Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
J Crohns Colitis. 2013 Sep;7(8):e286-91. doi: 10.1016/j.crohns.2012.10.013. Epub 2012 Dec 6.
Anemia often complicates the course of Inflammatory Bowel Disease (IBD). Hepcidin, a liver-produced peptide hormone, is a key mediator of anemia of chronic disease (ACD). We hypothesized that hepcidin is significantly elevated in anemic CD patients and that hepcidin may cause iron restriction and, therefore, mediate ACD.
We enrolled 17 patients with CD and ACD recruited from the Cedars-Sinai IBD Center. Routine blood tests included hemoglobin (Hgb), hematocrit, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Anemia was defined as hemoglobin <12g/dL and <13.5g/dL, in men and women, respectively. ACD was diagnosed on the basis of a combination of the following: a) normal or elevated ferritin b) lowered serum iron and total iron binding capacity and c) normal percent iron saturation. Serum and urine hepcidin, as well as IL-6 levels were also measured. Patients with documented iron-deficiency anemia were excluded.
There was an excellent correlation between urine (expressed as ng/mg of creatinine) and serum hepcidin levels expressed as ng/ml (r=0.853, p<0.001). We also found a strong positive correlation between serum hepcidin and ferritin levels (r=0.723, p=0.0015). There was a positive correlation between serum hepcidin and IL-6 levels (r=0.546, p=0.023). We found a strong negative correlation between serum hepcidin concentrations and Hgb levels (r=0.528, p=0.029).
We demonstrate that ACD in CD is characterized by high serum IL-6 and hepcidin levels, which negatively correlate with Hgb levels. Our data support the hypothesis that IL-6-driven hepcidin production mediates ACD in patients with CD.
炎症性肠病（IBD）常并发贫血。肝产生的肽激素hepcidin 是慢性病贫血（ACD）的关键介质。我们假设 CD 伴贫血患者的 hepcidin 水平显著升高，hepcidin 可能导致铁限制，并因此介导 ACD。
我们招募了来自 Cedars-Sinai IBD 中心的 17 名 CD 伴 ACD 患者。常规血液检查包括血红蛋白（Hb）、红细胞压积、红细胞沉降率（ESR）和 C 反应蛋白（CRP）。贫血定义为男性血红蛋白<12g/dL 和女性血红蛋白<13.5g/dL。ACD 根据以下标准诊断：a）铁蛋白正常或升高，b）血清铁和总铁结合力降低，c）正常的铁饱和度百分比。还测量了血清和尿液 hepcidin 以及 IL-6 水平。排除有明确缺铁性贫血的患者。
尿液（以肌酐表示的 ng/mg）和血清 hepcidin 水平（以 ng/ml 表示）之间具有极好的相关性（r=0.853，p<0.001）。我们还发现血清 hepcidin 与铁蛋白水平之间存在强正相关（r=0.723，p=0.0015）。血清 hepcidin 与 IL-6 水平之间存在正相关（r=0.546，p=0.023）。我们发现血清 hepcidin 浓度与 Hb 水平之间存在强负相关（r=0.528，p=0.029）。
我们证明 CD 中的 ACD 表现为高血清 IL-6 和 hepcidin 水平，与 Hb 水平呈负相关。我们的数据支持这样的假设，即 IL-6 驱动的 hepcidin 产生介导 CD 患者的 ACD。
