Lab Med Online.  2011 Apr;1(2):88-93. 10.3343/lmo.2011.1.2.4.

Serum Pro-hepcidin as an Predictor of Iron Deficiency in Anemic Patients

• Kim J
• Son Y
• Ihm C

• KMID: 1446274
• DOI: http://doi.org/10.3343/lmo.2011.1.2.4

Abstract

BACKGROUND
Hepcidin has recently been known as a negative regulatory hormone of iron. Hepcidin precursor, pro-hepcidin has been used as a surrogate and reported to be related to iron deficiency. We investigated serum pro-hepcidin levels in patients with iron deficiency anemia (IDA), anemia of chronic disorder (ACD) and ACD concomitant iron deficiency (ACD/ID) to assess its usefulness as a marker of iron deficiency and examined whether its level is associated with anemia, iron status or inflammation profiles involved in the synthesis of hepcidin.
METHODS
We enrolled 50 patients with IDA, 46 with ACD, 12 with ACD/ID and 60 healthy controls. Complete blood cell count, iron parameters (iron, TIBC, trasferrin saturation, ferritin), C-reactive protein (CRP) and serum pro-hepcidin were measured.
RESULTS
Patients with iron deficiency, the IDA group and ACD/ID group had lower serum pro-hepcidin levels than healthy controls and the ACD group. The cutoff value of pro-hepcidin for detecting iron deficiency was 230 ng/mL (sensitivity 88.1%, specificity 51.2%). Patients with increased CRP showed higher mean pro-hepcidin level than those with normal CRP and the difference was significant in the IDA group (P=0.02). And serum pro-hepcidin level was positively correlated with CRP level (r=0.30, P=0.04) in the IDA group but not with hemoglobin.
CONCLUSIONS
In patients with anemia, pro-hepcidin measurement may be useful for differentiating anemia patients with iron deficiency, IDA and ACD/ID from those with ACD. Serum pro-hepcidin levels may be more affected by inflammation than by the degree of anemia.

Keyword

Anemia; Inflammation; Iron deficiency; Pro-hepcidin

MeSH Terms

Anemia
Anemia, Iron-Deficiency
Antimicrobial Cationic Peptides
Blood Cell Count
C-Reactive Protein
Humans
Inflammation
Iron
Protein Precursors
Sensitivity and Specificity
Antimicrobial Cationic Peptides
C-Reactive Protein
Iron
Protein Precursors

Figure

• 

  Fig. 1 Serum prohepcidin levels in healthy control, anemia of chronic disorder (ACD), iron deficiency anemia (IDA), and ACD with iron deficiency (ACD/ID) groups. Data are depicted as lower quartile, median, and upper quartile (boxes) and minimum/maximum ranges (whiskers).

• 

  Fig. 2 Relationship between serum prohepcidin and C-reactive protein levels in patients with iron deficiency anemia.

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