Vermeulen E, Vermeersch P
Laboratory Sciences, University Hospitals Leuven, Leuven, Belgium.
Acta Clin Belg. 2012 May-Jun;67(3):190-7. doi: 10.2143/ACB.67.3.2062654.
Hepcidin plays a key role in the regulation of plasma iron levels through inhibition of iron export from enterocytes and macrophages. Hepcidin is considered a promising marker in the investigation of iron status, especially in patients that still pose a diagnostic challenge, such as infants and patients with chronic (kidney) disease.
To critically review the current evidence for the diagnostic utility of hepcidin, including the (pre) analytical aspects in hepcidin determination.
(Pre)analytical aspects--Since it is doubtful that the prohormone prohepcidin is a relevant biomarker, only the mature peptide hepcidin should be measured. Determinations of serum hepcidin are preferable, as the value of urine concentrations is still unclear. Method harmonization is needed since hepcidin values vary widely between methods. Several (pre-) analytical issues remain unanswered. These barriers hamper the investigation into the diagnostic value of hepcidin. Diagnostic utility--Hepcidin is an acute-phase reactant. The diagnostic potential of hepcidin is controversial in the different settings of iron deficiency as evidence is contradictory (anaemia of chronic disease) or limited (infants). In the setting of haemochromatosis, it has been suggested that hepcidin could be useful to stratify molecular testing, or to optimize the frequency of phlebotomies, but this remains to be investigated.
铁调素通过抑制肠上皮细胞和巨噬细胞的铁输出，在血浆铁水平的调节中起关键作用。铁调素被认为是铁状态研究中有前景的标志物，尤其是在仍面临诊断挑战的患者中，如婴儿和慢性（肾脏）疾病患者。
批判性地综述目前关于铁调素诊断效用的证据，包括铁调素测定中的（前）分析方面。
（前）分析方面——由于激素原前铁调素是否为相关生物标志物尚不确定，因此应仅测定成熟肽铁调素。血清铁调素测定更可取，因为尿液浓度的价值仍不明确。由于不同方法测得的铁调素值差异很大，所以需要方法协调。几个（前）分析问题仍未得到解答。这些障碍阻碍了对铁调素诊断价值的研究。诊断效用——铁调素是一种急性期反应物。在不同的缺铁情况下，铁调素的诊断潜力存在争议，因为证据相互矛盾（慢性病贫血）或有限（婴儿）。在血色素沉着症的情况下，有人提出铁调素可能有助于分子检测分层，或优化放血频率，但这仍有待研究。
