Manolov V, Atanasova B, Velizarova M, Vasilev V, Bogov B, Yonova D, Vazelov E, Paskaleva- Peycheva V, Hadjiev E, Hadjidekova S, Tzatchev K
Medical University - Sofia, Medical Faculty, Dept. of Medical Genetics, Bulgaria
Aim: Hepcidin is a key regulator of the iron homeostasis. The pathogenesis of the anemia of chronic disease (ACD) is coupled with hepcidin stimulated synthesis as a result of inflammation. Hereditary hemochromatosis covers genetic disorders in the metabolism of iron by the appearance of superimposition. Iron overload leads to organ damage such as liver fibrosis, cirrhosis, cardiomyopathia. In patients with iron-deficiency anemia (IDA) and those with low serum ferritin latent and pre-latent form of iron deficiency without concurrent anemia (due to blood loss or insufficient iron intake from food) sets very low hepcidin levels. The purpose of our study was to investigate serum hepcidin in patients with ACD and IDA in different diseases in order to help finding the right therapeutic choice.
Data: For a period 2012-2014 we study serum hepcidin levels using verified ELISA method in 50 healthy volunteers, 50 patients with chronic kidney disease (CKD, stages II to IV), 30 patients with CKD (stage V) and 30 patients with rheumatoid arthritis.
Results: We found significantly high serum hepcidin levels in patients with ACD [0.3 < r < 0.7; P < 0.001]: in CKD stages II to IV 81.52 ± 10.7 μg/L; in CKD stage V 219.14 ± 30.6 μg/L and in patients with RA 103.83 ± 18.4 μg/L compared to control group 13.67 ± 4.9 μg/L. In patients with RA and IDA we found significantly low serum hepcidin levels 0.78 ± 0.3 μg/L (P < 0.001).
Discussion: Reliable method for serum hepcidin is important for the proper therapeutic approach in patients with ACD and IDA in different diseases. The rate of rise may differentiate patients with functional iron deficiency than those with reticuloendothelial blockade. Monitoring of serum hepcidin concentrations in parenteral therapy with iron preparations reduces the risk of toxic overload of iron in the body. Hepcidin is a potential indicator of iron deficiency in RA patients with anemia and an active inflammatory process.