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Basic Science

Poster Session 2

(643) Functional gut microbiome variation impacts iron deficiency and responsiveness to iron supplementation: An Interventional Trial

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Careful regulation of iron absorption in the gut is mediated by key host and microbe molecular pathways controlling cellular function, metabolism, and DNA processing. Inconsistent response to oral iron supplementation (IS) suggests varying function in these molecular pathways. We hypothesized that the inferred functional gut microbiome would vary between iron sufficient and deficient participants, and responders vs non-responders following IS.

Study Design: People who menstruate without a known history of anemia or iron deficiency were included in our open label, prospective, interventional trial (n=26). Participants received 14 days of 65mg elemental iron. Blood (Days (D) 0 & 14) & stool (8 samples including D0 & D14) were collected for iron & anemia indices and microbiome analyses. Stool sample DNA underwent 16S amplicon sequencing and bioinformatic analysis of microbial ASVs (DADA2). To characterize the gut microbiome composition, taxonomic comparisons, & unsupervised clustering with Dirichlet multinomial mixtures (DMM) were performed. Participants who were iron deficient on D0 (n=17) were later subdivided into iron supplement responders (ferritin ≥ 30 ng/mL, n=4) and non-responders (ferritin < 30 ng/mL, n=12), based on their D14 ferritin.

Results: Inferred functional microbiome comparisons at D0 found 13 significantly differentially expressed functions whose taxonomic abundances differed significantly in association with responder class (Figure 1A). In the D0 iron deficient group, 67 inferred microbial functions were identified in relation to response status. Analysis of the 67 functions at D14 detected 4 significantly differentially expressed functions whose taxonomic contributions differed significantly in association with responder class (Figure1B,C).

Conclusion: These data show significant differences between the inferred functional microbiomes of iron deficient and sufficient participants, and between IS responders and non-responders. Our findings provide insight into the functional impact of gut microbiome composition on iron deficiency and responsiveness to IS.