Low serum levels of prohepcidin, but not hepcidin-25, are related to anemia in familial amyloidosis TTR V30M

Hepcidin, Serum Iron, and Transferrin Saturation in Full-Term and Premature Infants during the First Month of Life: A State-of-the-Art Review of Existing Evidence in Humans

Neonates regulate iron at birth and in early postnatal life. We reviewed literature from PubMed and Ovid Medline containing data on umbilical cord and venous blood concentrations of hepcidin and iron, and transferrin saturation (TSAT), in human neonates from 0 to 1 mo of age. Data from 59 studies were used to create reference ranges for hepcidin, iron, and TSAT for full-term-birth (FTB) neonates over the first month of life. In FTB neonates, venous hepcidin increases 100% over the first month of life (to reach 61.1 ng/mL; 95% CI: 20.1, 102.0 ng/mL) compared with umbilical cord blood (29.7 ng/mL; 95% CI: 21.1, 38.3 ng/mL). Cord blood has a high concentration of serum iron (28.4 μmol/L; 95% CI: 26.0, 31.1 μmol/L) and levels of TSAT (51.7%; 95% CI: 46.5%, 56.9%). After a short-lived immediate postnatal hypoferremia, iron and TSAT rebounded to approximately half the levels in the cord by the end of the first month. There were insufficient data to formulate reference ranges for preterm neonates.

The use of cluster and principal component analysis in the estimation of iron status in term newborns

OBJECTIVE

To assess the relationship between parameters of iron homeostasis in infants and clinical features characterizing newborns and their mothers.

METHODS

The goal of the present work was to determine nine iron status parameters, i.e. hepcidin, prohepcidin, soluble transferrin receptor, ferritin, total iron binding capacity, unsaturated iron binding capacity, transferrin saturation, erythropoietin and total iron concentration, in the cord blood of 57 term newborns as well as to determine the complete blood count in their mothers. Moreover, an appraisal of the relationships between all of the iron parameters, the mothers' hematological factors and 12 clinical attributes was carried out using both cluster analysis (CA) and principal component analysis (PCA).

RESULTS

We found that hepcidin is not correlated with its precursor, but it is strongly positively correlated with the total iron concentration. The CA divided all of the 24 parameters into three clusters and showed that certain clinical features, e.g. the APGAR score, mother's age or parity are related to the hepcidin and prohepcidin concentration.

CONCLUSION

We demonstrated that CA and PCA are efficacious methods for assessing the relationship between iron metabolism parameters in cord blood and large amounts of clinical characteristics.

Diagnosing anemia in inflammatory bowel disease: beyond the established markers

The main types of anemia in inflammatory bowel disease (IBD) are iron deficiency anemia (IDA) and anemia of inflammatory etiology, or anemia of chronic disease (ACD). In the management of IBD patients with anemia it is essential for the physician to diagnose the type of anemia in order to decide in an evidence-based manner for the appropriate treatment. However, the assessment of iron status in IBD in many cases is rather difficult due to coexistent inflammation. For this assessment several indices and markers have been suggested. Ferritin, seems to play a central role in the definition and diagnosis of anemia in IBD and transferrin, transferrin saturation (Tsat), and soluble transferrin receptors are also valuable markers. All these biochemical markers have several limitations because they are not consistently reliable indices, since they are influenced by factors other than changes in iron balance. In this review, in addition to them, we discuss the newer alternative markers for iron status that may be useful when serum ferritin and Tsat are not sufficient. The iron metabolism regulators, hepcidin and prohepcidin, are still under investigation in IBD. Erythrocytes parameters like the red cell distribution width (RDW) and the percentage of hypochromic red cells as well as reticulocyte parameters such as hemoglobin concentration of reticulocytes, red blood cell size factor and reticulocyte distribution width could be useful markers for the evaluation of anemia in IBD.