RESUMO
Background: Discovery of hepcidin, and its receptor in year 2000 has revolutionized iron metabolism studies. Measurement of serum hepcidin, may supplement existing investigational parameters of iron status in anemias. The aim of the study is to estimate baseline hepcidin level and evaluate it as a predictor of response after treatment of iron deficiency anemic with oral iron
Methods: This was a purposive follow up study; involving 102 patients aged 18 years and above selected from medical outpatient departments of a tertiary care hospital of Karachi. Baseline CBC, iron studies, and serum hepcidin-25 were measured. Patients of IDA were treated with oral ferrous sulphate 200mg thrice daily for 8 weeks. Repeat CBC on follow up visit assessed response, defined as increment in hemoglobin level by >1gm/dl post treatment. Logistic regression analysis was applied and receiver operating characteristics curves were plotted to find utility and identify hepcidin cutoff values as a predictor for response
Results: Mean baseline serum hepcidin-25 was 37.34+/-22.60 ng/mL. Regression models showed for every one unit increase of hepcidin, the odds of hemoglobin improvement decreased by [1-0.972]=0.028gm/dl, serum hepcidin-25 by itself significantly predicted improvement in hemoglobin level P=<0.05. The area under the curve for hepcidin compared with post treated hemoglobin was 0.73 [95% CI: 0.63-0.83]. For predicting response to therapy, hepcidin cutoff value of 40ng/mL, had sensitivity of 68%, specificity of 63%, positive predictive value of 85% and negative predictive value of 38%. Hepcidin quartiles were also constructed compairing 4th quartile parameters with 1st quartile parameters
Conclusion: Hepcidin 25 is a fair predictor for response of iron therapy in IDA patients; baseline hepcidin of 40ng/ml predicts treatment response