Gut microbiota and iron homeostasis: implications for glycemic control.

Isa G Rodrigues, José M Fernández-Real, Jose Moreno-Navarrete

Journal: Minerva medica 2025;116(4):329-349

PMID: 40371617

Abstract

The gut microbiome, comprised of diverse microorganisms, plays a critical role in maintaining metabolic, immune, and digestive health. This dynamic ecosystem is highly influenced by external factors such as diet, genetics, environmental factors, and even medication use, including antibiotics. Iron, already bioavailable in the Archean Ocean, is one of the most abundant elements on Earth. All organisms compete or collaborate to obtain iron, demonstrating its relevance in the biological and physiological processes essential to the maintenance of metabolic homeostasis. The bidirectional relationship between the intestinal microbiota, and the host organism in obtaining iron influences both the metabolism of the host, and that of the microbiota. Bacteria in microbiota affects the absorption of iron by the organism, while factors such as iron deficiency or excess in the host modify bacterial biodiversity, its taxonomic composition and its functions. These changes impact bacterial virulence, influencing systemic iron levels, tissue storage and glucose metabolism in the host organism. Patients with changes in glucose metabolism and insulin resistance often present imbalances in iron regulation and alterations in the profile of their intestinal microbiota. The interaction between microbiota, iron and glycemia represents an emerging field of research, standing out as a promising area for nutritional and therapeutic interventions to promote metabolic health. This review explores the relationship between iron metabolism and gut microbiota, highlighting its impact on glucose metabolism.

Address: Emergency Cardiology Unit, University of Pernambuco, Recife, Brazil.; Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta Hospital, Girona, Spain.; Nutrition, Eumetabolism and Health Group, Girona Biomedical Research Institute (IDIBGI-CERCA), Girona, Spain.; CIBER Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Madrid, Spain.; Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain.; Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta Hospital, Girona, Spain - [email protected].; Nutrition, Eumetabolism and Health Group, Girona Biomedical Research Institute (IDIBGI-CERCA), Girona, Spain.; CIBER Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Madrid, Spain.; Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain.

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