Hepcidin and iron status among pregnant women in Bangladesh

AIM: Anemia is common during pregnancy and is associated with higher perinatal maternal morbidity and mortality in developing countries. Identifying and finding the right treatment approach for iron deficiency in pregnant women is of great clinical importance because it can prevent unnecessary spelling of therapy with iron preparations. DATA: We determined serum hepcidin levels using ELISA assay in 50 pregnant women. The samples were taken in the University Hospital "Michin Dom" for a period 2013 – 2014 year. We measure serum iron levels, CRP, ferritin and hemoglobin concentration. Patients were divided into three groups: pregnant without anemia; pregnant women with iron deficiency anemia (IDA) and pregnancy with anemia of chronic inflammation (ACI). RESULTS: We found statistically significant differences in serum hepcidin levels between measured groups: pregnancy without anemia – 20.5 ± 6.2 μg/L; pregnancy with IDA – 1.3 ± 0.6 μg/L; pregnancy with ACI – 111.3 ± 24.4 μg/L....

Journal of Medical Science And clinical Research

Iron indices are useful in assessing the state of haemoglobin function and determination of state and degree of anaemia". "In humans, aside iron indices are the role of hepcidin in up and down regulation of iron metabolism in normal state and diverse state including pregnancy". We did evaluate gestational changes in serum hepcidin and iron status among pregnant women". We evaluated serum hepcidin, ferritin, soluble transferrin receptor, serum iron, unsaturated iron binding capacity, total iron binding capacity at 12, 20, and 30 weeks of gestation in a longitudinal study of 428 apparently healthy women who consisted of 328 pregnant women and 100 non-pregnant who served as control in Rivers State of Nigeria". Hepcidin, sTfR, Ferritin, Iron, TIBC and UIBC were assayed using Enzyme Linked Immunosorbent Assay and Photometric methods". Data was analyzed using (Graph Pad Prism version 9.0, and NCSS version 9.0). "Results obtained were expressed mean ± SD, median and 2.5-97.5 percentile. Hepcidin concentration declined throughout the three partitions of pregnancy (p<.05) and had greatest sensitivity than other iron parameters at week 20 and 30. The AUC ROC values for hepcidin to detect iron deficiency (ferritin <15ng/ml) were 0.96, p<.0001 and 0.97, p<.0001 at weeks 20 and 30 respectively. The prevalence of anaemia increased from 39.37%, to 89.33%, and 60.37%, at weeks 12, 20, and 30 respectively. The prevalence of iron deficiency anaemia defined as (sTfR>28nmol/l) was 17.99% at week 12, 17.68% at 20 and 35.98% at week 30. Hepcidin outperformed haemoglobin, ferritin, soluble transferrin receptor in diagnosing iron deficiency. This study found a progressive increase in development of IDA, even with increase iron demand by fetus economic. We had provided data and evidence on changes in serum hepcidin concentration and other iron parameter in pregnancy, and further asserts that hepcidin is a more useful assay in diagnosis of IDA in pregnancy.

Nutrients, 2014

Hepcidin is the master regulator of systemic iron bioavailability in humans. This review examines primary research articles that assessed hepcidin during pregnancy and postpartum and report its relationship to maternal and infant iron status and birth outcomes; areas for future research are also discussed. A systematic search of the databases Medline and Cumulative Index to Nursing and Allied Health returned 16 primary research articles including 10 human and six animal studies. Collectively, the results indicate that hepcidin is lower during pregnancy than in a non-pregnant state, presumably to ensure greater iron bioavailability to the mother and fetus. Pregnant women with undetectable serum hepcidin transferred a greater quantity of maternally ingested iron to their fetus compared to women with detectable hepcidin, indicating that maternal hepcidin in part determines the iron bioavailability to the fetus. However, inflammatory states, including preeclampsia, malaria infection, and obesity were associated with higher hepcidin during OPEN ACCESS Nutrients 2014, 6 3063 pregnancy compared to healthy controls, suggesting that maternal and fetal iron bioavailability could be compromised in such conditions. Future studies should examine the relative contribution of maternal versus fetal hepcidin to the control of placental iron transfer as well as optimizing maternal and fetal iron bioavailability in pregnancies complicated by inflammation.

2019

Background: The master regulator for the iron metabolism is hepicidin. The elevated levels of maternal hepicicn serum in the gestational diabetes could be probably because of the inflammation or irons stores in body. The ferritin serum presents a high quality approximates of iron stores in the serum of body which might be utilized to examine the correlation among status of iron and gestational diabetes’ risks.. Methods: By using enzyme linked immunosorbant assay technique, serum levels of Human Hepcidin were measured in forty pregnant women having gestational diabetes while forty pregnant women with no gestational diabetes cases. Also, Cobas integra 400 plus systems were used to measure iron status in both groups. Results: the levels of hepicidin serum in pregnant women with gestational diabess were observed to be significantly elevated as compared to the health women in control group. Ferritin levels were also increased in the GDM pregnant women. Conclusions: Serum hepcidin levels were expressed at significantly high levels in women having gestational diabetes in comparison to the controls, a positive association was found amongst the ferritin and hepicidin. The levels of ferritin were positively related to the risks of GDM as well.

The Indonesian Biomedical Journal

BACKGROUND: Cholecalciferol, hepcidin, and soluble transferrin receptor (sTfR) interaction play an essential role in iron hemostasis. Anemia in pregnancy contributes to morbidity and mortality both for the mother and baby. In this study, we assessed the correlation between hepcidin, sTfR and cholecalciferol in third trimester maternal anemia. We aimed to find the cut-off for hepcidin and sTfR.METHODS: A case-control study involving 56 pregnant women in each anemia and healthy group was nested on a previous larger cohort study in Indonesia. Serum hepcidin, sTfR and cholecalciferol level were measured by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: Serum hepcidin and sTfR level were significantly higher in case group, while serum cholecalciferol level has no difference between the two groups. New cut-off points were found for hepcidin (&lt;15.93 ng/mL) and sTfR level (&gt;2234.45 ng/mL). Low level of hepcidin (OR=5.32) and high level of sTfR (OR=8.28) increase the risk of...

European Journal of Clinical Nutrition, 2019

Background-Screening and diagnosis of iron deficiency anemia (IDA) is cumbersome as it may require testing for hemoglobin, ferritin, and an inflammatory biomarker. Objective-The aim of this study was to compare the diagnostic capacity of hematologic biomarkers to detect IDA among pregnant women in Tanzania. Methods-We pooled data from an iron supplementation trial of 1500 iron replete pregnant woman and a prospective cohort of 600 iron deficient pregnant women. Receiver operating Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:

Anemia

Introduction. Anemia in the third trimester has been identified as a risk factor for maternal and fetal morbidity that might lead to mortality. Due to its high cost, finding the best marker to predict anemia became more important to allow early prevention. Only one of ferritin, hepcidin, or soluble transferrin receptors can be picked for the prediction of anemia in the third trimester especially in low-resource setting. Objective. This study aimed at defining the best marker among ferritin, hepcidin, or soluble transferrin receptor (sTfR) in the first trimester for prediction of anemia in the third trimester. Materials, Methods, and Setting. This diagnostic study was nested on the cohort study of vitamin D and its impact during pregnancy in Indonesia. Singleton pregnant mothers with normal fetus were recruited in the first trimester from four cities in West Java, Indonesia. The 304 pregnant women were screened for hepcidin, ferritin, and sTfR level in the sera. All biomarkers were m...

Indian Journal of Public Health Research &amp; Development, 2020

Background: A common problem during pregnancy is anemia and to reduce its prevalence the WHO and national guidelines recommend a prescription of 30 to 60 mg of iron/day. The aim of this study was to evaluate the association of iron profile, hepcidin and oxidative stress in pregnant women prescribed with iron as a probable cause of metabolic disorders. Method: In this cohort study two groups were followed: A) women with low-risk pregnancy (WLRP), B) women with high-risk pregnancy (WHRP): women with metabolic disorders (dyslipidemias, GDM and high blood pressure). Oxidative stress enzymes, iron profile and hepcidin were measured in the second and third trimesters. Results: There were significant differences in hepcidin levels between WLRP and WHRP in 2nd (3.6 ± 4.2 vs 4.69 ± 3.23 P=0.005) and 3rd trimester (3.65 ± 3.44 vs 6.84 ± 5.14 P=0.02). The serum iron concentration had a negative relationship with catalase (-0.599; P=0.04) and a positive relationship with glutathione peroxidase (0.729; P=0.007). Conclusion: The iron serum levels increase could induce oxidative damage in pregnancy. Increased hepcidin is a useful biomarker for determining iron availability in pregnancy and its association with antioxidant systems.

PLoS ONE, 2013

Hepcidin regulation by competing stimuli such as infection and iron deficiency has not been studied in infants and it's yet unknown whether hepcidin regulatory pathways are fully functional in infants. In this cross-sectional study including 339 Kenyan infants aged 6.061.1 months (mean6SD), we assessed serum hepcidin-25, biomarkers of iron status and inflammation, and fecal calprotectin. Prevalence of inflammation, anemia, and iron deficiency was 31%, 71%, 26%, respectively. Geometric mean (6SD) serum hepcidin was 6.0 (63.4) ng/mL, and was significantly lower in males than females. Inflammation (C-reactive protein and interleukin-6) and iron status (serum ferritin, zinc protoporphyrin and soluble transferrin receptor) were significant predictors of serum hepcidin, explaining nearly 60% of its variance. There were small, but significant differences in serum hepcidin comparing iron deficient anemic (IDA) infants without inflammation to irondeficient anemic infants with inflammation (1.2 (64.9) vs. 3.4 (64.9) ng/mL; P,0.001). Fecal calprotectin correlated with blood/mucus in the stool but not with hepcidin. Similarly, the gut-linked cytokines IL-12 and IL-17 did not correlate with hepcidin. We conclude that hepcidin regulatory pathways are already functional in infancy, but serum hepcidin alone may not clearly discriminate between iron-deficient anemic infants with and without infection. We propose gender-specific reference values for serum hepcidin in iron-replete infants without inflammation.

The Journal of nutrition, 2018

To our knowledge, no studies have addressed whether maternal anemia of inflammation (AI) affects newborn iron status, and few have addressed risk factors for specific etiologies of maternal anemia. The study aims were to evaluate 1) the contribution of AI and iron deficiency anemia (IDA) to newborn iron endowment, 2) hepcidin as a biomarker to distinguish AI from IDA among pregnant women, and 3) risk factors for specific etiologies of maternal anemia. We measured hematologic biomarkers in maternal blood at 12 and 32 wk of gestation and in cord blood from a randomized trial of praziquantel in 358 pregnant women with Schistosoma japonicum in The Philippines. IDA was defined as anemia with serum ferritin &lt;30 ng/mL and non-IDA (NIDA), largely due to AI, as anemia with ferritin ≥30 ng/mL. We identified cutoffs for biomarkers to distinguish IDA from NIDA by using area under the curve (AUC) analyses and examined the impact of different causes of anemia on newborn iron status (primary ou...