Dysmetabolic iron overload in metabolic syndrome.

BACKGROUND We sought to determine the association of dysmetabolic iron overload syndrome (DIOS) with metabolic syndrome (MetS). METHODS-RESULTS Several studies have shown that DIOS is associated with Mets, mainly through the pathogenesis of its components: type 2 diabetes melitus (T2DM), essential hypertension, non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (POS). Serum ferritin levels increase proportionally according to the degree of insulin resistance (IR) and the number of components of Mets [5]. Moreover, DIOS predictis the onset of T2DM and NAFLD. Dysregulation of iron metabolism in DIOS is due to a multifactorial and dynamic process triggered by unhealthy diet, facilitated by environmental and genetic cofactors, and resulting in a bidirectional relation between the liver and visceral adipose tissue (VAT). Iron removal combined with healthy diet improved both insulin sensitivity and beta cell function, but had no significant effect on blood glucose; phlebotomy therapy might be considered with conflicting results however. CONCLUSIONS Iron overload is closely associated with the metabolic syndrome and its components; however, it remains under-appreciated in everyday clinical practice. Diet and lifestyle modification offer some clinical benefit; however, it is not adequate for the successful management of the disease. The results of phlebotomy remain controversial, underlying the necessity of further efforts in this field.