Hepcidin levels in children with chronic liver disease

Abstract

Background/Aim:We aimed to analyze serum hepcidin level in children with chronic liver disease (CLD) and its relationship with serum cytokines level, liver function tests, hepatic iron content, and liver fibrosis.Patients and Methods:The study included 34 children with CLD, and 15 age- and gender-matched healthy children. Serum hepcidin, ferritin, iron level, interleukin-6 (IL-6), transforming growth factor-β (TGF-β ), total oxidant status (TOS), and antioxidant status (TAS) were studied in all patients and in the control group. Liver iron content (LIC) was measured from the liver biopsy specimen.Results:Serum ferritin levels were higher in patients with CLD than control group (100.1 ± 98.2 ng/mL vs 50.5 ± 32.2 ng/mL, P = 0.016). No significant difference was found in hepcidin levels. Hepcidin levels in children with CLD was positively correlated with ferritin (r = 0.75, P = 0.001), pediatric end-stage liver disease (PELD) score (r = 0.56, P = 0.001), TAS (r = 0.42, P = 0.02), but negatively correlated with albumin level (r = −0.45, P = 0.008). Transferrin saturation and hepcidin:ferritin ratio were significantly low in patients with severe fibrosis compared with patients with mild/without fibrosis (15.5 ± 5.5 vs 34.3 ± 30.1, P = 0.017 and 1 ± 0.5 vs 1.9 ± 1.4, P = 0.04, respectively).Conclusion:Serum hepcidin levels in children with CLD reflect both liver functions and TAS, and severe fibrosis is associated with low hepcidin:ferritin ratio in children with CLD.

Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T1 hyperintensity

“…33 Hence, in patients with hepatic dysfunction such as liver cirrhosis, decreased levels of hepcidin might result in the upregulation of ferroportin and accelerated efflux of iron from iron storage areas, eg, the GP. 34 A prior case report described a rare hereditary metabolic disease with liver cirrhosis, dystonia, and hypermanganesemia. 29 There was some similarity between that reported case and the patients in the T 1 h group in this study.…”

“…This key peptide of iron metabolism is mainly produced by the liver . Hence, in patients with hepatic dysfunction such as liver cirrhosis, decreased levels of hepcidin might result in the upregulation of ferroportin and accelerated efflux of iron from iron storage areas, eg, the GP . A prior case report described a rare hereditary metabolic disease with liver cirrhosis, dystonia, and hypermanganesemia .…”

Iron and liver fibrosis: Mechanistic and clinical aspects

“…Moreover, the hepcidin:ferritin ratio was lower in CLD patients and further decreased as fibrosis progressed[112]. Similarly, another study showed that in children with CLD, as the severity of fibrosis increased, hepcidin:ferritin ratio decreased, while serum ferritin and transferrin saturation remained high[113]. These studies present hepcidin as a valuable marker of fibrosis progression.…”

Low hepcidin in liver fibrosis and cirrhosis; a tale of progressive disorder and a case for a new biochemical marker

“…When hepcidin values are corrected by iron-load (by using hepcidin/ferritin ratio), they show low values in patients with severe liver fibrosis (Cakir et al 2015 ). What is more important this ratio can differentiate between advanced fibrosis and lack of fibrosis (Tan et al 2012 ).…”