Association of pro-hepcidin with inflammation and iron metabolism in hemodialysis patients with erythropoietin resistance / 中华肾脏病杂志

Objective To examine the association of pro-hepcidin with iron metabolism and inflammation in maintenance hemodialysis (MHD) patients with erythropoietin (EPO) resistance.Methods Forty MHD patients and twenty healthy controls were enrolled in the study.Among MHD patients,20 were hyporesponsive to EPO therapy and 20 were normal responsive to EPO therapy.Complete blood red cell count (RBC),Hb concentration,hematocrit (Hct),reticulocyte count (Ret),and serum ferritin (SF),serum iron (Fe),total ironbinding capacity (TIBC),saturation rate of transferrin (TSAT),transferrin (TF),hyper-sensitive C-reactive protein (hs-CRP),pro-hepcidin were measured in all the patients and controls.Differences were compared between groups.Influencing factors were analyzed by Pearson correlation.Predicting value of pro-hepcidin was investigated by ROC curve.Results Serum levels of SF,pro-hepcidin and hs-CRP were significantly higher in MHD patients than those in healthy controls (P＜0.01),while serum TF was lower in MHD patients (P＜0.05).Serum levels of SF,pro-hepcidin and hs-CRP were significantly higher in EPO resistant patients as compared to normal responsive cases (P＜0.01).Serum prohepcidin level was positively correlated with SF (r=0.843,P=0.000) and hs-CRP (r=0.695,P=0.001).In predicting EPO resistance,area under ROC curve of pro-hepcidin,SF and hs-CRP was 0.713,0.769 and 0.958 respectively.Conclusions EPO resistance is correlated with inflammation and iron metabolism.Serum pro-hepcidin,SF and hs-CRP may be used as markers of EPO resistance in MHD patients.

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

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.

Relationship between Serum pro-hepcidin Concentration and Body Iron Status in Female College Students

Hepcidin, a peptide hormone synthesized mainly by the liver, has been implicated as a key regulator of iron homeostasis. Results from studies with experimental animal models suggested that hepcidin levels are related with body iron status, but little data is available in human subjects. This study was conducted to determine the relationship between serum pro-hepcidin levels, blood indexes of anemia, and dietary iron intake in female college students. Serum pro-hepcidin concentrations were measured by enzyme-linked immunosorbent assay in eighty-two women with 22.1 +/- 0.2 years old. Dietary intake data were collected by using the 24-hour recall method for 3 days. Mean concentrations of serum prohepcidin were 85.1 ng/ml +/- 6.1 (s.d.) with the range of 13.6 - 295.7 ng/ml. The median value of serum pro-hepcidin in the study subjects was 70.3 ng/ml. Serum pro-hepcidin concentrations were positively correlated with hemoglobin concentrations(r = 0.273, p = 0.013), and also with hematocrit (r = 0.291, p = 0.008). To examine whether the level of dietary iron intake affects serum pro-hepcidin levels, study subjects were divided into two groups according to the amounts of daily iron intake. Serum pro-hepcidin concentrations were 22% lower in groups with low iron intake ( 10.1 mg/day). In conclusion, these data, as in agreement with findings in mice, suggest that hepcidin plays an important role in regulating iron metabolism in the human body.