and SFe) following iron supplementation. Additional research is needed to understand the mechanisms linking Lp(a) to iron metabolism and anemia risk.

Funding Sources: National Cattlemen’s Beef Association (NCBA)