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Evaluation of serum hepcidin variation in patients with rheumatoid arthritis according to anemia profile and its correlation with disease activity
Adriana Sabău, Madălina Văleanu, Horațiu D. Boloșiu, Alexandra M. Crăciun
Abstract: Objective: The objectives of this study were: determination of serum hepcidin levels in patients with Rheumatoid arthritis (RA) with/without anemia and controls, and its correlation with disease activity and anemia parameters. Patients and Methods: 69 people were involved in our study: 54 patients and 15 healthy subjects (controls). Laboratory evaluation of anemia, iron parameters, serum hepcidin levels and disease activity was carried out. RA patients were divided in two groups: anemic group and non-anemic group (NA), according to hemoglobin levels (Hb). Soluble transferrin receptor-ferritin index (sTfR-F index) was used to classify anemia types: anemia of chronic disease (ACD) and anemia of chronic disease + iron deficiency anemia (ACD+IDA). Disease activity was evaluated using the following parameters: erythrocyte sedimentation rate (ESR), C-reactive protein (CPR), and disease activity score (DAS28). Results: ACD and ACD+IDA groups had significantly higher serum hepcidin concentrations than controls (p<0.001, p<0.001), and NA group (p=0.006, p=0.002). No difference in hepcidin levels was observed between ACD and ADC+IDA groups (p=0.85) and between NA and controls (p=0.66). ESR was significantly higher in ACD and ACD+IDA groups compared with NA group (p<0.001, p=0.002) and controls. (p<0.001, p<0.001).DAS 28 score was higher in anemic groups than NA group (ACD vs. NA, p=0.01), (ACD+IDA vs. NA, p=0.01) and no difference was observed between ACD and ACD+IDA In RA patients serum hepcidin concentration was significantly negatively correlated with hemoglobin (Hb) (r= -0.459, p<0.000) and serum iron( r=-0.357, p<0.01) and positively with disease activity variables: ESR (r=0.352, p<0.01) , CRP (r=0.369, p<0.01), DAS28 score (r=0.289, p<0.05). Conclusion: Hepcidin increases in RA patients with anemia and its levels correlate with Hb, serum iron, and disease activity variables.
Keywords: hepcidin,anemia of chronic disease,rheumatoid arthritis,DAS28,C reactive protein,erythrocyte sedimentation rate,soluble transferring receptor
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