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Study of Correlation of Serum Hepcidin with Iron Status Markers and Hematological Indices among Iron Deficient Anemic patients and healthy controls in Damascus : A Case-Control Study

دراسة الارتباط بين الهيبسيدين المصلي و واسمات حالة الحديد و المشعرات الدموية عند مصابين بفقر الدم بعوز الحديد و شواهد أصحاء في دمشق: دراسة حالة-شاهد

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 Publication date 2017
and research's language is العربية
 Created by Shamra Editor




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Hepcidin-25 is a peptide hormone plays an important role in regulating the systematic iron homeostasis. This paper was conducted to study the correlations of Hepcidin with some iron status markers and red cell indices among patients with iron deficiency anemia (IDA) and healthy controls in Damascus. Our study comprised 20 IDA patients (Hb≤11 g/dl for men and women,Tsat≤20% and ferritin <30 ng/dl) and 10 healthy non IDA controls. Complete hemogram was performed, iron status markers (serum iron, total iron binding capacity and ferritin) were measured and transferrin saturation was calculated .


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Research summary
تتناول هذه الدراسة العلاقة بين مستويات الهيبسيدين المصلي وبعض واسمات حالة الحديد والمشعرات الدموية لدى مرضى فقر الدم بعوز الحديد وشواهد أصحاء في دمشق. شملت الدراسة 20 مريضًا بفقر الدم بعوز الحديد و10 شواهد أصحاء. تم قياس مستويات الهيبسيدين المصلي باستخدام تقنية ELISA، وأظهرت النتائج أن متوسط قيم الهيبسيدين المصلي كان أخفض بشكل هام إحصائيًا عند المرضى مقارنة بالشواهد الأصحاء. أظهر اختبار سبيرمان ارتباطات إيجابية هامة بين قيم الهيبسيدين وكل من الفيريتين ونسبة الإشباع وحديد المصل، بينما كان هناك ارتباط سلبي غير معنوي مع السعة الرابطة للحديد. توصي الدراسة بإضافة اختبار الهيبسيدين إلى الاختبارات التشخيصية الحالية لحالة الحديد، خاصة في حالات فقر الدم بعوز الحديد، لكن الحاجة ملحة لمزيد من الأبحاث لتعيير هذه المقايسة عالميًا.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة هامة في فهم دور الهيبسيدين في تنظيم حالة الحديد لدى مرضى فقر الدم بعوز الحديد. ومع ذلك، هناك بعض النقاط التي تحتاج إلى تحسين. أولاً، حجم العينة صغير نسبيًا مما قد يؤثر على دقة النتائج. ثانياً، لم يتم تناول تأثير العوامل الأخرى مثل التغذية والحالة الصحية العامة للمشاركين بشكل كافٍ. ثالثاً، الدراسة تعتمد بشكل كبير على تقنية ELISA التي قد تكون مكلفة وغير متاحة في جميع المختبرات. من المهم أيضًا أن يتم تعميم نتائج هذه الدراسة على مجموعات أكبر ومتنوعة لضمان موثوقية النتائج.
Questions related to the research
  1. ما هو الهدف الرئيسي من هذه الدراسة؟

    الهدف الرئيسي هو تقييم العلاقة بين مستويات الهيبسيدين المصلي ومستويات واسمات الحديد التقليدية والمشعرات الدموية لدى مرضى فقر الدم بعوز الحديد وشواهد أصحاء في دمشق.

  2. ما هي التقنية المستخدمة لقياس مستويات الهيبسيدين المصلي في الدراسة؟

    تم استخدام تقنية ELISA لقياس مستويات الهيبسيدين المصلي في الدراسة.

  3. ما هي النتائج الرئيسية التي توصلت إليها الدراسة بخصوص مستويات الهيبسيدين المصلي؟

    أظهرت الدراسة أن متوسط قيم الهيبسيدين المصلي كان أخفض بشكل هام إحصائيًا عند المرضى المصابين بفقر الدم بعوز الحديد مقارنة بالشواهد الأصحاء.

  4. ما هي التوصيات التي قدمتها الدراسة بناءً على النتائج؟

    توصي الدراسة بإضافة اختبار الهيبسيدين إلى المخزون الحالي من الاختبارات التشخيصية لحالة الحديد، خصوصاً في حالات فقر الدم بعوز الحديد، مع الحاجة لمزيد من الأبحاث لتعيير هذه المقايسة عالميًا.


References used
CAMASCHELLA, C. 2013. Iron and hepcidin: a story of recycling and balance. ASH Education Program Book , 2013(1),1-8
SCHMIDT, P.J. 2015.Regulation of iron metabolism by hepcidin under conditions of inflammation. Journal of Biological Chemistry,)31(292 , 18975-18983
MICHELS, K., et al. 2015. Hepcidin and host defense against infectious diseases. PLoS Pathog, 11(8), e1004998
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Worldwide, iron deficiency anemia (IDA) is the most common nutritional deficiency, and its management remains a challenge in many cases.(OIT)Oral iron therapy, in appropriate doses and for a sufficient duration, is an effective first-line strategy for most patients. But some patients do not experiencean optimal response to(OIT).The need is still current and clinically relevant for predictors of response to OIT. Hepcidin-25, a major regulator of iron metabolism, may be use as a reliable guide for the use of iron and be one of them.112 patientswith IDA were enrolled in this follow up clinical trial, Selected from two university, hospitals in Damascus between JUNE2015 and JUNE2016. For patients who met the inclusion criteria, Baseline CBC, iron studies, and serum hepcidin-25 were measured, and then they received a 14-day course of oral iron (ferrous gluconate 325mg/ 3 times daily). Patients who achieved <1g/dl increase in Hb in 14 days were categorized as “nonresponders”. Screening hepcidin levels were (40.18± 86.35) versus (6.37±10.37)(p= 0.041(innonresponders versus responders to oral iron trial. HepcidinCutoff of >14.3 ng/ml, showed sensitivity of 40%,specificity of 90.2%, andpositive predictive value of 60% andnegative predictive value of 80% for predicting nonresponsiveness to oral iron.We conclude that serum hepcidin25predicts poorly nonresponsivenesstooral iron therapy in IDA patients, but it is superior to ferritin and TSAT for this purpose.
This study is conducted to assess the role of hepcidin as a biomarker of iron status in haemodialysis patients. The study included88 patients who had end-stage renal disease ( ESRD), and were treated with haemodialysis in the Department of Renal Medi cine in Al-Assad University Hospital in Lattakia. Serum hepcidin and ferritinlevelswere measured, and transferrin saturation (TSAT) was calculated after measuringthe total iron binding capacity (TIBC), these markers were then attached with iron and compared to know the hardest correlation. Results show that all the patients had high serum hepcidin levels,there was a statistically significant relation between iron and hepcidin, where P-VALUE smaller than 0.05, this relationship was inversal, hardly 40% the stongest correlation. Conclusion: These findings suggest that the increased hepcidinin haemodialysis patients may contribute to abnormal ironregulation and erythropoiesis, and may be a novel biomarker of iron status and erythropoietin resistance.
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