Post-prandial iron absorption in humans: Comparison between HFE genotypes and iron deficiency anaemia

Background & aims: Measurement of serum iron increase after ingestion of a meal could be an efficient method of comparing post-prandial iron absorption between groups of individuals. We determined whether the rise in post-prandial serum iron is increased in fully treated patients with hereditary haemochromatosis (HFE C282Y+/+; HH) compared to iron deficiency anaemia (IDA), iron-replete heterozygous subjects (HFE C282Y+/-) and iron-replete controls (HFE C282Y-/-). Methods: Serum iron increase was measured over 4 h after a meal containing 13.1 mg non-haem iron. Results: Post-prandial increase in serum iron was similar in treated HH versus IDA (P = 0.54), but greater than control subjects (P < 0.0001). In five HH patients, using ⁵⁸Fe as a tracer, the rate of iron absorption was increased (P < 0.05) and serum non-transferrin bound iron showed a tendency to increase (P = 0.06). Serum iron curves did not differ for heterozygous subjects and controls (P = 0.65). Conclusions: Using the serum iron method we found a comparable increase in post-prandial iron absorption in treated HH and IDA compared with controls. While post-prandial iron absorption in the group heterozygous for the C282Y mutation was modestly increased relative to controls, this difference was not statistically significant.