Department of Urology, University Hospital, Mainz, Germany.
Int J Lab Hematol. 2011 Apr;33(2):187-93. doi: 10.1111/j.1751-553X.2010.01265.x. Epub 2010 Sep 27.
Biochemical markers of iron deficiency do not distinguish iron-deficient anemia (IDA) from the anemia of chronic disease (ACD) and the combined state of ACD/IDA. Serum hepcidin-25 might be a marker resolving this problem. We investigated the extent to which serum hepcidin-25 enables the differentiation of the states above in comparison with the ferritin index plot, the so-called Thomas plot [soluble transferrin receptor (sTfR)/log ferritin and the reticulocyte hemoglobin content (CHr)].
Serum hepcidin-25 was determined in 155 anemic patients who were classified as having latent iron deficiency (latent ID), IDA, ACD, or ACD/IDA using the ferritin index plot (Thomas plot). Hepcidin-25 was determined using an isotope-dilution micro-HPLC-tandem mass spectrometry method. The ability to discriminate among these states based on serum hepcidin-25 alone or in combination with the CHr was evaluated in a receiver operating characteristic curve analysis and a comparison with the recently established ferritin index plot.
Serum hepcidin-25 correlated with ferritin and the ferritin index. Use of a hepcidin-25 cutoff level of ≤4 nmol/l allowed the differentiation of IDA from ACD and ACD/IDA. Furthermore, the discrimination of ACD/IDA from ACD required combination with CHr in a new plot (hepcidin-25 and the CHr). The hepcidin-25 plot and the ferritin index plot showed a good correspondence in the differentiation of iron states in patients with anemia.
Patients with IDA can be differentiated from ACD and ACD/IDA but not ACD from ACD/IDA based on hepcidin-25 alone. The combination of hepcidin-25 with CHr in the hepcidin-25 plot was useful for the differentiation of the states above.
生化铁缺乏标志物不能将缺铁性贫血 (IDA) 与慢性病贫血 (ACD) 和 ACD/IDA 合并状态区分开来。血清铁调素-25 可能是解决这个问题的标志物。我们研究了血清铁调素-25 在多大程度上能够与铁蛋白指数图谱（所谓的 Thomas 图谱 [可溶性转铁蛋白受体 (sTfR)/log 铁蛋白和网织红细胞血红蛋白含量 (CHr)]) 相比，区分上述状态。
使用铁蛋白指数图谱（Thomas 图谱）将 155 名贫血患者分类为潜在缺铁 (潜在 ID)、IDA、ACD 或 ACD/IDA，同时测定血清铁调素-25。使用同位素稀释微 HPLC-串联质谱法测定铁调素-25。通过受试者工作特征曲线分析评估单独使用血清铁调素-25或结合 CHr 来区分这些状态的能力，并与最近建立的铁蛋白指数图谱进行比较。
血清铁调素-25与铁蛋白和铁蛋白指数相关。使用铁调素-25 截断值≤4 nmol/l 可将 IDA 与 ACD 和 ACD/IDA 区分开来。此外，ACD/IDA 与 ACD 的区分需要在新图谱（铁调素-25 和 CHr）中结合 CHr。铁调素-25 图谱和铁蛋白指数图谱在区分贫血患者的铁状态方面具有良好的一致性。
单独使用铁调素-25 可将 IDA 患者与 ACD 和 ACD/IDA 区分开来，但不能将 ACD 与 ACD/IDA 区分开来。铁调素-25 图谱中结合 CHr 对上述状态的区分很有用。
