Serum Hepcidin and Iron Absorption in Paediatric Inflammatory Bowel Disease

Abstract

Background and Aims: We sought to correlate hepcidin levels in inflammatory bowel disease [IBD] children with disease activity, inflammatory markers, and iron load test [ILT] and to compare IBD patients with coeliac and healthy patients. Methods: Between December 2012 and June 2013, 145 subjects [50 IBD patients, 45 coeliac patients and 50 healthy controls] were included in the study. All patients underwent the following examinations: blood count, iron status, erythropoiesis parameters, serum hepcidin, C-reactive protein [CRP], and erythrocyte sedimentation rate [ESR]. In order to evaluate the efficacy of iron absorption, ILT was performed in IBD patients. Disease activity indexes and IBD duration, localisation, and therapy were also evaluated, and a faecal sample for calprotectin collected. Conclusions: Our study demonstrates that serum hepcidin is increased in IBD children with active disease and it is responsible for IM.

Hepcidin in newly diagnosed inflammatory bowel disease in children

“…The cross‐sectional design of the study demonstrated only significant associations but not causality between hepcidin and the related parameters. The patient cohorts were relatively small but comparable with other paediatric studies . Furthermore, there were no significant differences in clinical parameters that could influence the results.…”

“…PUCAI and PCDAI ≥30 were the only variables independently associated with serum hepcidin. Hepcidin was positively correlated with ferritin and CRP and was negatively correlated with iron load test . In our previous study, we also observed increased hepcidin levels in 55% of girls and in 18% of boys in various phases of IBD and a significant positive correlation between hepcidin and CRP .…”

“…Hepcidin was positively correlated with ferritin and CRP and was negatively correlated with iron load test. 27 In our previous study, we also observed increased hepcidin levels in 55% of girls and in 18% of boys in various phases of IBD and a significant positive correlation between hepcidin and CRP. 28 Basseri et al reported a positive correlation between serum hepcidin and IL-6 levels in IBD patients.…”

“…Only non‐significantly higher hepcidin levels in children with CD compared to those with UC were detected by Martinelli et al ., where a substantial part of patients was also pre‐treated (steroids – 20%, mesalazine – 62%, azathioprine – 22%, methotrexate – 2%, biological therapy – 4%). Mean disease activity indexes were also relatively low (PCDAI = 11.4 ± 14.4, PUCAI = 13.8 ± 16.4) . Recently, Krawiec et al .…”

Iron and inflammation – the gut reaction

“…49,50 Several studies have examined serum or urine hepcidin concentrations in patients with IBD in order to shed light on the pathogenesis of the associated anemia. 51–56 The results generally demonstrate that hepcidin levels are elevated in the patients relative to healthy controls and that they correlate with disease activity and serum ferritin concentrations. The findings are consistent with the idea that increased hepcidin expression is an important factor contributing to iron dysregulation in IBD and to the pathogenesis of AI in this condition.…”