Systematic evaluation of the association between hemoglobin levels and metabolic profile implicates beneficial effects of hypoxia

Juha Auvinen, Joona Tapio, Ville Karhunen, Johannes Kettunen, Raisa Serpi, Elitsa Y. Dimova, Dipender Gill, Pasi Soininen, Tuija Tammelin, Juha Mykkänen, Katri Puukka, Mika Kähönen, Emma Raitoharju, Terho Lehtimäki, Mika Ala-Korpela, Olli T. Raitakari, Sirkka Keinänen-Kiukaanniemi, Marjo Riitta Järvelin, Peppi Koivunen

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Abstract

Activation of the hypoxia-inducible factor (HIF) pathway reprograms energy metabolism. Hemoglobin (Hb) is the main carrier of oxygen. Using its normal variation as a surrogate measure for hypoxia, we explored whether lower Hb levels could lead to healthier metabolic profiles in mice and humans (n = 7175) and used Mendelian randomization (MR) to evaluate potential causality (n = 173,480). The results showed evidence for lower Hb levels being associated with lower body mass index, better glucose tolerance and other metabolic profiles, lower inflammatory load, and blood pressure. Expression of the key HIF target genes SLC2A4 and Slc2a1 in skeletal muscle and adipose tissue, respectively, associated with systolic blood pressure in MR analyses and body weight, liver weight, and adiposity in mice. Last, manipulation of murine Hb levels mediated changes to key metabolic parameters. In conclusion, low-end normal Hb levels may be favorable for metabolic health involving mild chronic activation of the HIF response.

Original languageEnglish
Article numbereabi4822
JournalScience Advances
Volume7
Issue number29
DOIs
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed

Publication forum classification

  • Publication forum level 3

ASJC Scopus subject areas

  • General

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