Changes in serum hepcidin according to thyrometabolic status in patients with Graves’ disease

Abstract

Introduction:Hepcidin is an acute-phase protein and a key regulator of iron homeostasis. Anaemia frequently occurs in patients with thyroid dysfunction, and hepcidin may be a potential link. Objectives: Prospective assessment of hepcidin serum concentration and other parameters related to Fe homeostasis in hyperthyroid patients in the course of GD at diagnosis and during remission. Patients and Methods: Out of the 70 patients recruited, 42 (32 women, 10 men), aged 42.5 ± 15.1 years, met the inclusion criteria. Clinical and biochemical assessment, including hepcidin measurement by ELISA, was performed at baseline (T0) and after restoration of euthyroidism (T1). Results: Hepcidin concentration at T0 in the 24 patients who completed the study was significantly higher than the value during euthyroidism (28.7 (8.1-39.4) ng/mL vs 7.9 (4.3-12.9) ng/mL, P < 0.001). Hepcidin level was most significantly correlated with ferritin (rho = 0.723) in women at T0. In both men (377 (171-411) vs 165 (84-237) ng/mL, P = 0.001) and women (84 (23-104) vs 35 (16-64) ng/mL, P = 0.001), a significant decrease in ferritin level was demonstrated following therapy. A significant (P < 0.001) increase in mean corpuscular volume (MCV) (83.5 (82.5-87.1) vs 89.5 (88.8-90.0) fL) and mean concentration of haemoglobin (MCH) (29.0 (28.0-29.4) vs 30.4 (29.5-31.1) pg) was observed. Conclusions: Hepcidin and ferritin decrease significantly during the transition from a hyperthyroid state to euthyroidism in patients with GD. The observed changes occur in parallel to iron homeostasis fluctuations. During the transition from the hyperthyroid state to euthyroidism, the improvement of haematological status is reflected mainly by the increase in MCV and MCH. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Iron Homeostasis and Hepcidin Concentration in Patients With Acromegaly

“…The previously widely recognized positive correlation between hepcidin and ferritin ( 9 – 11 ), was repeatedly confirmed in our study, and was particularly evident in men. The recognized hepcidin suppressors include sex hormones (testosterone, 17β-estradiol, progesterone), and erythropoiesis [through ligands and/or modulators, such as erythroferrone (ERFE), growth differentiation factor 15 (GDF15), twisted-gastrulation 1 (TWSG1), and growth factors [hepatocyte growth factor (HGF), epidermal growth factor (EGF), platelet-derived growth factor BB (PDGF-BB)].…”

“…Alterations in hepcidin level results in severe disturbances-excessive hepcidin causes Fe deficiency anemia, whereas its deficit leads to Fe overload, or hemochromatosis. Although hepcidin was first identified in 2000 (8), it has recently been evaluated in view of the various endocrine disorders associated with an increase in acute-phase proteins or with concomitant disturbances in Fe homeostasis (9)(10)(11). As a result of such reports, a growing awareness of the hormonal influence on Fe metabolism and hepcidin levels has emerged.…”

Novel Insight into Non-Genetic Risk Factors of Graves’ Orbitopathy

“…Krygier et al demonstrated that thyrotoxic patients had lower but still normal MCV, which increased during treatment. They postulated that this phenomenon is inversely correlated with hepcidin levels [ 35 ]. Similarly, we observed lower MCV in our non-GO patients in whom thyrotoxicosis was more severe.…”

Changes in complete blood count parameters influenced by endocrine disorders

“…The potential link between anaemia and thyroid diseases may be hepcidin, which is an important regulator of iron homeostasis. According to Krygier et al, the hepcidin concentration decreases during the treatment of Graves' disease [16]. Additionally, they observed an improvement in haematological parameters, especially increase in MCV and MCH.…”