Korean J Hematol.  2012 Dec;47(4):286-292. 10.5045/kjh.2012.47.4.286.

Serum hepcidin levels and iron parameters in children with iron deficiency

• Choi HS
• Song SH
• Lee JH
• Kim HJ
• Yang HR

• KMID: 1832108
• DOI: http://doi.org/10.5045/kjh.2012.47.4.286

Abstract

BACKGROUND
Iron deficiency (ID) and iron deficiency anemia (IDA) are common nutritional disorders in children. Hepcidin, a peptide hormone produced in the liver, is a central regulator of systemic iron metabolism. We evaluated whether serum hepcidin levels can diagnose ID in children.
METHODS
Sera from 59 children (23 males and 36 females; 5 months to 17 years) were analyzed for hepcidin-25 by ELISA. Patients were classified according to hemoglobin level and iron parameters as: IDA, (N=17), ID (N=18), and control (N=24).
RESULTS
Serum hepcidin, ferritin, soluble transferrin receptor (sTfR), transferrin saturation, and hemoglobin levels differed significantly between groups (P<0.0001). Serum hepcidin and ferritin levels (mean+/-SD) were 2.01+/-2.30 and 7.00+/-7.86, 7.72+/-8.03 and 29.35+/-24.01, 16.71+/-14.74 and 46.40+/-43.57 ng/mL in the IDA, ID, and control groups, respectively. The area under the receiver operating characteristic curve for serum hepcidin as a predictor of ID was 0.852 (95% CI, 0.755-0.950). Hepcidin < or =6.895 ng/mL had a sensitivity of 79.2% and specificity of 82.8% for the diagnosis of ID. Serum hepcidin levels were significantly correlated with ferritin, transferrin saturation, and hemoglobin levels and significantly negatively correlated with sTfR level and total iron binding capacity (P<0.0001).
CONCLUSION
Serum hepcidin levels are significantly associated with iron status and can be a useful indicator of ID. Further studies are necessary to validate these findings and determine a reliable cutoff value in children.

Keyword

Serum hepcidin; Iron deficiency; Children

MeSH Terms

Anemia, Iron-Deficiency
Antimicrobial Cationic Peptides
Child
Enzyme-Linked Immunosorbent Assay
Ferritins
Hemoglobins
Humans
Iron
Liver
Male
Nutrition Disorders
Receptors, Transferrin
ROC Curve
Sensitivity and Specificity
Transferrin
Antimicrobial Cationic Peptides
Ferritins
Hemoglobins
Iron
Receptors, Transferrin
Transferrin

Figure

• 

  Fig. 1 Receiver operating characteristic curves for serum hepcidin and serum ferritin. (A) Serum hepcidin as a predictor of iron deficiency anemia (IDA) and iron deficiency (ID). (B) Serum hepcidin and serum ferritin as predictors of IDA. (C) Serum hepcidin and serum ferritin as predictors of ID.

• 

  Fig. 2 Distribution of serum hepcidin levels in the IDA, ID, and normal controls around the cutoff point. IDA, iron deficiency anemia; ID, iron deficiency.

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  Fig. 3 Correlations between serum hepcidin and other parameters. Common regression lines are shown. (A) Log-transformed serum hepcidin and log-transformed ferritin (r=0.666). (B) Log-transformed serum hepcidin and soluble transferrin receptor (r=-0.712). (C) Log-transformed serum hepcidin and transferrin saturation (r=0.429). (D) Log-transformed serum hepcidin and hemoglobin (r=0.604).

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