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Hepcidin and hemoglobin content parameters in the diagnosis of iron deficiency in anemic rheumatoid arthritis patients
Arthritis & Rheumatism, 09/08/2011
Van Santen S et al. – Serum hepcidin and to lesser extent urinary hepcidin, reticulocyte– hemoglobin content (Ret– He) and erythrocyte– hemoglobin content (RBC– He) are potential useful indicators to detect iron deficiency in anemic inflamed rheumatoid arthritis (RA) patients.
Methods- In a cross–sectional explorative study blood samples of 106 outpatient RA patients were analyzed.
- Forty anemic patients were classified as having iron deficiency anemia (IDA), anemia of chronic disease (ACD), their combination (IDA/ACD) or as ‘anemic others’ based on biochemical parameters for inflammation and iron deficiency.
- The ability of serum and urinary hepcidin, Ret– He, and RBC– He to discriminate among these states was evaluated.
- Serum hepcidin from the IDA as well as that of the combined IDA/ACD group differed significantly from patients with ACD.
- This difference was also observed for urinary hepcidin, RET– He and RBC– He, albeit with less significance.
- The area under the Receiver Operating Characteristic curve for serum hepcidin comparing IDA/ACD with ACD patients was 0.88 and 0.92 if both IDA and IDA/ACD were compared with all anemic patients.
- Hepcidin <2.4 nmol/L had a sensitivity of 89% and a specificity of 88% to distinguish IDA/ACD from ACD patients.
- Both Ret– He and RBC– He allowed to differentiate these latter groups with a specificity of 100% and 75% and a sensitivity of 67% and 89%, respectively.
