Serum hepcidin levels and iron parameters in children with iron deficiency

Hyoung Soo Choi; Sang Hoon Song; Jae Hee Lee; Hee-Jin Kim; Hye Ran Yang

doi:10.5045/kjh.2012.47.4.286

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Original Article

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Korean J Hematol 2012; 47(4):

Published online December 31, 2012

https://doi.org/10.5045/kjh.2012.47.4.286

Serum hepcidin levels and iron parameters in children with iron deficiency

Hyoung Soo Choi¹, Sang Hoon Song², Jae Hee Lee³, Hee-Jin Kim⁴, and Hye Ran Yang^1*

Author Info. +

¹Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

²Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

³Department of Pediatrics, Chosun University Hospital, Gwangju, Korea.

⁴Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to : Correspondence to Hye Ran Yang, M.D., Ph.D. Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 463-707, Korea. Tel: +82-31-787-7285, Fax: +82-31-787-4054, hryang@snubh.org

Received: October 2, 2012; Revised: October 31, 2012; Accepted: November 16, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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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 ≤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.

Keywords Serum hepcidin, Iron deficiency, Children

Article

Original Article

Korean J Hematol 2012; 47(4): 286-292

Published online December 31, 2012 https://doi.org/10.5045/kjh.2012.47.4.286

Serum hepcidin levels and iron parameters in children with iron deficiency

Hyoung Soo Choi¹, Sang Hoon Song², Jae Hee Lee³, Hee-Jin Kim⁴, and Hye Ran Yang^1*

¹Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

²Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

³Department of Pediatrics, Chosun University Hospital, Gwangju, Korea.

⁴Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to: Correspondence to Hye Ran Yang, M.D., Ph.D. Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 463-707, Korea. Tel: +82-31-787-7285, Fax: +82-31-787-4054, hryang@snubh.org

Received: October 2, 2012; Revised: October 31, 2012; Accepted: November 16, 2012

Abstract

Background

Methods

Results

Conclusion

Keywords: Serum hepcidin, Iron deficiency, Children

Abstract

Fig 1.

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Figure 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.

Blood Research 2012; 47: 286-292https://doi.org/10.5045/kjh.2012.47.4.286

Fig 2.

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Figure 2.

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

Blood Research 2012; 47: 286-292https://doi.org/10.5045/kjh.2012.47.4.286

Fig 3.

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Figure 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).

Blood Research 2012; 47: 286-292https://doi.org/10.5045/kjh.2012.47.4.286

Table 1 . Subject characteristics..

Time of sampling (1/2/3): 1, before midday; 2, midday to 5 pm; 3, after 5 pm..

Abbreviations: BMI, body mass index; sTfR, soluble transferrin receptor; TIBC, total iron binding capacity; Hb, hemoglobin; CRP, C-reactive protein; H. pylori, Helicobacter pylori..

Table 2 . Correlations between log hepcidin and other parameters..

Abbreviations: BMI, body mass index; sTfR, soluble transferrin receptor; TIBC, total iron binding capacity; Hb, hemoglobin; CRP, C-reactive protein; H. pylori, Helicobacter pylori..

Table 3 . Adjusted^a) simple linear regression for log hepcidin..

^a)Adjusted for age, gender, and body mass index..

Abbreviations: sTfR, soluble transferrin receptor; TIBC, total iron binding capacity; Hb, hemoglobin; CRP, C-reactive protein; CI, confidence interval; SE, standard error..