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Hepcidin, Iron Status and Inflammation in School‐Aged Nepalese Children
Author(s) -
Baker Sarah,
Schulze Kerry,
Wu Lee,
Christian Parul,
West Keith
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.913.8
Subject(s) - hepcidin , ferritin , soluble transferrin receptor , iron status , iron deficiency , ferroportin , inflammation , medicine , endocrinology , interquartile range , chemistry , anemia
Iron deficiency (ID) is common throughout life in developing countries, but concurrent inflammation (INF) challenges interpretation of conventional iron status indicators. Hepcidin, an iron‐regulatory hormone, may improve iron status assessment when ID and INF coexist. Hepcidin is elevated in the presence of iron stores and INF, thereby preventing iron absorption. We assessed plasma hepcidin among 6‐8 year old children of rural Nepal (n=498) to determine its association with ferritin, transferrin receptor (TfR), and INF (C‐reactive protein, CRP > 5.0 mg/L, α‐1 acid glycoprotein, AGP > 1.0 g/L, or both), measured previously. Variables were ln‐transformed to normalize distributions. Ferritin was adjusted downward when INF was present by a multiplicative factor of 0.756, based on the ratio of the geometric mean of ferritin in the absence relative to presence of INF. Median (interquartile range) of hepcidin was 12.0 (6.7, 21.1) μg/L. ID as ferritin<15 mg/L occurred in 11.0% while INF occurred in 30.7% of children. Estimates of hepcidin values based on regression were geometric mean (95%CI): 11.6 (10.6, 12.7) with no INF and no ID, 3.8 (2.9, 5.0) with no INF and ID, 15.8 (13.3, 18.5) with INF and no ID, and 6.4 (4.3, 2.2) with INF and ID. Similar analyses with TfR did not reveal a significant impact of concurrence of ID (adjusted TfR>8.3 mg/mL) and INF on hepcidin, despite a higher prevalence of ID by elevated TfR (36.4%). These data are consistent with evidence that hepcidin is positively associated with iron stores and INF, but suggest a stronger role for compromised iron stores than inflammation in this setting. Supported by Gates Foundation grants OPPGH5241 and GH614 (Global Control of Micronutrient Deficiency).